Congenital heart disease
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Congenital heart disease · Nov 2010
Randomized Controlled Trial Multicenter Study Comparative StudyPlatelet activity associated with concomitant use of clopidogrel and proton pump inhibitors in children with cardiovascular disease.
In adults with acute coronary syndrome, decreased platelet inhibition associated with concomitant use of clopidogrel and proton pump inhibitors (PPI) has been reported. ⋯ Concomitant use of PPI + clopidogrel may be associated with decreased platelet inhibition in children with cardiac disease. Further study in a larger population and assessment of associated clinical outcomes is warranted.
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Congenital heart disease · Nov 2010
Case ReportsSurfactant treatment for congenital heart disease patients with acute respiratory distress syndrome.
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) can be a significant source of morbidity for pediatric cardiac patients in the intensive care unit. Children with unrepaired or palliated congenital heart disease are at increased risk for lower respiratory tract infections, while postoperatively they are at risk for ALI/ARDS precipitated by cardiopulmonary bypass. ⋯ Evidence for a beneficial effect of exogenous surfactant treatment in congenital heart disease patients with ALI/ARDS is lacking. We present three consecutive children with congenital heart disease and ARDS who had significant and sustained improvement in lung function and oxygenation after treatment with exogenous surfactant, hastening their recovery from life-threatening hypoxemia.
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Congenital heart disease · Nov 2010
Impact of staged palliation on somatic growth in patients with hypoplastic left heart syndrome.
Somatic growth pattern in infants undergoing staged palliation for hypoplastic left heart syndrome (Norwood procedure [NP], stage 2 palliation [S2P], and Fontan procedure [FP]) during transition toward a more energy efficient series circulation is not well understood. ⋯ Somatic growth is significantly impaired after NP but recovers steadily following S2P, as the patient transitions toward separated series circulation. Earlier S2P may lead to earlier resumption of normal growth in this critical period of early infancy.
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Congenital heart disease · Nov 2010
Case ReportsTransfusion-associated babesiosis in a 7-month-old infant after bidirectional Glenn procedure.
We describe a case of transfusion-associated babesiosis following bidirectional Glenn procedure. This unique case highlights the importance of including babesiosis and other typically vector-borne infections in the differential diagnosis for patients with recent blood transfusions and fever without obvious source.
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Congenital heart disease · Nov 2010
Case ReportsAn unusual case of Brugada syndrome in a 10-year-old child with fevers.
Brugada syndrome is an arrhythmogenic disease characterized by a pattern of ST segment elevation in the right precordial leads on an electrocardiogram with an increased risk of sudden cardiac death. It is primarily reported in adults with limited data about the prevalence, prognosis, and long-term management in children. We describe a 10-year-old boy with a family history of sudden cardiac death, who had near syncope associated with a febrile illness. ⋯ Although some investigators have reported the use of electrophysiological studies for distinguishing between high and low risk patients with Brugada syndrome, there are no precise predictors of risk for sudden cardiac death in pediatric patients. After careful discussion, this patient was considered intermediate to high risk for sudden cardiac death and had successful implantation of a transvenous defibrillator. Although Brugada syndrome is a rare diagnosis in the pediatric population, such patients should be referred for further evaluation and management.