Congenital heart disease
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Congenital heart disease · Mar 2007
Perimount bovine pericardial valve to restore pulmonary valve competence late after right ventricular outflow tract repair.
No ideal option exists for restoring pulmonary valve competence late after repair of the congenitally abnormal right ventricular outflow tract (RVOT). This has driven a continued search for new alternatives. Texas Children's Hospital has recently used the Carpentier-Edwards Perimount RSR Pericardial Aortic Prosthesis (Edwards Lifesciences, Irvine, Calif, USA) for this indication and reports the initial experience. ⋯ Initial results with the Perimount bovine pericardial tissue prosthesis for pulmonary valve replacement are encouraging. Further follow-up is required to define long-term function and durability.
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Congenital heart disease · Nov 2006
Comparative StudyPhysiologic limitation of omega exists in patients after the Norwood palliation and is underestimated by the arterial venous oxygen saturation difference.
Survival after the Norwood palliation (NW) is dependent on maximizing systemic oxygen delivery. Omega (Omega) is used to express the excess of oxygen delivery to oxygen consumption. We hypothesized that an intrinsic deficiency in the ability to maximize the relationship between oxygen delivery (DO(2)) and oxygen consumption (VO(2)) is present in infants after NW and is underestimated by arterial venous oxygen saturation difference (a-vO(2)). ⋯ Omega is lower for patients in the immediate postoperative period after NW and prior to their bidirectional Glenn operation than in patients after biventricular repair. This places NW patients closer to the critical point of DO(2) and therefore at greater risk for hemodynamic compromise than BV patients. The a-vO(2) difference underestimates this risk.
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Congenital heart disease · Nov 2006
The impact of aortic arch geometry on flow dynamics using a simplified approach with magnetic resonance velocity mapping.
We sought to determine, in vivo, the impact of aortic arch geometry on flow dynamics, which affects overall cardiovascular energetics and has implications for organ perfusion and Doppler flow calculations. ⋯ Right aortic arch geometry impacts flow dynamics in the ascending aorta whereas it is not altered in the descending aorta, where flow is predominantly in the posterior half. The sidedness of the aortic arch determined the location of maximum velocity. Alternatively, this also may suggest that hemodynamics could have played a role in the development of right aortic arch in certain individuals.
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Congenital heart disease · Jul 2006
Determinants of intensive care unit length of stay for infants undergoing cardiac surgery.
The purpose of this study was to identify factors that influence postoperative intensive care unit length of stay (ICULOS) in infants less than 6 months of age undergoing congenital heart surgery. ⋯ In conclusion, preoperative organ dysfunction, need for nasogastric feeding, and total support time may offer measurable variables useful in predicting that infant at greatest risk for extended ICULOS.
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Congenital heart disease · Jul 2006
Risk adjustment for congenital heart surgery (RACHS): is it useful in a single-center series of newborns as a predictor of outcome in a high-risk population?
Risk adjustment for congenital heart surgery (RACHS) was developed to compare outcome data for pediatric patients undergoing cardiac surgery. RACHS stratifies anatomic diversity into 6 categories based on age, type of surgery performed, and similar in-hospital mortality. The purpose of this retrospective review was to evaluate the use of RACHS in a single-center series as a predictor of outcome in a high-risk newborn population. ⋯ Limitations of risk assessment using RACHS in a single-center series of high-risk newborns include the lack of consideration of confounding variables. Further risk adjustments that include such confounding variables are warranted.