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https://www.readbyqxmd.com/read/29780065/prediction-of-fontan-associated-liver-disease-using-a-novel-cine-magnetic-resonance-imaging-vortex-flow-map-in-the-right-atrium
#1
Umiko Ishizaki, Michinobu Nagao, Yumi Shiina, Kenji Fukushima, Tatsunori Takahashi, Yamato Shimomiya, Yuka Matsuo, Kei Inai, Shuji Sakai
BACKGROUND: Long-term hepatic dysfunction is an increasingly recognized complication of the Fontan operation for univentricular hearts. The purpose of this study was to determine whether Fontan-associated liver disease (FALD) could be predicted by flow dynamics in the right atrium (RA) of Fontan circulation.Methods and Results:Cardiac MRI and the serum levels of total bilirubin (TBil) and hyaluronic acid (HA) were analyzed in 36 patients who underwent an atriopulmonary connection type of Fontan operation...
May 18, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29769130/diagnostic-accuracy-of-low-dose-dual-source-cardiac-computed-tomography-as-compared-to-surgery-in-univentricular-heart-patients
#2
Narumol Chaosuwannakit, Pattarapong Makarawate
BACKGROUND: To evaluate the ability of low radiation dose dual-source computed tomography (DSCT) to depict the features of morphological univentricular heart and to define accuracy by comparing findings with surgery. METHODS: Low radiation dose dual-source cardiac computed tomography (CCT) of 33 cases of functional univentricular heart preliminary diagnosis by echocardiography compared with the results of surgery were retrospectively analyzed (aged 1 day to 4 years, median 5 months)...
May 16, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29757371/outcomes-of-total-anomalous-pulmonary-venous-drainage-repair-in-neonates-with-univentricular-circulation
#3
Matthew S Yong, Michael Z L Zhu, Yves d'Udekem, Igor E Konstantinov
Survival after surgery for isolated total anomalous pulmonary venous drainage has improved in the current era. However, outcomes of total anomalous pulmonary venous drainage repair in patients with univentricular circulation are associated with high mortality. Furthermore, outcomes of surgery in neonates with univentricular circulation are rarely reported among larger studies. Hence, we reviewed our experience (n = 19) with this population at a single institution (between 1986 and 2015) to identify specific subgroups with high mortality...
May 10, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29736127/experimental-investigation-of-the-effect-of-non-newtonian-behavior-of-blood-flow-in-the-fontan-circulation
#4
Andrew L Cheng, Niema M Pahlevan, Derek G Rinderknecht, John C Wood, Morteza Gharib
The Fontan procedure for univentricular heart defects creates a unique circulation where all pulmonary blood flow is passively supplied directly from systemic veins. Computational simulations, aimed at optimizing the surgery, have assumed blood to be a Newtonian fluid without evaluating the potential error introduced by this assumption. We compared flow behavior between a non-Newtonian blood analog (0.04% xanthan gum) and a control Newtonian fluid (45% glycerol) in a simplified model of the Fontan circulation...
March 2018: European Journal of Mechanics. B, Fluids
https://www.readbyqxmd.com/read/29722889/double-arterial-cannulation-a-strategy-for-whole-body-perfusion-during-aortic-arch-reconstruction
#5
Michaela Kreuzer, Eva Sames-Dolzer, Laura Schausberger, Andreas Tulzer, Thomas Ratschiller, Bettina Haizinger, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Double-arterial cannulation enables cerebral perfusion and lower body perfusion during aortic arch reconstruction. The aim of this study was to analyse and report our experience of using this cannulation and perfusion technique on paediatric patients. METHODS: A retrospective single-centre study was carried out on 407 consecutive paediatric patients who underwent an aortic arch reconstruction under double-arterial cannulation between 2003 and 2015. The median age of the patients at surgery was 8 (range 2-5570) days, and body weight was 3...
May 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29717418/transition-from-tube-feeding-to-oral-feeding-experience-in-a-tertiary-care-paediatric-cardiology-unit
#6
Anne Marie Shine, Daragh Gerard Finn, Noeleen Allen, Colin J McMahon
BACKGROUND: Home enteral tube feeding (HETF) is imperative for many infants and children with congenital heart disease (CHD). Tube weaning (TW) facilitates the progression from tube feeding to oral diet. There is limited literature on TW practices, protocols and success for children with CHD that have been tube fed. AIMS: The objective of this study is to assess the process of weaning HETF in a tertiary referral centre for paediatric CHD. Specifically, we aimed to assess the duration of HETF, duration of TW and the interventions involved...
