European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jul 2009
Predictors of impaired neurodevelopmental outcomes at one year of age after infant cardiac surgery.
For most newborns, congenital heart defects (CHD) appear to be isolated anomalies and the brain is presumed to have normal developmental potential. Most studies of neurodevelopmental outcomes have focused on operative management strategies. ⋯ Patient factors (birth weight and preoperative status) are significant determinants of neurodevelopmental outcomes as opposed to operative management strategies. In this cohort, genetic syndromes unsuspected at birth were surprisingly common and correlate with poor neurodevelopmental outcomes. Without multiple congenital anomalies, syndromes may be missed in infancy. Genetic evaluation should be considered in all infants with CHD.
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Eur J Cardiothorac Surg · Jul 2009
A modification of the Ross procedure to prevent pulmonary autograft dilatation.
We present our initial experience in 10 patients operated on using a modified Ross operation. In our modification of the Ross operation the pulmonary autograft root was inserted in the Gelweave Valsalva graft to prevent dilatation of the neoaortic root. This type of graft was selected to match the discrepancy between diameters of the annulus and the sinotubular junction of the autograft and to preserve the characteristic configuration of the native root. In our group of 10 patients operated consecutively by this technique there was no change in the geometry of the neoaortic root in the follow-up 3-19 months (mean 14.6 months).
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Eur J Cardiothorac Surg · Jul 2009
Resuscitation after cardiac surgery: results of an international survey.
A survey was conducted on CTSNet, the cardiothoracic network website in order to ascertain an international viewpoint on a range of issues in resuscitation after cardiac surgery. ⋯ This survey supports the EACTS guideline for resuscitation in cardiac arrest after cardiac surgery published in this issue of the journal.
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Eur J Cardiothorac Surg · Jul 2009
Pulmonary arteriovenous malformations after a Fontan operation in the left isomerism and absent inferior vena cava.
To evaluate the occurrence of pulmonary arteriovenous malformations after a Fontan operation in the left isomerism and absent inferior vena cava. ⋯ We might prevent pulmonary arteriovenous malformations in patients with the left isomerism and absent inferior vena cava by designing the venous channels to achieve better mixing of the superior vena cava and the hepatic venous flow.
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Eur J Cardiothorac Surg · Jul 2009
Aortic and mitral valve replacement in children: is there any role for biologic and bioprosthetic substitutes?
The ideal valve substitute in children does not exist. Biologic and bioprosthetic valves do not require anticoagulation, however their use is complicated by accelerated degeneration and requirement for reoperation. We examine results following mitral (MVR) or aortic (AVR) replacement with biologic and bioprosthetic valves at our institution. ⋯ While valve reoperation is inevitable following AVR and MVR with biologic and bioprosthetic substitutes; favorable results such as low valve-related morbidity rate, good long-term survival and functional status encourage their consideration as valid replacement alternatives in selected children especially females. Valve durability is higher in the mitral position and longevity of bioprosthetic valves is greater than that of homografts especially in the mitral position.