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Heart failure premature infant

Michael L Rigby
Major congenital or acquired heart disease in neonates presents with cyanosis, hypoxia, acute circulatory failure or cardiogenic shock. Antenatal diagnosis is made in up to 50% but heart disease is unanticipated in the remainder. The presence of significant heart disease in premature infants is also frequently not suspected at first; in general, whatever the underling cardiac anomaly, the clinical condition is worse, deteriorates more quickly and carries a poorer prognosis in premature and low birth weight infants...
October 13, 2016: Early Human Development
Youn Ju Rhee, Sung Joon Han, Yoo Young Chong, Min-Woong Kang, Shin Kwang Kang, Jae-Hyeon Yu
With advancements in complex repairs in neonates with complicated congenital heart diseases, extracorporeal membrane oxygenation (ECMO) has been increasingly used as cardiac support. ECMO has also been increasingly used for low birth weight (LBW) or very low birth weight (VLBW) neonates. However, since prematurity and LBW are risk factors for ECMO, the appropriate indications for neonates with LBW, especially VLBW, are under dispute. We report a case of ECMO performed in a 1,360-g premature infant with VLBW due to cardiopulmonary bypass weaning failure after repairing infracardiac total anomalous pulmonary venous return...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Raja Nandyal, Ganga Moorthy
Hydrops fetalis is a rare manifestation of severe congestive heart failure in a fetus, resulting in pathological fluid accumulation in fetal soft tissues and/or serous cavities. Non-compaction of the ventricular myocardium, frequently referred to as the left ventricular non-compaction (LVNC), is a very rare congenital cardiomyopathy. For LVNC, echocardiography is the diagnostic modality of choice. Various diagnostic criteria exist based on either echocardiography or MRI. Currently, nonimmune hydrops fetalis (NIHF) comprise almost 90% of all hydrops fetalis cases...
April 2016: Journal of the Oklahoma State Medical Association
Sushitha Surendran, Thittamaranahalli K S Kumar, Christopher J Knott-Craig
Left thoracic sympathectomy has been shown to be an effective treatment for adults with long QT syndrome who are refractory to medical therapy. We report the successful use of left thoracic sympathectomy for the management of a 10-week-old premature baby with long QT syndrome and heart failure from a large ventricular septal defect and patent ductus arteriosus.
June 20, 2016: Cardiology in the Young
Dilek Ulubas Isik, Istemi H Celik, Osman Yilmaz, Ahmet Y Bas, Nihal Demirel
Pulmonary artery thrombosis is rarely reported in preterm neonates. Although treatment of neonatal thrombosis remains controversial, thrombolytic agents must be considered when the thrombosis is life threatening. We herein present a case of a preterm newborn with pulmonary artery thrombosis accompanied by acute-onset respiratory failure and cyanotic congenital heart disease. The thrombosis was successfully treated using tissue plasminogen activator. In conclusion, the thrombolytic therapy should be considered in treatment of patients in whom the thrombosis completely occludes the pulmonary arteries...
November 2016: Journal of Pediatric Hematology/oncology
Soham Dasgupta, Ashraf M Aly, Sunil K Jain
Introduction Congestive heart failure due to left to right cardiac shunt is usually managed medically with diuretics, angiotensin converting enzyme inhibitors, and, in some cases, with the addition of digoxin. Case We report a 31-week gestation premature male infant who did not respond to such treatment and developed hyperaldosteronism and severe hypokalemia secondary to activation of the renin angiotensin aldosterone system. The hypokalemia was not responsive to intravenous KCL supplementation and induced digoxin toxicity despite a relatively normal digoxin level...
March 2016: American Journal of Perinatology Reports
Uygar Teomete, Rubee Anne Gugol, Holly Neville, Ozgur Dandin, Ming-Lon Young
Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss...
2016: Case Reports in Vascular Medicine
Noriko Motoki, Yuji Inaba, Satoshi Matsuzaki, Yohei Akazawa, Takafumi Nishimura, Tetsuhiro Fukuyama, Kenichi Koike
BACKGROUND: Tuberous sclerosis complex (TSC) is an autosomal-dominant tumor suppressor gene syndrome that is characterized by the development of distinctive benign tumors and malformations in multiple organ systems (N Eng J Med 355:1345-1356, 2006). Cardiac rhabdomyomas are intracavitary or intramural tumors observed in 50-70 % of infants with TSC but only cause serious clinical problems in a very small fraction of these patients (N Eng J Med 355:1345-1356, 2006; Pediatrics 118:1146-1151, 2006; Eur J Pediatr 153:155-7, 1994); most individuals have no clinical symptoms and their tumors spontaneously regress...
