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Paediatric cardiac surgery

H Brun, R A B Bugge, L K R Suther, S Birkeland, R Kumar, E Pelanis, O J Elle
Aims: Proof of concept and feasibility study for preoperative diagnostic use of mixed reality (MR) holograms of individual 3D heart models from standard cardiac computed tomography angiograms (CTA) images. Optimal repair for complex congenital heart disease poses high demands on 3D anatomical imagination. Three-dimensional printed heart models are increasingly used for improved morphological understanding during surgical and interventional planning. Holograms are a dynamic and interactive alternative, probably with wider applications...
December 6, 2018: European Heart Journal Cardiovascular Imaging
Louise Tofft, Martin Salö, Einar Arnbjörnsson, Pernilla Stenström
Aim of the Study: To assess the frequency of and identify contributing factors to wound dehiscence after posterior sagittal anorectoplasty (PSARP) in children born with anorectal malformations (ARM). Methods: Ethical approval was obtained (DNR 2017/191). Charts of all children with anorectal malformations (ARM) reconstructed with PSARP, limited PSARP, or PSARVUP at a tertiary centre of paediatric surgery between 2001 and 2016 were reviewed. Wound dehiscence within 30 days postoperatively was analysed regarding gender, prematurity, birth weight, type of ARM, other congenital malformations, single- or multistaged reconstruction, age and weight at reconstruction, postoperative antibiotics, and fasting...
2018: BioMed Research International
Sara Hussain, Osman Al-Radi, Tae-Jin Yun, Zhongdong Hua, Budi Rahmat, Suresh Rao, An Qi, Charles Fraser, Yves d'Udekem, Quazi Ibrahim, Ingrid Copland, Richard Whitlock, Glen Van Arsdell
BACKGROUND: A wide variety of surgical strategies are used in tetralogy of Fallot repair. We sought to describe the international contemporary practice patterns for surgical management of tetralogy of Fallot. METHODS: Surgeons from 18 international paediatric cardiac surgery centres (representing over 1800 tetralogy of Fallot cases/year) completed a Research Electronic Data Capture-based survey. Participating countries include: China (4), India (2), Nepal (1), Korea (1), Indonesia (1), Saudi Arabia (3), Japan (1), Turkey (1), Australia (1), United States of America (2), and Canada (1)...
December 4, 2018: Cardiology in the Young
Jonathan R G Etnel, Willem A Helbing, Jolien W Roos-Hesselink, Regina The, Ad J J C Bogers, Johanna J M Takkenberg
Background: To assess the current state of patient information and decision-making in congenital aortic and pulmonary valve disease, we conducted a survey among patients, parents and physicians. Methods: A questionnaire was sent by ground mail to 157 adults and 32 parents of children who previously underwent surgery for congenital aortic or pulmonary valve disease at 0-40 years of age between January 2005 and February 2014 at the Erasmus University Medical Center and to all paediatric and adult congenital cardiologists and congenital cardiac surgeons in the Netherlands (n=88)...
2018: Open Heart
Emily Mary O'Brien, David Law, David Celermajer, Peter Watson Grant, Jon Waites
OBJECTIVE: The number of adults with congenital heart disease has increased with improvements in surgical and medical management, posing a challenge for regional and rural settings, which might have difficulties accessing specialised professionals with congenital heart disease services. This study aims to ascertain the demographics and management of adults with congenital heart disease seen by a cardiology practice in regional Australia to better understand the needs of regional adults with congenital heart disease...
November 19, 2018: Australian Journal of Rural Health
Nicholas Dufourq, Lara Nicole Goldstein, Martin Botha
Introduction: Despite the differences in exposure and experience in dealing with medical emergencies, all doctors should nevertheless be competent to assist a patient in need of resuscitation. The objective of this study was to describe the level of self-assessed emergency skill competence that specialist trainees in various disciplines possessed as well as to identify factors that may have contributed to their level of self-perceived competence. Methods: A prospective, cross-sectional, questionnaire study of various specialist trainees' self-perceived levels of competence in emergency skills was conducted across three academic hospitals in Johannesburg, South Africa...
