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Pediatric cardiac transplant

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https://www.readbyqxmd.com/read/27900408/prevalence-and-risk-factors-for-pericardial-effusions-requiring-readmission-after-pediatric-cardiac-surgery
#1
Matthew D Elias, Andrew C Glatz, Matthew J O'Connor, Susan Schachtner, Chitra Ravishankar, Christoper E Mascio, Meryl S Cohen
Pericardial effusion (PE) may require readmission after cardiac surgery and has been associated with postoperative morbidity and mortality. We sought to identify the prevalence and risk factors for postoperative PE requiring readmission in children. A retrospective analysis of the Pediatric Health Information System database was performed between January 1, 2003, and September 30, 2014. All patients ≤18 years old who underwent cardiac surgery were identified by ICD-9 codes. Those readmitted within 1 year with an ICD-9 code for PE were identified...
November 30, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27866017/safety-of-optical-coherence-tomography-in-pediatric-heart-transplant-patients
#2
Sarah M Ulrich, Anja Lehner, Julia Birnbaum, Stefanie Heckel, Nikolaus A Haas, Lale Hakami, Rene Schramm, Robert Dalla Pozza, Marcus Fischer, Rainer Kozlik-Feldmann
BACKGROUND: Cardiac allograft vasculopathy (CAV) is a crucial problem after heart transplantation, in adults as well as in children. CAV is the main risk factor for a reduced long-term graft survival. The early diagnosis and treatment of CAV is essential for a successful long-term preservation of the donor heart. However, asymptomatic progression of CAV and concentric hyperplasia of the coronary arteries may complicate the early diagnosis by conventional measures. Intravascular imaging, such as intravascular ultrasound and optical coherence tomography (OCT), enables the diagnosis of early stage CAV...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865734/vascular-endothelial-growth-factor-a-is-associated-with-the-subsequent-development-of-moderate-or-severe-cardiac-allograft-vasculopathy-in-pediatric-heart-transplant-recipients
#3
Kevin P Daly, Maria Stack, Michele F Eisenga, John F Keane, David Zurakowski, Elizabeth D Blume, David M Briscoe
BACKGROUND: Cardiac allograft vasculopathy (CAV) is the leading cause of chronic allograft loss after pediatric heart transplantation. We hypothesized that biomarkers of endothelial injury and repair would predict CAV development in pediatric heart transplant recipients. METHODS: Blood was collected from pediatric heart transplant recipients at the time of routine annual coronary angiography, and the concentrations of 13 angiogenesis-related molecules were determined...
October 3, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27865477/tracheostomy-among-infants-with-hypoplastic-left-heart-syndrome-undergoing-cardiac-operations-a-multicenter-analysis
#4
Parthak Prodhan, Amit Agarwal, Nahed O ElHassan, Elijah H Bolin, Brandon Beam, Xiomara Garcia, Michael Gaies, Xinyu Tang
BACKGROUND: Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27861431/pediatric-artificial-lung-a-low-resistance-pumpless-artificial-lung-alleviates-an-acute-lamb-model-of-increased-right-ventricle-afterload
#5
Fares Alghanem, Benjamin S Bryner, Emilia M Jahangir, Uditha P Fernando, John M Trahanas, Hayley R Hoffman, Robert H Bartlett, Alvaro Rojas-Peña, Ronald B Hirschl
Lung disease in children often results in pulmonary hypertension and right heart failure. The availability of a pediatric artificial lung (PAL) would open new approaches to the management of these conditions by bridging to recovery in acute disease or transplantation in chronic disease. This study investigates the efficacy of a novel PAL in alleviating an animal model of pulmonary hypertension and increased right ventricle afterload.Five juvenile lambs (20-30 Kg) underwent PAL implantation in a pulmonary artery to left atrium configuration...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27834759/current-expectations-for-cardiac-transplantation-in-patients-with-congenital-heart-disease
#6
James K Kirklin, Waldemar F Carlo, F Bennett Pearce
Congenital heart disease accounts for 40% of pediatric heart transplants and presents unique challenges to the transplant team. Suitability for transplantation is defined in part by degree of sensitization, pulmonary vascular resistance, and hepatic reserves. The incremental transplant risk for patients with congenital heart disease occurs within the first 3 months, after which survival is equivalent to transplantation for cardiomyopathy. Single ventricle with prior palliation, and especially the failing Fontan, carry the highest risk for transplantation and are least amenable to bridging with mechanical circulatory support...
