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Management of cyanotic congenital heart disease

https://read.qxmd.com/read/38495662/high-risk-congenital-heart-disease-in-pregnancy
#1
REVIEW
Saurabh Rajpal, Carla P Rodriguez
High-risk congenital heart disease (CHD) in pregnancy presents a complex clinical challenge. With improved medical care and increased survival rates, a growing population of adults with complex CHD are surviving to adulthood, including women of reproductive age. This chapter focuses on risk stratification and management of pregnant women with high-risk CHD, emphasizing the importance of considering both anatomical and physiological complexity. Maternal physiological changes, such as blood volume increase, cardiac output changes, and alterations in vascular resistance, can significantly impact high-risk CHD patients...
2024: Methodist DeBakey Cardiovascular Journal
https://read.qxmd.com/read/38447536/cyanotic-nephropathy-in-an-adult-patient-with-eisenmenger-syndrome-a-case-report-and-literature-review
#2
Fanyou Zhu, Rui Wen, Xiangling Tan, Hongjun Nie, Jiali Li, Qi Wang, Jiao Qin
INTRODUCTION: Cyanotic nephropathy, a rare disease characterized by proteinuria, decreased estimated glomerular filtration rate (eGFR), thrombocytopenia, polycythemia, and hyperuricemia, may occasionally be secondary to cyanotic congenital heart disease. There are currently no detailed diagnostic criteria or treatments for cyanotic nephropathy owing to its extremely low incidence. Eisenmenger syndrome (ES) was initially defined by Paul Wood in pathophysiologic terms as "pulmonary hypertension (PH) at the systemic level, caused by a high pulmonary vascular resistance (PVR), with a reversed or bidirectional shunt at aorto-pulmonary, ventricular, or atrial level...
March 6, 2024: Kidney & Blood Pressure Research
https://read.qxmd.com/read/38428677/anesthetic-management-of-pulmonary-artery-banding-in-adult-patient-with-single-ventricle-and-uncorrected-transposition-of-the-great-arteries
#3
M Ribas Ball, M de Miguel Negro, P Galán Menéndez, L Dos Subirà, M A Castro Alba, G Martí Aguasca
Pulmonary artery banding (PAB) is a procedure mainly performed during the neonatal period as an initial stage to definitive palliative reconstruction, a scenario in which the criteria for banding adjustment are well defined. However, the indication for BAP in the adult is extraordinarily rare, even more in patients with single ventricle and unrepaired transposition of the great arteries (TGA), and there are no established criteria for banding adjustment. Due to the small number of these procedures, there is limited experience in their anesthetic management and complications...
February 28, 2024: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/38406017/management-of-unrepaired-tetralogy-of-fallot-in-an-86-year-old-patient-undergoing-transcatheter-aortic-valve-replacement
#4
Armish Singh, Samantha Arzillo, Kevin Ergle
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect, typically requiring early treatment in infancy. Untreated TOF is associated with poor survival, with most uncorrected patients not surviving beyond the third decade. Here, we present a unique case of an 86-year-old female with uncorrected TOF who underwent a transcatheter aortic valve replacement (TAVR) procedure due to severe aortic stenosis (AS). The patient's TOF was identified during infancy, and she was categorized as an acyanotic "pink baby...
January 2024: Curēus
https://read.qxmd.com/read/38376703/tetralogy-of-fallot-with-vertebral-defect-and-left-aberrant-subclavian-artery-a-rare-occurrence
#5
JOURNAL ARTICLE
Marya Hameed, Muhammad Fazal Hussain Qureshi
BACKGROUND: The most prevalent cyanotic congenital heart disease is Tetralogy of Fallot (TOF). It has a variety of presentations and is made up of four anatomic abnormalities. Documented literature shows an incidence of 13-20% of a right aortic arch with an anomalous left subclavian artery among individuals diagnosed with TOF. This is the first case that discusses the rare occurrence of overriding of the aortic arch along with the left aberrant subclavian artery and vertebral defect in a 3-week-old girl...