2016: BMC Pediatrics
N Srinath Reddy, Mahesh Kappanayil, Rakhi Balachandran, Kathy J Jenkins, Abish Sudhakar, G S Sunil, R Benedict Raj, R Krishna Kumar
We studied the effect of preoperative determinants on early outcomes of 1028 consecutive infant heart operations in a limited-resource setting. Comprehensive data on pediatric heart surgery (January 2010-December 2012) were collected prospectively. Outcome measures included in-hospital mortality, prolonged ventilation (>48 hours), and bloodstream infection (BSI) after surgery. Preoperative variables that showed significant individual association with outcome measures were entered into a logistic regression model...
2015: Seminars in Thoracic and Cardiovascular Surgery
G Justus Hofmeyr, Jon F Barrett, Caroline A Crowther
BACKGROUND: Twin pregnancies are associated with increased perinatal mortality, mainly related to prematurity, but complications during birth may contribute to perinatal loss or morbidity. The option of planned caesarean section to avoid such complications must therefore be considered. On the other hand, randomised trials of other clinical interventions in the birth process to avoid problems related to labour and birth (planned caesarean section for breech, and continuous electronic fetal heart rate monitoring), have shown an unexpected discordance between short-term perinatal morbidity and long-term neurological outcome...
2015: Cochrane Database of Systematic Reviews
Andrew M Kilale, Godfather D Kimaro, Amos M Kahwa, Mabuba Chilagwile, Bernard J Ngowi, William Muller, Hassan Chande, Godfrey S Mfinanga, Sven G Hinderaker
The primary aims of tuberculosis (TB) control programmes is early diagnosis and prompt treatment of infectious cases to limit transmission. Failure to diagnose and adequately treat TB could lead to premature death and unrecognized transmission of Mycobacterium tuberculosis. The proportion of missed TB cases has not been reported in Tanzania. The objective of this study was to quantify the number of cases of TB identified by autopsy. Deceased morbid bodies from Muhimbili National Hospital were involved. Retrieval of admission, diagnostic and other important records used to manage the patient after admission was done...
July 2013: Tanzania Journal of Health Research
Heidi Helin, Jon van der Walt, Muriel Holder, Simi George
We present a case of pure erythroleukemia, diagnosed at autopsy, in a dysmorphic premature infant who died of multiorgan failure within 24 hours of birth. Dysmorphic features included facial and limb abnormalities with long philtrum, microagnathia, downturned mouth, short neck as well as abnormal and missing nails, missing distal phalanx from the second toe, and overlapping toes. Internal findings included gross hepatomegaly and patchy hemorrhages in the liver, splenomegaly, and cardiomegaly; and subdural, intracerebral, and intraventricular hemorrhages...
July 2016: Pediatric and Developmental Pathology
Adrienne H Kovacs, Elisabeth M Utens
Most infants born with congenital heart disease (CHD) are now expected to reach adulthood. However, adults with CHD of moderate or great complexity remain at elevated risk of heart failure, arrhythmias, additional surgeries and interventional procedures, and premature mortality. This creates a need for lifelong specialized cardiac care and leads to 2 sets of potential challenges: (1) the transition from pediatric to adult care and (2) the psychosocial implications of coping with a chronic and often life-shortening medical condition...
November 2015: Cardiology Clinics
Emrah Utku Kabatas, Pinar Altiaylik Ozer, Bengi Ece Kurtul, Serdar Beken, Aysegul Zenciroglu, Nurullah Okumus
A premature baby who was hospitalized with the diagnosis of sepsis was treated with diode laser photocoagulation for aggressive posterior retinopathy of prematurity. Diffuse corneal ectasia and corneal hydrops developed in the right eye, and hyphema and corneal hydrops developed on the left eye on postoperative day 12. The patient died because of cardiovascular collapse and hemodynamic instability. Sepsis may be a contributory factor to the clinical susceptibility of the patient for the postoperative corneal effects of the laser...
