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https://www.readbyqxmd.com/read/29116689/evaluation-of-hemodynamic-performance-of-total-cavopulmonary-connection-tcpc-with-porous-inserts
#1
K Dhayananth, Arunn Narasimhan
Infants born with univentricular heart disease undergo Fontan surgery in order to establish separate systemic and pulmonary circulations. This surgery results in better blood circulation across a single ventricle that supplies oxygenated blood to the body and passively returns venous blood to the lungs through the total cavopulmonary connection (TCPC). Reducing the pressure drop across the TCPC during Fontan circulation helps in reducing the work load of univentricular heart and various designs have been proposed for this purpose...
November 8, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29104017/neurodevelopmental-outcome-and-health-related-quality-of-life-in-children-with-single-ventricle-heart-disease-before-fontan-procedure
#2
Bettina Reich, Kristina Heye, Ruth Tuura, Ingrid Beck, Kristina Wetterling, Andreas Hahn, Karoline Hofmann, Dietmar Schranz, Hakan Akintürk, Beatrice Latal, Walter Knirsch
OBJECTIVE: Neurodevelopmental impairment and impaired quality of life constitute a major source of morbidity among children with complex congenital heart disease (CHD), in particular for single ventricle morphologies. Risk factors and quality of life determining clinical and neurodevelopmental outcome at two years of age are examined. METHODS: In a two-center cohort study, 48 patients with SV-morphology (26 HLHS, 22 other types of univentricular heart defect) have been examined prior Fontan procedure between 2010 and 2015...
November 2, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29084001/assessing-the-borderline-ventricle-in-a-term-infant-combining-imaging-and-physiology-to-establish-the-right-course
#3
Meryl S Cohen
PURPOSE OF REVIEW: The purpose of this review is to describe the challenges associated with the diagnosis and treatment of children with borderline ventricles. A borderline ventricle is one in which there is concern that it will not be able to support its circulation. If a biventricular repair is attempted and fails, outcome is often poor. Thus, this early decision is important. RECENT FINDINGS: For the borderline right ventricle, options to add an additional source of pulmonary blood flow make the surgical strategy a bit more flexible than for patients with a borderline left ventricle...
October 27, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29049818/dor-procedure-for-pulmonary-atresia-with-intact-ventricular-septum-in-an-infant
#4
Yoonjin Kang, Jae Gun Kwak, Eung Rae Kim, Woong-Han Kim
Pulmonary atresia with intact ventricular septum and right ventricle-dependent coronary circulation confers a high risk for myocardial infarction and complications of ischaemia, including left ventricle aneurysms. We describe an infant with pulmonary atresia with intact ventricular septum and right ventricle-dependent coronary circulation and a left ventricle apical aneurysm who successfully underwent the Dor procedure and a subsequent Fontan operation. Surgery for postinfarction left ventricle aneurysm can be considered in infants...
September 2, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28928608/intraocular-pressure-in-children-after-congenital-heart-surgery-a-single-center-study
#5
Sunali Goyal, Paul H Phillips, Lamonda A Corder, Michael J Robertson, Xiomara Garcia, Michael L Schmitz, Punkaj Gupta
BACKGROUND: The impact of varied cardiac physiologies on intraocular pressure (IOP) among children undergoing heart operations is unknown. AIM: The aim of this study was to determine the IOP among children with varying cardiovascular physiologies and varying hemodynamics after their heart operation. SETTING AND DESIGN: This was a prospective, observational study. MATERIALS AND METHODS: Patients ≤18 years undergoing congenital heart surgery were included in this study...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28928606/quantification-of-ventricular-unloading-by-3d-echocardiography-in-single-ventricle-of-left-ventricular-morphology-following-superior-cavo-pulmonary-anastomosis-and-fontan-completion-a-feasibility-study
#6
Deepa Sasikumar, Bijulal Sasidharan, Baiju S Dharan, Arun Gopalakrishnan, Kavasseri M Krishnamoorthy, Sivasubramanian Sivasankaran
BACKGROUND: Three-dimensional echocardiography. (3DE) is comparable to cardiac magnetic resonance imaging for estimating ventricular volume in congenital heart diseases. However, there are limited data on estimation of ventricular volumes by 3DE in univentricular heart and change in ventricular volumes after surgical creation of cavopulmonary connection. We sought to quantify the unloading of the single ventricle of left ventricular. (LV) morphology by 3DE after superior cavopulmonary anastomosis...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28904256/current-surgical-outcomes-of-congenital-heart-surgery-for-patients-with-down-syndrome-in-japan
#7
Takaya Hoashi, Norimichi Hirahara, Arata Murakami, Yasutaka Hirata, Hajime Ichikawa, Junjiro Kobayashi, Shinichi Takamoto
BACKGROUND: Current surgical outcomes of congenital heart surgery for patients with Down syndrome are unclear.Methods and Results:Of 29,087 operations between 2008 and 2012 registered in the Japan Congenital Cardiovascular Surgery Database (JCCVSD), 2,651 were carried out for patients with Down syndrome (9%). Of those, 5 major biventricular repair procedures [ventricular septal defect repair (n=752), atrioventricular septal defect repair (n=452), patent ductus arteriosus closure (n=184), atrial septal defect repair (n=167), tetralogy of Fallot (TOF) repair (n=108)], as well as 2 major single ventricular palliations [bidirectional Glenn (n=21) and Fontan operation (n=25)] were selected and their outcomes were compared...