February 20, 2024: Egyptian Heart Journal: EHJ
https://read.qxmd.com/read/38356351/fetomaternal-outcomes-in-pregnant-women-with-congenital-heart-disease-a-comparative-analysis-from-an-apex-institute
#6
JOURNAL ARTICLE
Soniya Dhiman, Aparna Sharma, Akanksha Gupta, Richa Vatsa, Juhi Bharti, Vidushi Kulshrestha, Satyavir Yadav, Vatsla Dadhwal, Neena Malhotra
OBJECTIVE: With advancements in cardiac surgical interventions during infancy and childhood, the incidence of maternal congenital heart disease (CHD) is increasing. This retrospective study compared fetal and cardiac outcomes in women with and without CHD, along with a sub-analysis between cyanotic versus non-cyanotic defects and operated versus non-operated cases. METHODS: A 10-year data were retrospectively collected from pregnant women with CHD and a 1:1 ratio of pregnant women without any heart disease...
February 15, 2024: Obstetrics & Gynecology Science
https://read.qxmd.com/read/38348778/dabigatran-for-treatment-and-secondary-prevention-of-venous-thromboembolism-in-pediatric-congenital-heart-disease
#7
JOURNAL ARTICLE
Manuela Albisetti, Igor Tartakovsky, Jacqueline Halton, Lisa Bomgaars, Elizabeth Chalmers, Lesley G Mitchell, Matteo Luciani, Ildar Nurmeev, Kirill Gorbatikov, Corinna Miede, Martina Brueckmann, Leonardo R Brandão
BACKGROUND: Congenital heart disease (CHD) is common in children and associated with greater risk of thrombotic complications. Management of these complications with standard-of-care treatment is suboptimal for these children. METHODS AND RESULTS: The effectiveness and safety of dabigatran were demonstrated in pivotal pediatric studies for the treatment of acute venous thromboembolism (VTE; NCT01895777) and secondary VTE prevention (NCT02197416). We report safety and efficacy outcomes from subgroup analyses of these studies for children with CHD (diagnosed according to local practice) and those without...
February 13, 2024: Journal of the American Heart Association
https://read.qxmd.com/read/38236921/quality-of-life-in-arab-children-with-congenital-heart-disease
#8
JOURNAL ARTICLE
Latefa Ali Dardas, Wei Pan, Ahmad Imad Hamdan, Raghed Abdel Hay Abu Jabeh, Ahmad Eid Ashakhanba, Omar Sami Abdelhai, Mohammad Naim Abid, Hashim Ahmad Mohammad, Iyad Al-Ammouri
BACKGROUND AND PURPOSE: Management strategies for children with congenital health diseases (CHDs) should encompass more than just the medical aspect of the disease and consider how heart diseases affect their everyday activities and, subsequently, their quality of life (QoL). Global studies witnessed a greater emphasis on studying the QoL associated with CHD. However, there is still a great lag in such data in the Arab region. The purpose of this study was to evaluate QoL in children with CHD using an Arab sample from Jordan...
2024: PloS One
https://read.qxmd.com/read/38161671/pregnancy-considerations-in-tetralogy-of-fallot
#9
REVIEW
Maria L Garagiola, Sara A Thorne
The majority of women with repaired tetralogy of Fallot are able to tolerate pregnancy with a low risk of cardiovascular events. However, proactive contraceptive advice, prepregnancy counselling, and care by a pregnancy heart team with expertise in congenital heart disease are key to ensuring a good outcome for mother and baby. Maternal and fetal risks are increased in the presence of severe valvular stenosis, poorly tolerated arrhythmia, significant ventricular dysfunction, and cyanosis. It is unusual to see cyanotic adults with tetralogy of Fallot, whether unoperated or shunt palliated; pregnancy risks are greatly reduced by completing their repair before pregnancy is undertaken...
December 2023: CJC Pediatr Congenit Heart Dis
https://read.qxmd.com/read/38021873/bacterial-brain-abscesses-in-a-patient-with-transposition-of-the-great-arteries-and-interventricular-communication
#10
Ana K Gómez-Gutiérrez, Araceli Morelos-Ulibarri, Daniela Trejo-Ponce de Leon, Carla D Gomez-Flores, Eder Luna-Ceron
Brain abscesses are localized infections in the brain's parenchyma, characterized by inflammation, pus formation, and the development of a surrounding capsule. These lesions typically occur due to underlying factors such as immunosuppression, ear and sinus infections, and contamination during neurosurgery. While brain abscesses are a life-threatening complication of cyanotic heart defects, they are rarely reported, with only sporadic cases previously documented. This article presents the case of an eight-year-old male patient with an uncorrected transposition of the great arteries, who was evaluated for symptoms including headache, fever, and neurological focalization...
