Cardiology in the young
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Cardiology in the young · Jun 2010
Comparative StudyA model for a nurse-led programme of bedside placement of peripherally inserted central catheters in neonates and infants with congenital cardiac disease.
Neonates and infants with congenital and acquired cardiac disease often require placement of central venous lines for extended intravenous therapy. It may be advantageous to avoid the larger venous vessels of the head and neck and lower extremities in order to preserve these for future interventions and therapies. We evaluated the results of a nursing led peripherally inserted central catheter team in our congenital cardiac centre. ⋯ In a population of infants with cardiac disease, a nursing staffed peripherally inserted central catheter team achieved an insertion rate of 78% with few complications and a rapid response time. Reliance on bedside insertion permits continuous critical care monitoring and may eliminate the need for fluoroscopy.
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Cardiology in the young · Jun 2010
Comparative StudyTransthoracic echocardiography does not reliably predict involvement of the aortic valve in patients with a discrete subaortic shelf.
A discrete subaortic membrane cannot only cause left ventricular outflow tract obstruction, but can grow onto the aortic valve leaflets. The late finding of this encroachment is aortic valve insufficiency or stenosis. Echocardiography is used to follow the progression of outflow tract obstruction, but its ability to show subaortic membrane encroachment onto the aortic valve is unclear. The purpose of this study is to determine the sensitivity and specificity of echocardiography for diagnosing whether a discrete subaortic membrane involves the aortic valve. ⋯ Echocardiography is not sensitive in assessing whether a discrete subaortic membrane involves the aortic valve. Since the morbidity and mortality for discrete subaortic membrane resection is negligible, resection may be indicated at the time of diagnosis to minimise aortic valve impairment.
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Cardiology in the young · Jun 2010
Case ReportsLeeuwenhoek's disease: diaphragmatic flutter in a cardiac patient.
A 15-year-old girl gave a recent history of dyspnoea and "funny turns". She had congenital aortic stenosis, previous valvotomies, a mechanical valve replacement, permanent pacemaker, atrial tachyarrhythmias, impaired ventricular function, systemic hypotension, pulmonary hypertension, and anxiety. The diagnosis of diaphragmatic flutter was delayed due to all the differential diagnoses and rarity of the condition. It was confirmed by observation, respiratory band monitoring, volume-time spirogram and fluoroscopy during an attack.