November 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27829640/experiences-with-aggressive-cardiac-rehabilitation-in-pediatric-patients-receiving-mechanical-circulatory-supports
#7
Rie Amao, Teruhiko Imamura, Yusuke Sawada, Sachiko Endo, Shinichi Ozaki, Kenichi Okamura, Akihiro Masuzawa, Tetsuhiro Takaoka, Yasutaka Hirata, Takahiro Shindo, Minoru Ono, Nobuhiko Haga
Although some patients with fulminant myocarditis can be rescued owing to the improvements in mechanical circulatory support therapy, there are few reports providing evidence of cardiac rehabilitation during mechanical circulatory supports, particularly among pediatric patients. We treated two pediatric patients who underwent aggressive cardiac rehabilitation during mechanical support. Five days after the initiation of extracorporeal membrane oxygenation therapy aggressive cardiac rehabilitation was started in a 10-year-old girl with fulminant myocarditis...
November 9, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27812522/extracorporeal-life-support-for-pediatric-heart-failure
#8
REVIEW
Christopher R Burke, D Michael McMullan
Extracorporeal life support (ECLS) represents an essential component in the treatment of the pediatric patient with refractory heart failure. Defined as the use of an extracorporeal system to provide cardiopulmonary support, ECLS provides hemodynamic support to facilitate end-organ recovery and can be used as a salvage therapy during acute cardiorespiratory failure. Support strategies employed in pediatric cardiac patients include bridge to recovery, bridge to therapy, and bridge to transplant. Advances in extracorporeal technology and refinements in patient selection have allowed wider application of this therapy in pediatric heart failure patients...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27803957/interstage-survival-for-patients-with-hypoplastic-left-heart-syndrome-after-ecmo
#9
Richard P Fernandez, Brian F Joy, Robin Allen, Jamie Stewart, Holly Miller-Tate, Yongjie Miao, Lisa Nicholson, Clifford L Cua
There is a reported 5-20 % incidence of extracorporeal membrane oxygenation (ECMO) following stage I palliation for hypoplastic left heart syndrome (HLHS). This study compares the interstage mortality of HLHS patients supported with ECMO (HLHS-ECMO) to those who were not supported with ECMO (HLHS-nECMO) using the National Pediatric Cardiology Quality Improvement Initiative database. Patients with HLHS who survived to hospital discharge after stage I palliation were analyzed. HLHS-ECMO patients were compared to HLHS-non-ECMO patients with respect to demographics, surgical variables, and interstage survival...
November 1, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27803956/improved-survival-while-waiting-and-risk-factors-for-death-in-pediatric-patients-listed-for-cardiac-transplantation
#10
Dala Zakaria, Elizabeth Frazier, Michiaki Imamura, Xiomara Garcia, Sherry Pye, Kenneth R Knecht, Parthak Prodhan, Jeffrey R Gossett, Christopher J Swearingen, W Robert Morrow
Our aim is to determine (a) the effect of changes in pre-transplant management and era of listing on survival of children listed for HTx and (b) risk factors for death while waiting. This retrospective study included all children listed between 1/1993 and 12/2009 at our center. Survival was determined using survival analysis and competing outcomes modeling. There were 254 listed patients of whom 144 (57%) had congenital heart disease, 208 (82%) were status 1, 52 used ECMO (20%), and 28 used ventricular assist device support (VAD) (11%) beginning in 2005...
