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https://www.readbyqxmd.com/read/29774394/longitudinal-health-care-cost-in-hypoplastic-left-heart-syndrome-palliation
#1
Jesse E Hansen, Nicolas L Madsen, Laurie Bishop, David L S Morales, Jeffrey B Anderson
Management of hypoplastic left heart syndrome (HLHS) is resource intensive. Heath care systems are pressured to provide value to patients by improving outcomes while decreasing costs. A single-center retrospective cohort of infants with HLHS who underwent Norwood procedure or hybrid Norwood from 2004 to 2014 and survived to first outpatient follow up were studied. The primary outcome was total cost through 12 months with a sub-analysis of patients with 60 months of data. Costs were calculated using internal cost accounting system and reported by cost center...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29523921/impact-of-hybrid-stage-1-palliation-for-hypoplastic-left-heart-syndrome-histopathological-findings
#2
Takashi Kido, Takaya Hoashi, Masataka Kitano, Masatoshi Shimada, Kenichi Kurosaki, Hatsue Ishibashi-Ueda, Hajime Ichikawa
The purpose of the study is to analyze the impact of hybrid stage 1 palliation on right ventricular myocardial pathology in hypoplastic left heart syndrome. Sufficient amount of right ventricular biopsies could be obtained from 16 of 32 patients who underwent Norwood operation between 2007 and 2013. Histopathological findings of right ventricle in patients who underwent primary Norwood operation (primary group, n = 5), patients with aortic atresia (HS1P AA group, n = 6) or aortic stenosis (HS1P AS group, n = 5) who underwent staged Norwood palliation following hybrid stage 1 palliation were compared...
June 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29497771/cerebral-blood-flow-following-hybrid-stage-i-palliation-in-infants-with-hypoplastic-left-heart-syndrome
#3
Sharon L Cheatham, Joanne L Chisolm, Nicole O'Brien
Hypoplastic left heart syndrome (HLHS) palliation may result in altered cerebral blood flow with subsequent neurodevelopmental implications. The purpose of the study was to assess blood flow in the middle cerebral artery (MCA) and investigate the relationship with early neurodevelopmental outcomes in infants with HLHS after hybrid stage I. Transcranial Doppler (TCD) was performed to obtain peak systolic, end-diastolic, and mean velocities, as well as pulsatility index of the MCA in infants with HLHS (n = 18) at baseline and at 2, 4, and 6 months of age...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29440831/prognostic-value-of-troponin-in-infants-with-hypoplastic-left-heart-syndrome-between-stage-i-and-ii-of-palliation
#4
Martin Christmann, Emanuela R Valsangiacomo Büchel, Hitendu Dave, Dietrich Klauwer, Anna Cavigelli-Brunner
Background: The period between stage I and II procedure for treatment of hypoplastic left heart syndrome (HLHS) bears high mortality and morbidity. Methods: We sought to analyze the prognostic value of Troponin T/I (Trop), a well-recognized marker for myocardial damage and heart failure, for predicting outcome in a retrospective analysis of 70 infants with HLHS at our institution between March 2001 and October 2014. Results: Stage I procedure consisted of Norwood I operation in 35 (50%) and Hybrid-approach in 22 (31%) patients...
January 2018: Annals of Pediatric 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
#5
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/29371373/interventional-treatments-and-risk-factors-in-patients-born-with-hypoplastic-left-heart-syndrome-in-england-and-wales-from-2000-to-2015
#6
Libby Rogers, Christina Pagel, Ian D Sullivan, Muhammed Mustafa, Victor Tsang, Martin Utley, Catherine Bull, Rodney C Franklin, Kate L Brown
OBJECTIVE: To describe the long-term outcomes, treatment pathways and risk factors for patients diagnosed with hypoplastic left heart syndrome (HLHS) in England and Wales. METHODS: The UK's national audit database captures every procedure undertaken for congenital heart disease and updated life status for resident patients in England and Wales. Patients with HLHS born between 2000 and 2015 were identified using codes from the International Paediatric and Congenital Cardiac Code...
January 25, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29273201/hybrid-palliation-outcomes-after-the-comprehensive-stage-2-procedure
#7
Clifford L Cua, Patrick I McConnell, James M Meza, Kevin D Hill, Shuaiqi Zhang, Diane Hersey, Tara Karamlou, Jeffrey P Jacobs, Marshall L Jacobs, Mark Galantowicz
BACKGROUND: The comprehensive stage 2 procedure (CS2) follows initial hybrid stage 1 palliation for patients with single-ventricle physiology. The goal of this study was to describe CS2 outcomes and differences between survivors of CS2 (s-CS2) and nonsurvivors (nons-CS2). METHOD: All patients in The Society of Thoracic Surgeons Congenital Heart Surgery Database who underwent CS2 as index operation from 2010 to 2016 were included. Preoperative, operative, and postoperative data were analyzed, stratified by operative mortality (in-hospital or within 30 days of the operation), with univariate comparisons using χ2 , Fisher exact, or Wilcoxon rank sum tests...
