Pediatric cardiology
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Pediatric cardiology · Oct 2009
Case ReportsImaging of a carotid aneurysm in two patients following extracorporeal membrane oxygenation therapy.
Following extracorporeal membrane oxygenation (ECMO), two patients subsequently developed carotid aneurysms at the site of cannulation. Given the invasive nature of ECMO, vascular ultrasound and/or computerized tomographic imaging should be considered to rule out cannulation-site complications post-ECMO.
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Pediatric cardiology · Oct 2009
Case ReportsAmiodarone for pediatric resuscitation: a word of caution.
Intravenous administration of amiodarone has recently been recommended for use during pediatric resuscitation of pediatric patients with ventricular fibrillation or pulseless ventricular tachycardia. We present two pediatric patients who received amiodarone for polymorphic ventricular tachycardia, although they were ultimately determined to have congenital long QT syndrome. Amiodarone is contraindicated in this setting and may have exacerbated the ventricular arrhythmia.
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Pediatric cardiology · Aug 2009
Comparative StudyThromboelastography of patients after fontan compared with healthy children.
Patients who have undergone a Fontan procedure face an increased risk for thromboembolic complications. This study aimed to evaluate whether thromboelastography, a global whole-blood assay of coagulation, can be used to detect hypercoagulability in pediatric Fontan patients compared with healthy children. This prospective, cross-sectional study investigated 25 Fontan patients and 51 healthy children in three age groups: 1-5 years, 6-10 years, and 11-16 years. ⋯ The findings suggest that the percentage of Fontan patients demonstrating hypercoagulability on thromboelastography is substantially lower than the reported incidence of thromboembolic complications. Whether thromboelastography could be helpful in predicting patients at increased risk for thromboembolic complications or not still is not known. Further studies comparing the thromboelastography of Fontan patients with the thromboembolic complications of those without Fontan are needed to delineate these issues.
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Pediatric cardiology · Aug 2009
Comparative StudyExercise performance after surgery for pulmonary atresia and intact ventricular septum.
The objective of this study was to assess exercise performance in subjects born in Sweden between 1980 and 1995 and undergoing surgery for pulmonary atresia and intact ventricular septum and to identify determinants of exercise performance. Twenty-seven subjects, 16 with biventricular repair and 11 with univentricular palliation, and 28 age- and sex-matched controls completed cardiopulmonary exercise and lung function testing. Peak oxygen uptake was determined using a symptom-limited ramp bicycle exercise protocol. ⋯ Decreased total lung capacity, low minute ventilation, and high physiologic dead space measured at peak exercise were all independent determinants of low peak V'O(2) Exercise capacity is generally decreased in subjects with pulmonary atresia and intact ventricular septum, although there are marked interindividual differences. Good exercise capacity was found in subjects without VCAC who had undergone biventricular repair. Decreased lung function was an unfavourable predictor of exercise capacity.
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Pediatric cardiology · Aug 2009
Case ReportsRight-sided pulmonary venous obstruction between a right aortic arch and an amplatzer septal occlusion device following closure of a secundum atrial septal defect.
Right-sided pulmonary venous obstruction between a right aortic arch and an Amplatzer Septal Occluder device developed following closure of a large secundum atrial septal defect. The obstruction was not apparent on postprocedure transesophageal echocardiogram but developed over time. The patient recovered completely following surgical removal of the device.