Cardiology in the young
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Cardiology in the young · Feb 2006
Comparative StudyLive three-dimensional paediatric intraoperative epicardial echocardiography as a guide to surgical repair of atrioventricular valves.
Real-time three dimensional echocardiography is increasingly used for imaging patients with congenital cardiac malformations. One of the limitations of a transthoracic approach is that intervening structures can impact on the quality of the images obtained. We hypothesised that, during surgery, epicardial three-dimensional echocardiography would provide images of high quality. ⋯ In all cases, we obtained images of good quality, which could be analysed rapidly in the operating room. Of the eight cases, seven had echocardiographic findings which matched exactly the surgical findings. The remaining child had been diagnosed echocardiographically with a cleft in the aortic leaflet of the mitral valve, but was found at surgery to have a double orifice in the valve.
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Cardiology in the young · Feb 2006
Comparative StudyQuantitative analysis of procalcitonin after pediatric cardiothoracic surgery.
Procalcitonin appears to be an early and sensitive marker of bacterial infection in a variety of clinical settings. The use of levels of procalcitonin to predict infection in children undergoing cardiac surgery, however, may be complicated by the systemic inflammatory response that normally accompanies cardiopulmonary bypass. The aim of our study was to estimate peri-operative concentrations of procalcitonin in non-infected children undergoing cardiac surgery. ⋯ In 8 patients, who had no evidence of infection, concentrations during the period from 24 to 72 hours were well above the median for the group. We conclude that concentrations of procalcitonin in the serum increase significantly in children following cardiac surgery, with a peak at 48 hours, and do not return to baseline within 72 hours of surgery. A proportion of patients, in the absence of infection, had exaggerated elevations post-operatively.
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Cardiology in the young · Feb 2006
Case ReportsPost-mortem magnetic resonance imaging provides the diagnosis following aortic rupture in an infant with treated aortic interruption.
In the United Kingdom, there has been a steady decline in the number of conventional autopsies performed in children. For cardiovascular disease, structural and not pathological considerations are often more important in defining the cause of death. ⋯ In this case report, we demonstrate how post-mortem magnetic resonance imaging was able to establish the diagnosis of aortic rupture in a patient who had undergone surgical repair of aortic interruption. In this patient, the parents had declined conventional histopathological autopsy, but were happy to consent to magnetic resonance post-mortem assessment.