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Norwood transfusion

Darwin Ang, Stan Kurek, Mark McKenney, Scott Norwood, Brian Kimbrell, Erik Barquist, Huazhi Liu, Annette O'Dell, Michele Ziglar, James Hurst
Outpatient anticoagulation in the geriatric trauma patient is a challenging clinical problem. The aim of this study is to determine clinical outcomes associated with class of preinjury anticoagulants (PA) used by this population. This is a multicenter retrospective cohort study among four Level II trauma centers. A total of 1642 patients were evaluated; 684 patients were on anticoagulation and 958 patients were not. Patients on PA were compared with those who were not. Drug classes were divided into thromboxane A2 inhibitors, vitamin K factor-dependent inhibitors, antithrombin III activation, platelet P2Y12 inhibitors, and thrombin inhibitors...
June 1, 2017: American Surgeon
Wolfgang Boettcher, Nicodème Sinzobahamvya, Oliver Miera, Matthias Redlin, Frank Dehmel, Mi-Young Cho, Peter Murin, Felix Berger, Joachim Photiadis
A restrictive transfusion strategy led us to routinely try to conduct donor-blood free open-heart surgery even in neonates. The cardio-pulmonary bypass (CPB) circuit was minimized by priming volumina at 73 ml for the smallest patients with body weight up to 2.5 kg and 85-95 ml for those with body weight of more than 2.5 kg, and by positioning the console as close as possible to operation table. Measures were applied to save blood during the procedure. Transfusion threshold of 8 g/dl hemoglobin was retained...
April 2017: Pediatric Cardiology
Brett R Anderson, Victoria L Blancha, Jennifer M Duchon, Paul J Chai, David Kalfa, Emile A Bacha, Ganga Krishnamurthy, Veniamin Ratner
OBJECTIVES: Our primary objective was to test the effects of first postoperative hematocrit on early shunt occlusion for children undergoing systemic to pulmonary artery shunt placement. Because any intervention to reduce shunt occlusion is only beneficial if it reduces mortality or is, at least, mortality neutral, we also tested the effects of first postoperative hematocrit on in-hospital mortality. METHODS: We conducted a retrospective study on all neonates who underwent primary systemic to pulmonary artery shunt placement, with or without a Norwood/Damus-Kaye-Stansel procedure, at Columbia University Medical Center between January 2010 and July 2015...
April 2017: Journal of Thoracic and Cardiovascular Surgery
Jill M Cholette, Michael F Swartz, Jeffrey Rubenstein, Kelly F Henrichs, Hongyue Wang, Karen S Powers, L Eugene Daugherty, George M Alfieris, Francisco Gensini, Neil Blumberg
BACKGROUND: The optimal hemoglobin for infants after cardiac operation is unknown. Red blood cells (RBCs) are commonly transfused to maintain high hemoglobin concentrations in the absence of a clinical indication. We hypothesized that infants can be managed with a postoperative conservative RBC transfusion strategy, resulting in lower daily hemoglobin concentrations, without evidence of impaired oxygen delivery (ie, lactate, arteriovenous oxygen difference [avO2 diff]), or adverse clinical outcomes...
January 2017: Annals of Thoracic Surgery
Punkaj Gupta, Caitlin King, Lisle Benjamin, Timothy Goodhart, Michael J Robertson, Jeffrey M Gossett, Gina A Pesek, Rahul DasGupta
The objective of this study was to investigate the association between red blood cell (RBC) transfusion and hematocrit values with outcomes in infants undergoing Norwood operation. This study included infants ≤2 months of age who underwent Norwood operation with either a modified Blalock-Taussig shunt or a right ventricle-pulmonary artery shunt. Demographics, preoperative, operative, daily laboratory data, and postoperative variables were collected. The primary outcome measures evaluated included mortality, ICU length of stay, length of mechanical ventilation, and days to chest closure...
August 2015: Pediatric Cardiology
Rahul Dasgupta, Andrew Parsons, Sarenthia Mcclelland, Elizabeth Morgan, Michael J Robertson, Tommy R Noel, Michael L Schmitz, Mallikarjuna Rettiganti, Punkaj Gupta
BACKGROUND: The aim of this study was to investigate the association between red blood cell (RBC) transfusion and haematocrit values with outcomes in infants with univentricular physiology undergoing surgery for a modified Blalock-Taussig shunt. MATERIAL AND METHODS: This study included infants ≤ 2 months of age who underwent modified Blalock-Taussig shunt surgery at the Arkansas Children's Hospital (2006-2012). Infants undergoing a Norwood operation or Damus-Kaye-Stansel operation with modified Blalock-Taussig shunt were excluded...
