Cardiology in the young
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Cardiology in the young · Aug 2007
Concentrations of brain natriuretic peptide in the plasma predicts outcomes of treatment of children with decompensated heart failure admitted to the Intensive Care unit.
It is known that levels of brain natriuretic peptide predict outcomes of treatment for adults with decompensated heart failure. We hypothesized that it could predict outcomes in children with this condition. ⋯ A final level of brain natriuretic peptide of greater than or equal to 760 picograms per millilitre strongly predicted an adverse outcome. Patients with higher final levels may be at higher risk of death and readmission, suggesting that this variable effectively predicts the response to treatment and prognosis in children with heart failure.
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Cardiology in the young · Aug 2007
What is the optimal time to repair atrioventricular septal defect and common atrioventricular valvar orifice?
With improvements in technology and surgical technique, paediatric cardiologists are challenging surgeons to repair balanced atrioventricular septal defects in smaller patients. Early repair minimizes aggressive medical therapy to prevent heart failure, maintains growth, and limits exposure to elevated pulmonary pressures. We compare the outcomes of repair among different-sized children. ⋯ Our data shows that, with the exception of a slightly longer and more complicated postoperative course, early surgery for symptomatic patients with atrioventricular septal defects and common atrioventricular valvar orifice can be undertaken safely and effectively in smaller children with excellent outcomes.
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Cardiology in the young · Aug 2007
Case ReportsA new approach to hypoplastic left heart syndrome with an intact atrial septum.
An intact atrial septum places infants with hypoplasia of the left heart into a group with an extremely high rate of mortality. We report a neonate, diagnosed antenatally, who was delivered by Caesarian section in the cardiac theatre, urgently placed onto cardiopulmonary bypass, and who then underwent an atrial septectomy and banding of both pulmonary arteries. After stabilisation, his arterial duct was stented, completing the first stage of hybrid palliation.