December 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29233199/hypoplastic-left-heart-in-turner-s-syndrome-a-primary-indication-for-transplant
#8
Joseph Philip, Dipankar Gupta, Mark S Bleiweis, Biagio A Pietra, Himesh V Vyas
Survival for hypoplastic left heart syndrome patients following the Norwood procedure is 71-90%. Mortality in patients with Turner's syndrome and hypoplastic left heart syndrome after conventional palliation (Norwood operation) has been reported as high as 80%. This questions the approach of traditional staged palliation. Here, we report a patient with hypoplastic left heart syndrome and Turner's syndrome bridged to orthotopic heart transplantation following a hybrid procedure.
March 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29118890/a-novel-technique-for-the-administration-of-sub-ambient-oxygen-in-the-operating-room
#9
Asad A Khawaja, Marco Corridore, Joseph D Tobias
Hypoplastic left heart syndrome (HLHS) is a common form of congenital heart disease with abnormal development of left-sided structures of the heart. As excessive pulmonary blood flow is common prior to palliative surgical procedures, therapeutic maneuvers may be required to decrease pulmonary blood flow and augment systemic cardiac output. Respiratory manipulations to optimize the ratio of pulmonary to systemic blood flow may include techniques to induce hypercarbia or the delivery of sub-ambient concentrations of oxygen (FiO2 less than 0...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/28921168/chromosomal-abnormalities-affect-the-surgical-outcome-in-infants-with-hypoplastic-left-heart-syndrome-a-large-cohort-analysis
#10
Dala Zakaria, Xinyu Tang, Rupal Bhakta, Nahed O ElHassan, Parthak Prodhan
Patients with hypoplastic left heart syndrome (HLHS) can have associated genetic abnormalities. This study evaluated the incidence of genetic abnormalities among infants with HLHS and the short-term outcomes of this population during the first hospitalization. This is a retrospective analysis of the multi-center Pediatric Heath Information System database of infants with HLHS who underwent Stage I Norwood, Hybrid, or heart transplant during their first hospitalization from 2004 through 2013. We compared clinical data between infants with and without genetic abnormality, among the three most common chromosomal abnormalities, and between survivors and non-survivors...
January 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/28889833/acute-kidney-injury-following-first-stage-palliation-in-hypoplastic-left-heart-syndrome-hybrid-versus-norwood-palliation
#11
Richard U Garcia, Girija Natarajan, Henry L Walters, Ralph E Delius, Sanjeev Aggarwal
OBJECTIVE: The aim of this study was to evaluate the prevalence of acute kidney injury after first-stage surgical palliation in patients with a single ventricle and to explore associated risk factors and outcomes. Design and patients This single-centre retrospective study included neonates who underwent either Norwood or Hybrid procedure from 2008 to 2015 for a single ventricle. Postoperative acute kidney injury was defined using the paediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE), criteria within 72 hours of the procedure...
February 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/28838527/aortic-dissection-after-the-hybrid-stage-1-procedure-diagnosis-and-management-strategy
#12
Scott Hittinger, Varsha Bandisode, Shahryar Chowdhury, Minoo N Kavarana
Hybrid Norwood palliation is gaining acceptance as an alternative to open Norwood palliation in high-risk neonates with hypoplastic left heart syndrome. Aortic dissection after hybrid Norwood palliation is a rare but ominous complication that has not been reported.
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28832800/modified-hybrid-procedure-in-hypoplastic-left-heart-syndrome-initial-experience-of-a-center-in-northeastern-brazil
#13
Renato Max Faria, Juliana Torres Pacheco, Itamar Ribeiro de Oliveira, José Madson Vidal, Anilton Bezerra Rodrigues, Ana Luiza Lafeta Costa, Vinicius José da Silva Nina, Marcelo Matos Cascudo
Introduction: Although it only corresponds to 2.5% of congenital heart defects, hypoplastic left heart syndrome (HLHS) is responsible for more than 25% of cardiac deaths in the first week of life. Palliative surgery performed after the second week of life is considered an important risk factor in the treatment of HLHS. Objective: The aim of this study is to describe the initial experience of a medical center in Northeastern Brazil with a modified off-pump hybrid approach for palliation of HLHS...
May 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28831530/evolution-of-ventricular-energetics-in-the-different-stages-of-palliation-of-hypoplastic-left-heart-syndrome-a-retrospective-clinical-study
#14
A Di Molfetta, R Iacobelli, P Guccione, L Di Chiara, M Rocchi, F Cobianchi Belisari, M Campanale, M G Gagliardi, S Filippelli, G Ferrari, A Amodeo
Hyperplastic left heart syndrome (HLHS) patients are palliated by creating a Fontan-type circulation passing from different surgical stages. The aim of this work is to describe the evolution of ventricular energetics parameters in HLHS patients during the different stages of palliation including the hybrid, the Norwood, the bidirectional Glenn (BDG), and the Fontan procedures. We conducted a retrospective clinical study enrolling all HLHS patients surgically treated with hybrid procedure and/or Norwood and/or BDG and/or Fontan operation from 2011 to 2016 collecting echocardiographic and hemodynamic data...