October 2023: Curēus
https://read.qxmd.com/read/37861587/complex-cyanotic-congenital-heart-disease-and-cervical-spine-surgery-ticking-all-the-right-boxes
#11
Sanjay Jaswal, Vinitha Narayan, Punith Gowda, Shalvi Mahajan
Although complex congenital heart disease (CHD) patients usually present in childhood, it is not rare to see adults well past middle age. These patients undergo continuous pathophysiological changes in their heart and blood vessels, making anesthetic management more challenging if surgery is required. Herein, we report a case in which understanding the anatomy and pathophysiology helped optimally manage a patient with a double outlet right ventricle (DORV) who underwent plating and fixation for a hangman's fracture in the prone position...
2023: Annals of Cardiac Anaesthesia
https://read.qxmd.com/read/37854257/unobstructed-infracardiac-total-anomalous-pulmonary-venous-connection-in-a-7-month-old-infant-a-rare-case-report
#12
Eman Shhada, Ali Alakbar Nahle, Hussein Hamdar, Ali Jawad, Hasan Hasan, Mohammad Shadi Hamra, Mohannad Saleh, Alwaleed Al-Dairy, Huda Daood
KEY CLINICAL MESSAGE: This case underscores the importance of early detection and treatment for total anomalous pulmonary venous connection, a rare congenital heart condition, through comprehensive newborn physical exams and prompt specialist referrals. ABSTRACT: Total anomalous pulmonary venous connection (TAPVC) is a rare form of congenital heart disease that is typically diagnosed in neonates. TAPVC has four subtypes, with the infracardiac type at risk of obstruction...
October 2023: Clinical Case Reports
https://read.qxmd.com/read/37841993/the-utility-of-invengenx%C3%A2-bovine-patch-for-right-ventricular-outflow-tract-rvot-reconstruction-and-augmentation-in-the-surgical-management-of-tetralogy-of-fallot-tof-a-contemporary-study-and-review-of-the-literature
#13
JOURNAL ARTICLE
Vishal V Bhende, Tanishq S Sharma, Mathangi Krishnakumar, Anikode Subramanian Ramaswamy, Kanchan Bilgi, Sohilkhan R Pathan
Background and objective Complex congenital heart diseases (CHDs), such as the tetralogy of Fallot (TOF), often warrant reconstruction and augmentation of the right ventricular outflow tract (RVOT). This procedure requires the use of both synthetic and natural materials. However, finding the ideal material for tissue implants can be challenging. Biological materials often face issues such as tissue degeneration, calcium deposition, antigenicity, rejection, shrinkage, and fibrosis. These issues can lead to complications such as stenosis and insufficiency, potentially requiring early reoperations...
October 2023: Curēus
https://read.qxmd.com/read/37824153/red-blood-cell-transfusion-2023-aabb-international-guidelines
#14
JOURNAL ARTICLE
Jeffrey L Carson, Simon J Stanworth, Gordon Guyatt, Stacey Valentine, Jane Dennis, Sara Bakhtary, Claudia S Cohn, Allan Dubon, Brenda J Grossman, Gaurav K Gupta, Aaron S Hess, Jessica L Jacobson, Lewis J Kaplan, Yulia Lin, Ryan A Metcalf, Colin H Murphy, Katerina Pavenski, Micah T Prochaska, Jay S Raval, Eric Salazar, Nabiha H Saifee, Aaron A R Tobian, Cynthia So-Osman, Jonathan Waters, Erica M Wood, Nicole D Zantek, Monica B Pagano
IMPORTANCE: Red blood cell transfusion is a common medical intervention with benefits and harms. OBJECTIVE: To provide recommendations for use of red blood cell transfusion in adults and children. EVIDENCE REVIEW: Standards for trustworthy guidelines were followed, including using Grading of Recommendations Assessment, Development and Evaluation methods, managing conflicts of interest, and making values and preferences explicit. Evidence from systematic reviews of randomized controlled trials was reviewed...
November 21, 2023: JAMA
https://read.qxmd.com/read/37802594/anaesthesia-of-a-parturient-with-uncorrected-pentalogy-of-fallot-undergoing-caesarean-section-and-postpartum-sterilisation
#15
JOURNAL ARTICLE
Rachel Wei-Li Leong, Jinghui Chen, Abey Matthew Varughese Mathews, Harikrishnan Kothandan
Pentalogy of Fallot is a rare congenital cyanotic heart disease; few patients with uncorrected disease survive to childbearing age. Cardiovascular changes during pregnancy and delivery can lead to haemodynamic instability, while anaesthesia can cause right-to-left shunting and worsen hypoxaemia.We present the learning points from the anaesthetic management of an obstetric patient with uncorrected pentalogy of Fallot. We describe the successful application of general anaesthesia, choice of transoesophageal echocardiography for real-time haemodynamic monitoring and management, and the comprehensive multidisciplinary care of this high cardiovascular risk obstetric patient perioperatively...
