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https://www.readbyqxmd.com/read/28434546/surgical-strategy-toward-biventricular-repair-for-severe-ebstein-anomaly-in-neonates-and-infancy
#1
Shu-Chien Huang, En-Ting Wu, Shyh-Jye Chen, Chi-Hsiang Huang, Jin-Chung Shih, Hen-Wen Chou, Chung-I Chang, Ing-Sh Chiu, Yih-Sharng Chen
BACKGROUND: Neonates with severe forms of Ebstein anomaly present a surgical challenge, and the Starnes operation as single ventricle palliation is highly advocated. Cone reconstruction for tricuspid valvuloplasty (TVP) has become a widely accepted technique, although very few cases of TVP have been reported in neonates. This report describes a surgical strategy for neonatal Ebstein anomaly, with an aim toward biventricular repair. METHODS: Since 2007, 7 neonates or young infants with severe Ebstein anomalies have received TVP at the National Taiwan University Hospital, Taipei, Taiwan...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#2
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
May 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27958617/results-of-the-fontan-operation-with-no-early-mortality-in-248-consecutive-patients
#3
MULTICENTER STUDY
Edward Malec, Christoph Schmidt, Anja Lehner, Katarzyna Januszewska
BACKGROUND: The Fontan operation has undergone several modifications and today is the primary way to treat a broad spectrum of congenital heart defects. AIM: The purpose of this study is to present the results of treatment of children with a single ventricle operated by the same surgical team and managed according to a uniform strategy. METHODS: In the years 2007-2015, in 248 children aged 3.7 ± 2.6 years and weighing 14.6 ± 6.1 kg with a single ventricle, Fontan surgery was performed...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/27939495/development-and-impact-of-arrhythmias-after-the-norwood-procedure-a-report-from-the-pediatric-heart-network
#4
Matthew E Oster, Shan Chen, Nicholas Dagincourt, Yaniv Bar-Cohen, Matthew Brothers, Nicole Cain, Steven D Colan, Richard J Czosek, Jamie A Decker, David G Gamboa, Salim F Idriss, Joel A Kirsh, Martin J LaPage, Richard G Ohye, Elizabeth Radojewski, Maully Shah, Eric S Silver, Anoop K Singh, Joel D Temple, John Triedman, Jonathan R Kaltman
OBJECTIVES: The study objective was to determine the predictors of new-onset arrhythmia among infants with single-ventricle anomalies during the post-Norwood hospitalization and the association of those arrhythmias with postoperative outcomes (ventilator time and length of stay) and interstage mortality. METHODS: After excluding patients with preoperative arrhythmias, we used data from the Pediatric Heart Network Single Ventricle Reconstruction Trial to identify risk factors for tachyarrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, junctional ectopic tachycardia, and ventricular tachycardia) and atrioventricular block (second or third degree) among 544 eligible patients...
March 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27872994/outcomes-of-tracheostomy-in-children-requiring-surgery-for-congenital-heart-disease
#5
Laura A Ortmann, Winston M Manimtim, Charisse I Lachica
Outcomes after discharge in children requiring tracheostomy after cardiac surgery have not been fully described. A retrospective, single-center study was performed on all children <18 years of age requiring both tracheostomy and surgery for congenital heart disease from January 2002 to May 2015. Forty-six tracheostomies were placed after surgery and four before. Single-ventricle anatomy was present in 12 (33%) patients. Incidence of tracheostomy after heart surgery increased from 0.8% the first half of the study period to 2% the second half...
