Pediatric cardiology
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Pediatric cardiology · Jun 2011
The outcome of open heart surgery for congenital heart disease in infants with low body weight less than 2500 g.
Although the outcome of neonatal cardiac surgery has dramatically improved, low body weight (LBW) is still considered an important risk for open heart surgery. The factors contributing to poor outcomes in LBW infants, however, are still unclear. We investigated risk factors for poor outcomes in infants weighing <2500 g who underwent surgical correction with cardiopulmonary bypass (CPB). ⋯ The overall actuarial survival rate at 10 years was 74.95% ± 4.37%. In conclusion, among infants weighing <2500 g who underwent open heart surgery with CPB, perioperative hemodynamic status, such as emergency surgery and LCO, strongly influenced early mortality. In contrast, LBW itself was not associated with patient morbidity or mortality.
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Pediatric cardiology · Jun 2011
Preoperative management with nitrogen inhalation therapy for a low-birth weight infant with tetralogy of Fallot and absent pulmonary valve.
Tetralogy of Fallot and absent pulmonary valve (TOF/APV) is a rare congenital heart disease. Patients with TOF/APV with severe clinical symptoms require surgical intervention for cardiac abnormality in the neonatal period, but the preoperative conditioning for surgical treatment is extremely complicated. We experienced a low-birth-weight patient with TOF/APV who was successfully treated by radical surgery at 63 days of age after long-term intensive management using nitrogen inhalation therapy.
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Pediatric cardiology · Jun 2011
Clinical experience with Berlin Heart Excor in pediatric patients in Argentina: 1373 days of cardiac support.
The objective of this study was to describe our experience (1373 days of support) with the Berlin Heart Excor (BH) ventricular-assist device (VAD) as bridging to cardiac transplantation in pediatric patients with end-stage cardiomyopathy. This study involved a retrospective observational cohort. Records of patients supported with the BH VAD were reviewed. ⋯ Three patients had fatal complications: 2 had thrombo-hemorrhagic stroke leading to brain death, and one had refractory vasoplegic shock. The BH VAD is a useful and reasonable safe device for cardiac transplantation bridging in children with end-stage heart failure. Team experience resulted in less morbidity and mortality, and time for implantation, surgical procedure, anticoagulation monitoring, and patient care improved.
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Pediatric cardiology · Jun 2011
Validation of cardiac output measurement by ultrasound dilution technique with pulmonary artery thermodilution in a pediatric animal model.
Novel COstatus system (Transonic Systems, Inc., NY), based on ultrasound dilution (UD), works off in situ arterial and central venous catheters in pediatric patients to measure cardiac output (CO). The purpose of the present study was to validate CO measurement by UD (COUD) with pulmonary artery (PA) thermodilution (COTD) in a prospective animal study. Ten anesthetized pigs (16-45 kg) were instrumented with pediatric PA, central venous, and peripheral artery catheters. ⋯ COTD mean was 2.98 ± 1.21 l/min (range 1.33-6.29), and COUD mean was 2.68 ± 1.16 l/min (range 1.33-5.85). This study yielded a correlation r = 0.96, COUD = 0.91*(COTD) - 0.04 l/min; bias was 0.3 l/min with limits of agreement as -0.39 to 0.99 l/min; and the percentage error was 23.73% between the methods. CO measurements by UD agreed well with thermodilution measurements in the pediatric swine model.