November 1, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27800456/successful-lung-transplant-after-prolonged-extracorporeal-membrane-oxygenation-ecmo-in-a-child-with-pulmonary-hypertension-a-case-report
#11
Cecile Tissot, Walid Habre, Paola Soccal, Maja Isabel Hug, Dominique Bettex, Michel Pellegrini, Yacine Aggoun, Anne Mornand, Afksendyios Kalangos, Peter Rimensberger, Maurice Beghetti
INTRODUCTION: The use of extracorporeal membrane oxygenation (ECMO) is considered a risk factor for, or even a potential contraindication to, lung transplantation. However, only a few pediatric cases have been described thus far. CASE PRESENTATION: A 9-year-old boy with idiopathic pulmonary arterial hypertension developed cardiac arrest after the insertion of a central catheter. ECMO was used as a bridge to lung transplantation. However, after prolonged resuscitation, he developed medullary ischemia and medullary syndrome...
August 2016: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27796066/decline-in-ventricular-function-as-a-result-of-general-anesthesia-in-pediatric-heart-transplant-recipients
#12
Justin J Elhoff, Shahryar M Chowdhury, Carolyn L Taylor, Marc Hassid, Andrew J Savage, Andrew M Atz, Ryan J Butts
Echocardiography is frequently performed under anesthesia during procedures such as cardiac catheterization with EMB in pediatric HTx recipients. Anesthetic agents may depress ventricular function, resulting in concern for rejection. The aim of this study was to compare ventricular function as measured by echocardiography before and during GA in 17 pediatric HTx recipients. Nearly all markers of ventricular systolic function were significantly decreased under GA, including EF (-4.2% ±1.2, P < .01) and RV FAC (-0...
October 30, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27788786/potential-pediatric-organ-donors-after-cardiac-death
#13
A Pregernig, O Karam
BACKGROUND: More than 50 people die each year on the Swiss transplant waiting list. To increase their organ donors pool, some centers have developed a post-cardiac death organ donation program. Information about its impact in the pediatric population is still scarce. The aim of this work was to determine the potential impact of a program of organ donation after cardiac in a pediatric population. METHODS: This was a retrospective study of all children deceased from 2005 to 2014 in a tertiary pediatric and neonatal intensive care unit...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27765663/comprehensive-technical-and-patient-care-optimization-in-the-management-of-pediatric-apheresis-for-peripheral-blood-stem-cell-harvesting
#14
Yoshihiro Ohara, Hitoshi Ohto, Tetsunori Tasaki, Hideki Sano, Kazuhiro Mochizuki, Mitsuko Akaihata, Shogo Kobayashi, Tomoko Waragai, Masaki Ito, Mitsuaki Hosoya, Kenneth E Nollet, Kazuhiko Ikeda, Chitose Ogawa, Takahiro Kanno, Yayoi Shikama, Atsushi Kikuta
BACKGROUND: Pediatric apheresis for peripheral blood stem cell transplantation should be carried out with due concern for low corporeal blood volume and vulnerability to hypocalcemia-related complications, hypovolemic shock, and hypervolemic cardiac overload. STUDY DESIGN AND METHODS: We retrospectively investigated a total of 267 apheresis procedures from 1990 to 2013 on 93 children between 0 and 10 years old, including 89 patients and 4 healthy donors, with body weights of 6...
September 30, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27739163/interpreting-measurements-of-cardiac-function-using-vendor-independent-speckle-tracking-echocardiography-in-children-a-prospective-blinded-comparison-with-catheter-derived-measurements
#15
Suma P Goudar, G Hamilton Baker, Shahryar M Chowdhury, Kimberly J Reid, Girish Shirali, Mark A Scheurer
BACKGROUND: Adult studies demonstrate that echocardiographic measurements of cardiac function using speckle tracking correlate with invasive measurements, but such data in the pediatric population are sparse. Our aim was to compare speckle-derived measures of cardiac function to measurements routinely obtained by cardiac catheterization in children. METHODS: Echocardiograms were performed on the day of cardiac catheterization. Using Tomtec 2D Cardiac Performance Analysis, longitudinal strain (LS), longitudinal strain rate (LSR), early diastolic LSR, and ejection fraction (EF) for the right and left ventricle (RV and LV) were calculated via speckle tracking...
