Patients who underwent a Fontan procedure for single ventricle physiology were evaluated with serial cardiac MR over time to identify changes in vessel characteristics and their relationship to flow. Although vessel diameter increased over time, normalized diameters decreased. This was not associated with changes in flow, but hemodynamic efficiency
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January 10, 2015
Increased Congenital Heart Defects in Children Born to Women with Systemic Lupus Erythematosus: Results from the Offspring of Systemic Lupus Erythematosus Mothers Registry Study
November 17, 2014
The authors aimed to study whether systemic lupus erythematosus (SLE) resulted in an increased risk of congenital heart defects (CHD). Mothers with SLE were selected from a large Quebec healthcare database and matched to mothers without SLE. Children born to mothers with SLE were more likely to experience CHD (5.2% versus 1.9%).
Excess Costs Associated With Complications and Prolonged Length of Stay After Congenital Heart Surgery
November 5, 2014
Challenges of balancing reduced costs and improved quality were explored for congenital heart surgery linking clinical data from STS Congenital Heart Surgery Database patients to administrative data from the Pediatric Health Information Systems Database. Excess costs associated with any complication were over $56,000, and this increased to more than
October 20, 2014
This video demonstrates a hybrid procedure for the closure of a large muscular ventricular septal defect in a 4-month-old boy. This direct approach is very useful in small patients with apical defects and difficult vascular access.
Effect of Preoperative ACE- Inhibitor and ARBs in Pediatric Patients Undergoing Cardiopulmonary Bypass
October 16, 2014
In a retrospective cohort study of patients less than 18 years old who underwent cardiopulmonary bypass, intraoperative hemodynamics and vasopressor use were compared between patients who received preoperative ACE inhibitor/ARB therapy and those who did not.
October 1, 2014
Optimal management of a VSD at the time of coarctation repair is controversial. The retrospective review of the Pediatric Cardiac Care Consortium 1982-2007 evaluated outcomes for 2,022 patients. The presence of a VSD increased operative mortality 4-fold to 8.3%. Patients underwent coarct repair and VSD closure at an older age (87 days) than for
Surgeon and Center Volume Influence on Outcomes After Arterial Switch Operation: Analysis of the STS Congenital Heart Surgery Database
September 4, 2014
The impact of center and surgeon volume on outcomes after arterial switch for TGV was investigated using data from the STS database. Median center and surgeon annual volumes were 4 and 2. Both center and surgeon volume were important determinants of the composite outcome (death or major complication), with surgeon volume having the most important e
August 5, 2014
The formation of endotracheal casts comprised of inflammatory debris (plastic bronchitis) is a rare but life-threatening complication of the Fontan procedure. This summary of 14 pts so affected demonstrated a mean interval to development of plastic bronchitis of 1.5 years. Casts were treated with outpt t-PA (13 pts) and pulmonary vasodilators. Les
What is the Optimal Position for the Surgeon during an Infracardiac Total Anomalous Pulmonary Venous Drainage Repair?
July 23, 2014
This video shows the repair of an infracardiac Total Anomalous Pulmonary Venous Drainage (TAPVD) with the surgeon standing to the left of the patient.
July 17, 2014
Filmed at the 2014 STS Annual Meeting in Orlando, Florida, this roundtable discussion focuses on the management of adults with congenital heart disease. Joseph Dearani moderates this discussion with Stephanie Fuller, Ralph Mosca, and Thomas MacGillivray.