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Surgical ventricular reconstruction

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https://www.readbyqxmd.com/read/29425527/approaches-to-pulmonary-atresia-with-major-aortopulmonary-collateral-arteries
#1
REVIEW
David J Barron, Phil Botha
Pulmonary atresia with major aortopulmonary collateral arteries (MAPCAs) is one of the most challenging surgical conditions to manage-not only because of the technical complexity of the surgery but also in terms of defining the anatomy of the pulmonary vasculature, the timing of surgery, and decision making on staged vs complete repair. The importance of early definition of pulmonary blood supply is paramount, establishing which areas of the lung are supplied by MAPCAs alone and which have dual supply with the native system (noting that 20% of patients have absent intrapericardial native vessels)...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/29367212/impact-of-cardiac-progenitor-cells-on-heart-failure-and-survival-in-single-ventricle-congenital-heart-disease
#2
Toshikazu Sano, Daiki Ousaka, Takuya Goto, Shuta Ishigami, Kenta Hirai, Shingo Kasahara, Shinichi Ohtsuki, Shunji Sano, Hidemasa Oh
Rationale: Intracoronary administration of cardiosphere-derived cells (CDCs) in patients with single ventricles resulted in a short-term improvement in cardiac function. Objective: To test the hypothesis that CDC infusion is associated with improved cardiac function and reduced mortality in patients with heart failure. Methods and Results: We evaluated the effectiveness of CDCs using an integrated cohort study in 101 patients with single ventricles, including 41 patients that received CDC infusion and 60 controls treated with staged palliation alone...
January 24, 2018: Circulation Research
https://www.readbyqxmd.com/read/29365077/programmed-electrical-stimulation-guided-encircling-cryoablation-concomitant-to-surgical-ventricular-reconstruction-for-primary-prevention-of-ventricular-arrhythmias
#3
Carine F van Huls van Taxis, Adrianus P Wijnmaalen, Patrick Klein, Olaf M Dekkers, Jerry Braun, Harriette F Verwey, Martin J Schalij, Robert J Klautz, Katja Zeppenfeld
OBJECTIVES: Surgical ventricular reconstruction (SVR) is an effective treatment to improve left ventricular (LV) function in patients with ischaemic heart failure and an LV anterior-apical aneurysm. Ventricular arrhythmia (VA) is an important cause for morbidity and mortality in these patients. Therefore, encircling cryoablation targeting the VA substrate may be required. Programmed electrical stimulation (PES) can identify patients at risk for VA. The objective of this study was to evaluate the incidence and type of VA during long-term follow-up after PES-guided encircling cryoablation concomitant to SVR for primary prevention of VA...
January 22, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29352588/pulmonary-reinterventions-after-complete-unifocalization-and-repair-in-infants-and-young-children-with-tetralogy-of-fallot-with-major-aortopulmonary-collaterals
#4
Holly Bauser-Heaton, Alejandro Borquez, Ritu Asija, Lisa Wise-Faberowski, Yulin Zhang, Laura Downey, Stanton B Perry, Andrew Koth, Lynn F Peng, Claudia A Algaze, Frank L Hanley, Doff B McElhinney
BACKGROUND: Our institutional approach to tetralogy of Fallot (TOF) with major aortopulmonary collaterals (MAPCAs) emphasizes unifocalization and augmentation of the reconstructed pulmonary arterial (PA) circulation and complete intracardiac repair in infancy, usually in a single procedure. This approach yields a high rate of complete repair with excellent survival and low right ventricular (RV) pressure. However, little is known about remodeling of the unifocalized and reconstructed pulmonary circulation or about reinterventions on the reconstructed PAs or the RV outflow tract conduit...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29343297/pulmonary-valve-replacement-after-right-ventricular-outflow-tract-reconstruction-with-homograft-vs-contegra%C3%A2-a-case-control-comparison-of-mortality-and-morbidity
#5
Nicolas Poinot, Jean-Francois Fils, Hélène Demanet, Hugues Dessy, Dominique Biarent, Pierre Wauthy
BACKGROUND: Repair of congenital heart defects involving the right ventricular outflow tract may require the implantation of a right ventricle to pulmonary artery conduit. This conduit is likely to be replaced during childhood. This study compares the operative outcomes of the replacement procedure of Contegra® and homografts in pulmonary position. METHODS: From 1999 to 2016, 82 children underwent 87 right ventricle to pulmonary artery conduit replacements (60 Contegra® and 27 homografts)...