May 2, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29662811/management-of-coronary-sinus-ostial-atresia-during-a-staged-operation-of-a-functional-single-ventricle
#7
Seung Ri Kang, Won Kyoun Park, Bo Sang Kwon, Jae Kon Ko, Hyun Woo Goo, Jeong-Jun Park
Coronary sinus ostial atresia (CSOA) with persistent left superior vena cava (LSVC) in the absence of an unroofed coronary sinus is a benign and rare anomaly that may be taken lightly in most instances. However, if overlooked in patients undergoing univentricular heart repair such as bidirectional Glenn or Fontan-type surgery, fatal surgical outcomes may occur due to coronary venous drainage failure. We report a case of CSOA with a persistent LSVC that was managed through coronary sinus rerouting during a total cavopulmonary connection, and provide a review of the literature regarding this rare anomaly...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29609514/superior-cavopulmonary-anastomosis-in-patients-with-bilateral-superior-caval-veins-use-of-a-rolled-pericardial-graft-to-create-a-single-caval-vein
#8
Tran-Thuy Nguyen, Ngoc-Thanh Le, Quoc-Hung Doan
We propose a new surgical technique for superior cavopulmonary anastomosis in patients with functionally univentricular heart and bilateral superior caval veins. One of the reasons of failed bidirectional Glenn shunts in patients with bilateral superior caval veins is the small caliber of one or both veins, with limited flow through each cavopulmonary anastomosis that can easily result in torsion, blockage, or clot formation. The conversion of two small superior caval veins into a single confluence which is large enough to connect with the pulmonary artery (PA) can resolve this problem...
January 1, 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29569770/immediate-effects-and-outcomes-after-in-utero-pulmonary-valvuloplasty-in-fetuses-with-pulmonary-atresia-with-intact-septum-or-critical-pulmonary-stenosis
#9
A Tulzer, W Arzt, R Gitter, C Prandstetter, E Grohmann, R Mair, G Tulzer
OBJECTIVES: to assess the immediate effects of fetal pulmonary valvuloplasty on right ventricular (RV) size and function as well as in-utero RV growth and postnatal outcome. METHODS: Thirty-five fetal pulmonary valvuloplasties have been performed in 23 fetuses with pulmonary atresia with intact ventricular septum (PAIVS) (n=15) or critical pulmonary stenosis (CPS) (n=8) at our institution. Median gestational age was 28+4 weeks (23+6 to 32+1). RV morphologic and functional parameters were obtained before and after the procedure (median interval after intervention 1 day; range: 1-3 days) and analyzed retrospectively...
March 23, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29521133/cavopulmonary-mechanical-circulatory-support-in-fontan-patients-and-the-need-for-physiologic-control-a-computational-study-with-a-closed-loop-exercise-model
#10
Marcus Granegger, Martin Schweiger, Marianne Schmid Daners, Mirko Meboldt, Michael Hübler
PURPOSE: Rotary blood pumps are a promising treatment approach for patients with a total cavopulmonary connection and a failing cardiovascular system. The aim of this study was to investigate the hemodynamic effects of cavopulmonary support using a numerical model with closed-loop baroreflex and exercise mechanisms. METHODS: A numerical model of the univentricular cardiovascular system was developed, mimicking the hemodynamics during rest and exercise. Rotary blood pumps with different hydraulic pump characteristics (flat vs steep pressure-flow relationships) were investigated in the cavopulmonary position...
May 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29492392/overview-of-adult-congenital-heart-transplants
#11
Roosevelt Bryant, David Morales
Transplantation for adult patients with congenital heart disease (ACHD) is a growing clinical endeavor in the transplant community. Understanding the results and defining potential high-risk patient subsets will allow optimization of patient outcomes. This review summarizes the scope of ACHD transplantation, the mechanisms of late ventricular dysfunction, the ACHD population at risk of developing heart failure, the indications and potential contraindications for transplant, surgical considerations, and post-transplant outcomes...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29455772/prenatal-diagnosis-of-congenital-heart-disease-a-review-of-current-knowledge
#12
REVIEW
Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Edward Araujo Júnior
This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29440829/exercise-performance-after-univentricular-palliation
#13
Sachin Talwar, Manikala Vinod Kumar, Vishnubhatla Sreenivas, Vishwa Prakash Gupta, Shiv Kumary Choudhary, Balram Airan
Background: The optimal timing, need for primary/staged procedure in patients undergoing univentricular palliation, is debatable. Aims: We performed this study to assess the exercise performance of patients undergoing various forms of univentricular palliation. Setting and Design: This was a retrospective, prospective comparative study conducted at a multispecialty tertiary referral center. Patients and Methods: Between January 2012 and June 2015, 117 patients undergoing either bidirectional Glenn (BDG) ( n = 43) or Fontan (total cavopulmonary connection [TCPC]) ( n = 74) underwent exercise testing...