July 2015: Blood Transfusion, Trasfusione del Sangue
Rebecca L Townsend, Erin D Moritz, Lawrence B Fialkow, Victor Berardi, Susan L Stramer
BACKGROUND: Anaplasma phagocytophilum (AP), a tick-borne obligate intracellular bacterium, causes human granulocytic anaplasmosis (HGA) and has been implicated in seven transfusion-transmitted (TT)-HGA cases associated with red blood cells (RBCs). Here we report the first probable case of TT-HGA involving leukoreduced platelets (PLTs). CASE REPORT: A hospitalized male received 25 blood components (November 2012) before his death from trauma. Hospital testing confirmed HGA by peripheral blood smears; samples were also sent to IMUGEN, Inc...
November 2014: Transfusion
Stephanie L Siehr, Jana K Norris, Julie A Bushnell, Chandra Ramamoorthy, V Mohan Reddy, Frank L Hanley, Gail E Wright
BACKGROUND: From 2002 to 2005, the interstage mortality after a modified Norwood procedure was 7% in our program. An interstage home monitoring program (HMP) was established to identify Norwood procedure patients at increased risk of decompensation and to reduce interstage mortality. METHODS: Results of the first 5 years of the Norwood HMP were reviewed retrospectively. Interstage was defined as the time between Norwood hospital discharge and admission for second stage surgical palliation...
February 2014: Journal of Thoracic and Cardiovascular Surgery
Matthew J O'Connor, Curt Lind, Xinyu Tang, Jeffrey Gossett, Janice Weber, Dimitrios Monos, Robert E Shaddy
BACKGROUND: Allografts are used for vascular reconstruction in many forms of congenital heart disease. Although allografts induce anti-human leukocyte antibody (HLA) formation, much about this response is unknown. METHODS: Three groups of patients aged 8 to 18 years old underwent analysis for class I and II anti-HLA antibodies using Luminex. Groups were defined by timing of allograft exposure and diagnosis at Norwood for hypoplastic left heart syndrome (neonatal group), at Glenn for single-ventricle lesions not requiring arch reconstruction (infant group), and cardiac defects repaired during infancy without allografts (controls)...
April 2013: Journal of Heart and Lung Transplantation
Joseph Deptula, James Hammel, Kari George, John Detwiler, Kimberly Glogowski, Melinda Valleley, Kim Duncan
In the 30 years since Norwood described the palliative procedure for hypoplastic left heart syndrome (HLHS), many modifications have been described which have increased the survival rate of children born with this lesion. We describe further modifications which result in reduced cardiopulmonary bypass time, no cooling or circulatory arrest time, and decreased banked blood exposure. A 16-day-old infant with HLHS undiagnosed during pregnancy presented for stage 1 palliation incorporating the Mee modification, Sano right ventricle to pulmonary artery conduit, dual arterial cannulation of the innominate artery and descending aorta, single venous cannulation of the right atrium, and a bypass prime volume of 130 mL...
December 2011: Journal of Extra-corporeal Technology
Jaime Blackwood, Ari R Joffe, Charlene M T Robertson, Irina A Dinu, Gwen Alton, Karen Penner, David B Ross, Ivan M Rebeyka
BACKGROUND: Red blood cell transfusions may or may not improve oxygen delivery to the tissues. Some studies suggest transfusion might contribute to adverse outcomes. This study investigated the association between hemoglobin concentration and transfusion with outcome in cyanotic neonates undergoing Norwood operations. METHODS: Infants 6 weeks old or younger with hypoplastic left heart syndrome undergoing staged Norwood operations between September 1996 and July 2005 were included...
May 2010: Annals of Thoracic Surgery
Michael Huebler, Wolfgang Boettcher, Andreas Koster, Roland Hetzer, Peter Ewert, Felix Berger
Intraoperative stent implantation into a stenotic left pulmonary artery branch and surgical creation of a bidirectional Glenn anastomosis resulted in avoidance of aortic cross-clamping and transection of the aorta for surgical patching of the pulmonary artery. The hybrid approach thereby reduced the complexity of the surgical procedure, facilitated the use of a minimized cardiopulmonary bypass circuit, reduced the degree of hemodilution and blood trauma and resulted in transfusion-free surgery and excellent clinical outcome in an 11 kg child...
