The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2013
Influence of left ventricular function on development of systolic anterior motion after mitral valve repair.
A hyperkinetic heart has been suggested as a risk factor for systolic anterior motion (SAM) after mitral valve repair, but the influence of preoperative left ventricular (LV) function on the development of SAM has not been elucidated. ⋯ The study indicates that the development of SAM after mitral valve repair is associated with preoperative LV function. A small hyperkinetic heart is considered a risk factor for SAM and should be treated with caution.
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J. Thorac. Cardiovasc. Surg. · Aug 2013
"Reverse Blalock-Taussig shunt": application in single ventricle hybrid palliation.
Retrograde aortic arch malperfusion after ductal stenting can be life-threatening after univentricular hybrid palliation. Arch perfusion can be maintained with a main pulmonary artery to innominate artery shunt placed during the stage I procedure: a "reverse Blalock-Taussig shunt." ⋯ The presence of a reverse Blalock-Taussig shunt was not associated with more adverse events than those without. Gradual retrograde arch obstruction occurs commonly in palliated infants with aortic atresia. A reverse Blalock-Taussig shunt might play an important role to address the potential of retrograde obstruction, augmenting arch blood flow.
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J. Thorac. Cardiovasc. Surg. · Aug 2013
Short- and intermediate-term survival after extracorporeal membrane oxygenation in children with cardiac disease.
In children with cardiac disease, common indications for extracorporeal membrane oxygenation (ECMO) include refractory cardiopulmonary resuscitation (E-CPR), failure to separate from cardiopulmonary bypass (OR-ECMO), and low cardiac output syndrome (LCOS-ECMO). Despite established acceptance, ECMO outcomes are suboptimal with a survival between 38% and 55%. We evaluated factors associated with significantly increased survival in cardiac patients requiring ECMO. ⋯ ECMO was successfully used in children with cardiac disease with 73% and 66% short- and intermediate-term survival, respectively. The majority of the survivors had normal function or only a minimal neurodevelopmental deficit.
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J. Thorac. Cardiovasc. Surg. · Aug 2013
Clinical and echocardiographic outcomes after surgery for severe isolated tricuspid regurgitation.
Few studies have investigated the outcomes after surgical correction of severe isolated tricuspid regurgitation. ⋯ In the present cohort, preoperative anemia, renal/hepatic dysfunction, right ventricular dilatation, and significant postoperative tricuspid regurgitation were associated with poor outcomes. Timely surgery is advisable in patients with severe isolated tricuspid regurgitation before the development of anemia, organ dysfunction, or right ventricular dilatation.
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J. Thorac. Cardiovasc. Surg. · Aug 2013
Characterizing peritoneal dialysis catheter use in pediatric patients after cardiac surgery.
Children who undergo cardiac surgery are at high risk for renal insufficiency and abdominal compartment syndrome. Peritoneal dialysis catheter (PDC) implantation is used in this population for abdominal decompression and access for dialysis. However, there is no consensus regarding PDC use, and the practice varies widely. This study was undertaken to assess associated factors, outcomes, and variability in the use of PDC in patients who have undergone cardiac surgery. ⋯ Patients receiving PDC after cardiac surgery had 20% mortality, which remained 12% after excluding patients with acute renal failure. Given the variability in PDC use and poor outcomes, further research is needed to assess the possible benefit of earlier intervention for peritoneal access in this high-risk cohort.