World journal for pediatric & congenital heart surgery
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World J Pediatr Congenit Heart Surg · Jan 2014
Comparative StudyA complete extracorporeal circulation-free approach to patients with functionally univentricular hearts provides superior early outcomes.
We compared the early outcomes of patients undergoing extracardiac total cavopulmonary connection (TCPC) with or without cardiopulmonary bypass (CPB). ⋯ The TCPC without CPB is easy to perform, is cost-effective, and is associated with superior early postoperative outcomes as compared to TCPC on CPB. With appropriate modifications, this operation can be performed in almost all morphological subsets of patients who do not need an associated intracardiac procedure.
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World J Pediatr Congenit Heart Surg · Jan 2014
Case ReportsResuscitation of a neonate with medium chain acyl-coenzyme a dehydrogenase deficiency using extracorporeal life support.
We report a neonate with medium chain acyl-coenzyme A dehydrogenase deficiency (MCAD) who had a cardiac arrest due to ventricular tachycardia and fibrillation. Extracorporeal life support (ECLS) was deployed, from which the baby was subsequently separated and discharged from hospital. This case was a rare neonatal presentation of MCAD and an uncommon indication for ECLS. We discuss the presentations of patients with MCAD and the use of ECLS for patients with possible inborn errors of metabolism and other unknown primary diagnoses.
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World J Pediatr Congenit Heart Surg · Jan 2014
Case ReportsVideo fluoroscopy swallow study and nutritional support during ambulatory venovenous extracorporeal membrane oxygenation as a bridge to lung transplantation.
We present the successful completion of a video fluoroscopy swallow study and subsequent nutritional plan of a child bridged to lung transplantation with ambulatory venovenous (VV) extracorporeal membrane oxygenation (ECMO). With a limited number of programs bridging pediatric patients to lung transplantation with VV ECMO, a better understanding of nutritional support is needed to provide optimal care to this patient population awaiting organ donation.
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World J Pediatr Congenit Heart Surg · Oct 2013
Early cyanosis after stage II palliation for single ventricle physiology: etiologies and outcomes.
In the early postoperative period after stage II palliation, patients with single ventricle physiology can have cyanosis due to a variety of causes. This cyanosis can be significant and necessitate cardiac catheterization to determine etiology and attempt treatment. Our objective was to determine the etiology of early postoperative cyanosis and outcomes in patients referred to the catheterization laboratory from the cardiac intensive care unit (CICU) after stage II palliation. ⋯ Regardless of the etiology or treatment strategy, severe cyanosis in the early postoperative period after stage II palliation imparts high mortality and usually indicates failing stage II physiology. Venovenous collateral occlusion and thrombectomy are usually futile, and those who survive have a low likelihood of having stage II physiology at hospital discharge.
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World J Pediatr Congenit Heart Surg · Oct 2013
Multicenter StudyFunctionally univentricular heart and the fontan operation: lessons learned about patterns of practice and outcomes from the congenital heart surgery databases of the European association for cardio-thoracic surgery and the society of thoracic surgeons.
"The term "functionally univentricular heart" describes a spectrum of congenital cardiovascular malformations in which the ventricular mass may not readily lend itself to partitioning that commits one ventricular pump to the systemic circulation and another to the pulmonary circulation." The purpose of this article is to review patterns of practice and outcomes in the Congenital Heart Surgery Databases (CHSDBs) of the European Association for Cardio-Thoracic Surgery (EACTS) and the Society of Thoracic Surgeons (STS) in patients with functionally univentricular hearts undergoing the Fontan operation. ⋯ The STS database is largest CHSDB in North America. The EACTS database is largest CHSDB in Europe. This review of data from EACTS and STS allows for unique documentation of practice patterns and outcomes. From this analysis, it is clear that patients with functionally univentricular hearts present a challenging problem; however, exclusive of Fontan revision or conversion (Re-do Fontan), the Fontan operation has a discharge mortality of 2.3%.