December 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28754809/ventricular-function-and-vascular-dimensions-after-norwood-and-hybrid-palliation-of-hypoplastic-left-heart-syndrome
#15
Heiner Latus, Mohamed S Nassar, James Wong, Pauline Hachmann, Hannah Bellsham-Revell, Tarique Hussain, Christian Apitz, Caner Salih, Conal Austin, David Anderson, Can Yerebakan, Hakan Akintuerk, Juergen Bauer, Reza Razavi, Dietmar Schranz, Gerald Greil
OBJECTIVE: Norwood and hybrid procedure are two options available for initial palliation of patients with hypoplastic left heart syndrome (HLHS). Our study aimed to assess potential differences in right ventricular (RV) function and pulmonary artery dimensions using cardiac magnetic resonance (CMR) in survivors with HLHS. METHODS: 42 Norwood (mean age 2.4±0.8) and 44 hybrid (mean age 2.0±1.0 years) patients were evaluated by CMR after stage II palliation prior to planned Fontan completion...
February 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28667405/utilizing-hybrid-techniques-to-maximize-clinical-outcomes-in-congenital-heart-disease
#16
REVIEW
David W Bearl, Gregory A Fleming
PURPOSE OF REVIEW: The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital cardiology. Recent collaborations between interventional cardiologists and cardiac surgeons have sparked novel innovative hybrid procedures that provide potentially safer, faster, and less invasive alternatives to the management of many diseases. This paper will review the most recent advances in hybrid interventions in the field of pediatric and adult congenital cardiology...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28329111/hypoplastic-left-heart-syndrome-a-novel-surgical-strategy-for-small-volume-centres
#17
Margaux Pontailler, Régis Gaudin, Marien Lenoir, Ayman Haydar, Diala Kraiche, Damien Bonnet, Pascal Vouhé, Olivier Raisky
OBJECTIVES: We describe in a prospective study, a novel surgical technique for the management of hypoplastic left heart syndrome inspired by the hybrid Norwood approach. METHODS: This new neonatal palliation comprises replacement of the patent ductus arteriosus (PDA) and aortic arch plasty with a pulmonary homograft associated with the banding of both pulmonary arteries and atrial septectomy, under cardiopulmonary bypass without aortic clamping and cardioplegia...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28274521/cavopulmonary-anastomosis-during-same-hospitalization-as-stage-1-norwood-hybrid-palliative-surgery
#18
MULTICENTER STUDY
Sachin D Tadphale, Xinyu Tang, Nahed O ElHassan, Brandon Beam, Parthak Prodhan
BACKGROUND: Limited literature has examined characteristics of infants with hypoplastic left heart syndrome (HLHS) who remain hospitalized during the interstage period. We described their epidemiologic characteristics, in-hospital outcomes, and identified risk factors that predict the need for superior cavopulmonary anastomosis (SCPA) during the same hospitalization. METHODS: This retrospective multicenter database analysis included infants with HLHS who underwent stage 1 palliation from 2004 through 2013...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28100120/hybrid-stage-i-procedure-as-initial-palliation-for-neonate-with-hypoplastic-left-heart-syndrome-and-right-congenital-diaphragmatic-hernia
#19
Draginja Cvetkovic, Joseph Giamelli, Michael Lyew, Markus Erb, Suvro Sett, Youmna DiStefano
During the past decade, a hybrid procedure has emerged and dramatically evolved as an alternative stage I palliation to the conventional Norwood procedure in neonates with hypoplastic left heart syndrome (HLHS). The hybrid approach avoids the need for cardiopulmonary bypass (CPB) utilizing stenting of the arterial duct and bilateral pulmonary artery banding. Cerebral and coronary perfusion pressure is maintained, and the pulmonary vasculature is protected from higher systemic pressure. Elimination of risks associated with CPB gains vital time to stabilize the patient and correct coexisting noncardiac anomalies and allows growth in preparation for the later stages of the Fontan pathway...
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27981915/variability-of-antithrombotics-use-in-patients-with-hypoplastic-left-heart-syndrome-and-its-variants-following-first-and-second-stage-palliation-surgery-a-national-report-using-the-national-pediatric-cardiology-quality-improvement-collaborative-registry
#20
MULTICENTER STUDY
Preeti Ramachandran, Eileen King, Ashley Nebbia, Robert H Beekman, Jeffrey B Anderson
Purpose Patients with hypoplastic left heart syndrome and its variants following palliation surgery are at risk for thrombosis. This study examines variability of antithrombotic practice, the incidence of interstage shunt thrombosis, and other adverse events following Stage I and Stage II palliation within the National Pediatric Cardiology Quality Improvement Collaborative registry. METHODS: We carried out a multicentre, retrospective review using the National Pediatric Cardiology Quality Improvement Collaborative registry including patients from 2008 to 2013 across 52 surgical sites...
May 2017: Cardiology in the Young
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