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Lurie Cardiology Fellow Collection- CICU

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23 papers 0 to 25 followers
D C Bellinger, R A Jonas, L A Rappaport, D Wypij, G Wernovsky, K C Kuban, P D Barnes, G L Holmes, P R Hickey, R D Strand
BACKGROUND: Deep hypothermia with either total circulatory arrest or low-flow cardiopulmonary bypass is used to support vital organs during heart surgery in infants. We compared the developmental and neurologic sequelae of these two strategies one year after surgery. METHODS: Infants with D-transposition of the great arteries who underwent an arterial-switch operation were randomly assigned to a method of support consisting predominantly of circulatory arrest or a method consisting predominantly of low-flow bypass...
March 2, 1995: New England Journal of Medicine
Ellen McGrath, David Wypij, Leonard A Rappaport, Jane W Newburger, David C Bellinger
OBJECTIVE: Studies of developmental outcomes in children with congenital heart disease (CHD) frequently use assessments conducted in infancy as primary endpoints. Whether test scores of CHD patients in infancy are predictive of status at school age has not been evaluated, however. METHODS: In the Boston Circulatory Arrest Study, 135 children with D-transposition of the great arteries repaired by arterial switch operation were administered the Bayley Scales of Infant Development and the Fagan Test of Infant Intelligence at 1 year of age and the Wechsler Intelligence Scale for Children, Third Edition and the Wechsler Individual Achievement Test at 8 years...
November 2004: Pediatrics
Gil Wernovsky, Marijn Kuijpers, Maaike C Van Rossem, Bradley S Marino, Chitra Ravishankar, Troy Dominguez, Rodolfo I Godinez, Kathryn M Dodds, Richard F Ittenbach, Susan C Nicolson, Geoffrey L Bird, J William Gaynor, Thomas L Spray, Sarah Tabbutt
The medical records of all patients born between 1 September, 2000, and 31 August, 2002, and undergoing the first stage of Norwood reconstruction, were retrospectively reviewed for details of the perioperative course. We found 99 consecutive patients who met the criterions for inclusion. Hospital mortality for the entire cohort was 15.2%, but was 7.3%, with 4 of 55 dying, in the setting of a "standard" risk profile, as opposed to 25.0% for those with a "high" risk profile, 11 of 44 patients dying in this group...
December 2007: Cardiology in the Young
Evan M Zahn, Nancy C Dobrolet, David G Nykanen, Jorge Ojito, Robert L Hannan, Redmond P Burke
OBJECTIVES: The purpose of this study was to examine the safety and efficacy of interventional catheterization performed early after congenital heart surgery. BACKGROUND: Transcatheter interventions performed in the early postoperative period are viewed as high risk. To date, there have been limited published data regarding these procedures. METHODS: All catheterizations performed within six weeks after congenital heart surgery between August 1995 and January 2001 were retrospectively reviewed...
April 7, 2004: Journal of the American College of Cardiology
James S Tweddell, Nancy S Ghanayem, Kathleen A Mussatto, Michael E Mitchell, Luke J Lamers, Ndidiamaka L Musa, Stuart Berger, S Bert Litwin, George M Hoffman
BACKGROUND: Staged palliation for hypoplastic left heart syndrome has been marked by high early mortality due to the limited cardiac output of the postischemic single right ventricle combined with the inefficiency and volatility of parallel circulation. METHODS: Since July 1996, we have performed stage 1 palliation (S1P) in 178 patients. Within this group is a consecutive cohort of 116 patients with true hypoplastic left heart syndrome that underwent S1P with a modified Blalock-Taussig shunt...
October 2007: Annals of Thoracic Surgery
Timothy M Hoffman, Gil Wernovsky, Andrew M Atz, Thomas J Kulik, David P Nelson, Anthony C Chang, James M Bailey, Akbar Akbary, John F Kocsis, Raymond Kaczmarek, Thomas L Spray, David L Wessel
BACKGROUND: Low cardiac output syndrome (LCOS), affecting up to 25% of neonates and young children after cardiac surgery, contributes to postoperative morbidity and mortality. This study evaluated the efficacy and safety of prophylactic milrinone in pediatric patients at high risk for developing LCOS. METHODS AND RESULTS: The study was a double-blind, placebo-controlled trial with 3 parallel groups (low dose, 25- microg/kg bolus over 60 minutes followed by a 0.25- microg/kg per min infusion for 35 hours; high dose, 75- microg/kg bolus followed by a 0...
