Congenital heart disease
-
Congenital heart disease · May 2010
Disparities exist in the emergency department evaluation of pediatric chest pain.
To identify and describe disparities in the provision of Emergency Department (ED) care in pediatric patients presenting with chest pain (CP). ⋯ Disparities exist in the ED care of pediatric patients with CP. Identification of such variations is important and provides an opportunity for targeted interventions that ensure delivery of high-quality, cost-effective health care for children.
-
Congenital heart disease · May 2010
Case ReportsInduction of left ventricular fascicular tachycardia with transesophageal pacing in a toddler.
J. V. is a 3(1/2)-year-old patient with left ventricular fascicular ventricular tachycardia that had been well controlled on verapamil for 3 years. He was taken for a transesophageal electrophysiology study prior to discontinuing medication in an attempt to induce his tachycardia. We report the use of transesophageal electrophysiology study as a noninvasive method to induce left ventricular fascicular ventricular tachycardia in a toddler.
-
Congenital heart disease · May 2010
Multicenter StudyHybrid procedures: adverse events and procedural characteristics--results of a multi-institutional registry.
Procedural cooperation between cardiac surgeon and interventional cardiologist to facilitate interventions such as device delivery or angioplasty (hybrid procedure) has become increasingly common in the management of patients with congenital heart disease. ⋯ Hybrid procedures appear to have a low incidence of associated major AEs. PDA stent placement performed as a palliation of hypoplastic left heart syndrome (HLHS) or complex single/two ventricle patients may have a lower incidence of AEs if performed using a direct approach with surgical exposure rather than a percutaneous approach. Accurate definitions of these innovative procedures are required to facilitate prospective data collection.
-
Congenital heart disease · May 2010
B-type natriuretic peptide: perioperative patterns in congenital heart disease.
B-type natriuretic peptide (BNP) has diagnostic, prognostic, and therapeutic roles in adults with heart failure. BNP levels in children undergoing surgical repair of congenital heart disease (CHD) were characterized broadly, and distinguishable subgroup patterns delineated. ⋯ Perioperative BNP correlates to severity of illness and lengths of therapy in the CHD population, overall. Substantial variation in BNP across time as well as within and between CHD lesions limits its practical utility as an isolated point-of-care measure. BNP commonly peaks 6-12 hours postoperatively, but the timing and magnitude of BNP elevation demonstrates notable age-dependency, peaking earlier and rising an order of magnitude higher in neonates. In spite of higher clinical acuity, non-neonatal univentricular CHD paradoxically demonstrates lower BNP levels compared with biventricular physiologies.