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anesthesia for the patients with congenital heart disease

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https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#1
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#2
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27801973/scai-ccas-spa-expert-consensus-statement-for-anesthesia-and-sedation-practice-recommendations-for-patients-undergoing-diagnostic-and-therapeutic-procedures-in-the-pediatric-and-congenital-cardiac-catheterization-laboratory
#3
Kirsten C Odegard, Robert Vincent, Rahul Baijal, SuAnne Daves, Robert Gray, Alex Javois, Barry Love, Phil Moore, David Nykanen, Lori Riegger, Scott G Walker, Elizabeth C Wilson
Current practice of sedation and anesthesia for patients undergoing pediatric congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions (SCAI), the Society for Pediatric Anesthesia (SPA) and the Congenital Cardiac Anesthesia Society (CCAS) was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL...
November 1, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27779344/dexmedetomidine-use-in-patients-undergoing-electrophysiological-study-for-supraventricular-tachyarrhythmias
#4
Christopher F Tirotta, Tuan Nguyen, Steven Fishberger, Evelio Velis, Melissa Olen, Lourdes Lam, Danielle R Madril, Jessica Hughes, Richard G Lagueruela
BACKGROUND: Dexmedetomidine is a selective alpha-2 adrenergic agonist with sedative, analgesic, and anxiolytic properties. Dexmedetomidine has not been approved for use in pediatrics. Dexmedetomidine has been reported to depress sinus node and atrioventricular nodal function in pediatric patients; it has been suggested that the use of dexmedetomidine may not be desirable during electrophysiological studies. AIM: We hypothesize that the use of dexmedetomidine does not inhibit the induction of supraventricular tachyarrhythmias (SVT) during electrophysiological studies and does not inhibit the ablation of such arrhythmias...
October 25, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27749349/scai-ccas-spa-expert-consensus-statement-for-anesthesia-and-sedation-practice-recommendations-for-patients-undergoing-diagnostic-and-therapeutic-procedures-in-the-pediatric-and-congenital-cardiac-catheterization-laboratory
#5
Kirsten C Odegard, Robert Vincent, Rahul G Baijal, Suanne M Daves, Robert G Gray, Alexander J Javois, Barry A Love, Philip Moore, David Nykanen, Lori Q Riegger, Scott G Walker, Elizabeth C Wilson
Current practice of sedation and anesthesia for patients undergoing pediatric and congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions, the Society for Pediatric Anesthesia and the Congenital Cardiac Anesthesia Society was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27711024/reference-intervals-of-thromboelastometric-evaluation-of-coagulation-in-pediatric-patients-with-congenital-heart-diseases-a-retrospective-investigation
#6
Ji Young Kim, Yu Rim Shin, Hae Keum Kil, Mi Ran Park, Jong Wha Lee
BACKGROUND Rotational thromboelastometry (ROTEM®) is a point-of-care test for coagulation, enabling physicians to make a swift decision. The aim of this investigation was to establish reference intervals of thromboelastometric evaluation for coagulation in pediatric patients with congenital heart diseases (CHD). MATERIAL AND METHODS As baseline data, 3 assays of ROTEM® (INTEM, EXTEM, and FIBTEM) were measured after anesthesia induction. ROTEM® parameters were clotting time (CT), amplitude at 10 min (A10), clot formation time (CFT), a angle, maximal clot firmness (MCF), clot lysis index at 60 min (LI60), and maximal clot elasticity (MCE)...
October 6, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27678106/feasibility-of-ferumoxytol-enhanced-neonatal-and-young-infant-cardiac-mri-without-general-anesthesia
#7
Lillian M Lai, Joseph Y Cheng, Marcus T Alley, Tao Zhang, Michael Lustig, Shreyas S Vasanawala
PURPOSE: To assess the feasibility of ferumoxytol-enhanced anesthesia-free cardiac MRI in neonates and young infants for complex congenital heart disease (CHD). MATERIALS AND METHODS: With Institutional Review Board approval, 21 consecutive neonates and young infants (1 day to 11 weeks old; median age of 3 days) who underwent a rapid two-sequence (MR angiography [MRA] and four-dimensional [4D] flow) MRI protocol with intravenous ferumoxytol without sedation (n = 17) or light sedation (n = 4) at 3 Tesla (T) (except one case at 1...
