Cardiology in the young
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Cardiology in the young · Feb 2008
Randomized Controlled Trial Comparative StudyCan analysis of the bispectral index prove helpful when monitoring titration of doses of midazolam and ketamine for sedation during paediatric cardiac catheterization.
We investigated the use of the bispectral index for monitoring sedation during cardiac catheterization. The scores for the bispectral index may not reflect correct values in children, but may be helpful during titration of sedatives such as midazolam and ketamine. ⋯ When using the bispectral index for monitoring sedation during catheterization in children, we noted decreased need for doses of midazolam and ketamine, a lower need for respiratory support and less adverse effects.
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Cardiology in the young · Feb 2008
Comparative StudyAbnormalities in myocardial perfusion after surgical correction of pulmonary atresia with intact ventricular septum.
We describe the results of myocardial perfusion scintigraphy performed 4 to 15 years after surgery in 12 patients with pulmonary atresia and intact ventricular septum. We used single photon emission computed tomography after injection of technetium Tc-99m tetrofosmin at submaximal exercise test. The patients, 7 girls and 5 boys, with a mean age of 11 years, and a range from 6 to 19 years, had either undergone biventricular repair, in 5 cases, or univentricular palliation in the remaining 7. ⋯ Of the children, 3 with biventricular repair and 6 with univentricular palliation had perfusion defects. Children with biventricular repair had perfusion defects in the ventricular septum, while those having univentricular palliation also had defects located to the left ventricular free wall. All children with ventriculo-coronary arterial communications had perfusion defects both in the ventricular septum and in the left ventricular free wall.
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Cardiology in the young · Feb 2008
Comparative StudyAltered endothelial function following the Fontan procedure.
Thrombosis has been widely described after the Fontan procedure. The vascular endothelium plays a central role in the control of coagulation and fibrinolysis. The aim of this study was to investigate if patients undergoing a modified Fontan procedure have impaired endothelial function and fibrinolysis in the late postoperative course. ⋯ Our data suggest that patients with the Fontan circulation may have endothelial dysfunction, as indicated by raised levels of von Willebrand factor. Fibrinolysis seems to be relatively preserved, as suggested by appropriate response to venous occlusion.
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Cardiology in the young · Feb 2008
Comparative StudyCongenital cardiac surgery without routine placement of wires for temporary pacing.
Temporary pacing wires have been associated with serious postoperative complications. Recommendations for their routine use after open heart surgery are decades old, and may not reflect current surgical techniques and outcomes. ⋯ The diminished risk of unexpected postoperative arrhythmias in the current era alleviates the necessity for routine placement of temporary pacing wires. Those institutions with experienced surgical and cardiac critical care teams may be able to predict the need for temporary pacing wires preoperatively or intraoperatively.