September 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28889811/cardiovascular-ct-for-evaluation-of-single-ventricle-heart-disease-risks-and-accuracy-compared-with-interventional-findings
#8
B Kelly Han, Marnie Huntley, David Overman, Dawn Witt, David Dassenko, Ross F Garberich, John R Lesser
OBJECTIVE: We sought to evaluate the risk and image quality from cardiovascular CT in patients across all stages of single-ventricle palliation, and to define accuracy by comparing findings with intervention and surgery. METHODS: Consecutive CT scans performed in patients with single-ventricle heart disease were retrospectively reviewed at a single institution. Diagnosis, sedation needs, estimated radiation dose, and adverse events were recorded. Anatomical findings, image quality (1-4, 1=optimal), and discrepancy compared with interventional findings were determined...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28884283/clinical-outcomes-of-early-scheduled-fontan-completion-following-kawashima-operation
#9
Takashi Kido, Takaya Hoashi, Masatoshi Shimada, Hideo Ohuchi, Kenichi Kurosaki, Hajime Ichikawa
OBJECTIVES: This study reviewed late clinical features after Kawashima operation to confirm the impact of scheduled subsequent early Fontan completion. METHODS: Of the 17 consecutive patients who underwent the Kawashima operation between 1987 and 2010, 11 underwent the procedure as inter-stage palliation (scheduled Fontan group). Ten of these patients underwent subsequent early Fontan completion after a median interval of 0.6 years. The remaining 6 patients underwent the Kawashima operation initially as definitive surgery (non-scheduled group)...
September 7, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28881280/a-computational-study-of-the-fontan-circulation-with-fenestration-or-hepatic-vein-exclusion
#10
Charles Puelz, Sebastián Acosta, Béatrice Rivière, Daniel J Penny, Ken M Brady, Craig G Rusin
Fontan patients may undergo additional surgical modifications to mitigate complications like protein-losing enteropathy, liver cirrhosis, and other issues in their splanchnic circulation. Recent case reports show promise for several types of modifications, but the subtle effects of these surgeries on the circulation are not well understood. In this paper, we employ mathematical modeling of blood flow to systematically quantify the impact of these surgical changes on extracardiac Fontan hemodynamics. We investigate two modifications: (1) the fenestrated Fontan and (2) the Fontan with hepatic vein exclusion...
October 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28879464/prevalence-of-subclinical-enteric-alpha-1-antitrypsin-loss-in-children-with-univentricular-circulation-following-total-cavopulmonary-connection
#11
Colm R Breatnach, Aoife Cleary, Terence Prendiville, Kathleen Crumlish, Helene Murchan, Colin J McMahon
Protein-Losing Enteropathy post Fontan palliation is associated with significant morbidity and mortality. To date, very little research has been carried out to improve early identification of enteric protein loss in these patients. We hypothesise that subclinical enteric protein loss may occur in patients post Fontan surgery. A cross-sectional study was performed on 43 patients post Fontan surgery. We collected specimens of stool and blood from patients with no symptoms of protein-losing enteropathy post Fontan...
September 6, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28831564/post-operative-outcomes-in-children-undergoing-fontan-palliation-in-a-regionalized-surgical-system
#12
Billie-Jean Martin, David B Ross, Mohammed Al Aklabi, Joyce Harder, John D Dyck, Ivan M Rebeyka
Evidence suggests that outcomes in pediatric cardiac surgery are improved by consolidating care into centers of excellence. Our objective was to determine if outcomes are equivalent in patients across a large regional referral base, or if patients from centers without on-site surgery are at a disadvantage. Since 1996, all pediatric cardiac surgery has been offered at one of two centers within the region assessed, with the majority being performed at Stollery Children's Hospital. All patients who underwent a Fontan between 1996 and 2016 were included...
August 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28793902/30-year-experience-of-fontan-surgery-single-centre-s-data
#13
Laurynas Bezuska, Virgilijus Lebetkevicius, Rita Sudikiene, Daina Liekiene, Virgilijus Tarutis
BACKGROUND: The Fontan procedure has been modified several times since it was introduced into practice in 1968. As many patients now survive to adulthood, attention is directed towards their clinical status and late morbidity. We report our surgical experience of 30 years in Fontan procedures. METHODS: From January 1985 to January 2015, 80 patients underwent Fontan surgery. Twenty-one patients received an atrio-pulmonary Fontan (Group I), four patients underwent total cavopulmonary connection (TCPC) with an intra-atrial lateral tunnel (Group II), six patients received extra-cardiac TCPC with an aortic homograft (group III) and 49 patients received extra-cardiac TCPC with an expanded polytetrafluoroethylene conduit...
