Congenital heart disease
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Congenital heart disease · Jan 2014
Case ReportsPercutaneous closure of a prosthetic pulmonary paravalvular leak.
Paravalvular leak following prosthetic valve surgery has the potential to cause serious complications such as hemolysis and congestive heart failure. Successful percutaneous closures of prosthetic mitral and aortic paravalvular leaks have been performed as an alternative to reoperation. This case represents the first known report of successful percutaneous closure of a prosthetic pulmonary paravalvular leak in an adult patient with a history of congenital heart disease using two muscular ventricular septal defect occluder devices.
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Congenital heart disease · Jan 2014
Case ReportsLong QT syndrome unmasked by dexmedetomidine: a case report.
Dexmedetomidine is a selective alpha-2 adrenergic agonist that is used frequently for short-term sedation in children. It has been noted to cause hypertension, hypotension, bradycardia, and sinus pauses; however, QTc prolongation has not been reported with dexmedetomidine administration. We describe a case of marked QT prolongation with use of dexmedetomidine in a pediatric critical care setting. Clinicians should be vigilant about potential QT prolongation in patients on dexmedetomidine, particularly in those receiving multiple other medications.
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Congenital heart disease · Jan 2014
Perioperative nutritional support and malnutrition in infants and children with congenital heart disease.
To assess the effect of nutritional status and cardiovascular risk on hospital outcomes after congenital heart surgery in infants and children. ⋯ Although nearly half of the patients were malnourished at surgery, only two-thirds of their recommended caloric and protein requirements were provided by week 1. To improve hospital outcomes, care should be taken to optimize the nutritional condition of infants and children prior to and following surgical correction of congenital heart disease to improve hospital outcomes.
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Congenital heart disease · Jan 2014
Knowledge and attitudes of anesthesia providers about noncardiac surgery in adults with congenital heart disease.
To examine the knowledge and attitudes of anesthesia providers in relation to the care of adult congenital heart disease (ACHD) patients presenting for noncardiac surgery. ⋯ Within the context of the limitations of a single-institution survey design, the low levels of knowledge and comfort we observed suggest that providers may benefit from improved training and protocols for ensuring adequate preparedness for the care of ACHD patients.
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Congenital heart disease · Nov 2013
Case ReportsA case of life-threatening Staphylococcus aureus endocarditis involving percutaneous transcatheter prosthetic pulmonary valve.
While right ventricle to pulmonary artery homograft is the surgical procedure of choice for relieving right ventricle outflow tract obstruction; it is limited by the need for multiple surgical replacements owing to progressive conduit obstruction, valve dysfunction, or patient growth. Since January 2010, percutaneous transcatheter placement of prosthetic pulmonary valve (Melody valve) has emerged as an attractive alternative to surgical replacement of dysfunctional right ventricle to pulmonary artery homograft in the United States. ⋯ The infection caused multi-organ dysfunction despite bacteriological clearance and led to severe dysfunction of the valve which ultimately required surgical removal. The case highlights a rare but serious complication of percutaneous prosthetic pulmonary valves.