Cirugía congénitos

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Common atrioventricular valve failure during single ventricle palliation†.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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Common atrioventricular valve failure during single ventricle palliation†.

Eur J Cardiothorac Surg. 2017 Mar 23;:

Authors: King G, Gentles TL, Winlaw DS, Cordina R, Bullock A, Grigg LE, Alphonso N, Radford DJ, Zannino D, Buratto E, d'Udekem Y

Abstract
OBJECTIVES: To determine the risk of atrioventricular valve failure (valve intervention or moderate or greater regurgitation) during the lifetime of patients with single ventricle physiology and common atrioventricular valve.
METHODS: Patients' data were extracted from an existing bi-national, population based registry. A retrospective review of their medical records was undertaken to determine the incidence of atrioventricular valve repair/replacement or moderate or greater regurgitation.
RESULTS: From a registry of 1468 Fontan survivors, 136 patients with common atrioventricular valve were identified. Complete echocardiographic follow-up was available for 114 patients. Median length of follow-up was 10.2 years (interquartile range 5-15 years). Twenty-five year survival and freedom from Fontan failure were 94% [95% confidence interval (CI), 88-100%] and 74% (95% CI, 64-87%), respectively. Twenty-eight patients underwent 24 initial repairs and 4 replacements. The 24 patients undergoing repair subsequently needed 6 re-repairs, 2 replacements and 8 had moderate or greater regurgitation at last follow-up. Four-year freedom from atrioventricular valve repair failure was 50% (95% CI, 34-75%). An additional 30 patients developed moderate or greater atrioventricular valve regurgitation (6 New York Heart Association ≥3, 10 Fontan failures, 0 deaths). Cumulative incidence of the composite endpoint of atrioventricular valve failure at 28 years was 62% (95% CI, 49-74%).
CONCLUSIONS: Patients with single ventricle physiology and common atrioventricular valve experience a continuous decline in valve function. The majority of patients experience valve failure in the first 30 years of life.

PMID: 28369323 [PubMed - as supplied by publisher]

Categorías: Cirugía congénitos

Severe Aortic Stenosis and Severe Coarctation of the Aorta: A Hybrid Approach to Treatment.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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Severe Aortic Stenosis and Severe Coarctation of the Aorta: A Hybrid Approach to Treatment.

Front Surg. 2017;4:16

Authors: McLennan D, Caputo M, Taliotis D

Abstract
Hybrid surgery is becoming more popular in the treatment of children with congenital heart disease, particularly small infants and neonates. We report a case of a patient with aortic stenosis (AS) and coarctation of the aorta (CoA).
CASE: a 1-month-old baby presented with severe AS and CoA. The decision was made to perform a hybrid surgical procedure. The patient underwent a lateral thoracotomy for repair of the CoA and carotid cutdown for aortic balloon valvuloplasty (AoVP).

PMID: 28367436 [PubMed - in process]

Categorías: Cirugía congénitos

Twenty Years of Anesthetic and Perioperative Management of Patients With Tetralogy of Fallot With Absent Pulmonary Valve.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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Twenty Years of Anesthetic and Perioperative Management of Patients With Tetralogy of Fallot With Absent Pulmonary Valve.

J Cardiothorac Vasc Anesth. 2017 Feb 04;:

Authors: Jochman JD, Atkinson DB, Quinonez LG, Brown ML

Abstract
OBJECTIVE: Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve.
DESIGN: Retrospective chart review.
SETTING: Large academic children's hospital.
PARTICIPANTS: Patients with the diagnosis of tetralogy of Fallot with absent pulmonary valve undergoing primary cardiac repair over a 20-year period.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Forty-four patients were identified with tetralogy of Fallot with an absent pulmonary valve from January 1995 through August 2014. Forty-two patients (95%) required surgery in their first year of life. Sixteen patients (36%) required mechanical ventilation preoperatively, including 11 neonates. Of the 28 patients not intubated preoperatively, only 1 (3.8%) exhibited minor airway obstruction following induction that was managed uneventfully. All intubations in the operating room were performed in the supine position. Five patients who were mechanically ventilated preoperatively in a lateral or prone position were supinated in the operating room without significant cardiopulmonary compromise. There were no patients who suffered cardiopulmonary arrest or required mechanical circulatory support. The median time to extubation was 2 days (range 1-13 days) in those patients who were not mechanically ventilated prior to their surgery. Ultimately, 5 patients required tracheostomy and 1 patient underwent lobectomy. Although, there was no mortality at 30 days, 4 children died within 1 year of their surgery. All the children who died had a genetic syndrome and required mechanical ventilation preoperatively.
CONCLUSIONS: While there are theoretical concerns specific to the induction and airway management of tetralogy of Fallot with an absent pulmonary valve, there were no episodes of cardiorespiratory arrest or extracorporeal membrane oxygenation in the authors' series. Neonatal age at the time of surgery, preoperative need for mechanical ventilation, and concomitant genetic syndromes are risk factors for respiratory morbidity. Mortality in this study was low compared to historic reports, likely reflecting improvement in surgical technique and intensive care management.

PMID: 28366715 [PubMed - as supplied by publisher]

Categorías: Cirugía congénitos

4D MUSIC CMR: value-based imaging of neonates and infants with congenital heart disease.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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4D MUSIC CMR: value-based imaging of neonates and infants with congenital heart disease.

J Cardiovasc Magn Reson. 2017 Apr 03;19(1):40

Authors: Nguyen KL, Han F, Zhou Z, Brunengraber DZ, Ayad I, Levi DS, Satou GM, Reemtsen BL, Hu P, Finn JP

Abstract
BACKGROUND: 4D Multiphase Steady State Imaging with Contrast (MUSIC) acquires high-resolution volumetric images of the beating heart during uninterrupted ventilation. We aim to evaluate the diagnostic performance and clinical impact of 4D MUSIC in a cohort of neonates and infants with congenital heart disease (CHD).
METHODS: Forty consecutive neonates and infants with CHD (age range 2 days to 2 years, weight 1 to 13 kg) underwent 3.0 T CMR with ferumoxytol enhancement (FE) at a single institution. Independently, two readers graded the diagnostic image quality of intra-cardiac structures and related vascular segments on FE-MUSIC and breath held FE-CMRA images using a four-point scale. Correlation of the CMR findings with surgery and other imaging modalities was performed in all patients. Clinical impact was evaluated in consensus with referring surgeons and cardiologists. One point was given for each of five key outcome measures: 1) change in overall management, 2) change in surgical approach, 3) reduction in the need for diagnostic catheterization, 4) improved assessment of risk-to-benefit for planned intervention and discussion with parents, 5) accurate pre-procedural roadmap.
RESULTS: All FE-CMR studies were completed successfully, safely and without adverse events. On a four-point scale, the average FE-MUSIC image quality scores were >3.5 for intra-cardiac structures and >3.0 for coronary arteries. Intra-cardiac morphology and vascular anatomy were well visualized with good interobserver agreement (r = 0.46). Correspondence between the findings on MUSIC, surgery, correlative imaging and autopsy was excellent. The average clinical impact score was 4.2 ± 0.9. In five patients with discordant findings on echo/MUSIC (n = 5) and catheter angiography/MUSIC (n = 1), findings on FE-MUSIC were shown to be accurate at autopsy (n = 1) and surgery (n = 4). The decision to undertake biventricular vs univentricular repair was amended in 2 patients based on FE-MUSIC findings. Plans for surgical approaches which would have involved circulatory arrest were amended in two of 28 surgical cases. In all 28 cases requiring procedural intervention, FE-MUSIC provided accurate dynamic 3D roadmaps and more confident risk-to-benefit assessments for proposed interventions.
CONCLUSIONS: FE-MUSIC CMR has high clinical impact by providing accurate, high quality, simple and safe dynamic 3D imaging of cardiac and vascular anatomy in neonates and infants with CHD. The findings influenced patient management in a positive manner.

PMID: 28366171 [PubMed - in process]

Categorías: Cirugía congénitos

Interstage Home Monitoring After Newborn First-Stage Palliation for Hypoplastic Left Heart Syndrome: Family Education Strategies.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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Interstage Home Monitoring After Newborn First-Stage Palliation for Hypoplastic Left Heart Syndrome: Family Education Strategies.