January 17, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29317056/a-potentially-curative-fetal-intervention-for-hypoplastic-left-heart-syndrome
#6
Andrew T Hattam
Hypoplastic left heart syndrome (HLHS) encapsulates a spectrum of complex congenital cardiovascular malformations involving varying degrees of underdevelopment of the left-sided heart structures. However, despite improved survival rates since the introduction of staged surgical reconstruction, treatment options for HLHS remain palliative rather than curative. A major limiting factor in the development of definitive curative therapy for HLHS is an incomplete understanding of its pathogenesis. Currently, the aetiology HLHS is best conceptualised by the 'flow theory' of cardiogenesis, which states that normal cardiac development is reliant on the interrelationship of normal flow patterns of blood through the developing heart, and appropriate growth of the cardiac valves and myocardium...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29302948/the-hancock%C3%A2-valved-conduit-for-right-ventricular-outflow-tract-reconstruction-in-sheep-for-assessing-new-devices
#7
John P Carney, Lindsey M Zhang, Jeffrey J Larson, Matthew T Lahti, Nicholas A Robinson, Agustin P Dalmasso, Richard W Bianco
BACKGROUND: Xenograft conduits have been used successfully to repair congenital heart defects, but are prone to failure over time. Hence, in order to improve patient outcomes, better xenografts are being developed. When evaluating a conduit's performance and safety it must first be compared against a clinically available control in a large animal model. The study aim was to evaluate a clinically available xenograft conduit used in right ventricular outflow tract (RVOT) reconstruction in a sheep model...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29276930/-perfusion-metabolic-myocardial-scintigraphy-in-prognosis-of-left-ventricular-remodeling-after-complex-surgical-treatment-of-ischemic-cardiomyopathy
#8
Y B Lishmanov, M O Gulya, K V Zavadovsky, S L Andreev, E A Alexandrova
PURPOSE: To study capabilities of perfusion-metabolic myocardial scintigraphy for prediction of the left ventricular (LV) reverse remodeling after comprehensive surgical treatment of ischemic cardiomyopathy (ICMP). METHODS: The study included ICMP patients aged 56±7 years (n=32) who underwent surgical correction of LV dysfunction (myocardial revascularization, LV reconstruction, and mitral valve restoration). Inclusion criteria were significant coronary artery disease; myocardial infarction; New York Heart Association (NYHA) class III-IV heart failure; LV ejection fraction (EF) ≤45%; LV end-systolic index (ESI) >60 mL/m2; and LV akinesia or dyskinesia according to echocardiography...
October 2017: Kardiologiia
https://www.readbyqxmd.com/read/29259502/left-ventricular-reconstruction-for-postinfarction-left-ventricular-aneurysm-review-of-surgical-techniques
#9
REVIEW
Andrea Ruzza, Lawrence S C Czer, Francisco Arabia, Roberta Vespignani, Fardad Esmailian, Wen Cheng, Michele A De Robertis, Alfredo Trento
Different surgical techniques, each with its own advantages and disadvantages, have been used to reverse adverse left ventricular remodeling due to postinfarction left ventricular aneurysm. The most appropriate surgical technique depends on the location and size of the aneurysm and the scarred tissue, the patient's preoperative characteristics, and surgeon preference. This review covers the reconstructive surgical techniques for postinfarction left ventricular aneurysm.
October 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29248281/repair-of-a-quadricuspid-truncal-valve-by-tricuspidization-and-reconstruction-of-right-ventricular-outflow-tract-with-the-excised-truncal-cusp
#10
Ling-Yi Wei, Yih-Sharng Chen, Ing-Sh Chiu, Shu-Chien Huang
OBJECTIVE: Quadricuspid truncal valves are susceptible to regurgitation, and tricuspid configuration is considered more durable after repairing the truncal valve. We report a new method by excising the excessive truncal cuspid to reconstruct a new competent aortic valve. METHODS: Bilateral pulmonary banding failed to stabilize a 4-month-old baby with type I truncus arteriosus and quadricuspid truncal valve with severe regurgitation, so surgery was performed. The aorta was transected, and the pulmonary arteries was separated from the aorta...