February 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27761444/outcomes-of-off-pump-versus-on-pump-coronary-artery-bypass-graft-surgery-in-patients-with-severely-dilated-left-ventricle
#6
Sen Li, Wenhui Gong, Quan Qi, Zezhe Yuan, Anqing Chen, Jun Liu, Junfeng Cai, Mi Zhou, Zhe Wang, Xiaofeng Ye, Qiang Zhao
BACKGROUND: Currently, off-pump coronary artery bypass (OPCAB) grafting has been the standard procedure for surgical revascularization in patients with coronary artery disease (CAD). This study aimed to examine the safety and applicability of OPCAB compared with on-pump coronary artery bypass (ONCAB) in patients with severely dilated left ventricle. METHODS: A retrospective study of giant left ventricle patients [left ventricular end diastolic diameter (LVEDD) ≥ VE mm] undergoing coronary bypass grafting from 2009 through 2015 at a single center was conducted...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27568146/the-effect-of-noncardiac-and-genetic-abnormalities-on-outcomes-following-neonatal-congenital-heart-surgery
#7
Bahaaldin Alsoufi, Scott Gillespie, William T Mahle, Shriprasad Deshpande, Brian Kogon, Kevin Maher, Kirk Kanter
Significant noncardiac and genetic abnormalities (NC and GA) are common in neonates with congenital heart defects. We sought to examine current-era effect of those abnormalities on early and late outcomes following cardiac surgery. The method from 2002-2012, 1538 neonates underwent repair (n = 860, 56%) or palliation (n = 678, 44%) of congenital heart defects. Regression models examined the effect of NC and GA on operative results, resource utilization, and late outcomes. Neonates with NC and GA (n = 312, 20%) had higher incidence of prematurity (21% vs 13%; P < 0...
2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27529321/development-and-validation-of-a-risk-stratification-score-for-children-with-congenital-heart-disease-undergoing-noncardiac-surgery
#8
David Faraoni, Daniel Vo, Viviane G Nasr, James A DiNardo
BACKGROUND: Children with major and severe congenital heart disease (CHD) undergoing noncardiac surgery are at increased risk of mortality. The objective of this study was to identify the predictors for in-hospital mortality, and to develop a risk stratification score that could be used to help decision making and the development of perioperative management guidelines. METHODS: We included all children with major (eg, tetralogy of Fallot with wide open pulmonary insufficiency, hypoplastic left heart syndrome including stage 1 repair) or severe CHD (eg, children with uncorrected CHD, children with documented pulmonary hypertension, children with ventricular dysfunction requiring medications, or children listed for heart transplant) recorded in the 2012 and 2013 American College of Surgeons National Surgical Quality Improvement Program Pediatric databases in a derivation cohort, and those recorded in the 2014 database in a validation cohort...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27528445/perioperative-echocardiography-derived-right-ventricle-function-parameters-and-early-outcomes-after-tetralogy-of-fallot-repair-in-mid-childhood-a-single-center-prospective-observational-study
#9
Ravi Raj, Goverdhan Dutt Puri, Aveek Jayant, Shyam Kumar Singh Thingnam, Rana Sandip Singh, Manoj Kumar Rohit
BACKGROUND: Right ventricular (RV) function alterations are invariably present in all patients after tetralogy of Fallot (TOF) repair. Unlike the developed world where most of the patients with TOF are corrected in infancy, average age of presentation and thus surgery for these patients in the developing world may be higher. We aimed to study the correlation between RV function parameters such as tricuspid annular peak systolic excursion (TAPSE), fractional area change (FAC), and tricuspid annular peak systolic velocity (S') with early outcome variables after intracardiac repair for TOF...
November 2016: Echocardiography
https://www.readbyqxmd.com/read/27424467/mechanical-circulatory-support-as-bridge-to-transplantation-for-the-failing-single-ventricle
#10
George J Arnaoutakis, David Blitzer, Stephanie Fuller, Aaron W Eckhauser, Lisa M Montenegro, Joseph W Rossano, J William Gaynor
BACKGROUND: Circulatory failure necessitating cardiac transplantation will ultimately develop in many patients with functional single-ventricle physiology. Interest in the use of mechanical circulatory support (MCS) in this population is growing. METHODS: This was a retrospective case series of patients with functional single-ventricle physiology who underwent MCS with a ventricular assist device or a total artificial heart as a bridge to cardiac transplantation between January 2006 and December 2014...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27402424/perioperative-management-of-pediatric-en-bloc-combined-heart-liver-transplants-a-case-series-review
#11
Manchula Navaratnam, Ann Ng, Glyn D Williams, Katsuhide Maeda, Julianne M Mendoza, Waldo Concepcion, Seth A Hollander, Chandra Ramamoorthy
BACKGROUND: Combined heart and liver transplantation (CHLT) in the pediatric population involves a complex group of patients, many of whom have palliated congenital heart disease (CHD) involving single ventricle physiology. OBJECTIVE: The purpose of this study was to describe the perioperative management of pediatric patients undergoing CHLT at a single institution and to identify management strategies that may be used to optimize perioperative care. METHODS: We did a retrospective database review of all patients receiving CHLT at a children's hospital between 2006 and 2014...
