Ventricular Dysfunction is a Critical Determinant of Mortality in Congenital Diaphragmatic Hernia.

Ventricular Dysfunction is a Critical Determinant of Mortality in Congenital Diaphragmatic Hernia. Am J Respir Crit Care Med. 2019 Aug 13;: Authors: Patel N, Lally PA, Kipfmueller F, Massolo AC, Luco M, Van Meurs KP, Lally KP, Harting MT, Congenital Diaphragmatic Hernia Study Group Abstract RATIONALE Congenital diaphragmatic hernia (CDH) is an anomaly with a high morbidity and mortality. Cardiac dysfunction may be an important and under-recognized contributor to CDH pathophysiology and determinant of disease severity. OBJECTIVES To investigate the association between early, postnatal ventricular dysfunction and outcome among infants with CDH. METHODS Multicenter, prospectively-collected data in the Congenital Diaphragmatic Hernia Study Group (CDHSG) registry, abstracted between 2015 and 2018, were evaluated. Ventricular function on early echocardiograms, obtained within the first 48 hours of life, was categorized into four hierarchical groups: normal function, right ventricular dysfunction only (RVdys), left ventricular dysfunction only (LVdys), and combined RV and LV dysfunction (RV&LVdys). Univariate, multivariate, and Cox proportional hazards regression analyses were performed. MEASUREMENT AND MAIN RESULTS Cardiac function data from early echocardiograms were available for 1173 (71%) cases and categorized as normal in 711 (61%), RVdys in 182 (15%), LVdys in 61 (5%), and combined RV&LVdys in 219 (19%) cases. Ventricular dysfunction was significantly as...
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research

Related Links:

CONCLUSION: Morgagni hernias are amenable to minimally invasive repair with this simple technique. With large defects, synthetic patches should be used. Recurrences are rare, and morbidity is low. PMID: 31926567 [PubMed - in process]
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
We report a case of Fryns Syndrome who was incidentally found to have Edward Syndrome as well. Such an extremely rare combination is yet to be reported in medical literature.Also with updated genetic studies, better diagnostics and treatment options coming up in future, there are chances to improve the survivability of these babies. It is prudent to document all such cases to aid in better understanding of the disease process.
Source: Medical Journal Armed Forces India - Category: General Medicine Source Type: research
We describe a newborn with fetal aberrant ductus venosus with progressive right ventricular dilation prompting early delivery. Post-natally, the baby had frequent episodes of cyanosis. Echocardiogram during distress showed compression of the inferior vena cava and of the right heart, with significant right to left shunt through patent foramen ovale. Infant underwent successful laparoscopic diaphragmatic hernia repair with resolution in her episodes of cyanosis.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
Recurrence of congenital diaphragmatic hernia (CDH) was retrospectively evaluated after correction with or without a patch in an institution where tension-free repair is advocated.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
CONCLUSIONS: AKI is common in CDH cases treated in our centre and is associated with adverse outcomes. Potentially modifiable risk factors include nephrotoxic medication exposure. Prevention and early recognition of contributory factors for AKI may improve outcomes in CDH. PMID: 31639793 [PubMed - as supplied by publisher]
Source: Neonatology - Category: Perinatology & Neonatology Authors: Tags: Neonatology Source Type: research
We reported the surgical repair of bilateral CDH in a male infant aged 6 weeks. The patient had herniation of the liver on the right side with HPF in association with anomalous drainage of the right pulmonary vein into the hepatic vein and ventricular septal defect. We approached both sides thoracoscopically; however, the right side required a subcostal incision. We separated the liver from the right lower lung lobe laterally using electrocautery, and the defect was closed with a mesh. The medial portion was left intact to avoid injury of the anomalous pulmonary venous drainage. After 2 weeks, the patients had a surgi...
Source: Saudi Medical Journal - Category: Middle East Health Tags: Saudi Med J Source Type: research
Publication date: Available online 9 September 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): Amanda Muñoz, Victoria Pepper, Faraz A. Khan, Andrei RadulescuAbstractAnterior diaphragmatic hernias through the foramen of Morgagni are rare accounting for about 3% of surgically treated diaphragmatic hernias. Current management of Morgagni type diaphragmatic hernias involves surgical intervention, which is traditionally done by open laparotomy, laparoscopy or thoracoscopic approach. Here we present the case of a two year old female with a Morgagni type congenital diaphragmatic hernia (CDH) found during wo...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
Congenital diaphragmatic hernia (CDH) repair is technically challenging with different approaches for repair. The aim of this study was to compare outcomes between patch and flap repair.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
ConclusionAlthough there was a trend towards an increased risk of the pectus deformity and scoliosis in patients repaired with muscle flap, it did not reach statistical significance. There is a correlation between musculoskeletal deformities and the severity of the CDH.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
AbstractBackground/purposeThe volume –outcome relationship and optimal surgical volumes for repair of congenital anomalies in neonates is unknown.MethodsA retrospective study of infants who underwent diaphragmatic hernia (CDH), gastroschisis (GS), and esophageal atresia/tracheoesophageal fistula (EA/TEF) repair at US hospitals using the Kids ’ Inpatient Database 2009–2012. Distribution of institutional volumes was calculated. Multi-level logistic/linear regressions were used to determine the association between volume and mortality, length of stay, and costs.ResultsTotal surgical volumes were 1186 for CDH...
Source: Pediatric Surgery International - Category: Surgery Source Type: research
More News: Congenital Diaphragmatic Hernia | Congenital Diaphragmatic Hernia Repair | Gastroschisis Repair | Hernia Repair | Liver | Pediatric Hernia | Pediatric Hernia Repair | Respiratory Medicine | Study | Urology & Nephrology