September 28, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27537760/unrepaired-tetralogy-of-fallot-related-pathophysiologic-changes-reduce-systemic-clearance-of-etomidate-in-children
#8
Yang Shen, Mei-Hua Cai, Wei Ji, Jie Bai, Yue Huang, Ying Sun, Lin Lin, Jing Niu, Ma-Zhong Zhang
BACKGROUND: Pathophysiologic changes in children with congenital heart disease may alter the effect of drugs by influencing the pharmacokinetics (PK). Considering the limited literature that describes the PK of etomidate in pediatric patients, especially in those with tetralogy of Fallot (TOF), our aim was to characterize the PK of etomidate and explore the effects of TOF. METHODS: Twenty-nine pediatric patients (15 with TOF and 14 with normal cardiac anatomy) scheduled to undergo elective surgery under general anesthesia were recruited in the study...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27397451/comparison-of-speed-of-inhalational-induction-in-children-with-and-without-congenital-heart-disease
#9
Suruchi Hasija, Sandeep Chauhan, Pawan Jain, Arin Choudhury, Neelam Aggarwal, Ravinder Kumar Pandey
BACKGROUND: Conduct of stable inhalational anesthetic induction in children with congenital heart disease (CHD) presents special challenges. It requires in-depth understanding of the effect of congenital shunt lesions on the uptake, delivery, and equilibration of anesthetic drugs. Intracardiac shunts can alter the induction time and if delivery of anesthetic agent is not carefully titrated, can lead to overdosing and undesirable myocardial depression. AIMS: To study the effect of congenital shunt lesions on the speed of inhalational induction and also the impact of inhalational induction on hemodynamics in the presence of congenital shunt lesions...
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27167685/the-perioperative-use-of-dexmedetomidine-in-pediatric-patients-with-congenital-heart-disease-an-analysis-from-the-congenital-cardiac-anesthesia-society-society-of-thoracic-surgeons-congenital-heart-disease-database
#10
Lawrence I Schwartz, Mark Twite, Brian Gulack, Kevin Hill, Sunghee Kim, David F Vener
BACKGROUND: Dexmedetomidine is a selective α-2 receptor agonist with a sedative and cardiopulmonary profile that makes it an attractive anesthetic for pediatric patients with congenital heart disease (CHD). Although several smaller, single-center studies suggest that dexmedetomidine use is gaining traction in the perioperative setting in children with CHD, there are limited multicenter data, with little understanding of the variation in use across age ranges, procedural complexity, and centers...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27069835/anesthetic-management-for-cesarean-section-in-a-patient-with-uncorrected-double-outlet-right-ventricle
#11
Juan Gu, Yunxia Cai, Bin Liu, Sheng Lv
BACKGROUND: We describe the anesthetic management for cesarean section in a pregnant woman with uncorrected double-outlet right ventricle. The anesthetic method, treatment of complications and lessons are discussed. CASE PRESENTATION: A 28-year-old woman visited our emergency room for progressive dyspnea and recurrent hemoptysis at 30 weeks' gestation. Her New York Heart Association functional class was III-IV. Echocardiography indicated that she had congenital heart disease of double-outlet right ventricle...
2016: SpringerPlus
https://www.readbyqxmd.com/read/26988679/-efficacy-of-interventional-therapy-on-paravalvular-leakage-after-mitral-valve-replacement
#12
C N Xu, Y Liu, X F Li, W S Chen, X L Yang, X W Wang, Y S Zhu, H L Li, R Ma, M Chen, S Q Yu, J Yang
OBJECTIVE: To evaluate the efficacy of transcatheter intervention of paravalvular leakage (PVL) after mitral valve replacement. METHODS: Present respective study included 15 patients (8 males and mean age (53.5±11.7) years) with mitral PVL who underwent interventional therapy in our hospital from April 2014 to May 2015. There were 9 cases with NYHA heart function Ⅲ, 6 cases with NYHA heart function Ⅳ. Left ventricular ejection fraction was (46.8±8.2)%, and mitral regurgitation volume was 12...
March 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/26803698/outcome-of-noncardiac-surgery-in-children-with-congenital-heart-disease-performed-outside-a-cardiac-center
#13
Shermayne M Ng, Xi Jin, Robert Yates, Anthony W R Kelsall
OBJECTIVE: The objective of this study was to review the outcome of children with congenital heart disease (CHD) undergoing noncardiac surgery requiring general anesthesia (GA) in a tertiary pediatric center between January 2010 and December 2012. STUDY DESIGN: A retrospective case note review of children <16years of age with confirmed CHD undergoing a surgical or interventional procedure requiring GA was performed. Patients were categorized into three risk groups according to White and Peyton's anesthetic risk classification of children with CHD undergoing noncardiac surgery [Critical Care and Pain 2012;12:17-22]...
February 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26765454/effects-of-hypothermic-cardiopulmonary-bypass-on-internal-jugular-bulb-venous-oxygen-saturation-cerebral-oxygen-saturation-and-bispectral-index-in-pediatric-patients-undergoing-cardiac-surgery-a-prospective-study
#14
COMPARATIVE STUDY
Zhiyong Hu, Lili Xu, Zhirui Zhu, Robert Seal, Patrick M McQuillan
The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients.Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded...
