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https://www.readbyqxmd.com/read/28714856/use-of-human-aortic-extracellular-matrix-as-a-scaffold-for-construction-of-patient-specific-tissue-engineered-vascular-patch
#1
Liping Gao, Mingjun Du, Jingjing Lv, Sebastian Schmull, Ritai Huang, Jun Li
Abstract Synthetic or biologic materials are usually used to repair vascular malformation in congenital heart defects; however, non-autologous materials show both mismatch compliance and antigenicity, as well as a lack of recellularization on its surface. Here, we constructed a tissue-engineered vascular patch (TEVP) using decellularized extracellular matrix (ECM) scaffold obtained from excised human aorta during surgery, which was seeded with patient-derived bone marrow CD34-positive (CD34+) progenitor cells...
July 17, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#2
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/28711963/transfer-of-neonates-with-critical-congenital-heart-disease-within-a-regionalized-network
#3
Michael F Swartz, Jill M Cholette, Jennifer M Orie, Marshall L Jacobs, Jeffrey P Jacobs, George M Alfieris
Regionalization of pediatric cardiac surgical care varies between and within states. In most geographic regions, at least some neonates with critical heart disease are transferred from their birth hospital to a different hospital for surgery. The impact of neonatal transfer for surgery, particularly over a considerable distance (>10 miles), has been largely unexplored. We sought to examine the impact of transferring neonates for cardiac surgery. We queried the New York State Cardiac Surgery database (2005-2014) from a single institution to identify neonates born within the cardiac surgery center and those transferred for surgery...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28708210/particle-image-velocimetry-tests-on-pediatric-45-cc-and-30-cc-ventricle-assist-devices-effects-of-heart-rate-on-vad-operation
#4
Dariusz Witkowski, Damian Obidowski, Piotr Reorowicz, Daniel Jodko, Krzysztof Jozwik
BACKGROUND: This study investigated flow analysis inside pediatric ventricle assist devices (VADs) designed and manufactured at the Foundation for Cardiac Surgery Development (FRK), Zabrze, Poland. The main goal of the experiment was to define the minimal heart rate admissible in clinical practice. METHODS: The flow was directed by mechanical, single-disc valves developed at the Lodz University of Technology, Institute of Turbomachinery in Lodz, Poland. VAD operation conditions under different heart rates were analyzed...
July 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28707420/transthoracic-intracardiac-catheters-in-pediatric-cardiac-patients-a-single-center-experience
#5
Kristoffer Beham, Hitendu Dave, Janet Kelly, Bernhard Frey, Maja I Hug, Barbara Brotschi
BACKGROUND: Transthoracic intracardiac catheters are frequently inserted in children during congenital heart surgery for monitoring and vascular access purposes. Their use entails a small potential risk. AIM: We aimed to evaluate both catheter-associated morbidities related to maintenance and removal of transthoracic intracardiac catheters in pediatric cardiac patients, and predictors for catheter-associated adverse events. METHODS: Single-center retrospective cohort study of prospectively collected data of children aged 0-14 years receiving a transthoracic intracardiac catheter inserted in the operating room during 7 consecutive years at the University Children's Hospital Zurich...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28706621/pediatric-laparoscopy-and-adaptive-oxygenation-and-hemodynamic-changes
#6
Gloria Pelizzo, Veronica Carlini, Giulio Iacob, Noemi Pasqua, Giuseppe Maggio, Marco Brunero, Simonetta Mencherini, Annalisa De Silvestri, Valeria Calcaterra
Adaptive changes in oxygenation and hemodynamics are evaluated during pediatric laparoscopy. The children underwent laparoscopy (LAP Group, n=20) or open surgery (Open Group, n=10). Regional cerebral (rScO2) and peripheral oxygen saturation (SpO2), heart rate (HR), diastolic (DP) and systolic pressure (SP) were monitored at different intervals: basal (T0); anesthesia induction (T1); CO2PP insufflation (T2); surgery (T3); CO2PP cessation (T4); before extubation (T5). At T1, in both the LAP and Open groups significant changes in rScO2, DP and SP were recorded compared with T0; a decrease in SatO2 was also observed at T5...
