Long-term outcome after treatment of pulmonary atresia with ventricular septal defect: nationwide study of 109 patients born in 1970-2007 CONGENITAL

This study evaluated 41-year experience of outcome, survival and treatment of PA + VSD patients. METHODS Patient records and angiograms of 109 patients with PA + VSD born in Finland between 1970 and 2007, and treated at the Children's Hospital, Helsinki University Central Hospital, were retrospectively analysed in this nationwide study. RESULTS Of the 109 patients, 66 (61%) had simple PA + VSD without major aortopulmonary collateral arteries (MAPCAs). Although we observed no difference in overall survival between those with or without MAPCAs, the patients without MAPCAs had better probability to achieve repair (64 vs 28%, P
Source: European Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Mechanical Circulatory Assistance CONGENITAL Source Type: research

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Atrial enlargement  The normal P wave has a maximum amplitude of 2.5 mm (0.25 mV) and a maximum width of 2.5 mm (100 ms). In right atrial enlargement, the amplitude increases while in left atrial enlargement, it is the width (duration) which increases. Both increases in biatrial enlargement. P wave abnormalities are best assessed in leads II and V1. Normal P wave is upright in lead II. In V1, a tiny initial spike is followed by a shallow negative wave. P mitrale: P mitrale is a notched and broad P wave with taller second peak indicating left atrial enlargement. It may be noted that initial part of P wave is contribut...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC incomplete right bundle branch block pattern Left ventricular pressure overload left ventricular volume overload LVH strain pattern P mitrale P pulmonale P tricuspidale Right ventricular pressure overload right ventricular volume ove Source Type: blogs
We describe 3 children with complex congenital heart defects who have a variable degree of segmental pulmonary hypertension and discuss management strategies and the role of interventional and/or pulmonary hypertension targeted therapies. PMID: 32987636 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
General examination – eyes and facial dysmorphism Clinically examination is guided by the symptoms. Unless the history is not correlated with findings, important diagnostic possibilities may be missed. Clinical examination starts off with a focused general examination followed by a detailed examination of the cardiovascular system. Relevant points in other systems like basal crepitations, hepatosplenomegaly and neurological deficits should be looked for. Examination strategy should be fitting to the clinical situation. When a patient presents to the emergency room, it should be a short but focused examination to perm...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC Source Type: blogs
Publication date: Available online 4 September 2020Source: The Annals of Thoracic SurgeryAuthor(s): Eung Re Kim, Chang-Ha Lee, Woong-Han Kim, Jae Hong Lim, Yong-Jin Kim, Jooncheol Min, Sungkyu Cho, Jae Gun Kwak
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
In this study, we report the combined outcomes from 2 hospitals using different strategies. METHODS: Between 2004 and 2017, 66 neonates underwent surgery with palliative shunts (BTS group: n=30, 45.5%) or primary biventricular repair (pBVR group: n=36, 54.5%). The two groups were similar in age, body weight, and Nakata index scores. The overall mean follow-up duration was 7.51 ± 4.35 years, and early and late results were compared between the groups. RESULTS: The 10-year overall survival was 84.8% (94.4% for pBVR versus 75.7% for BTS, p=0.032). The BTS group had 2 early and 6 interstage mortalities, while ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Objectives: Caring for a child with gastrostomy and/or tracheostomy can cause measurable parental stress. It is generally known that children with 22q11.2 deletion syndrome are at greater risk of requiring gastrostomy or tracheostomy after heart surgery, although the magnitude of that risk after complete repair of tetralogy of Fallot has not been described. We sought to determine the degree to which 22q11.2 deletion is associated with postoperative gastrostomy and/or tracheostomy after repair of tetralogy of Fallot. Design: Retrospective cohort study. Setting: Pediatric Health Information System. Patients: Child...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research
Conclusion: Evaluating patients with PA/VSD/MAPCAs in detail and subdividing them is quite useful in determining the appropriate surgical approach. With this strategy, TC can be achieved in most patients. Single-stage TC is better than other surgical methods due to its lower mortality and reintervention rates. Care should be taken in terms of early postoperative intensive care complications and reintervention indications during follow-ups.
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Discussion Congenital heart diseases (CHD) are malformations of the heart and great vessels. It occurs in about 5-8/1000 live births. Cyanotic congenital heart disease is often noted perinatally because of cyanosis, respiratory distress and/or poor feeding or other distress type problems. A review can be found here. Acyanotic congenital heart disease (ACHD) can present at birth but often is seen in older children or adults unless the lesions are severe, especially obstructive lesions. Severe lesions may also cause cyanosis and distress type problems in patients also. Shunting lesions cause problems by diverting blood flo...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Despite advances in surgical techniques, residual pulmonary valve regurgitation and right ventricular outflow tract obstruction remain problematic for many patients with tetralogy of Fallot, pulmonary atresia with ventricular septal defect, and congenital pulmonary valve stenosis after their initial surgical intervention.1 Pulmonary valve regurgitation has been especially detrimental to these patients' long-term cardiovascular health, as morbidity related to chronic pulmonary valve regurgitation was not initially recognized, pulmonary valve regurgitation diagnosis can be missed by providers who do not care for congenital h...
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
AbstractWe hereby present a rare variant course of left brachiocephalic vein coexisting with an aberrant right subclavian artery in a patient with a ventricular septal defect with pulmonary atresia. This case highlights the importance of CT angiography in diagnosing associated aortic arch and systemic venous anomalies in complex congenital heart diseases.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: IMAGES IN CARDIAC SURGERY Source Type: research
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