November 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29240067/-myocardial-protection-during-left-ventricular-reconstruction-in-patients-with-an-ejection-fraction-below-30
#11
V V Bazylev, E V Rosseĭkin, E E Kobzev, M E Evdokimov
Surgical reconstruction of the left ventricle is an effective method of treatment for ischaemic cardiomyopathy. One of the conditions of successful intervention is correctly choosing a method of intraoperative myocardial protection. Currently, two techniques of myocardial protection are used: cardioplegic cardiac arrest and continuous myocardial perfusion on the beating heart. A series of experimental studies demonstrated that myocardial oxygen requirements in ischaemic cardiomyopathy during permanent perfusion are three times higher than during cardioplegic cardiac arrest...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29194961/computational-simulation-of-postoperative-pulmonary-flow-distribution-in-alagille-patients-with-peripheral-pulmonary-artery-stenosis
#12
Weiguang Yang, Frank L Hanley, Frandics P Chan, Alison L Marsden, Irene E Vignon-Clementel, Jeffrey A Feinstein
BACKGROUND: Up to 90% of individuals with Alagille syndrome have congenital heart diseases. Peripheral pulmonary artery stenosis (PPS), resulting in right ventricular hypertension and pulmonary flow disparity, is one of the most common abnormalities, yet the hemodynamic effects are ill-defined, and optimal patient management and treatment strategies are not well established. The purpose of this pilot study is to use recently refined computational simulation in the setting of multiple surgical strategies, to examine the influence of pulmonary artery reconstruction on hemodynamics in this population...
December 1, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29188428/surgical-treatment-for-endocardial-radiofrequency-ablation-resistant-sustained-monomorphic-ventricular-tachycardia-with-mural-thrombus-including-dense-calcification-in-the-left-ventricle
#13
Takuya Higuchi, Yasushi Tsutsumi, Osamu Monta, Satoshi Asada, Ryota Matsumoto, Shouhei Yamada, Hirokazu Ohashi
Catheter ablation provides effective results for sustained monomorphic ventricular tachycardia (VT), but the presence of mural thrombus including dense calcification occasionally causes unfavorable outcomes. The case of a 67-year-old man in whom sustained monomorphic VT, which was resistant to endocardial radiofrequency ablation, in the presence of mural thrombus including dense calcification after coronary artery bypass grafting was successfully treated by left ventricular reconstruction with cryoablation is reported...
November 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29126782/feasibility-and-limitations-of-mitral-valve-repair-with-or-without-left-ventricular-reconstruction-in-non-ischemic-dilated-cardiomyopathy
#14
Yasushige Shingu, Tomonori Ooka, Hiroki Katoh, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
BACKGROUND: Although non-transplant surgical interventions for non-ischemic dilated cardiomyopathy (NIDCM) are relatively effective, their feasibility and limitations have not been fully elucidated. The aim of this study was to define the feasibility and limitations of mitral valve repair, with or without surgical ventricular reconstruction for patients with NIDCM in terms of postoperative low cardiac output syndrome (LOS). METHODS: Twenty non-transplant candidates (aged 57±13 years) with NIDCM and significant mitral regurgitation had undergone mitral valve repair combined with submitral procedures...
