Pre-operative veno-venous ECMO for D-Transposition with severe pulmonary hypertension in a newborn.
We report the case of a newborn with transposition of great arteries and ventricular septal defect associated with severe pulmonary hypertension. Profound hypoxaemia despite successful balloon atrial septostomy and conventional supportive measures with mechanical ventilation, inhaled nitric oxide, and inotropes led to the use of veno-venous extracorporeal membrane oxygenation to rapidly stabilized the child pre-operatively. Different from most reported cases on this scenario, we intentionally opted for a veno-venous mode of support despite the presence of circulatory compromise. PMID: 31586616 [PubMed - as supplied by publisher]
CONCLUSION: pmVSD closure with the Nit-Occlud Lê VSD Coil is feasible in older children and adults. However, residual shunting (leading to haemolysis) is a dreaded complication that should not be tolerated. pmVSD closure with the Nit-Occlud Lê VSD as a therapeutic strategy remains controversial and is limited to selected patients. PMID: 31982353 [PubMed - as supplied by publisher]
ConclusionInterventional paediatric catheterisation has grown remarkably in Morocco. These procedures have become the treatment of choice for many cardiac lesions, and serve as alternatives or adjuncts to surgical treatment.
AbstractPulmonary arterial hypertension (PAH) related to left-to-right shunt can progress to Eisenmenger syndrome, a serious and fatal disease that is not yet curable. This pilot study considered stem cell injection as a new treatment modality in persistent pulmonary hypertension after the correction of a congenital heart defect. Three patients with persistent pulmonary hypertension after ventricular septal defect repair were included in this pilot study for a clinical trial. Mononuclear stem cells derived from patients ’ bone marrow specimens were injected into the right and left pulmonary arteries via cardiac cathe...
Patients with simple shunt lesions, such as atrial septal defect (ASD), ventricular septal defect (VSD) and persistent arterial duct (PDA) remain at risk of developing pulmonary hypertension (PH) even after correction of their cardiac defect. We aimed to assess the contemporary prevalence of PH in a well characterized nationwide group of patients based on the German National Register for Congenital Heart Defects.
ConclusionSurgery in adult patients with congenital heart disease may be successfully performed with low morbidity and mortality.
AbstractTransthoracic echocardiogram (TTE) is commonly used to screen for pulmonary hypertension (PHTN) in neonates and young infants. However, in the absence of sufficient tricuspid regurgitation (TR), a ventricular septal defect (VSD), or a patent ductus arteriosus (PDA), the estimation of systolic pulmonary artery pressure (SPAP) becomes challenging. Pulmonary artery acceleration time (PAAT) is an alternate parameter that is easy to obtain in almost all patients and does not require the presence of tricuspid valvar regurgitation or an anatomical cardiac defect. We sought to examine the correlation of PAAT with estimated...
We report the case of a newborn with transposition of great arteries and ventricular septal defect associated with severe pulmonary hypertension. Profound hypoxaemia despite successful balloon atrial septostomy and conventional supportive measures with mechanical ventilation, inhaled nitric oxide, and inotropes led to the use of veno-venous extracorporeal membrane oxygenation to rapidly stabilized the child pre-operatively. Different from most reported cases on this scenario, we intentionally opted for a veno-venous mode of support despite the presence of circulatory compromise.
Publication date: Available online 17 September 2019Source: Journal of Cardiology CasesAuthor(s): Roberto Mijangos-Vázquez, Rogelio Hernández-Reyes, José R. López-JiménezAbstractGerbode defect is defined as an abnormal left ventricle–right atrium shunting which may have congenital or acquired origin, first described by Thurman in 1838, representing 0.08% of intracardiac shunts and
CONCLUSION: Transcatheter PDA closure can be performed with high success rate in highlanders. Off-label devices may be required for these procedures. Pulmonary hypertension is frequent but regresses after ductal closure. Transient left ventricular dysfunction after transcatheter closure is rarely seen in these patients and resolves without any medication. PMID: 31483299 [PubMed - in process]
Conclusion: The prevalence of CHD in patients with Down syndrome is similar between Malaysia and high-income countries. The lower survival rate is attributed to limited expertise and resources which limit timely surgery.What is Known:•The survival of patients with Down syndrome with congenital heart disease (CHD) has improved in high-income countries. However, little is known about the survival of patients with Down syndrome with CHD from middle-income countries.•In the Caucasian population, atrioventricular septal defect is the most common type of CHD associated with Down syndrome.What is New:•In middle-inc...