January 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/29427773/tissue-engineered-vascular-grafts-in-children-with-congenital-heart-disease-intermediate-term-follow-up
#14
Tadahisa Sugiura, Goki Matsumura, Shinka Miyamoto, Hideki Miyachi, Christopher K Breuer, Toshiharu Shinoka
Tissue engineering holds great promise for the advancement of cardiovascular surgery as well as other medical fields. Tissue-engineered vascular grafts have the ability to grow and remodel and could therefore make great advances for pediatric cardiovascular surgery. In 2001, we began a human clinical trial evaluating these grafts in patients with a univentricular physiology. Herein, we report the long-term results of patients who underwent implantation of tissue-engineered vascular grafts as extracardiac total cavopulmonary conduits...
February 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29425566/functional-outcome-in-contemporary-children-with-total-cavopulmonary-connection-health-related-physical-fitness-exercise-capacity-and-health-related-quality-of-life
#15
Julia Hock, Barbara Reiner, Rhoia C Neidenbach, Renate Oberhoffer, Alfred Hager, Peter Ewert, Jan Müller
OBJECTIVE: Children and adolescents with an univentricular heart after total cavopulmonary connection (TCPC) have functional impairments. This study assesses health-related physical fitness (HRPF) and exercise capacity, as well as their relation to health-related quality of life (HRQoL) in patients with an univentricular heart after total-pulmonary connection (TCPC). PATIENTS AND METHODS: Between July 2014 and October 2016 a total of 78 children and adolescents with TCPC (12...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29425520/giessen-procedure-as-comprehensive-stage-ii-palliation-with-aortic-arch-reconstruction-after-hybrid-bilateral-pulmonary-artery-banding-and-ductal-stenting-for-hypoplastic-left-heart-syndrome
#16
REVIEW
Uygar Yörüker, Hakan Akintürk
This article reviews our experience using hybrid stage I palliation in the neonatal period and subsequently with comprehensive stage II palliation for hypoplastic left heart syndrome. Between June 1998 and April 2017, 154 patients with the diagnosis of hypoplastic left heart syndrome and variants underwent a hybrid stage I palliation (bilateral pulmonary artery banding and ductal stenting). One hundred thirty-nine patients could be further univentricularly palliated. One hundred twenty-one patients underwent a comprehensive stage II operation with an operative mortality of 6...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/29411679/pulmonary-atresia-with-an-intact-ventricular-septum-preoperative-physiology-imaging-and-management
#17
Sathish M Chikkabyrappa, Rohit S Loomba, Justin T Tretter
Pulmonary atresia with intact ventricular septum (PA-IVS) is a rare complex cyanotic congenital heart disease with heterogeneous morphological variation. Prenatal diagnosis allows for developing a safe plan for delivery and postnatal management. While transthoracic echocardiography allows for detailed delineation of the cardiac anatomy, additional imaging modalities such as computed tomography, magnetic resonance imaging, and catheterization may be necessary to further outline features of the cardiac anatomy, specifically coronary artery anatomy...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29406374/cerebral-oxygen-metabolism-before-and-after-rbc-transfusion-in-infants-following-major-surgical-procedures
#18
Felix Neunhoeffer, Michael Hofbeck, Martin Ulrich Schuhmann, Jörg Fuchs, Christian Schlensak, Martin Esslinger, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Matthias Kumpf, Jörg Michel
OBJECTIVE: Although infants following major surgery frequently require RBC transfusions, there is still controversy concerning the best definition for requirement of transfusion in the individual patient. The aim of this study was to determine the impact of RBC transfusion on cerebral oxygen metabolism in noncardiac and cardiac postsurgical infants. DESIGN: Prospective observational cohort study. SETTING: Pediatric critical care unit of a tertiary referral center...
April 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29396582/comparative-noninvasive-measurement-of-cardiac-output-based-on-the-inert-gas-rebreathing-method-innocor%C3%A2-and-mri-in-patients-with-univentricular-hearts
#19
Miriam Kuhn, Andreas Hornung, Heidi Ulmer, Christian Schlensak, Michael Hofbeck, Gesa Wiegand
There are many complex cardiac malformations that are characterized by a functionally univentricular physiology. Staged surgical repair according to the Fontan principle separates the systemic and pulmonary circulations by connecting the systemic venous return to the pulmonary arteries. However, long-term follow-up studies demonstrate a gradual deterioration of cardiac function, particularly from the second or third decade. Noninvasive evaluation of the cardiac function is, therefore, important in the follow-up of these patients...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29372588/five-decades-of-the-fontan-operation-a-systematic-review-of-international-reports-on-outcomes-after-univentricular-palliation
#20
REVIEW
Laura S Kverneland, Peter Kramer, Stanislav Ovroutski
Almost fifty years after its first clinical application, the modified Fontan operation is among the most frequently performed procedures in congenital heart disease surgery in children today. The objective of this review is to systematically summarize the international evolution of outcomes in regard to morbidity and mortality of patients with Fontan palliation. All studies published over the past five decades with more than 100 Fontan patients included were screened. In eligible studies, information concerning preoperative patients' characteristics, Fontan modifications employed, early mortality, long-term survival and frequency of relevant complications was extracted...
March 2018: Congenital Heart Disease
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