December 2016: Echocardiography
https://www.readbyqxmd.com/read/27724157/neuropsychological-functioning-in-preschool-aged-children-undergoing-evaluation-for-organ-transplant
#16
Tanya N Antonini, Stacey S Beer, Tamir Miloh, William J Dreyer, Susan E Caudle
OBJECTIVE: The purpose of this study was to review the current literature on neuropsychological functioning in two groups of children requiring organ transplants (liver or heart) and present recent clinical data collected through the liver and cardiac transplantation programs at a large pediatric academic medical center. METHOD: Data included in this study came from 18 patients who completed evaluations for heart transplant (n = 8) or liver transplant (n = 10) between the ages of 2 and 6 years (inclusive)...
October 11, 2016: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/27685423/secondary-combined-immunodeficiency-in-pediatric-patients-after-the-fontan-operation-three-case-reports
#17
Eva Hlavackova, Martin Liska, Hana Jicinska, Jiri Navratil, Jiri Litzman
The Fontan operation or total cavopulmonal connection (TCPC) is a palliative surgical correction of rare and complex inborn cardiac malformations that are characterized by univentricular circulation. Protein-losing enteropathy (PLE) develops in 4-13% of patients after the Fontan procedure. Fontan-related PLE leads to secondary combined immunodeficiency marked by hypogammaglobulinemia and predominantly CD4+ lymphocytopenia. Here, we present 3 case reports of patients with secondary immunodeficiency after the Fontan operation...
September 30, 2016: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/27670566/ileocolic-and-jejunal-intussusceptions-requiring-surgical-intervention-in-a-pediatric-patient-with-posttransplant-lymphoproliferative-disorder
#18
Ilan Maizlin, David A Klima, Elizabeth A Beierle
Posttransplant lymphoproliferative disorder (PTLD) is not uncommon in pediatrics. This case report describes a case of intestinal intussusception that occurred secondary to lymphoid hyperplasia in a child with PTLD following a cardiac transplant. This case was unique in its presentation with multiple areas of intussusception and with need for surgical intervention. The diagnosis of intussusception secondary to lead points from PTLD should be strongly considered in pediatric transplant patients presenting with abdominal complaints...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27660899/transplant-survival-following-berlin-heart-excor%C3%A2-support
#19
Roosevelt Bryant, Farhan Zafar, Chesney Castleberry, John L Jefferies, Angela Lorts, Clifford Chin, David L S Morales
The Berlin Heart EXCOR pediatric ventricular assist device is approved by the FDA for bridge to cardiac transplantation (BTT) in children. As the clinical outcomes of the EXCOR continue to be evaluated in the U.S., data on post transplant survival are needed. The UNOS database was used to identify patients < 18 years old undergoing orthotopic heart transplantation (OHT) from 6/2004 to 6/2014. Patients undergoing BTT with the EXCOR were identified. A matched cohort of (358) patients undergoing OHT without pre-transplant mechanical circulatory support (no-MCS) was also identified as controls...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27658616/calcineurin-inhibitor-and-corticosteroid-free-immunosuppression-in-pediatric-heart-transplant-patients
#20
Caroline M Sierra, Robert Tan, Jim Eguchi, Leonard Bailey, Richard E Chinnock
Pediatric heart transplant patients at our institution are immunosuppressed with a CNI and another immune-modulating agent without utilizing corticosteroids. Patients whose renal function worsened and who did not respond to CNI minimization had their CNI discontinued. The clinical history of 35 pediatric heart transplant patients with significant renal insufficiency whose CNI was discontinued was retrospectively analyzed. Data including serum creatinine and weight were collected before, at time of, and every 3-6 months after CNI discontinuation...
September 23, 2016: Pediatric Transplantation
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