February 25, 2003: Circulation
Therese M Giglia, Ronald Bronicki, Paul A Checchia, Peter C Laussen
No abstract text is available yet for this article.
March 2010: Pediatric Critical Care Medicine
T L Gentles, J E Mayer, K Gauvreau, J W Newburger, J E Lock, J P Kupferschmid, J Burnett, R A Jonas, A R CastaƱeda, G Wernovsky
OBJECTIVES: The purpose of this study was to review a large, evolving, single-center experience with the Fontan operation and to determine risk factors influencing early and late outcome. METHODS: The first 500 patients undergoing modifications of the Fontan operation at our institution were identified. Perioperative variables were recorded and a cross-sectional review of survivors was undertaken. RESULTS: The incidence of early failure decreased from 27...
September 1997: Journal of Thoracic and Cardiovascular Surgery
J R Charpie, M K Dekeon, C S Goldberg, R S Mosca, E L Bove, T J Kulik
OBJECTIVES: Neonates with congenital heart disease may appear hemodynamically stable after operation and then suddenly experience catastrophic decompensation. An improved means of predicting which infants will suddenly die in the early postoperative period may lead to lifesaving interventions. Studies indicate that blood lactate level is proportional to tissue oxygen debt, but information linking lactate levels with outcome in infants after operation is limited. We sought to determine whether a change in lactate level over time was predictive of a poor outcome defined as death within the first 72 hours or the need for extracorporeal membrane oxygenation...
July 2000: Journal of Thoracic and Cardiovascular Surgery
Scott M Bradley, Janet M Simsic, Denise M Mulvihill
OBJECTIVE: Bidirectional superior cavopulmonary connection may be complicated by systemic hypoxemia. Previous work has shown that hyperventilation worsens systemic oxygenation in patients after bidirectional superior cavopulmonary connection. The likely mechanism is that hyperventilation-induced hypocarbia decreases cerebral, superior vena caval, and pulmonary blood flow. The aim of the current study was to determine whether the converse approach, hypoventilation, improves oxygenation after bidirectional superior cavopulmonary connection...
October 2003: Journal of Thoracic and Cardiovascular Surgery
Ronald A Bronicki, Anthony C Chang
OBJECTIVE: To review the salient aspects and latest advances in the management of the postoperative pediatric cardiac patient. DATA SOURCE: A Medline-based literature source. CONCLUSION: The practice of pediatric cardiac intensive care has evolved considerably over the last several years. These efforts are the result of a collaborative effort from all subspecialties involved in the care of pediatric patients with congenital heart disease. Discoveries and innovations that are representative of this effort include the extension of cerebral oximetry from the operating room into the critical care setting; mechanical circulatory devices designed for pediatric patients; and surgery in very low birth weight neonates...
August 2011: Critical Care Medicine
Satish K Rajagopal, Christopher S Almond, Peter C Laussen, Peter T Rycus, David Wypij, Ravi R Thiagarajan
OBJECTIVE: To describe survival outcomes for pediatric patients supported with extracorporeal membrane oxygenation for severe myocarditis and identify risk factors for in-hospital mortality. DESIGN: Retrospective review of Extracorporeal Life Support Organization registry database. SETTING: Data reported to Extracorporeal Life Support Organization from 116 extracorporeal membrane oxygenation centers. PATIENTS: Patients < or = 18 yrs of age supported with extracorporeal membrane oxygenation for myocarditis during 1995 to 2006...
February 2010: Critical Care Medicine
Nikoleta S Kolovos, Susan L Bratton, Frank W Moler, Edward L Bove, Richard G Ohye, Robert H Bartlett, Thomas J Kulik
BACKGROUND: Extracorporeal life support (ECLS) has been used for over two decades in select patients after cardiac surgery. We previously described factors associated with death in this population. We now review our recent experience to reassess factors related to mortality. METHODS: All pediatric patients who received ECLS support within 7 days after surgery between July 1995 and June 2001 were examined to describe clinical features associated with survival. We compared the results with our prior report to assess changes in practice and outcome...
November 2003: Annals of Thoracic Surgery
Karen L Booth, Stephen J Roth, Ravi R Thiagarajan, Melvin C Almodovar, Pedro J del Nido, Peter C Laussen
BACKGROUND: Extracorporeal membrane oxygenation can provide effective mechanical circulatory support for the failing circulation in children. Patients with failing Fontan and bidirectional Glenn physiology present additional challenges both for extracorporeal membrane oxygenation cannulation and support. We report our institutional experience in patients with cavopulmonary connections who received extracorporeal membrane oxygenation. METHODS: We performed a retrospective review of 20 patients with cavopulmonary connections (14 Fontan and 6 bidirectional Glenn) who were supported with extracorporeal membrane oxygenation from a single, large pediatric tertiary care center...
