Congenital heart disease
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Congenital heart disease · Nov 2011
High long-term morbidity in repaired aortic coarctation: weak association with residual arch obstruction.
The objective of this study was to assess late morbidity after repair of aortic coarctation and its association with residual aortic arch obstruction. ⋯ Cure by repair of aortic coarctation is rare; heart diseases, aortopathy, and hypertension are common. Morbidity is only weakly associated with mild/moderate recoarctation.
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Congenital heart disease · Nov 2011
Case ReportsObstructive right ventricular outflow tract hemangioma in an adolescent.
Cardiac tumors are rare in children, but they are being diagnosed with increasing frequency and great accuracy with wide array of imaging modalities. Cardiac rhabdomyoma and myxoma are the most common tumors in children and adults, respectively. Cardiac hemangiomas comprise about 2.8% of all primary cardiac tumors and fewer than 100 cases have been reported in the literature. We report a successful resection of cardiac hemangioma in the right ventricular outflow tract in an adolescent, presented with moderate to severe obstruction.
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Congenital heart disease · Sep 2011
Randomized Controlled TrialClinical efficacy of phosphodiesterase-5 inhibitor tadalafil in Eisenmenger syndrome--a randomized, placebo-controlled, double-blind crossover study.
In a randomized double-blind crossover trial, we compared the efficacy of phosphodiesterase-5 (PDE-5) inhibitor tadalafil with placebo in patients of Eisenmenger Syndrome (ES). The primary end point was the change in 6-minute walk test distance (6 MWD). Secondary end points were the effect of the drug on systemic oxygen saturation (SO(2) ), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), effective pulmonary blood flow (EPBF), and World Health Organization (WHO) functional class. ⋯ In this first short-term placebo-controlled trial of tadalafil in patients of ES, the drug was well tolerated and significantly improved exercise capacity, functional class, SO(2) , and pulmonary hemodynamics.
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Congenital heart disease · Sep 2011
Computational simulations demonstrate altered wall shear stress in aortic coarctation patients treated by resection with end-to-end anastomosis.
Atherosclerotic plaque in the descending thoracic aorta (dAo) is related to altered wall shear stress (WSS) for normal patients. Resection with end-to-end anastomosis (RWEA) is the gold standard for coarctation of the aorta (CoA) repair, but may lead to altered WSS indices that contribute to morbidity. ⋯ Localized differences in WSS indices within the dAo of CoA patients treated by RWEA suggest that plaque may form in unique locations influenced by the surgical repair. These regions can be visualized in familiar and intuitive ways allowing clinicians to track their contribution to morbidity in longitudinal studies.
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Congenital heart disease · Sep 2011
Pericardiocentesis of noncircumferential effusions using nonstandard catheter entry sites guided by echocardiography and fluoroscopy.
Classically pericardiocentesis has been described and performed through the subxiphiod approach, which is feasible if the pericardial fluid is circumferential or collected inferior or anterior to the heart. However, not uncommonly, the collection of fluid is at the base of the heart or in the posterior or apical portion of the pericardium, necessitating a different approach. The purpose of this study is to describe echo and fluoroscopic guided pericardiocentesis to evacuate noncircumferential effusions, which are not accessible from the standard subcostal approach. ⋯ Echocardiographic and fluoroscopic guided pericardiocentesis is a feasible, relatively safe, and reliable technique to drain loculated pericardial effusions using nonstandard entry sites.