Right Ventricle-to-Pulmonary Artery Shunt in Pulmonary Atresia with a Ventricular Septal Defect: A Word of Caution

AbstractThe management of pulmonary atresia with a ventricular septal defect (PA/VSD) depends on the anatomy of the pulmonary artery or on the surgical strategy used at individual institutions. In our institution, we adopted a right ventricle-to-pulmonary artery (RV-PA) shunt in 2011 as a palliative procedure for PA/VSD to overcome the disadvantages of a Blalock-Taussig shunt. We evaluated the results of the RV-PA shunt as initial palliative surgery for PA/VSD. Thirteen patients with ductus-dependent PA/VSD from August 2011 to August 2015 were enrolled. The mean age at surgery was 17.9  ± 15.3 (range 5–60) days, and the mean body weight was 2.9 ± 0.6 (range 2.2–4.0) kg. A Gore-Tex tube graft was used in all patients. We retrospectively observed intra- and postoperative complications, early and late mortality, and palliation duration to definitive repair. Left pulmona ry artery angioplasty was performed as a concomitant procedure in three patients. There were no early hospital mortalities, although two inter-stage deaths occurred 34 and 47 days postoperatively: one patient died of aspiration and the other of right ventricular outflow tract (RVOT) pseudoaneurysm rupture. Two patients (15.4%) required the extracorporeal membrane oxygenation support postoperatively: one because of failure to wean from a bypass caused by persistent hypoxemia and the other because of sudden massive bleeding from the RVOT suture line in the ...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research

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Authors: Hicks SM, Coupland LA, Jahangiri A, Choi PY, Gardiner EE Abstract Diagnosis of immune thrombocytopenia (ITP) and prediction of response to therapy remain significant and constant challenges in hematology. In patients who present with ITP, the platelet count is frequently used as a surrogate marker for disease severity, and so often determines the need for therapy. Although there is a clear link between thrombocytopenia and hemostasis, a direct correlation between the extent of thrombocytopenia and bleeding symptoms, especially at lower platelet counts is lacking. Thus, bleeding in ITP is heterogeneous, unp...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
Authors: Fernández Conesa M, Milena Muñoz A, Valero González MÁ Abstract We read with interest the article by Guido Villa-Gómez, Manuel Alejandro Mahler and Dante Manazzoni "A new case of pseudoaneurysm of the right hepatic artery secondary to laparoscopic cholecystectomy". A 57-year-old cholecystectomized female was admitted due to abdominal pain with an analytical pattern of cholestasis and liver enzyme alterations, with cholangitis that progressed to septic shock of a biliary origin with gradual anemia and hypotension. PMID: 32054281 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We present the clinical case of a 34-year-old woman with a history of stage IV choriocarcinoma, after her diagnostic debut two years ago, a hysterectomy and resection of the right single pulmonary nodule with anatomopathological confirmation of both as uterine choriocarcinoma and pulmonary nodule compatible with metastatic choriocarcinoma, subsequently the patient received chemotherapy treatment with stability of her disease until now. PMID: 32054277 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
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Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
Authors: Kim JH, Choi PW, Um E, Jung SM, Shin YC, Jung SW, Kim JI, Heo TG, Lee MS, Jun H Abstract Purpose: Since insertion of foreign body (FB) into the anus is considered as taboo practice, the patients may impose therapeutic dilemma on attending surgeon. Herein, we performed present study to evaluate the clinical characteristics of patient with retained rectal FB in Koreans, and to suggest management guideline for such cases. Methods: We retrospectively investigated 14 patients between January 2006 and December 2018. We assessed demographic features, mechanism of FB insertion, clinical course between diagnosi...
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
Authors: Chung JS, Kwak HD, Ju JK Abstract Purpose: There has been a concern that the concept of enhanced recovery after surgery could affect other proposed quality measures, including the rate of readmission due to early discharge. We aimed to examine the 30-day readmission rate, risk factors associated with readmission after elective colorectal surgery for colon cancer, causes of readmission, disease-free survival (DFS), and overall survival (OS) in a single institution. Methods: We retrospectively investigated 292 patients who underwent elective colorectal surgery for colon cancer between 2010 and 2015. Base...
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
This report describes an infant diagnosed with pulmonary atresia, ventricular septal defect, and multifocal collateral lung perfusion through four major aortopulmonary collateral arteries (MAPCAs). A central aorto‚Äźpulmonary shunt was performed at 4 months of age. Because of postoperative pulmonary hyperperfusion, one of the MAPCAs was closed interventionally using a 5 mm AVP4. This MAPCA originated from the descending aorta (DAO) near the fifth thoracic vertebra and ran behind the esophagus to the lower lobe of the right lung. The MAPCA was closed near its origin from the DAO. Four weeks later, the patient presented with...
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Pediatric and Congenital Heart Disease Source Type: research
More News: Anatomy | Angioplasty | Atresia | Bleeding | Cardiology | Gastroschisis Repair | Heart | Hole in the Heart | Hospital Management | Hospitals | Intensive Care | Palliative | Palliative Care | Pediatrics | Pulmonary Artery Catheterization | Ventricular Septal Defect