October 2015: Ophthalmic Surgery, Lasers & Imaging Retina
Mohammad A Alqahtani, Ayed A Shati, Minjing Zou, Ali M Alsuheel, Abdullah A Alhayani, Saleh M Al-Qahtani, Hessa M Gilban, Brain F Meyer, Yufei Shi
Congenital adrenal hyperplasia (CAH) due to steroid 11β-hydroxylase deficiency is the second most common form of CAH, resulting from a mutation in the CYP11B1 gene. Steroid 11β-hydroxylase deficiency results in excessive mineralcorticoids and androgen production leading to hypertension, precocious puberty with acne, enlarged penis, and hyperpigmentation of scrotum of genetically male infants. In the present study, we reported 3 male cases from a Saudi family who presented with penile enlargement, progressive darkness of skin, hypertension, and cardiomyopathy...
2015: International Journal of Endocrinology
Jeffrey P Jacobs, Sean M O'Brien, Sara K Pasquali, J William Gaynor, John E Mayer, Tara Karamlou, Karl F Welke, Giovanni Filardo, Jane M Han, Sunghee Kim, James A Quintessenza, Christian Pizarro, Christo I Tchervenkov, Francois Lacour-Gayet, Constantine Mavroudis, Carl L Backer, Erle H Austin, Charles D Fraser, James S Tweddell, Richard A Jonas, Fred H Edwards, Frederick L Grover, Richard L Prager, David M Shahian, Marshall L Jacobs
BACKGROUND: The empirically derived 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model incorporates adjustment for procedure type and patient-specific factors. The purpose of this report is to describe this model and its application in the assessment of variation in outcomes across centers. METHODS: All index cardiac operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (January 1, 2010, to December 31, 2013) were eligible for inclusion...
September 2015: Annals of Thoracic Surgery
Sharon Anderson, Susan Sklower Brooks
BACKGROUND: Advanced prenatal screening and diagnostic testing have increased the number of newborns born with a confirmed diagnosis. Not all infants, however, are born with a known diagnosis. In fact, for some conditions, physical findings evolve over time and diagnosis can be further delayed because of premature birth. PURPOSE: This article shares a case report of a dysmorphic preterm infant admitted to the intensive care nursery for routine care. The emergence of physical findings as the baby matured during the first weeks of life and the stepwise, diagnostic approach used to confirm a rare genetic condition, cardiofaciocutaneous (CFC) syndrome, is provided...
August 2015: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Alina-Costina Luca, Andreea-Simona Holoc, C Iordache
UNLABELLED: Congenital heart malformations represent a public health problem, holding a significant percentage of the total of heart diseases. Beside the elevated frequency of the malformations, we also notice their occurrence in newborn babies with low birth weight, increasing, thus, the risk of complications and late therapeutic approach. The goal of the study was to highlight the general and particular aspects of cardiovascular malformations epidemiology in newborn babies with low weight at birth, the correlation of the malformations with implied genetic and environmental factors, assessing the complications and their procedures on the therapeutic management...
April 2015: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Rohit Loomba, Karan Nijhawan
INTRODUCTION: Preterm infants are at increased risk of having a patent arterial duct (PAD). PADs may cause congestive heart failure, respiratory distress, necrotizing enterocolitis, and renal impairment. Consequently, in some infants, it becomes necessary to attempt closure of the PAD. Surgical closure can be difficult in small infants and is not without its risks; thus, medical closure offers advantages. Cyclooxygenase inhibitors have been used for medical closure of the PAD with both ibuprofen and indomethacin having been used clinically...
June 2015: Curēus
Bahaaldin Alsoufi, Makoto Mori, Scott Gillespie, Brian Schlosser, Timothy Slesnick, Brian Kogon, Dennis Kim, Ritu Sachdeva, Kirk Kanter
BACKGROUND: We sought to review current-era experience with multistage palliation of neonates with hypoplastic left heart syndrome (HLHS) and to examine the patients' anatomic, and surgical risk factors influencing outcomes. METHODS: A retrospective review of 219 HLHS patients who underwent the Norwood operation from 2002 to 2012 was performed. Competing risks analyses modeled events after the Norwood operation (death/transplantation, progression to Glenn operation) and after the Glenn operation (death/transplantation progression to Fontan operation), and examined the risk factors affecting outcomes...
August 2015: Annals of Thoracic Surgery
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