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https://www.readbyqxmd.com/read/28532240/ventricular-assist-devices-for-the-failing-univentricular-circulation
#1
Edward Buratto, William Y Shi, Xin Tao Ye, Igor E Konstantinov
Improved survival following single ventricle palliation has led to a large population of patients with a Fontan circulation, many of whom will eventually develop Fontan failure. Many of these patients will require heart transplantation. However, more than half of these patients have Fontan failure despite preserved ventricular function. Increasing experience with ventricular assist devices (VAD) in children has paved the way for VAD support in those with failing univentricular circulation. Areas covered: The use of VADs to support the failing univentricular circulation is a relatively new concept...
May 22, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28520941/risk-factors-for-in-hospital-shunt-thrombosis-and-mortality-in-patients-weighing-less-than-3%C3%A2-kg-with-functionally-univentricular-heart-undergoing-a-modified-blalock-taussig-shunt%C3%A2
#2
Voravit Chittithavorn, Pongsanae Duangpakdee, Chareonkiat Rergkliang, Napat Pruekprasert
OBJECTIVES: To determine the association between several perioperative variables and in-hospital shunt thrombosis and mortality in patients weighing less than 3 kg with functional univentricular heart (UVH) who underwent modified Blalock-Taussig shunt. METHODS: Between January 2006 and February 2016, 85 patients who weighed less than 3 kg with functional UVH and underwent modified Blalock-Taussig shunt were reviewed. In-hospital shunt thrombosis and mortality were the primary outcomes...
May 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28491086/left-univentricular-pacing-for-cardiac-resynchronization-therapy-using-rate-adaptive-atrioventricular-delay
#3
Li-Jin Pu, Yu Wang, Lu-Lu Zhao, Tao Guo, Shu-Min Li, Bao-Tong Hua, Ping Yang, Jun Yang, Yan-Zhou Lu, Liu-Qing Yang, Ling Zhao, Hai-Yun Luo
OBJECTIVE: To evaluate left univentricular (LUV) pacing for cardiac resynchronization therapy (CRT) using a rate-adaptive atrioventricular delay (RAAVD) algorithm to track physiological atrioventricular delay (AVD). METHODS: A total of 72 patients with congestive heart failure (CHF) were randomized to RAAVD LUV pacing versus standard biventricular (BiV) pacing in a 1: 1 ratio. Echocardiography was used to optimize AVD for both groups. The effects of sequential BiV pacing and LUV pacing with optimized A-V (right atrio-LV) delay using an RAAVD algorithm were compared...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28457237/sudden-cardiac-death-in-adult-congenital-heart-disease
#4
REVIEW
Pablo Ávila, Marie-A Chaix, Blandine Mondésert, Paul Khairy
Sudden death of presumed arrhythmic etiology is a leading cause of mortality in adults with congenital heart disease. Anticipated benefits of the implantable cardioverter-defibrillator (ICD) must be weighed against high complication rates. Without robust evidence from randomized trials, caregivers face difficult decisions in selecting appropriate candidates. Although secondary prevention indications are often clear-cut, risk stratification for primary prevention ICDs is more challenging. Factors associated with sudden death in patients with tetralogy of Fallot are reasonably consistent across studies...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28454633/effective-cardiac-index-and-systemic-pulmonary-collaterals-evaluated-by-cardiac-magnetic-resonance-late-after-fontan-palliation
#5
Lamia Ait Ali, Alessandra Cadoni, Giuseppe Rossi, Petra Keilberg, Claudio Passino, Pierluigi Festa
The regulation of cardiac output in the Fontan circuit is not completely understood. Systemic-pulmonary collaterals (SPCs) are frequent in patients with univentricular heart, and their clinical significance and management remain controversial. The aims of our study were to identify factors associated with SPCs' flow at late follow-up after Fontan and evaluate the relation between SPCs flow (QSPCs) and the effective cardiac index (CI). From our cardiac magnetic resonance database, we identified all Fontan patients with a complete set of flow measurements allowing calculation of QSPCs and effective CI...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28384638/fetal-aortic-valvuloplasty-experience-and-results-of-two-tertiary-centers-in-spain
#6
Alberto Galindo, Enery Gómez-Montes, Olga Gómez, Mar Bennasar, Fàtima Crispi, Ignacio Herraiz, Alberto Mendoza, David Escribano, Enrique García-Torres, Juan Manuel Carretero, Eduard Gratacós, Josep María Martínez
OBJECTIVE: Fetal aortic valvuloplasty (FAV) may avoid progression of critical aortic stenosis (CAS) to hypoplastic left ventricle, improving the options for biventricular circulation (BVC). We describe the results of FAV in 2 referral centers in Spain. METHODS: We analyzed all FAVs performed in the period 2007-2015. The selection of candidates, the technique, and postnatal management were made following an agreed protocol. A descriptive analysis of survival, type of circulation after birth, and complications was made, considering all deaths in the first 48 h after FAV as FAV-related...
