Congenital heart disease
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Congenital heart disease · Mar 2013
Use of a pressure guidewire to assess pulmonary artery band adequacy in the hybrid stage I procedure for high-risk neonates with hypoplastic left heart syndrome and variants.
The hybrid stage I procedure is an alternative palliative strategy for patients with hypoplastic left heart syndrome who traditionally have undergone the Norwood operation. At our institution, the hybrid stage I procedure is employed only for patients with high operative risk. Our objective was to describe our use of a pressure guidewire during the hybrid stage I procedure to assess quantitatively pulmonary artery band adequacy. ⋯ This novel use of a pressure guidewire to assess quantitatively pulmonary artery band adequacy at the time of placement is feasible, safe and may decrease the need for reoperation for pulmonary artery band adjustment.
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Congenital heart disease · Mar 2013
Impact of central venous pressure on cardiorenal interactions in adult patients with congenital heart disease after biventricular repair.
Cardiorenal interactions adversely impact the prognosis in heart failure patients an effect which crucially involves increased central venous pressure (CVP). However, it is unclear whether the same pathophysiology operates in adults with congenital heart disease (CHD). ⋯ Hemodynamics, especially a high CVP, independently predicted the enlarged kidney and abnormal intrarenal flow dynamics that are closely associated with heart failure severity and cardiovascular events in adults with CHD after biventricular repair.
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Congenital heart disease · Mar 2013
Comparative StudyHemodynamic characteristics of cyanotic adults with single-ventricle physiology without Fontan completion.
The aim of the current study is to describe the long-term clinical and hemodynamic characteristics of adult patients with single-ventricle physiology who have not undergone the Fontan operation and consequently have remained cyanotic. ⋯ Cyanotic adult single-ventricle patients not palliated with Fontan completion have preserved single-ventricle systolic function but develop elevated ventricular filling pressure with increasing age. Only invasive hemodynamic measurements demonstrated elevated ventricular filling pressures, while traditional echo/Doppler criteria for diastolic dysfunction were not met. Aging with cyanotic single-ventricle physiology is associated with a greater degree of filling pressure elevations than in the general population. Single-ventricle patients with EDP >12 exhibited markedly elevated BNP compared to those with normal EDP.
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In medical literature, few cases of Rasmussen's aneurysm have been reported until now, and to the best of our knowledge, there has been no description of a case of Rasmussen's aneurysm in childhood. The child described in the case report had a restrictive cardiomyopathy, complicated by pulmonary hypertension, in association with miliary tuberculosis.
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Congenital heart disease · Mar 2013
Predictors of left ventricular remodeling after aortic valve replacement in pediatric patients with isolated aortic regurgitation.
To identify the risk factors that could predict postoperative outcome after aortic valve replacement in pediatric patients with isolated aortic regurgitation (AR). ⋯ In children with AR, preoperative LV dysfunction and extreme LV dilation (>4 SD) are significant predictors of incomplete LV remodeling or persistent LV dysfunction.