December 2017: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Caroline Tumelo Bayebaye, Palesa Motshabi-Chakane, Michel Kasongo Muteba
BACKGROUND: Cardiac surgery is associated with peri-operative bleeding, which may result in the need for blood transfusion, particularly in paediatric congenital cardiac surgery on cardiopulmonary bypass (CPB). There is a necessity for regular auditing in order to improve practices. METHODS: Retrospective, contextual, descriptive data of 105 patients were collected for the period January to December 2014. RESULTS: The median age of patients was four (1-6) years, weight was 13 (8...
November 6, 2018: Cardiovascular Journal of Africa
Tariq M Wani, Mohammed Hakim, Archana Ramesh, Shabina Rehman, Yasser Majid, Rebecca Miller, Dmitry Tumin, Joseph D Tobias
BACKGROUND: Preoperative factors have been correlated with pre-incision hypotension (PIH) in children undergoing surgery, suggesting that PIH can be predicted through preoperative screening. We studied blood pressure (BP) changes in the 12 min following the induction of anesthesia to study the incidence of post-induction hypotension and to assess the feasibility of predicting PIH in low-risk children without preoperative hypotension or comorbid features. METHODS: We retrospectively evaluated 200 patients ranging in age from 2 to 8 years with American Society of Anesthesiologists' (ASA) physical status I or II, undergoing non-cardiac surgery...
December 2018: Pediatric Surgery International
Kathleen N Fenton, Marcelo Cardarelli, Frank Molloy, William M Novick
BACKGROUND: In countries with ample resources, no debate exists as to whether heart surgery should be provided. However, where funding is limited, what responsibility exists to care for children with congenital heart defects? If children have a "right" to surgical treatment, to whom is the "duty" to provide it assigned? These questions are subjected to ethical analysis. METHODS: Examination is initially based on the four principles of medical ethics: autonomy, beneficence, non-maleficence, and justice...
October 18, 2018: Cardiology in the Young
R D Eveleens, D K Dungen, S C A T Verbruggen, J M Hulst, K F M Joosten
BACKGROUND: Reaching an optimal nutritional intake is challenging in critically ill infants. One possible way to minimise nutritional deficits is the use of protein and energy-enriched (PE)-formulas. We aimed to describe weight achievement and gastrointestinal symptoms in infants admitted to the paediatric intensive care unit (PICU) while receiving PE-formula for a prolonged period. METHODS: Records from infants admitted to a multidisciplinary PICU and using PE-formula were analysed retrospectively...
October 14, 2018: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
Pascal Amedro, Arthur Gavotto, Delphine Gelibert, Virginie Fraysse, Gregoire De La Villeon, D'Arcy Vandenberghe, Charlene Bredy
BACKGROUND: The use of hypnosis in children has been described more than two centuries ago, with a more recent research and clinical application. There is currently a good level of evidence for the efficacy of clinical hypnosis in children for minor surgery, medical procedures or pain management. The use of clinical hypnosis, in paediatric cardiology, for invasive procedures such as transesophageal echocardiography, has not been reported. AIMS: This study evaluated the feasibility of clinical hypnosis in children undergoing transesophageal echocardiography...
September 19, 2018: European Journal of Cardiovascular Nursing
Anne C Taylor, Katherine E Bates, Alaina K Kipps
Limited evidence exists to guide chest tube management following cardiac surgery in children. We assessed chest tube practice variation by surveying paediatric heart centres to prepare for a multi-site quality improvement project. We summarised management strategies highlighting variability in criteria for chest tube removal between and within centres. This lack of standardisation provides an opportunity for quality improvement.
September 10, 2018: Cardiology in the Young
P A Calderón-Ávila, J A Garrocho-Rangel, J A Cepeda-Bravo, M S Ruiz-Rodríguez, M Pierdant-Pérez, A Pozos-Guillén
BACKGROUND: Eisenmenger syndrome (ES) is a heart cyanotic condition characterised by elevated pulmonary vascular resistance and an intra-cardiac right-to-left shunting of blood through a systemic-to-pulmonary circulation connection. Affected children usually exhibit severe hypoxia, clubbing of fingers/toes, haemoptysis, anaemia, and organ damage. CASE REPORT: During autumn 2015, the patient and her parents arrived at the paediatric dentistry clinic. The patient presented with the main complaint of generalised inflamed gingival tissues, severely protruded upper incisors, and evident abnormal mouth breathing...
