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By Javier Castro Heart Failure And Heart Transplantation
Awais Ashfaq, Michael Seckeler, Stephen Pophal, Edward Rhee, Justin Ryan, Rohit Rao, Scott Klewer, John J Nigro
Neonatal critical aortic stenosis is life threatening and requires intervention shortly after birth. Early percutaneous aortic valvuloplasty is generally considered to be an effective way to obtain reliable prograde flow. We describe the integrated use of hybrid, open surgical, and single ventricle rehabilitation techniques to successfully treat a neonate with borderline left-sided cardiac structures, who sustained a complication from balloon aortic valvuloplasty.
July 2016: World Journal for Pediatric & Congenital Heart Surgery
Nilanjan Dutta, Rajarshi Ghosh, Neeraj Awasthy, Parvathi U Iyer, Sumir Girotra, Krishna S Iyer
Thrombus formation within the right ventricle (RV) in the setting of pulmonary atresia with intact ventricular septum (PAIVS) is not a very common occurrence and can be catastrophic. We present the case of a seven-month-old child with PAIVS and RV clot who successfully underwent biventricular repair. We discuss the interesting case and the rationale for management by means of biventricular repair over single ventricle repair when feasible in such a setting.
September 2016: World Journal for Pediatric & Congenital Heart Surgery
Madan Mohan Maddali, Minakshi Sandip Junghare, Arora Ram Nishant, Pranav Subbaraya Kandachar, Johan Valliattu
Hypoxemia is a well-known trigger for precipitating a sickling crisis in patients with sickle cell disease. Patients undergoing staged single ventricle palliation have hypoxemia during the initial stages of the Fontan pathway. The successful completion of staged single ventricle palliation in a child with a combination of homozygous sickle cell disease and a single ventricle physiology that tolerate prolonged hypoxemia during earlier stages of Fontan pathway is described.
April 2016: Journal of Cardiac Surgery
Lawrence Israel Schwartz, Shelley D Miyamoto, Scott Stenquist, Mark David Twite
Dexmedetomidine is an α-2 agonist with a sedative and cardiopulmonary profile that makes it an attractive anesthetic in pediatric cardiac patients. Cardiac transplant patients may suffer from acute cellular rejection of the cardiac conduction system and, therefore, are at an increased risk of the electrophysiological effect of dexmedetomidine. We present such a patient who had a cardiac arrest while receiving dexmedetomidine during cardiac catheterization. Because acute cellular rejection of the cardiac conduction system is difficult to diagnose, dexmedetomidine should be used with caution in pediatric heart transplant patients...
June 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Gregory J Latham, Christa Jefferis Kirk, Amy Falconer, Renee Dickey, Erin L Albers, David Michael McMullan
A 6-year-old child developed heparin-induced thrombocytopenia while on extracorporeal life support. Hours after a difficult transition from heparin to argatroban for anticoagulation therapy, the child underwent heart transplantation. Intraoperative management was plagued with circuit thrombus formation while on cardiopulmonary bypass and subsequent massive hemorrhage after bypass. We review the child's anticoagulation management, clinical challenges encountered, and review current literature related to the use of argatroban in pediatric cardiac surgery...
June 2016: Seminars in Cardiothoracic and Vascular Anesthesia
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