June 26, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28704916/three-dimensional-echocardiography-in-adult-congenital-heart-disease
#7
REVIEW
Hyun Suk Yang
Congenital heart disease (CHD) is now more common in adults than in children due to improvements in fetal echo, neonatal and pediatric care, and surgical techniques leading to dramatically increased survivability into adulthood. Adult patients with CHD, regardless of prior cardiac surgery, experience further cardiac problems or therapeutic challenges; therefore, a non-invasive, easily accessible echocardiographic examination is an essential follow-up tool. Among echocardiographic modalities, three-dimensional (3D) echocardiography provides better delineation of spatial relationships in complex cardiac geometries and more accurate volumetric information without geometric assumptions...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28701597/randomized-comparative-study-of-intravenous-infusion-of-three-different-fixed-doses-of-milrinone-in-pediatric-patients-with-pulmonary-hypertension-undergoing-open-heart-surgery
#8
Neeraj Kumar Barnwal, Sanjeeta Rajendra Umbarkar, Manjula Sudeep Sarkar, Raylene J Dias
BACKGROUND: Pulmonary hypertension secondary to congenital heart disease is a common problem in pediatric patients presenting for open heart surgery. Milrinone has been shown to reduce pulmonary vascular resistance and pulmonary artery pressure in pediatric patients and neonates postcardiac surgery. We aimed to evaluate the postoperative outcome in such patients with three different fixed maintenance doses of milrinone. METHODOLOGY: Patients were randomized into three groups...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28700489/the-effect-of-intraoperative-dexmedetomidine-on-acute-kidney-injury-after-pediatric-congenital-heart-surgery-a-prospective-randomized-trial
#9
Youn Yi Jo, Ji Young Kim, Ji Yeon Lee, Chang Hu Choi, Young Jin Chang, Hyun Jeong Kwak
BACKGROUND: Dexmedetomidine has been reported to have a renal protective effect after adult open heart surgery. The authors hypothesized that intraoperative infusion of dexmedetomidine would attenuate the decrease in renal function after pediatric open heart surgery. METHODS: Twenty-nine pediatric patients (1-6 years) scheduled for atrial or ventricular septal defect repair were randomly assigned to receive either continuous infusion of normal saline (control group, n = 14) or dexmedetomidine (a bolus dose of 0...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28696882/risk-factors-for-mortality-in-reoperations-for-pediatric-and-congenital-heart-surgery-in-a-developing-country
#10
Carlos A Villa-Hincapie, Marisol Carreno-Jaimes, Carlos E Obando-Lopez, Jaime Camacho-Mackenzie, Juan P Umaña-Mallarino, Nestor F Sandoval-Reyes
BACKGROUND: The survival of patients with congenital heart disease has increased in the recent years, because of enhanced diagnostic capabilities, better surgical techniques, and improved perioperative care. Many patients will require reoperation as part of staged procedures or to treat grafts deterioration and residual or recurrent lesions. Reoperations favor the formation of cardiac adhesions and consequently increase surgery time; however, the impact on morbidity and operative mortality is certain...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28696880/performance-of-pediatric-risk-of-mortality-score-among-critically-ill-children-with-heart-disease
#11
Rebecca A Russell, Mallikarjuna Rettiganti, Nancy Brundage, Howard E Jeffries, Punkaj Gupta
OBJECTIVE: To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease. METHODS: Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28696877/multicenter-quality-improvement-project-to-prevent-sternal-wound-infections-in-pediatric-cardiac-surgery-patients
#12
Cathy Woodward, Richard Taylor, Minnette Son, Roozbeh Taeed, Marshall L Jacobs, Lauren Kane, Jeffrey P Jacobs, S Adil Husain
BACKGROUND: Children undergoing cardiac surgery are at risk for sternal wound infections (SWIs) leading to increased morbidity and mortality. Single-center quality improvement (QI) initiatives have demonstrated decreased infection rates utilizing a bundled approach. This multicenter project was designed to assess the efficacy of a protocolized approach to decrease SWI. METHODS: Pediatric cardiac programs joined a collaborative effort to prevent SWI. Programs implemented the protocol, collected compliance data, and provided data points from local clinical registries using Society of Thoracic Surgery Congenital Heart Surgery Database harvest-compliant software or from other registries...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28696875/status-and-challenges-of-care-in-africa-for-adults-with-congenital-heart-defects
#13
Frank Edwin, Liesl Zühlke, Heba Farouk, Ana Olga Mocumbi, Kow Entsua-Mensah, Desrie Delsol-Gyan, Fidelia Bode-Thomas, Andre Brooks, Blanche Cupido, Mark Tettey, Ernest Aniteye, Martin M Tamatey, Kofi B Gyan, Jacques Cabral Tantchou Tchoumi, Mohamed-Adel Elgamal
The 54 countries in Africa have an estimated total annual congenital heart defect (CHD) birth prevalence of 300,486 cases. More than half (51.4%) of the continental birth prevalence occurs in only seven countries. Congenital heart disease remains primarily a pediatric health issue in Africa because of the deficient health-care systems: the adults with CHD made up just 10% of patients with CHD in Ghana, and 13.7% of patients with CHD presenting for surgery in Mozambique. With Africa's population projected to double in the next 35 years, the already deficient health systems for CHD care will suffer unbearable strain unless determined and courageous action is undertaken by the African leaders...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28691936/national-variation-in-the-use-of-tracheostomy-in-patients-with-congenital-heart-disease
#14
Joyce T Johnson, Bradley S Marino, Darren Klugman, Pirouz Shamszad
OBJECTIVES: The postsurgical care of children with congenital heart disease may be complicated by the need for cardiorespiratory support, including tracheostomy. The variation of the use of tracheostomy across multiple pediatric cardiac surgical centers has not been defined. We describe multicenter variation in the use of tracheostomy in children undergoing congenital heart surgery. DESIGN: We retrospectively analyzed a multicenter cohort. SETTING: Pediatric Health Information Systems database retrospective cohort...