January 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26606173/case-scenario-perioperative-management-of-a-young-woman-with-fontan-repair-for-major-gynecologic-surgery
#15
Antonio Maria Dell'Anna, Domenico Luca Grieco, Andrea Russo, Elisabetta Marana, Massimo Antonelli
Effective treatment for many congenital heart diseases diagnosed before birth has become available since the last three decades. Continuous improvements in surgical knowledge and techniques have allowed patients born with severe heart defects to survive through adulthood. However, palliative surgery often implies profound modifications of classical circulatory physiology, which must be taken into account particularly when general anesthesia is needed for major noncardiac surgery. Among the palliative surgeries, Fontan repair is an intervention aiming at excluding the right heart chambers with a total cavopulmonary conduit, which directs blood flow from both inferior and superior vena cavae directly to the right pulmonary artery...
February 2016: Anesthesiology
https://www.readbyqxmd.com/read/26542436/effect-of-intercurrent-operation-and-cerebral-oxygenation-on-developmental-trajectory-in-congenital-heart-disease
#16
George M Hoffman, Cheryl L Brosig, Laurel M Bear, James S Tweddell, Kathleen A Mussatto
BACKGROUND: Children with congenital heart disease are at increased risk of abnormal neurodevelopment (ND). Demographic and perioperative physiologic factors have both been associated with developmental outcome. The acute physiologic effect of a surgical procedure, anesthesia, and hospitalization may offset any potential advantage gained from anatomic correction and circulatory palliation. The specific risk/benefit balance on ND outcome of the insult of the operation, offset by the benefit of improved anatomy and physiology, has not been addressed...
February 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26488080/pain-management-with-bilateral-continuous-thoracic-paravertebral-block-in-a-patient-with-fontan-associated-hepatocellular-carcinoma-undergoing-hepatectomy
#17
Akihiko Maeda, Sho C Shibata, Kenta Okitsu, Tatsuyuki Imada, Ayako Takahashi, Akinori Uchiyama, Takahiko Kamibayashi, Yuji Fujino
OBJECTIVE: We report a case of perioperative management of a single-ventricle patient with Fontan-associated liver disease undergoing hepatectomy. CASE REPORT: A 12-year-old boy with Fontan circulation was scheduled for partial hepatectomy to remove a liver mass in segment 6. He received stent implantation to relieve conduit stenosis 6 months before the operation. The operation was performed under general anesthesia and with a bilateral thoracic paravertebral block (PVB)...
November 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26466501/-a-case-of-undiagnosed-extra-adrenal-pheochromocytoma-in-an-adult-patient-with-single-ventricle-circulation-after-the-bidirectional-glenn-operation
#18
Masaki Kohno, Yusuke Nagamine, Takahisa Goto
We experienced a case of undiagnosed extra-adrenal pheochromocytoma in an adult patient with single ventricle circulation after the bidirectional Glenn operation. A 32-year-old woman was scheduled for open abdominal surgery for incidental retroperitoneal tumor. She had undergone the bidirectional Glenn operation for complex congenital heart disease consisting of double outlet right ventricle, ventricular septal defect, and pulmonary artery stenosis. She had not undergone the Fontan operation because of insufficient development of pulmonary circulation...
September 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26161325/oral-dexmedetomidine-versus-midazolam-as-anesthetic-premedication-in-children-undergoing-congenital-heart-surgery
#19
Seyedeh Zahra Faritus, Mehrdad Khazaee-Koohpar, Mohsen Ziyaeifard, Mohammad Javad Mehrabanian
BACKGROUND: Premedication is required for reducing anxiety and child's struggling against mask acceptance on anesthesia in pediatric surgery for congenital heart disease. Midazolam has been widely used for this purpose, but because of its side effects, finding an effective replacement with less complication is necessary. OBJECTIVES: In the present study, we compared the efficacy of oral midazolam versus dexmedetomidine in terms of anxiolysis and mask acceptance behavior...
June 2015: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/26121811/-management-of-pulmonary-blood-flow-for-a-patient-with-congenital-pulmonary-vein-stenosis-undergoing-pulmonary-venous-obstruction-release-and-pulmonary-artery-banding
#20
Satoshi Ideno, Shinichi Yamamoto, Fujiko Oda, Rie Wakamiya, Kana Ozawa, Haruka Kaneko, Taku Matsuoka, Atsushi Shinto, Hiromi Mikasa, Noriko Miyazawa
Congenital pulmonary vein stenosis (CPVS) is a rare fetal congenital heart disease with a prevalence of 1.7 per 100,000 children younger than two years of age. Because of the difficulty of maintaining the pulmonary blood flow, CPVS is associated with a 50% survival rate within five years of diagnosis. We describe a successful management of pulmonary blood flow for a 4-month-old-girl with CPVS, combined with atrial septal defect and ventricular septal defect, undergoing pulmonary vein obstruction release (PVOR)...
February 2015: Masui. the Japanese Journal of Anesthesiology
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