April 7, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28366171/4d-music-cmr-value-based-imaging-of-neonates-and-infants-with-congenital-heart-disease
#7
Kim-Lien Nguyen, Fei Han, Ziwu Zhou, Daniel Z Brunengraber, Ihab Ayad, Daniel S Levi, Gary M Satou, Brian L Reemtsen, Peng Hu, J Paul Finn
BACKGROUND: 4D Multiphase Steady State Imaging with Contrast (MUSIC) acquires high-resolution volumetric images of the beating heart during uninterrupted ventilation. We aim to evaluate the diagnostic performance and clinical impact of 4D MUSIC in a cohort of neonates and infants with congenital heart disease (CHD). METHODS: Forty consecutive neonates and infants with CHD (age range 2 days to 2 years, weight 1 to 13 kg) underwent 3.0 T CMR with ferumoxytol enhancement (FE) at a single institution...
April 3, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28339579/left-univentricular-pacing-for-cardiac-resynchronization-therapy
#8
Haran Burri, Frits W Prinzen, Maurizio Gasparini, Christophe Leclercq
This review describes the rationale and published evidence for left univentricular pacing for cardiac resynchronization therapy, gives an overview of the existing optimization algorithms featuring this mode, and discusses future perspectives.
October 6, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28319523/plasma-levels-of-microrna-155-are-upregulated-with-long-term-left-ventricular-assist-device-support
#9
Teresa Wang, Emily C O'Brien, Joseph G Rogers, Daniel L Jacoby, Michael E Chen, Jeffrey M Testani, Dawn E Bowles, Carmelo A Milano, G Michael Felker, Chetan B Patel, Pramod N Bonde, Tariq Ahmad
Left ventricular assist device (LVAD) therapy unloads the failing heart but exposes the human body to unique pathophysiologic demands such as continuous blood flow and complete univentricular support, which are associated with increased risk of adverse clinical outcomes. MicroRNAs (miRNAs) are 22-23 nucleotide RNAs involved in regulation of multiple biologic processes including the pathogenesis of heart failure (HF). Thus, measurement of miRNAs may have potential in both diagnostics as circulating biomarkers and in therapeutics for targeted interventions...
May 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319522/a-numerical-simulation-comparing-a-cavopulmonary-assist-device-and-va-ecmo-for-failing-fontan-support
#10
Po-Lin Hsu, Dongfang Wang, Cherry Ballard-Croft, Dawei Xiao, Joseph B Zwischenberger
A cavopulmonary assist device (CPAD) has been developed for failing Fontan support. This CPAD pumps blood from superior/inferior vena cavae to pulmonary artery. In this study, we compared failing Fontan support with CPAD versus VA ECMO in silico. A numerical lumped-parameter circulatory system model was used to simulate Fontan circulation. Failing Fontan was simulated by increased pulmonary resistance. Central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), left atrial pressure (LAP), and univentricular outflow (CO) were simulated and compared to published clinical data...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28318514/incorporating-comorbidity-within-risk-adjustment-for-uk-pediatric-cardiac-surgery
#11
Katherine L Brown, Libby Rogers, David J Barron, Victor Tsang, David Anderson, Shane Tibby, Thomas Witter, John Stickley, Sonya Crowe, Kate English, Rodney C Franklin, Christina Pagel
BACKGROUND: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28314534/total-cavopulmonary-connection-with-a-new-bioabsorbable-vascular-graft-first-clinical-experience
#12
Leo A Bockeria, Oleg Svanidze, Alex Kim, Konstantin Shatalov, Vladimir Makarenko, Martijn Cox, Thierry Carrel
OBJECTIVES: To assess safety and clinical performance of a novel bioabsorbable vascular graft in pediatric patients with univentricular cardiac malformation who received surgical correction via an extracardiac cavopulmonary conduit. METHODS: The implanted graft material is designed to attract patient's own cells and proteins, which trigger a cascade of physiological events leading to endogenous tissue restoration. As the graft resorbs progressively after implantation, components of native tissue including collagen, endothelial lining, and capillary blood vessels develop and organize into a natural tissue...
February 7, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28290794/-hemodynamic-derangements-in-patients-with-functional-univentricular-heart-mechanisms-of-development-possibilities-of-treatment
#13
I A Kovalev, S Ovroutski, I V Plotnikova, A A Tupikina
Heart failure (HF) is a predictable outcome of nearly all cardiovascular diseases including congenital heart diseases (CHD). A special category comprises patients with functional single ventricle (FSV) of the heart because of extreme diversity of anatomical changes of the heart and great vessels, complex mechanisms of development of HF, multistage surgical correction of the defect, presence of arrhythmias, progressive rise of pulmonary vascular resistance, etc. Prevention and treatment of HF in patients with FSV includes surgical optimization of pulmonary blood flow during neonatal period, timely staged surgical correction of the defect, pharmacotherapy, cardiac resynchronization therapy, and in severe cases mechanical cardiac support and heart transplantation...