Crit Care Nurse. 2017 Apr;37(2):72-88

Authors: Nieves JA, Uzark K, Rudd NA, Strawn J, Schmelzer A, Dobrolet N

Abstract
Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period. A crucial focus of care is the comprehensive family training in the use of home surveillance monitoring of oxygen saturation, enteral intake, weight, and the early recognition of "red flag" symptoms indicating potential cardiopulmonary or nutritional decompensation. Beginning with admission to the intensive care unit of the newborn with hypoplastic left heart syndrome, nurses provide critical care and education to prepare the family for interstage home care. This article presents detailed nursing guidelines for educating families on the home care of their medically fragile infant with single-ventricle circulation.

PMID: 28365652 [PubMed - in process]

Categorías: Cirugía congénitos

Utility of Sonoclot in Prediction of Postoperative Bleeding in Pediatric Patients Undergoing Cardiac Surgery for Congenital Cyanotic Heart Disease: A Prospective Observational Study.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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Utility of Sonoclot in Prediction of Postoperative Bleeding in Pediatric Patients Undergoing Cardiac Surgery for Congenital Cyanotic Heart Disease: A Prospective Observational Study.

J Cardiothorac Vasc Anesth. 2017 Feb 04;:

Authors: Rajkumar V, Kumar B, Dutta V, Mishra AK, Puri GD

Abstract
OBJECTIVES: To assess the utility of Sonoclot in prediction of postoperative bleeding in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass for congenital cyanotic heart disease.
DESIGN: Prospective, observational study.
SETTING: Single university hospital.
PARTICIPANTS: Eighty-seven pediatric patients undergoing cardiac surgery for congenital cyanotic heart disease.
INTERVENTIONS: Laboratory coagulation parameters (prothrombin time, international normalization ratio, activated partial thromboplastin time, fibrinogen, D-dimer) as well as point-of-care Sonoclot glass bead activation time, clot rate, and platelet function (gbPF) were done before induction of anesthesia and following heparin reversal after termination of cardiopulmonary bypass (CPB) in all patients.
MEASUREMENTS AND MAIN RESULTS: Postoperative blood loss was monitored by the amount of chest tube drainage. The primary outcome was to define Sonoclot parameters for prediction of postoperative bleeding. Secondary outcomes studied were amount of postoperative blood loss, transfusion requirement of various blood products, incidence of surgical re-exploration, duration of postoperative mechanical ventilation, intensive care unit and hospital stay. Among studied subjects, 37.9% (33 of 87 patients) were designated as bleeders while 62.1% (54 of 87 patients) were non-bleeders. Lower age, D-dimer, and gbPF test after termination of CPB following heparin neutralization were predictive for postoperative bleeders. Among these, post-protamine gbPF had the highest area under the curve (0.725), 95% confidence interval (0.619-0.831) for prediction of postoperative bleeders. Duration of mechanical ventilation (26.41 ± 36.44 v 8.25 ± 6.36 h, respectively, p = 0.001), intensive care unit stay (7.36 ± 4.05 v 4.96 ± 2.49, p = 0.001), and hospital stay (11.69 ± 4.82 v 8.63 ± 3.48 p = 0.001) were higher in bleeders; however, incidence of re-exploration was comparable between both groups.
CONCLUSION: Postoperative bleeders may be predicted independently by post-CPB gbPF, postoperative D-dimer, and lower age of patients. Among these, post-CPB gbPF has maximum predictive value.

PMID: 28365134 [PubMed - as supplied by publisher]

Categorías: Cirugía congénitos

Long-Term Outcomes and Complications of Intracardiac Echocardiography-Assisted Patent Foramen Ovale Closure in 1,000 Consecutive Patients.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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Long-Term Outcomes and Complications of Intracardiac Echocardiography-Assisted Patent Foramen Ovale Closure in 1,000 Consecutive Patients.

