Congenital heart disease
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Congenital heart disease · Nov 2018
Efficiency of the home cardiac rehabilitation program for adults with complex congenital heart disease.
We aimed to study the efficiency and safety of once-a-week outpatient rehabilitation followed by home program with tele-monitoring in patients with complex cyanotic congenital heart disease. ⋯ Once-a-week outpatient hospital-based exercise program followed by supervised home-based exercise program showed a significant benefit in improvement of exercise capacity in adults with complex cyanotic congenital heart disease without serious adverse outcomes.
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Congenital heart disease · Sep 2018
Meta AnalysisEfficacy of dexmedetomidine in prevention of junctional ectopic tachycardia and acute kidney injury after pediatric cardiac surgery: A meta-analysis.
We conducted a meta-analysis to evaluate the effects of prophylactic perioperative dexmedetomidine administration on postoperative junctional ectopic tachycardia (JET) and acute kidney injury (AKI) in pediatric patients having undergone cardiac surgery. ⋯ The administration of perioperative dexmedetomidine effectively prevents JET in pediatric patients undergoing cardiac surgery but has no significant effect on postoperative renal function. However, the quality of evidence for these findings is low; thus, future larger scale randomized studies are needed to verify the real clinical effects of dexmedetomidine prophylaxis in pediatric patients.
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Congenital heart disease · Jul 2018
Multicenter StudyGastrostomy tube placement among infants with hypoplastic left heart syndrome undergoing stage 1 palliation.
Different feeding strategies have been suggested to improve growth and survival of infants with hypoplastic left heart syndrome following stage 1 palliation. The study objective was to assess hospital mortality following stage 1 palliation among infants with hypoplastic left heart syndrome who had two feeding modalities, gastrostomy tube vs no gastrostomy tube. ⋯ The gastrostomy procedure did not place infants with hypoplastic left heart syndrome at higher risk of mortality. These infants should be considered for gastrostomy tube placement if they had persistent difficulty in oral feeding following stage 1 palliation.
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Congenital heart disease · Jul 2018
What is the role of apical ventriculotomy in children and young adults with hypertrophic cardiomyopathy?
The transapical approach has been utilized in adult HCM patients with either midventricular obstruction or a small LV cavity; however, there are little data on its use in children. ⋯ In children with HCM, transapical myectomy is an effective adjunct to a transaortic approach to abolish midventricular obstruction and it effectively increases LV stroke volume in patients with small LV cavities and nonobstructive HCM. It may be beneficial for these patients with significant symptoms and who have failed medical therapy as a treatment alternative to cardiac transplantation.
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Congenital heart disease · Jul 2018
Pheochromocytoma and paraganglioma in Fontan patients: Common more than expected.
Pheochromocytoma and paraganglioma (extra-adrenal pheochromocytoma) are rare neuroendocrine tumors that arise from the neuroendocrine cells. Chronic hypoxia is known as a possible cause, and a strong link between cyanotic congenital heart disease and these tumors has been reported. However, reports of phechromocytoma/paraganglioma in Fontan patients were scarce. We herein report seven cases of phechromocytoma/paraganglioma after Fontan operation at a single tertiary center. ⋯ Phechromocytoma/paraganglioma could occur in Fontan patients more than expected. Because it is curable by tumor resection during its early phase, early diagnosis and treatment of pheochromocytoma are crucial in Fontan patients not to make hemodynamic deterioration and aggravation of heart failure.