October 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27142405/tracheostomy-following-surgery-for-congenital-heart-disease-a-14-year-institutional-experience
#12
Brian D Benneyworth, Jenny M Shao, A Ioana Cristea, Veda Ackerman, Mark D Rodefeld, Mark W Turrentine, John W Brown
BACKGROUND: Tracheostomy following congenital heart disease (CHD) surgery is a rare event and associated with significant mortality. Hospital survival has been reported from 20% to 40%. Late mortality for these patients is not well characterized. METHODS: We performed a retrospective observational study of patients who had a tracheostomy following CHD surgery (excluding isolated patent ductus arteriosus ligation) between January 2000 and December 2013. Patients were categorized into single-ventricle or biventricular physiology groups...
2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27101500/intraoperative-red-blood-cell-transfusion-in-infant-heart-transplant-patients-is-not-associated-with-worsened-outcomes
#13
Harmony F Carter, Carol Lau, David Juma, Briana Wells, Richard L Applegate
BACKGROUND: Red blood cell (RBC) transfusion is common during infant cardiac surgery. A previous report of pediatric heart transplant recipients showed that increased RBC transfusion volume was independently associated with increased length of intensive care unit stay. It is unclear whether transfusion to infants as a subgroup carries similar risks. This study investigated relationships between intraoperative RBC transfusion during heart transplantation and postoperative length of stay (LOS), morbidity, and mortality in infants...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27099973/severe-acute-kidney-injury-following-stage-1-norwood-palliation-effect-on-outcomes-and-risk-of-severe-acute-kidney-injury-at-subsequent-surgical-stages
#14
Joshua H Wong, David T Selewski, Sunkyung Yu, Kay E Leopold, Katelyn H Roberts, Janet E Donohue, Richard G Ohye, John R Charpie, Caren S Goldberg, Aaron G DeWitt
OBJECTIVES: To identify associations of severe acute kidney injury early after stage 1 (Norwood) operation with risk of severe acute kidney injury and comorbidities at subsequent palliative stages in patients with hypoplastic left heart syndrome and other single ventricle lesions with left-sided obstruction. DESIGN: Retrospective cohort study. Severe acute kidney injury defined as Kidney Disease Improving Global Outcomes stage 3. SETTING: Single pediatric cardiac center...
July 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27091396/-comparative-results-of-fontan-surgery-in-patients-with-and-without-hypoplastic-left-heart-syndrome
#15
Pedro Becker Rencoret, Santiago Besa Bandeira, Sergio Riveros González, Patricia Frangini Sanhueza, Daniel Springmüller Pinto, Rodrigo González Foretic, Gonzalo Urcelay Montecinos
INTRODUCTION: During the last few years, numerous patients with univentricular heart disease have been treated surgically with total cavopulmonary anastomosis according to a staged surgery protocol in our institution. OBJECTIVE: To evaluate the perioperative outcomes and survival of patients with hypoplastic left heart syndrome (HLHS) after the Fontan procedure and compare them with other types of univentricular heart disease. PATIENTS AND METHOD: A total of 102 patients underwent a Fontan procedure between April 1996 and March 2014, 25 with HLHS (group I), and 77 patients with other types of univentricular heart disease (group II)...
