Results of AV valve surgery in patients with Fontan circulation were evaluated over a 23 year period. 54 (9.3%) of patients requird AV valve surgery, mostly prior to the Fontan operation. 90% of patients were free from death or transplantation at 5 years; this fell to 81% at 10 years. Nearly 45% required AV valve reoperation. The rate of persis
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Congenital
April 15, 2015
Propensity score-matched analysis of surgical ligation versus medical management of clinically significant patent ductus arteriosus in premature (<37 weeks), extremely low birth weight infants (<1000 g). Infants undergoing surgical ligation had lower mortality (15% vs 26%) and a higher rate of routine disposition from the hospital (48% vs 41%)
April 2, 2015
Repair of this congenital defect in 34 pts was associated with no early mortality and substantial improvement in LV function (EF, shortening fraction, LVEDD). No postoperative circulatory support was required.
March 2, 2015
This study examined the utility/accuracy of an administrative database compared to the STS Congenital Database for the outcome of mortality, which is used to rank quality. The administrative database had substantially lower volume and mortality numbers than the STS Database, resulting in ranking differences of 5 or more places for 24% of hospitals.
January 10, 2015
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
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%).
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.
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