J Interv Cardiol. 2016 Oct;29(5):530-538

Authors: Rigatelli G, Pedon L, Zecchel R, Dell'Avvocata F, Carrozza A, Zennaro M, Mazza A, Zuin M, Russo M, Zanchetta M

Abstract
BACKGROUNDS: Long-term fate of patients submitted to patent foramen ovale (PFO) closure is still unclear. The aim of the study was to evaluate the incidence of atrial fibrillation (AF), aortic or atrial free wall erosion, device thrombosis (DT), new onset or worsening of mitral valve regurgitation (MVR), and recurrent cerebral ischemic events in the long-term follow up after intracardiac echocardiography (ICE)-aided PFO closure in a large population.
METHODS: We reviewed the medical and instrumental data of 1,000 consecutive patients (mean age 47.3 ± 17.1 years, females) prospectively enrolled in 2 centres over a 13 years period (February 1999-February 2012) for R-to-L shunt ICE-aided catheter-based closure using different devices.
RESULTS: Immediate success was 99.8%. Implanted devices were Amplatzer PFO Occluder in 463 patients (46.3%), Amplatzer ASD Cribriform Occluder in 420 patients (42.0%), Premere Occlusion System in 95 patients (9.5%), and Biostar Occluder in 22 patients (2.2%). On a mean follow-up of 12.3 ± 0.6 years (minimum 4- maximum 17 years), permanent AF occurred in 0.5%, DT was apparent in 0.5%, new onset or worsening of MVR was observed in 0.2%, whereas recurrent cerebral ischemic events were 0.8%. Occlusion rate was 93.8%. No aortic or atrial free wall erosion has been observed.
CONCLUSION: ICE-aided closure of PFO using different devices, appeared very safe and effective on very long-term follow up with low incidence of erosion, DT, recurrent ischemic events, MVR new onset or worsening, and permanent AF.

PMID: 27500752 [PubMed - indexed for MEDLINE]

Categorías: Cirugía congénitos

Lack of Impact of Presence of Positive C4d Staining in Capillaries in Myocardial Biopsies on Long-term Survival of Heart Transplant Patients.

Congenital cardiac surgery - Mar, 04/04/2017 - 18:18
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Lack of Impact of Presence of Positive C4d Staining in Capillaries in Myocardial Biopsies on Long-term Survival of Heart Transplant Patients.

Transplant Proc. 2016 Jun;48(5):1767-9

Authors: Zieliński T, Sobieszczańska-Małek M, Karczmarz M, Komuda K, Grajkowska W, Pronicki M, Szymańska S, Kluge P, Browarek A, Bekta P, Karcz M, Parulski A, Wójcik A, Klisiewicz A, Kuśmierczyk M, Różański J, Korewicki J

Abstract
BACKGROUND: The long-term survival of 209 consecutive patients (mean age, 46 ± 15 years) from a single center with ≥1 diagnostic myocardial biopsy after heart transplantation was analyzed.
METHODS: Patients were considered as C4d positive if a capillary staining (immunohistochemistry in paraffin samples) was observed in ≥1 myocardial biopsy. Data were analyzed according to pathologic consensus of antibody mediated rejection definition of C4d+ positivity: 2004 definition in group A and the 2013 definition in group B and compared with their respective controls, composed of patients who do not meet those criteria. Age, follow-up time, and number of biopsies were comparable between patients with C4d+ and controls in both groups. Follow-up was 100% complete with mean of observation time 2143 days.
RESULTS: During the follow-up period, 62 patients died (group A: C4d+ 32% vs controls 29%; group B: C4d+ 36% vs controls 29% [P = NS]). There were no differences in survival between patients with positive staining and without C4d+ staining when Kaplan-Meier survival curves were compared.
CONCLUSIONS: The presence of C4d positive staining in myocardial capillaries of heart biopsies of patients after heart transplantation, as an isolated finding, was not related to worse long-term survival.

PMID: 27496488 [PubMed - indexed for MEDLINE]

Categorías: Cirugía congénitos

Postoperative interventricular septal haematoma following tetralogy of Fallot repair and perimembranous ventricular septal defect repair.

Congenital cardiac surgery - Lun, 04/03/2017 - 18:10
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Postoperative interventricular septal haematoma following tetralogy of Fallot repair and perimembranous ventricular septal defect repair.