September 2016: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/27090649/mechanical-ventilation-after-bidirectional-superior-cavopulmonary-anastomosis-for-single-ventricle-physiology-a-comparison-of-pressure-support-ventilation-and-neurally-adjusted-ventilatory-assist
#16
Limin Zhu, Zhuoming Xu, Xiaolei Gong, Jinghao Zheng, Yanjun Sun, Liping Liu, Lu Han, Haibo Zhang, Zhiwei Xu, Jinfen Liu, Peter C Rimensberger
We evaluated the effects of different respiratory assist modes on cerebral blood flow (CBF) and arterial oxygenation in single-ventricle patients after bidirectional superior cavopulmonary anastomosis (BCPA). We hypothesized that preserved auto-regulation of respiration during neurally adjusted ventilatory assist (NAVA) may have potential advantages for CBF and pulmonary blood flow regulation after the BCPA procedure. We enrolled 23 patients scheduled for BCPA, who underwent pressure-controlled ventilation (PCV), pressure support ventilation (PSV), and NAVA at two assist levels for all modes in a randomized order...
August 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27085618/outcomes-of-multistage-palliation-of-infants-with-functional-single-ventricle-and-heterotaxy-syndrome
#17
COMPARATIVE STUDY
Bahaaldin Alsoufi, Courtney McCracken, Brian Schlosser, Ritu Sachdeva, Andrew Well, Brian Kogon, William Border, Kirk Kanter
BACKGROUND: Management of infants with heterotaxy syndrome and functional single ventricle is complicated due to associated cardiac and extracardiac anomalies. We report current era palliation results. METHODS: Between 2002 and 2012, 67 infants with heterotaxy syndrome underwent multistage palliation. Competing risks analyses modeled events after surgery (death vs Glenn procedure) and examined factors associated with survival. In addition, early and late outcomes following first-stage palliation surgery were compared with a matched contemporaneous control group of patients with nonheterotaxy single ventricle anomalies...
May 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26904211/outcomes-of-total-cavopulmonary-connection-for-single-ventricle-palliation
#18
Minghui Zou, Yanfei Wang, Hujun Cui, Li Ma, Shengchun Yang, Yuansheng Xia, Weidan Chen, Xinxin Chen
BACKGROUND: The aim of this study was to review the early and mid-term outcomes of the total cavopulmonary connection (TCPC) procedure and evaluate risk factors for prolonged pleural effusions. METHODS: The clinical records of 82 consecutive patients, who underwent a TCPC operation between January 2008 and December 2013, were reviewed for incidence of prolonged pleural effusions, duration of ventilation time and pleural drainage, length of intensive care unit (ICU) stay, and early and mid-term morbidity and mortality...
January 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/26872731/prospective-validation-of-a-novel-vasoactive-ventilation-renal-score-as-a-predictor-of-outcomes-after-pediatric-cardiac-surgery
#19
Kyle G Miletic, Ralph E Delius, Henry L Walters, Christopher W Mastropietro
BACKGROUND: We sought to further validate the novel vasoactive-ventilation-renal (VVR) score in a prospective study of a heterogeneous cohort of children undergoing cardiac surgery that includes patients with single-ventricle anatomy and residual mixing lesions. METHODS: We prospectively performed an observational study of all children less than 18 years of age who underwent surgery for congenital heart disease at our center from November 2013 to June 2014. We calculated VVR score as follows: vasoactive-inotrope score + ventilation index + (change in serum creatinine from baseline × 10)...
April 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26832211/venovenous-extracorporeal-membrane-oxygenation-for-patients-with-single-ventricle-anatomy-a-registry-report
#20
Scott I Aydin, Melissa Duffy, Daniel Rodriguez, Peter T Rycus, Patricia Friedman, Ravi R Thiagarajan, Samuel Weinstein
OBJECTIVE: Support with extracorporeal membrane oxygenation for cardiopulmonary failure is done so with venoarterial cannulation in the majority of children with single-ventricle anatomy. However, there is a growing experience for patients with pure oxygenation/ventilation impairment supported with venovenous extracorporeal membrane oxygenation. We describe that experience. METHODS: Data were collected from the Extracorporeal Life Support Organization registry for patients with single-ventricle anatomy supported with venovenous extracorporeal membrane oxygenation from 1990 to 2012...
June 2016: Journal of Thoracic and Cardiovascular Surgery
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