October 6, 2023: BMJ Case Reports
https://read.qxmd.com/read/37716810/managing-tetralogy-of-fallot-during-interhospital-transfers
#16
REVIEW
Roger L Layell, Kory A Lane
Pediatric and neonatal critical care providers involved in transport run calls involving patients diagnosed with Tetralogy of Fallot, which can occasionally be a challenge for some providers. Making up around 10% of all congenital heart defects, inevitably makes Tetralogy of Fallot (TOF) the most common of all the cyanotic congenital heart diseases. There are some transport teams that do not have the capability and invasive equipment that a referring hospital may have to manage these high acuity low volume patients...
2023: Air Medical Journal
https://read.qxmd.com/read/37632152/unrepaired-tetralogy-of-fallot-in-a-71-years-old-woman-a-case-report-and-review-of-the-literature
#17
Fereshteh Ghaderi, Tooba Kazemi, Amir Masoud Jafari-Nozad
Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease (CHD) in infants. The four components that constitute ToF are an overriding aorta over the crest of the interventricular septum, obstruction in the right ventricular outflow tract, right ventricular hypertrophy, and a typically large non-restricted ventricular septal defect. ToF may also be associated with other extracardiac abnormalities, including patent ductus arteriosus or multiple aortopulmonary collateral arteries, which can impact the patient's survival...
August 25, 2023: Echocardiography
https://read.qxmd.com/read/37568344/infective-endocarditis-among-pediatric-patients-with-prosthetic-valves-and-cardiac-devices-a-review-and-update-of-recent-emerging-diagnostic-and-management-strategies
#18
REVIEW
Mohamed Dardari, Eliza Cinteza, Corina Maria Vasile, Paul Padovani, Radu Vatasescu
Infective endocarditis (IE) is a disease of the endocardium, which leads to the appearance of vegetation on the valves, cardiac structures, or, potentially, vascular endothelium of the heart. The risk of IE can be increased more than 140 times by congenital heart disease (50-59% of all IE), particularly if cyanotic. An increase in mortality may result from IE in patients with a complex cardiac pathology or patients with an implanted prosthetic material, most frequently conduits in a pulmonary position. Cardiac implantable electronic devices (CIED) infective endocarditis is a life-threatening complication representing 10% of all cases of endocarditis...
July 27, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37543567/large-cameral-coronary-artery-fistula-in-a-5%C3%A2-months-old-infant-with-unusual-presentation-and-fatal-outcome-case-report
#19
JOURNAL ARTICLE
Tamirat Moges, Hayat Ahmed, Azmeraw Gisila
BACKGROUND: Congenital coronary fistulas (CAFs) are uncommon abnormalities communicating the coronary arteries with the cardiac chambers or portion of the systemic or pulmonary circulation. Over 90% of the cases drain into the right side of the heart with only 3% terminating in the left ventricle. Infants with a large CAFs may develop congestive heart failure. CASE PRESENTATION: A 5 months old female infant presented with labored breathing and worsening of bluish discoloration of the lips and extremities following a prolonged cry...
August 5, 2023: BMC Pediatrics
https://read.qxmd.com/read/37489199/perioperative-management-of-emergency-craniotomes-in-children-with-cyanotic-congenital-heart-disease-a-case-series
#20
Chandan K Dey, Varun Anand, Mussavvir Agha, Habib Md R Karim, Pharanitharan N, Chinmaya K Panda, Manu P Kesavankutty
While congenital heart disease is not uncommon, cyanotic congenital heart disease (CCHD) accounts for a minor fraction of them. However, when cyanosis is present, it usually indicates a severe or critical illness. Tetralogy of Fallot (TOF) is one of the common CCHDs, representing 7-10% of all congenital cardiac malformations. Double-outlet right ventricle (DORV) is another CCHD similar to the TOF and associated with decreased pulmonary flow, ventricular septal defect (VSD), and aorta receiving blood from both ventricles...
June 2023: Curēus
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