Interact Cardiovasc Thorac Surg. 2017 Feb 01;24(2):296-298

Authors: Bailey FJ, Jivanji SG, Kostolny M

Abstract
Interventricular septal haematoma is a rare postoperative complication in congenital heart surgery. We present one case of a 6-month-old after tetralogy of Fallot repair and 1 case of a 10-month-old after ventricular septal defect repair. Both were noted to have interventricular septal haematoma on intraoperative transoesophageal and postoperative echocardiogram. Although multiple previous reports, mainly in adults, have suggested aggressive intervention, both these cases were managed conservatively, highlighting the management and evolution of a rare postoperative complication in the paediatric population.

PMID: 28364481 [PubMed - in process]

Categorías: Cirugía congénitos

Surgical management of hydatid bilio-bronchial fistula by exclusive thoracotomy.

Congenital cardiac surgery - Lun, 04/03/2017 - 18:10
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Surgical management of hydatid bilio-bronchial fistula by exclusive thoracotomy.

Int J Surg. 2017 Mar 28;:

Authors: Rabiou S, Lakranbi M, Ouadnouni Y, Panaro F, Smahi M

Abstract
In the industrialized countries, most of Bilio-bronchial fistula are secondary to hepatobiliary trauma, hepatic resection surgery or in the case of congenital malformation of the biliary tract, Bilio-bronchial fistula is recognized as the complication of a number of infectious pathologies such as hydatidosis and hepatic amoebiasis. Among the causes, the Bilio-bronchial fistula of hydatic origin is by far the most frequent especially in the zones of hydatid endemic as Morocco. It is a serious complication of liver hydatid cysts. The surgical management has long been believed to be difficult, and often associated with a very pejorative prognosis due to the simultaneous attack of the thoracic and abdominal stage through the diaphragm. This tripartite involvement reflects the difficulty of choosing the first approach between the thoracic, abdominal or a combination of both approaches. However, progress, especially in the possibility of carrying out adequate preoperative preparation with the increasing introduction of retrograde endoscopic cholangiography with sphincterotomy, has made possible this exclusive thoracotomy surgery with acceptable outcomes.

PMID: 28363624 [PubMed - as supplied by publisher]

Categorías: Cirugía congénitos

Evolution of right ventricular size over time after tetralogy of Fallot repair: a longitudinal cardiac magnetic resonance study.

Congenital cardiac surgery - Sáb, 04/01/2017 - 16:36
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Evolution of right ventricular size over time after tetralogy of Fallot repair: a longitudinal cardiac magnetic resonance study.

Eur Heart J Cardiovasc Imaging. 2017 Mar 01;18(3):364-370

Authors: Rutz T, Ghandour F, Meierhofer C, Naumann S, Martinoff S, Lange R, Ewert P, Stern HC, Fratz S

Abstract
Aims: It is commonly believed that pulmonary regurgitation (PR) after surgical repair of tetralogy of Fallot (TOF) leads to progressive right ventricular (RV) enlargement. However, progressive RV dilatation has never clearly been documented in this patient population. Therefore, we studied the size of the RV over time in patients after surgical TOF repair.
Methods and results: Fifty-one consecutive patients after surgical TOF repair underwent at least two cardiovascular magnetic resonance (CMR) exams using a single CMR scanner. Patients with RV outflow tract obstruction, interventions other than the initial repair and CMR exams with use of sedation were excluded. Three subgroups with different repair techniques were studied: transannular patch repair [n = 22, age 17 ± 10 years], subvalvular patch repair [n = 15, age 22 ± 8 years], or non-patch repair/infundibulectomy (n = 14, age 28 ± 11 years). Right ventricular end-diastolic volume index (RVEDVI) and PR fraction did not change during the 37 ± 21 months follow-up between first and last CMR in the whole group (RVEDVI: 118 ± 23 mL/m2 vs. 119 ± 23 mL/m2, P = 0.720; PR fraction: 33% (23-40%) vs. 32% (24-39%), P = 0.268). RVEDVI remained stable in all subgroups (transannular patch: 120 ± 21 mL/m2 vs. 122 ± 22 mL/m2, subvalvular patch: 112 ± 23 mL/m2 vs. 111 ± 23 mL/m2, non-patch: 123 ± 28 mL/m2 vs. 123 ± 23 mL/m2, P = 0.827). RVEDVI at last CMR did not differ between groups (P = 0.301).
Conclusions: This study shows no progression of RV dilatation in patients after surgical repair of TOF with moderately dilated RVs and significant PR during a 3-year follow-up. RV dilatation in our patient group seems to be independent from surgical repair techniques.