November 7, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29100642/medium-term-outcomes-after-implantation-of-expanded-polytetrafluoroethylene-valved-conduit
#15
Yoshio Ootaki, Allison S Welch, Michael J Walsh, Michael D Quartermain, Derek A Williams, Ross M Ungerleider
BACKGROUND: Pulmonary valve replacement is becoming the most frequent congenital heart surgery performed on adolescents and young adults. Numerous surgical options are available, including autologous pericardium, mechanical valves, allografts, and bioprosthetic valves. Each option has limitations with durability and freedom from reintervention for stenosis or insufficiency, particularly in the pediatric population. The purpose of this study was to analyze our uniquely designed, expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) for right ventricular outflow tract reconstruction...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29050847/anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-presenting-in-adulthood-a-french-nationwide-retrospective-study
#16
Laura Le Berre, Alban-Elouen Baruteau, Alain Fraisse, Dominique Boulmier, Maria Jimenez, Bruno Gallet, Karine Warin Fresse, Jacques Mansourati, Patrice Guerin
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease usually diagnosed during the first months of life. Without surgical treatment, ALCAPA carries a high mortality risk, and disease presentation in adulthood is rare. We describe the diagnosis and management of patients presenting with ALCAPA in adulthood. This multicenter French nationwide retrospective study included adult patients diagnosed from 1980 to 2014. Eleven adult patients (mean age: 38 ± 17 years) were analyzed...
August 25, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049811/effect-of-cone-reconstruction-on-right-ventricular-function-in-patients-with-ebstein-s-anomaly-a-meta-analysis
#17
Dongxu Li, Yasutaka Hirata, Xu Zhou, Akihiro Masuzawa, Minoru Ono, Qi An
OBJECTIVES: Cone reconstruction (CR) is a novel technique for surgically treating the tricuspid valve and right ventricle (RV) in patients with Ebstein's anomaly. However, precise changes in the RV function after CR remain unclear. This study aimed to evaluate the RV size and New York Heart Association (NYHA) functional class by conducting a meta-analysis of reported data. METHODS: The MEDLINE, EMBASE, Cochrane Library and China National Knowledge Infrastructure databases were searched for relevant studies...
September 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049796/surgical-strategy-for-aortic-arch-reconstruction-after-the-norwood-procedure-based-on-numerical-flow-analysis
#18
Shohei Miyazaki, Kagami Miyaji, Keiichi Itatani, Norihiko Oka, Shinji Goto, Masanori Nakamura, Tadashi Kitamura, Tetsuya Horai, Koichi Sughimoto, Yuki Nakamura, Naoki Yoshimura
OBJECTIVES: Inefficient aortic flow after the Norwood procedure is known to lead to the deterioration of ventricular function due to an increased cardiac workload. To prevent the progression of aortic arch obstruction, arch reconstruction concomitant with second-stage surgery is recommended. The aim of this study was to determine the indications for reconstruction based on numerical simulation and to reveal the morphology that affects the haemodynamic parameters. METHODS: Fifteen patients who underwent the Norwood procedure or arch repair and Damus-Kaye-Stansel anastomosis were enrolled...
October 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29026988/pulmonary-annular-motion-velocity-reflects-right-ventricular-outflow-tract-function-in-children-with-surgically-repaired-congenital-heart-disease
#19
Yasunobu Hayabuchi, Akemi Ono, Yukako Homma, Shoji Kagami
Right ventricular (RV) dysfunction is generally evaluated using analyses of tricuspid annular motion. However, it represents only one aspect of RV performance. Whether measuring pulmonary annular motion velocity could serve as a novel way to evaluate global RV and/or RV outflow tract (RVOT) performance in pediatric congenital heart disease (CHD) patients with surgically repaired RVOT was evaluated. In this prospective study, tissue Doppler-derived pulmonary annular motion velocity was measured in children (aged 2-5 years) with RVOT reconstruction (RVOTR group, n = 48) and age-matched healthy children (Control, n = 60)...
October 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29019299/additional-mechanism-for-left-ventricular-dysfunction-chronic-pulmonary-regurgitation-decreases-left-ventricular-preload-in-patients-with-tetralogy-of-fallot
#20
Pekka Ylitalo, Eero Jokinen, Kirsi Lauerma, Miia Holmström, Olli M Pitkänen-Argillander
BACKGROUND: Right ventricular dysfunction in patients with tetralogy of Fallot and significant pulmonary regurgitation may lead to systolic dysfunction of the left ventricle due to altered ventricular interaction. We were interested in determining whether chronic pulmonary regurgitation affects the preload of the left ventricle. In addition, we wanted to study whether severe chronic pulmonary regurgitation would alter the preload of the left ventricle when compared with patients having preserved pulmonary valve annulus...
October 11, 2017: Cardiology in the Young
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