December 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
A-M Kassa, M Dahl, M Strinnholm, H Engstrand Lilja
AIM: Knowledge on the neurodevelopmental and physical function in children with vertebral defects, anorectal malformations, cardiac defects, tracheo-oesophageal fistula, renal and limb malformations (VACTERL) is scarce. We evaluated Swedish preschool children with VACTERL and identified whether they would need extra support in school. METHODS: From 2015 to 2017, we recruited children aged 5-7 with VACTERL association from the paediatric surgical centre at the University Children's Hospital at Uppsala...
September 5, 2018: Acta Paediatrica
Silvio Simeone, Gianluca Pucciarelli, Marco Perrone, Grazia Dell Angelo, Rea Teresa, Assunta Guillari, Gianpaolo Gargiulo, Giuseppe Comentale, Gaetano Palma
BACKGROUND: Congenital heart disease is a common birth defect rather than a paediatric disease. Parents often discover this disease after their children's birth and then often learn that cardiac surgery is the only solution. A child's admission to a paediatric cardiac intensive care unit (PCICU) may lead to high levels of stress, anxiety and depression in parents. OBJECTIVES: To describe the lived experiences of mothers and fathers during their children's confinement in a PCICU...
November 2018: Heart & Lung: the Journal of Critical Care
Li Xiang, Zhanhao Su, Yiwei Liu, Xiaoling Zhang, Shoujun Li, Shengshou Hu, Hao Zhang
BACKGROUND: Low socioeconomic status is associated with increased mortality for patients with cardiovascular disease; however, the effect of family socioeconomic status on the prognosis of children with congenital heart disease remains unclear, particularly in low-income and middle-income countries. We aimed to examine the association between family socioeconomic status and postoperative outcomes for paediatric patients with complex congenital heart disease (CCHD). METHODS: In this observational cohort study, we enrolled children (aged <7 years) who had CCHD surgery at Fuwai Hospital (Beijing, China) between May 1, 2012, and Dec 31, 2015...
June 2018: Lancet Child & Adolescent Health
Katherine L Brown
No abstract text is available yet for this article.
June 2018: Lancet Child & Adolescent Health
J Karlsson, P Winberg, B Scarr, P A Lönnqvist, E Neovius, M Wallin, M Hallbäck
BACKGROUND: Effective pulmonary blood flow (COEPBF ) has recently been validated as a technique for determining cardiac output (CO) in animals of varying sizes. The primary aim of our study was to investigate this new technique in paediatric surgical patients, compared with suprasternal two-dimensional Doppler (COSSD ). METHODS: A total of 15 children undergoing cleft lip/palate surgery were investigated. Before the start of surgery, manoeuvres that were anticipated to reduce (increase in PEEP from 3 to 10 cm H2 O) and increase (atropine) CO were undertaken...
September 2018: British Journal of Anaesthesia
Nadine Shehata, Nikhil Mistry, Bruno R da Costa, Tiago V Pereira, Richard Whitlock, Gerard F Curley, David A Scott, Gregory M T Hare, Peter Jüni, C David Mazer
Aims: To determine whether a restrictive strategy of red blood cell (RBC) transfusion at lower haemoglobin concentrations is inferior to a liberal strategy of RBC transfusion at higher haemoglobin concentrations in patients undergoing cardiac surgery. Methods and results: We conducted a systematic review, meta-analysis, and trial sequential analysis of randomized controlled trials of the effect of restrictive and liberal RBC transfusion strategies on mortality within 30 days of surgery as the primary outcome...
August 10, 2018: European Heart Journal
Nigel E Drury, Angela Horsburgh, Rehana Bi, Robert G Willetts, Timothy J Jones
INTRODUCTION: Many techniques are available for cardioplegic arrest in children, but there is a lack of late phase clinical trials to guide practice. We surveyed paediatric cardiac surgeons and perfusionists to establish current practice and willingness to change within a clinical trial. METHODS: An online survey was sent to all consultant paediatric cardiac surgeons and chief perfusionists in paediatric centres in the UK and Ireland. Information was sought on cardioplegia type, composition, temperature, topical cooling, dosing for induction and maintenance, interval between doses, whether practice changed with patient age or complexity and whether respondents would be willing and able to use different cardioplegia solutions within a randomised trial...
August 10, 2018: Perfusion
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