PMID: 28363200 [PubMed - in process]

Categorías: Cirugía congénitos

Acute kidney injury and fluid overload in infants and children after cardiac surgery.

Congenital cardiac surgery - Sáb, 04/01/2017 - 16:36
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Acute kidney injury and fluid overload in infants and children after cardiac surgery.

Pediatr Nephrol. 2017 Mar 30;:

Authors: Kwiatkowski DM, Krawczeski CD

Abstract
Acute kidney injury is a common and serious complication after congenital heart surgery, particularly among infants. This comorbidity has been independently associated with adverse outcomes including an increase in mortality. Postoperative acute kidney injury has a complex pathophysiology with many risk factors, and therefore no single medication or therapy has been demonstrated to be effective for treatment or prevention. However, it has been established that the associated fluid overload is one of the major determinants of morbidity, particularly in infants after cardiac surgery. Therefore, in the absence of an intervention to prevent acute kidney injury, much of the effort to improve outcomes has focused on treating and preventing fluid overload. Early renal replacement therapy, often in the form of peritoneal dialysis, has been shown to be safe and beneficial in infants with oliguria after heart surgery. As understanding of the pathophysiology of acute kidney injury and the ability to confidently diagnose it earlier continues to evolve, it is likely that novel preventative and therapeutic interventions will be available in the future.

PMID: 28361230 [PubMed - as supplied by publisher]

Categorías: Cirugía congénitos

Clinical Progress in Cell Therapy for Single Ventricle Congenital Heart Disease.

Congenital cardiac surgery - Sáb, 04/01/2017 - 16:36
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Clinical Progress in Cell Therapy for Single Ventricle Congenital Heart Disease.

Circ Res. 2017 Mar 31;120(7):1060-1062

Authors: Bittle GJ, Wehman B, Karathanasis SK, Kaushal S

PMID: 28360342 [PubMed - in process]

Categorías: Cirugía congénitos

Simulation in congenital cardiac surgical education: We have arrived.

Congenital cardiac surgery - Sáb, 04/01/2017 - 16:36
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Simulation in congenital cardiac surgical education: We have arrived.

J Thorac Cardiovasc Surg. 2017 Mar 10;:

Authors: Burkhart HM

PMID: 28359578 [PubMed - as supplied by publisher]

Categorías: Cirugía congénitos

Invited Commentary.

Congenital cardiac surgery - Sáb, 04/01/2017 - 16:36
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Invited Commentary.

Ann Thorac Surg. 2017 Apr;103(4):1292

Authors: Clark JB

PMID: 28359467 [PubMed - in process]

Categorías: Cirugía congénitos

A Permanent Epicardial Pacemaker Lead That Penetrated the Esophageal Wall 26 years After Implantation.

Congenital cardiac surgery - Sáb, 04/01/2017 - 16:36
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A Permanent Epicardial Pacemaker Lead That Penetrated the Esophageal Wall 26 years After Implantation.

Ann Thorac Surg. 2016 Sep;102(3):e185-6

Authors: Inoue S, Hashizume K, Koizumi K, Hotoda K, Shinozaki H

Abstract
We treated a patient in whom a permanent epicardial pacemaker lead penetrated the esophageal wall 26 years after the index pacemaker implantation. A 28-year-old man with loss of appetite and weight loss underwent upper gastrointestinal endoscopy and was found to have a foreign body protruding into the esophagus. Computed tomography revealed an epicardial lead penetrating the esophageal wall. He had undergone pacemaker implantation with permanent epicardial leads when he was 2 years old. The lead was surgically removed.