February 2017: Kardiologiia
https://www.readbyqxmd.com/read/28218352/concomitant-pulsatile-and-continuous-flow-vad-in-biventricular-and-univentricular-physiology-a-comparison-study-with-a-numerical-model
#14
COMPARATIVE STUDY
Arianna Di Molfetta, Gianfranco Ferrari, Roberta Iacobelli, Sergio Filippelli, Paolo Guccione, Libera Fresiello, Gianluigi Perri, Antonio Amodeo
INTRODUCTION: To develop and test a lumped parameter model to simulate and compare the effects of the simultaneous use of continuous flow (CF) and pulsatile flow (PF) ventricular assist devices (VADs) to assist biventricular circulation vs. single ventricle circulation in pediatrics. METHODS: Baseline data of 5 patients with biventricular circulation eligible for LVAD and of 5 patients with Fontan physiology were retrospectively collected and used to simulate patient baselines...
March 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28210768/the-lymphatic-circulation-in-adaptations-to-the-fontan-circulation
#15
REVIEW
Sabarinath Menon, Murthy Chennapragada, Shinya Ugaki, Gary F Sholler, Julian Ayer, David S Winlaw
Failing Fontan continues to be major problem for patients on the univentricular pathway. Failing Fontan is often complicated by chylothorax, plastic bronchitis and protein loosing enteropathy. The role of lymphatic circulation in Fontan circulation is still being researched. Newer imaging modalities give insight into the role of abnormal dilatation and retrograde flow in lymphatic channels post Fontan. Interventional strategies targeting abnormal lymphatic channels, provides an alternative management strategy for patients with failing Fontan...
February 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28181900/an-alternative-technique-for-fontan-completion-in-patients-with-widely-separated-connections-of-the-inferior-systemic-veins-to-the-atrial-mass
#16
Giuseppe Pomè, Faker Ghedira, Eitan Keizman
Several surgical approaches for completion of a total cavopulmonary connection have been established for patients with anomalies of systemic venous connection in association with a functionally univentricular heart. We report an alternative technique designed to address the problem of widely separated inferior systemic veins, in which two extracardiac conduits were used. This technique was performed on three patients and yielded excellent short-term results, allowing us to operate on a beating heart with no need for cardioplegic arrest and aortic cross-clamping...
March 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28163439/impact-of-abernathy-malformation-on-pulmonary-circulatory-hemodynamics-in-a-univentricular-heart
#17
Vinoth Doraiswamy, Kothandam Sivakumar
No abstract text is available yet for this article.
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28162139/clinical-application-of-three-dimensional-printing-to-the-management-of-complex-univentricular-hearts-with-abnormal-systemic-or-pulmonary-venous-drainage
#18
Eimear McGovern, Eoin Kelleher, Aisling Snow, Kevin Walsh, Bassem Gadallah, Shelby Kutty, John M Redmond, Colin J McMahon
In recent years, three-dimensional printing has demonstrated reliable reproducibility of several organs including hearts with complex congenital cardiac anomalies. This represents the next step in advanced image processing and can be used to plan surgical repair. In this study, we describe three children with complex univentricular hearts and abnormal systemic or pulmonary venous drainage, in whom three-dimensional printed models based on CT data assisted with preoperative planning. For two children, after group discussion and examination of the models, a decision was made not to proceed with surgery...
February 6, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28143885/does-first-trimester-screening-modify-the-natural-history-of-congenital-heart-disease-analysis-of-outcome-of-regional-cardiac-screening-at-2-different-time-periods
#19
Hana Jicinska, Pavel Vlasin, Michal Jicinsky, Ilga Grochova, Viktor Tomek, Julia Volaufova, Jan Skovranek, Jan Marek
BACKGROUND: The study analyzed the impact of first-trimester screening on the spectrum of congenital heart defects (CHDs) later in pregnancy and on the outcome of fetuses and children born alive with a CHD. METHODS: The spectrum of CHDs, associated comorbidities, and outcome of fetuses, either diagnosed with a CHD in the first trimester (Group I, 127 fetuses) or only in the second-trimester screening (Group II, 344 fetuses), were analyzed retrospectively between 2007 and 2013...
March 14, 2017: Circulation
https://www.readbyqxmd.com/read/28139455/vascular-anatomy-in-children-with-univentricular-hearts-regarding-transcatheter-bidirectional-glenn-anastomosis
#20
Aleksander Sizarov, Francesca Raimondi, Damien Bonnet, Younes Boudjemline
BACKGROUND: Transcatheter stent-secured Glenn anastomosis, aiming to reduce the invasiveness of palliation in patients with univentricular heart defects, has been reported in large experimental animals. The advent of biodegradable stents and tissue-engineered vascular grafts will make this procedure a reality in human patients. However, the relationship between the superior vena cava (SVC) and the right pulmonary artery (RPA) is different in humans. AIM: To characterise vascular anatomy in children with univentricular hearts, regarding technical aspects and device design for this procedure...
January 27, 2017: Archives of Cardiovascular Diseases
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