August 9, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28783102/the-pulmonary-circulation-in-the-single-ventricle-patient
#14
REVIEW
Amanda Hauck, Nicolas Porta, Steven Lestrud, Stuart Berger
In recent decades, survival of children with complex congenital heart disease has improved considerably. Specifically, children with a variety of congenital heart defects resulting in 'single ventricle' physiology can now undergo palliative surgery that allows survival beyond the neonatal period, and in many cases into adulthood, despite having a single functional ventricular pumping chamber supplying both the pulmonary and systemic circulation. Our growing understanding of the functionally univentricular heart has resulted in freedom from Fontan failure of >50% at 25 years post-Fontan...
August 7, 2017: Children
https://www.readbyqxmd.com/read/28761995/intermediate-term-thrombotic-risk-in-contemporary-total-cavo-pulmonary-connection-for-single-ventricle-circulations
#15
Jenna M Faircloth, Olivia Roe, Tarek Alsaied, Joseph S Palumbo, Alexander Vinks, Gruschen R Veldtman
Despite the common occurrence of thrombosis in Fontan circulations, the mid-term thrombotic risk beyond the first two postoperative years is poorly defined especially in total cavo pulmonary Fontan. This study examines the thrombotic incidence and risk beyond the first 2 years after contemporary Fontan surgery. Using a retrospective cohort study design, 89 Fontan patients, 50 male, were included and evaluated with a median of 8.3 years (IQR 6.8-11.4) follow-up. Hospital records were reviewed for known risk factors of thrombosis, thrombotic events, antiplatelet and anticoagulation management, and basic characteristics...
October 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28730300/health-related-quality-of-life-in-paediatric-patients-with-congenital-heart-defects-association-with-the-type-of-heart-defect-and-the-surgical-technique
#16
A Heusch, H J Kahl, K O Hensel, G Calaminus
The aim of the study was to investigate the impact of a number of surgical interventions for a various congenital cardiac defects (CHDs) on self-reported HRQoL. METHODS: Patients who had received corrective surgery of several congenital heart defects (surgical VSD closure, Fallot, TGA after atrial or arterial switch or Fontan-type circulation for univentricular AV-connection) were interviewed in the office of their home peadiatric cardiologist. HRQoL in children along 7 dimensions was assessed using a standardised questionnaire (PEDQoL); information on the medical case history of each respondent was also collected...
November 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28702716/can-the-pulmonary-artery-wedge-pressure-be-used-reliably-as-a-surrogate-for-the-left-atrial-mean-pressure-in-pre-fontan-evaluation
#17
Bassel Mohammad Nijres, Ra-Id Abdulla, Sawsan Awad, Joshua Murphy
The correlation between mean pulmonary artery wedge pressure (PAWP) and left atrial mean pressure (LAMP) has been poorly studied in patients with single ventricle (SV) physiology (Bernstein et al. in Pediatr Cardiol 33: 15-20 2012). The aim of this study is to determine if the PAWP can be used safely as a surrogate to the LAMP to calculate the pulmonary vascular resistance (PVR) during the pre-Fontan evaluation. Also, we aimed to understand if the presence of significant systemic-to-pulmonary collaterals (SPCs) is a confounding factor for accurate estimation of the LAMP...
July 12, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28651677/influence-of-weight-at-the-time-of-first-palliation-on-survival-in-patients-with-a-single-ventricle
#18
Sushitha Surendran, T K Susheel Kumar, Ben Tansey, Jerry Allen, David Zurakowski, Umar Boston, Samir H Shah, Christopher J Knott-Craig
BACKGROUND: Numerous advances in surgical techniques and understanding of single-ventricle physiology have resulted in improved survival. We sought to determine the influence of various demographic, perioperative, and patient-specific factors on the survival of single-ventricle patients following stage 1 palliation at our institution. METHODS: We conducted a retrospective study of all single-ventricle patients who had undergone staged palliation at our institution over an 8-year period...
June 27, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28651669/gastrointestinal-haemorrhage-due-to-lymphangiectasia-caused-by-protein-losing-enteropathy-in-the-fontan-circulation
#19
Pauline Gras, Frédéric Gottrand, François Godart
We report the case of a 14-year-old boy with severe protein-losing enteropathy after Fontan surgery that led to lymphangiectasia, which caused gastrointestinal haemorrhage and required invasive treatment to stop the bleeding. Through this case and a review of the literature on protein-losing enteropathy after Fontan surgery, we highlight a rare and serious presentation of the disease and the difficulties of diagnosis and management.
October 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28649147/multiblock-high-order-large-eddy-simulation-of-powered-fontan-hemodynamics-towards-computational-surgery
#20
Yann T Delorme, Mark D Rodefeld, Steven H Frankel
Children born with only one functional ventricle must typically undergo a series of three surgeries to obtain the so-called Fontan circulation in which the blood coming from the body passively flows from the Vena Cavae (VCs) to the Pulmonary Arteries (PAs) through the Total Cavopulmonary Connection (TCPC). The circulation is inherently inefficient due to the lack of a subpulmonary ventricle. Survivors face the risk of circulatory sequelae and eventual failure for the duration of their lives. Current efforts are focused on improving the outcomes of Fontan palliation, either passively by optimizing the TCPC, or actively by using mechanical support...
January 17, 2017: Computers & Fluids
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