PMID: 27549536 [PubMed - indexed for MEDLINE]

Categorías: Cirugía congénitos

A Novel Surgical Technique for Right-Sided Interrupted Aortic Arch by Interposition of a Pulmonary Autograft Tube.

Congenital cardiac surgery - Sáb, 04/01/2017 - 16:36
Related Articles

A Novel Surgical Technique for Right-Sided Interrupted Aortic Arch by Interposition of a Pulmonary Autograft Tube.

Ann Thorac Surg. 2016 Aug;102(2):e125-7

Authors: Kato N, Yamagishi M, Miyazaki T, Maeda Y, Asada S, Hongu H, Yamashita E, Yaku H

Abstract
Right-sided interrupted aortic arch (IAA) is a rare cardiac anomaly. In general, the right bronchus sits higher than the left bronchus, so aortic arch reconstruction with a direct anastomosis has a risk of tracheal and bronchial obstruction. This report describes the successful definitive repair of a right-sided IAA in a 2.5-kg neonate by aortic arch reconstruction with a pulmonary autograft tube (PA tube). Postoperative three-dimensional multidetector computed tomography showed the reconstructed aortic arch without airway obstruction or aortic stenosis. The use of a PA tube is a simple and useful technique for aortic arch reconstruction in patients with a high risk of tracheal andbronchial obstruction, such as right-sided IAA.

PMID: 27449446 [PubMed - indexed for MEDLINE]

Categorías: Cirugía congénitos

Congenital cardiac surgery; +33 new citations

Congenital cardiac surgery - Vie, 03/31/2017 - 15:25

33 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

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Categorías: Cirugía congénitos

Prenatal diagnosis, 3-D virtual rendering and lung sparing surgery by ligasure device in a baby with "CCAM and intralobar pulmonary sequestration".

Congenital cardiac surgery - Jue, 03/30/2017 - 14:47
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Prenatal diagnosis, 3-D virtual rendering and lung sparing surgery by ligasure device in a baby with "CCAM and intralobar pulmonary sequestration".

Open Med (Wars). 2016;11(1):200-203

Authors: Molinaro F, Angotti R, Garzi A, Di Crescenzo VG, Cortese A, Messina M

Abstract
Congenital cystic lung lesions are a rare but clinically significant group of anomalies, including congenital cystic adenomatoid malformation (CCAM), pulmonary sequestration, congenital lobar emphysema (CLE) and bronchogenic cysts. Despite the knowledge of these lesions increasing in the last years, some aspects are still debated and controversial. The diagnosis is certainly one aspect which underwent many changes in the last 15 years due to the improvement of antenatal scan and the introduction of 3-D reconstruction techniques. As it is known, a prompt diagnosis has an essential role in the management of these children. The new imaging studies as 3D Volume rendering system are the focus of this paper. We describe our preliminary experience in a case of hybrid lung lesion, which we approached by thoracoscopy after a preoperative study with 3D VR reconstruction. Our final balance is absolutely positive.

PMID: 28352794 [PubMed - in process]

Categorías: Cirugía congénitos

Sternal reconstruction by extracellular matrix: a rare case of phaces syndrome.

Congenital cardiac surgery - Jue, 03/30/2017 - 14:47
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Sternal reconstruction by extracellular matrix: a rare case of phaces syndrome.

Open Med (Wars). 2016;11(1):196-199

Authors: Molinaro F, Garzi A, Cerchia E, Di Crescenzo VG, Luzzi L, Bulotta AL, Gotti G, Messina M

Abstract
Congenital defects of the sternum are rare and due to a failure of midline development and fusion of the sternal bones. Surgical correction of a sternal cleft should be preferred during infancy for functional reasons. Chest wall reconstruction represented a complex problem in the last decades. We report our successful outcome of sternal reconstruction in a rare case of PHACES syndrome, in which the patient was submitted to reconstruction of the sternum and complete closure of the thoracic defect by the employ of an extracellular matrix XCM Biologic tissue matrix. We promote the use of extracellular matrix in surgical reconstruction of chest defects for its maneuverability, plasticity, tolerability and the possibility of growing with the children's chest getting a good compliance and optimal cosmetic results.

PMID: 28352793 [PubMed - in process]

Categorías: Cirugía congénitos
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