April 2004: Annals of Thoracic Surgery
L Shekerdemian, D Bohn
No abstract text is available yet for this article.
May 1999: Archives of Disease in Childhood
Steven M Schwartz, Catherine L Dent, Ndidi L Musa, David P Nelson
The patient with single-ventricle physiology presents a significant challenge to the intensive care team at all stages of management. An integrated approach that applies a working knowledge of cardiac anatomy, cardiopulmonary physiology, and the basic principles of intensive care is essential to guide management for each individual patient. This management requires cooperative and constructive involvement of surgeons, cardiologists, and intensivists, as well as a nursing and respiratory care team experienced in the management of single-ventricle patients...
July 2003: Critical Care Clinics
John M Costello, Mjaye L Mazwi, Mary E McBride, Katherine E Gambetta, Osama Eltayeb, Conrad L Epting
This review offers a critical-care perspective on the pathophysiology, monitoring, and management of acute heart failure syndromes in children. An in-depth understanding of the cardiovascular physiological disturbances in this population of patients is essential to correctly interpret clinical signs, symptoms and monitoring data, and to implement appropriate therapies. In this regard, the myocardial force-velocity relationship, the Frank-Starling mechanism, and pressure-volume loops are discussed. A variety of monitoring modalities are used to provide insight into the haemodynamic state, clinical trajectory, and response to treatment...
August 2015: Cardiology in the Young
E P Walsh, J P Saul, G F Sholler, J K Triedman, R A Jonas, J E Mayer, D L Wessel
OBJECTIVES: This study sought to 1) develop an efficient treatment protocol for postoperative automatic junctional tachycardia (JT) using conventional drugs and techniques, and 2) identify clinical features associated with this disorder by analyzing a large study group. BACKGROUND: Postoperative JT is a transient arrhythmia that may be fatal after operation for congenital cardiac defects. Its precise cause is unknown. A variety of palliative treatments have evolved, but because of a low incidence of JT, large studies of the most efficient therapeutic sequence are lacking...
April 1997: Journal of the American College of Cardiology
Richard G Ohye, Lynn A Sleeper, Lynn Mahony, Jane W Newburger, Gail D Pearson, Minmin Lu, Caren S Goldberg, Sarah Tabbutt, Peter C Frommelt, Nancy S Ghanayem, Peter C Laussen, John F Rhodes, Alan B Lewis, Seema Mital, Chitra Ravishankar, Ismee A Williams, Carolyn Dunbar-Masterson, Andrew M Atz, Steven Colan, L LuAnn Minich, Christian Pizarro, Kirk R Kanter, James Jaggers, Jeffrey P Jacobs, Catherine Dent Krawczeski, Nancy Pike, Brian W McCrindle, Lisa Virzi, J William Gaynor
BACKGROUND: The Norwood procedure with a modified Blalock-Taussig (MBT) shunt, the first palliative stage for single-ventricle lesions with systemic outflow obstruction, is associated with high mortality. The right ventricle-pulmonary artery (RVPA) shunt may improve coronary flow but requires a ventriculotomy. We compared the two shunts in infants with hypoplastic heart syndrome or related anomalies. METHODS: Infants undergoing the Norwood procedure were randomly assigned to the MBT shunt (275 infants) or the RVPA shunt (274 infants) at 15 North American centers...
May 27, 2010: New England Journal of Medicine
Kirsten C Odegard, David Zurakowski, James A DiNardo, Robert A Castro, Francis X McGowan, Ellis J Neufeld, Peter C Laussen
OBJECTIVE: The risk for thrombosis is increased after the Fontan operation. It is unknown whether children with univentricular heart disease have an intrinsic coagulation anomaly or acquire a defect in coagulation during the course of the staged repair. This prospective, longitudinal study evaluated changes in coagulation profiles in a cohort of patients with hypoplastic left heart syndrome from stage I palliation through completion of the Fontan operation. METHODS: Thirty-seven patients with hypoplastic left heart syndrome were enrolled prospectively, and the concentration of factors II, V, VII, VIII, IX, X, proteins C and S, fibrinogen, antithrombin, serum albumin, and liver enzymes were measured before stage I palliation (mean age 4 +/- 2 days), before bidirectional Glenn (mean age 5...
April 2009: Journal of Thoracic and Cardiovascular Surgery
2016-06-16 15:37:38
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