World journal for pediatric & congenital heart surgery
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World J Pediatr Congenit Heart Surg · Nov 2020
Early Impact of the COVID-19 Pandemic on Congenital Heart Surgery Programs Across the World: Assessment by a Global Multi-Societal Consortium.
The coronavirus disease 2019 (COVID-19) pandemic currently gripping the globe is impacting the entire health care system with rapidly escalating morbidities and mortality. Although the infectious risk to the pediatric population appears low, the effects on children with congenital heart disease (CHD) remain poorly understood. ⋯ Pediatric and congenital heart surgeons, given their small numbers and close relationships, are uniquely positioned to collectively assess the impact of the pandemic on surgical practice and care of children with CHD. We present the results of an international survey sent to pediatric and congenital heart surgeons characterizing the early impact of COVID-19 on the care of patients with CHD.
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World J Pediatr Congenit Heart Surg · May 2020
Multicenter StudyEfforts to Reduce Infections in Delayed Sternal Closure Patients: A Survey of Pediatric Practice.
Pediatric patients with sternum left open after cardiac surgery experience a higher risk for sternal wound infection (SWI). These infections are costly for programs, payers, and patients and their families. Despite efforts by individual programs to reduce infections in patients undergoing delayed sternal closure (DSC), there are no established guidelines that address preventive procedures. The purpose of this study was to determine the practice of pediatric cardiac surgery programs to prevent infection in their DSC patients and if preventive measures were associated with less infections. ⋯ The results of this survey of children's cardiac surgery programs describe their practices to reduce infection rates in DSC patients. A multicenter project on wound care and closure techniques that might impact this costly complication is needed.
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World J Pediatr Congenit Heart Surg · Mar 2020
Characterization of Extracorporeal Membrane Oxygenation Support for Single Ventricle Patients.
Extracorporeal membrane oxygenation (ECMO) can provide crucial support for single ventricle (SV) patients at various stages of palliation. However, characterization of the utilization and outcomes of ECMO in these unique patients remains incompletely studied. ⋯ Extracorporeal membrane oxygenation can be useful to rescue SV patients with approximately half surviving to discharge, although complications are frequent. Early recognition of the role of heart transplant is imperative. Further study is required to identify areas for improvement in this population.
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World J Pediatr Congenit Heart Surg · Mar 2020
Case ReportsModified Damus-Kaye-Stansel Connection for Systemic Outflow Tract Obstruction After Fontan Operation.
Late systemic outflow tract obstruction following completion of the Fontan palliation is rarely seen and is a difficult problem to treat. Absence of the main pulmonary trunk and pulmonary valve at this stage makes a conventional Damus-Kaye-Stansel connection difficult to achieve. We report the case of a 37-year-old female who underwent Fontan completion as an adult and subsequently presented with systemic outflow tract obstruction. A valved conduit was interposed between the native pulmonary annulus and the ascending aorta to create a modified Damus-Kaye-Stansel type connection.
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World J Pediatr Congenit Heart Surg · Jan 2020
Atrioventricular Valve Repair in Single Ventricle Physiology: Timing Matters.
Atrioventricular valve (AVV) regurgitation in patients with single ventricle (SV) physiology severely impacts prognosis; the appropriate timing for surgical treatment is unknown. We sought to study the results of surgical treatment of AVV regurgitation in SV patients and evaluate risk factors for mortality. ⋯ Univentricular physiology with AVV regurgitation is a high-risk group of patients. Surgery for AVV regurgitation at stage 1 palliation was associated with less effective repair and higher mortality in this initial experience. On the other hand, effective repair determined better outcomes, highlighting the importance of experience and the learning curve in the management of such patients.