November 2007: Journal of Cardiac Surgery
Steven R Meyer, David B Ross, Karen Forbes, Lois E Hawkins, Anne M Halpin, Susan N Nahirniak, Jennifer M Rutledge, Ivan M Rebeyka, Patricia M Campbell
OBJECTIVE: Cryopreserved allograft tissue used in the Norwood procedure for infants with hypoplastic left heart syndrome causes profound immunologic sensitization, which may complicate future transplantation. Intravenous immunoglobulin has been shown to reduce sensitization after it has developed, allowing successful transplantation. The purpose of this pilot trial was to determine whether intravenous immunoglobulin given before and after the procedure could prevent sensitization to cryopreserved allograft patches used in the initial repair of hypoplastic left heart syndrome...
June 2007: Journal of Thoracic and Cardiovascular Surgery
Lindsay M Ryerson, Stephanie Burns Wechsler, Richard G Ohye
The Norwood procedure with a modified Blalock-Taussig shunt (MBTS) is the first of the three-stage surgical palliation for infants with hypoplastic left heart syndrome. We report a patient with schistocytic hemolytic anemia that developed following a right MBTS with a Gore-Tex graft. Hemolysis associated with a MBTS has not been previously reported in the literature. Multiple packed red blood cell transfusions were required due to desaturation and hypoxemia. Hemi-Fontan procedure was performed early for chronic anemia...
May 2007: Pediatric Cardiology
M Emmel, N Sreeram, F Pillekamp, W Boehm, K Brockmeier
UNLABELLED: We report on our experience with transhepatic access for catheter interventions in six children (age range 2.5 months-9 years). Three had systemic venous anomalies, and one infant a femoral venous occlusion. In two further patients with bradyarrhythmia after a Fontan operation with an intraatrial Gore-Tex tunnel, transhepatic access was chosen to achieve a perpendicular orientation of the transseptal needle to the atrial baffle, allowing puncture of the Gore-Tex membrane. Two of the patients underwent ablation of an accessory pathway; in one an atrial septal defect was closed...
June 2006: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
(no author information available yet)
No abstract text is available yet for this article.
January 15, 1991: North Eastern Reporter. Second Series
Richard J Forest, Robert C Groom, Reed Quinn, Jon Donnelly, Cantwell Clark
The care of patients who refuse homologous transfusions has challenged cardiac surgery teams to refine blood conservation techniques and question standard transfusion practices. We cared for a newborn child with hypoplastic left heart syndrome (HLHS) whose parents refused to give consent to care for the child that involved the transfusion of homologous blood. A Norwood Stage I procedure was planned with the understanding that transfusions would be avoided, if possible. A court order was obtained that specified the conditions under which the attending physicians would transfuse the newborn...
May 2002: Perfusion
H Uemura, T Yagihara, K Yamashita, T Ishizaka, K Yoshizumi, Y Kawahira
OBJECTIVE: To minimize deleterious postoperative influences of cardiopulmonary bypass on the pulmonary circulation immediately after the Fontan type procedure, total cavopulmonary connection was achieved without use of cardiopulmonary bypass. METHODS: Since April 1996, 15 patients including five patients with visceral heterotaxy, in whom no intracardiac procedure was needed, have undergone this operative maneuver. Age at operation ranged from 1.2 to 44.6 years. Construction of a systemic to pulmonary shunt had been previously employed in seven patients, banding of the pulmonary trunk in two patients, and the Norwood procedure in one patient...
May 1998: European Journal of Cardio-thoracic Surgery
I Steiman, C Norwood, S Charache
Measurement of the proportion of abnormal hemoglobin in a hemolysate is essential for differentiation of simple and compound heterozygotes (e.g., sickle cell trait vs. sickle thalassemia), for differential of alpha- and beta-thalassemia in compound heterozygotes, and for differentiation of various types of beta-thalassemia in such persons. Utilization of such measurements is hampered by the imprecision and inconvenience of current methods. We have adapted a readily available agar electrophoresis method for this purpose, scanning unstained gels at 420 nm...
March 1985: Journal of Laboratory and Clinical Medicine
C S Manno, K W Hedberg, H C Kim, G R Bunin, S Nicolson, D Jobes, E Schwartz, W I Norwood
In a double-blind study, we compared the postoperative (post-op) blood loss in 161 children undergoing open heart surgery with cardiopulmonary bypass whose immediate post-op transfusion requirements were met with either very fresh whole blood (VFWB), 24- to 48-hour-old whole blood or reconstituted whole blood (packed red blood cells, fresh frozen plasma [FFP], and platelets). Assignment to treatment groups was not strictly random but dependent, in part, on the ability of families to provide directed donors for fresh blood...
March 1, 1991: Blood
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