Pediatric cardiology
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Pediatric cardiology · Jan 2013
Comparative StudyInterventions after Norwood procedure: comparison of Sano and modified Blalock-Taussig shunt.
Improved results have evolved from the modified Norwood procedure (NP). This study compares the incidence of interventions after NP with the Sano (n = 37) and modified Blalock-Taussig (BT n = 70) shunt. Incidence, location, interval of interventions, and weight were retrospectively analysed for 107 neonates undergoing NP during the period from October 2002 to December 2009. ⋯ Interventions after NP were common irrespective of shunt type. However, a significantly greater rate of shunt interventions was noted in the Sano group. In particular, interventions addressing the aortic arch and the shunt were related with a significant rate of complications.
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Pediatric cardiology · Jan 2013
Case ReportsSuccessful treatment of severe mechanical mitral valve thrombosis with tissue plasminogen activator in a 7-month-old infant.
Severe thrombosis of a mechanical valve is a rare complication in pediatric patients. Thrombolytic therapy as treatment of mechanical mitral valve thrombosis has rarely been reported in young infants. We report the successful treatment with recombinant tissue-type plasminogen activator of a mechanical mitral valve thrombus in a 7 month-old patient with trisomy 21, complete atrioventricular canal defect and pulmonary hypertension status post complete atrioventricular canal repair and subsequent prosthetic mitral valve replacement. ⋯ Serial echocardiograms showed significant resolution of the thrombus within 18 h of infusion with no major bleeding complications during the treatment course. Although a rare complication of mechanical valve placement in pediatrics, thrombosis of mechanical valves may result in severe hemodynamic and respiratory compromise. This case demonstrates that thrombolytic therapy is a feasible option for the treatment of critical thrombosis in pediatric patients after MVR.
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Pediatric cardiology · Jan 2013
Case ReportsEfficacy of an interleukin-1β receptor antagonist (anakinra) in idiopathic recurrent pericarditis.
Pericarditis may recur in up to 30 % of adult patients, but recurrent pericarditis is a rare disease in childhood. The etiology of the initial attack and the causes of recurrences often remain unknown. Recurrent pericarditis is accompanied by a high morbidity rate and may represent a challenge to the clinician due to problems in management. ⋯ Controlled trials have demonstrated that colchicine can reduce the recurrent rate of pericarditis, whereas early corticosteroid therapy promotes recurrences. Anakinra, a recombinant human interleukin-1β receptor antagonist, is a promising new biologic agent for the treatment of autoinflammatory diseases such as cryopyrinopathies, tumor necrosis factor receptor-associated periodic syndrome, and hyperimmunoglobulinemia D with periodic fever syndrome. This report describes an 11-year-old boy successfully treated with anakinra for a steroid-dependent recurrent pericarditis unresponsive to conventional treatment.
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Pediatric cardiology · Jan 2013
Impact of chest X-ray before discharge in asymptomatic children after cardiac surgery--prospective evaluation.
In many paediatric cardiac units chest radiographs are performed routinely before discharge after cardiac surgery. These radiographs contribute to radiation exposure. To evaluate the diagnostic impact of routine chest X-rays before discharge in children undergoing open heart surgery and to analyze certain risk factors predicting pathologic findings. ⋯ Risk factor analysis showed only pulmonary complications during PICU stay to be significantly associated (p = 0.005) with pathologic X-ray findings. Routine chest radiographs before discharge after cardiac surgery can be omitted in asymptomatic children with an uneventful and straightforward perioperative course. Chest radiographs before discharge are warrantable if pulmonary complications did occur during their PICU stay, as this is a risk factor for pathologic findings in chest X-rays before discharge.
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Pediatric cardiology · Jan 2013
Case ReportsIsolated total anomalous systemic venous drainage in an adult: case report.
Total anomalous systemic venous drainage is a rare form of congenital heart disease. All the systemic venous flow from the body (i.e., from the superior vena cava, inferior vena cava, and coronary sinus) drains abnormally into the left atrium. ⋯ This disorder may be associated with heterotaxy syndromes. This report describes a patient with unique total anomalous systemic venous drainage that was successfully corrected surgically.