July 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28688940/thoracostomy-tube-removal-implementation-of-a-multidisciplinary-procedural-pain-management-guideline
#15
Lisa M Ring, Anne Watson
OBJECTIVE: Thoracostomy tubes are placed following cardiothoracic surgery for the repair or palliation of congenital heart defects. The aim of this project was to develop and implement a clinical practice guideline for the provision of optimal analgesia during removal of thoracostomy tubes in pediatric postoperative cardiothoracic surgery patients. METHODS: Methods used include a nonexperimental design utilizing chart audits to determine baseline documentation as well as procedure note evaluation to determine both baseline documentation and compliance with the new guideline...
July 6, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28676203/-frequency-type-and-predictors-of-pleuropulmonary-complications-during-the-first-thirty-days-after-cardiopulmonary-bypass-surgery-in-children
#16
Jessica Jacqueline Hernández-López, Alejandro Solano-Gutiérrez, Flor Teresita Rosas-Aragón, Airam Gabriela Antúnez-Soto, Janet Flores-Lujano, Juan Carlos Nuñez-Enríquez
OBJECTIVE: To determine the frequency, type and predictors of pleuropulmonary complications in the first thirty postoperative days of patients undergoing surgery without cardiopulmonary bypass. METHODS: A retrospective cohort study was carried out between January 2013 and December 2014. It includes all patients with congenital heart disease who underwent cardiac surgery with a sternal or thoracic approach, without cardiopulmonary bypass with a registered admission to Neonatal or Pediatric Intensive Care...
July 1, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28674685/risk-factors-prophylaxis-and-treatment-of-venous-thromboembolism-in-congenital-heart-disease-patients
#17
REVIEW
Michael Silvey, Leonardo R Brandão
Congenital heart disease (CHD) is a common condition in the pediatric population, affecting up to 1% of all live births (i.e., around 40,000 newborns/year in the United States). Although CHD does have a wide range of severity, by the age of 5 years approximately 80% of patients will require at least one surgical intervention to achieve a complete/palliative cardiac repair. Today, in light of their much-improved surgical survival, the care of these patients focuses on morbidity prevention and/or treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28672079/acute-kidney-injury-in-congenital-cardiac-surgery-comparison-of-prifle-akin
#18
Murat Tanyildiz, Mesiha Ekim, Tanil Kendirli, Ercan Tutar, Zeynep Eyileten, Zeynep Birsin Ozcakar, Asli Kavaz, Fatos Yalcınkaya, Adnan Uysalel, Semra Atalay
BACKGROUND: Acute kidney injury (AKI) is associated with an increased risk of mortality especially in pediatric intensive care units. The aim of this study is to determine the risk factors of AKI in children undergoing cardiac surgery for congenital heart disease and compare two different classification systems: pRIFLE and AKIN. METHODS: We retrospectively analyzed 145 patient undergoing pediatric congenital heart surgery who were between 1 month and 18 years and treated by the cardiovascular surgery department from January 2009 to October 2011...
July 3, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28669107/outcomes-and-costs-of-cardiac-surgery-in-adults-with-congenital-heart-disease
#19
Viviane G Nasr, David Faraoni, Anne Marie Valente, James A DiNardo
Advances in pediatric cardiac surgical and medical care have led to increased survival of patients with congenital heart disease (CHD). Consequently, many CHD patients survive long enough to require cardiac surgery as adults. Using the 2013 Nationwide Inpatient Sample (NIS) database, we compared costs and outcomes for adult patients undergoing surgery for treatment of CHD to a reference population of adults undergoing CABG. Patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) procedure codes...
July 1, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28658196/late-term-gestation-is-associated-with-improved-survival-in-neonates-with-congenital-heart-disease-following-postoperative-extracorporeal-life-support
#20
Jane M McKenzie, Thomas Scodellaro, Yves d'Udekem, Roberto Chiletti, Warwick Butt, Siva P Namachivayam
OBJECTIVE: Several population-based studies have shown that gestational age 39-40 weeks at birth is associated with superior outcomes in various pediatric settings. A high proportion of births for neonates with congenital heart disease occur before 39 weeks. We aimed to assess the influence of late-term gestation (39-40 wk) on survival in neonates requiring extracorporeal life support following surgery for congenital heart disease. DESIGN: Retrospective cohort study...
June 27, 2017: Pediatric Critical Care Medicine
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