Spillover of Early Extubation Practices From the Pediatric Heart Network Collaborative Learning Study*

Conclusions: We observed spillover of extubation practices promoted by the Collaborative Learning Study clinical practice guideline to lower complexity operations not included in the original study that was sustainable 1 year after study completion, though this effect differed across sites and operation subtypes. No changes in postoperative extubation outcomes following higher complexity surgeries were seen. The significant variation in outcomes by site suggests that center-specific factors may have influenced spillover of clinical practice guideline practices.
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

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Limited data are available on long-term outcome after repair of partial atrioventricular septal defects (pAVSD) in adults. We sought to review our experience. Between 1/1/1957 and 12/31/2016, 179 adult patients [median age (IQR) 34 (18, 72) years] underwent primary repair of pAVSD. The most common associated defects were secundum atrial septal defect (n=38) and ventricular septal defect (VSD) (n=7). Left atrioventricular valve (LAVV) zone of apposition (ZOA) was complete in 47 patients and LAVV regurgitation ( ≥moderate) was present in 73 patients.
Source: Seminars in Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CONGENITAL – Original Submission Source Type: research
AbstractA meta-analysis is performed for a comparison of outcomes between the modified one-patch repair (MPR) and two-patch repair (TPR) for complete atrioventricular septal defects (CAVSD). Electronic databases, including PubMed, Scopus, Embase, and Cochrane Library were searched systematically for the literature which aimed mainly at comparing the therapeutic effects for CAVSD administrated by MPR and TPR. Corresponding data sets were extracted and two reviewers independently assessed the risks of bias. Meta-analysis was performed using Revman 5.3 and Stata 12.0. Fifteen studies meeting the inclusion criteria were includ...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research
Abstract BACKGROUND: To identify modifiable factors to improve survival of neonatal biventricular repair by analyzing the cause of death and predictors of mortality and re-intervention in the last two decades. METHODS: 991 consecutive neonates between 1995 and 2016 were included. The cohort was divided by era: Era I(1995-1999), Era II(2000-2007), Era III(2008-2016). The Kaplan-Meier method was used to estimate freedom from death and re-intervention. Univariable and multivariable Cox regression was applied to assess predictors for mortality or re-intervention in the contemporary cohorts(2000-2016). RESULT...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
ConclusionsSecondary subaortic stenosis (SSS) occurs after DORV surgery. The Konno operation or the RRIB can be selected for surgical correction, which is more satisfactory and safer for the treatment of stenosis. For patients with SSS after the operation of VSD or PAVSD, the FMR can be chosen for the operation. The operation is relatively simple, the operation time is short and the effect is satisfactory. Existing problems include that the incidence of a third ‐degree atrioventricular block is slightly higher after the operation.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Abstract OBJECTIVE: To examine the performance of the routine 11-13 weeks scan in detecting fetal non-chromosomal abnormalities. METHODS: This was a retrospective study of prospectively collected data from 100,997 singleton pregnancies attending for a routine ultrasound examination for fetal anatomy, according to a standardized protocol, at 11-13 weeks' gestation. All continuing pregnancies had an additional scan at 18-24 weeks and 71,754 had a scan at either 30-34 or 35-37 weeks. The final diagnosis of fetal abnormalities was based on the results of postnatal examination in the case of livebirths and on the ...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
ConclusionsThe specific and exclusive shape of the MVA in patients with repaired AVSD was revealed in the patients studied, resulting in a loss of the saddle shape structure. Those results could help in the comprehension of anatomic changes of the mitral valve annulus occurring after AVSD surgery.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Abstract OBJECTIVES: Congenital heart defects (CHD) are still frequently missed in prenatal screening programs, which can result in severe morbidity or even death. This case-control study evaluated the original images of the second-trimester standard anomaly scan (SAS) images to explore reasons for a missed prenatal diagnosis. METHODS: All cases born with severe CHD in 2015-2016 were extracted from the PRECOR registry. Severe CHD was defined as requiring surgical repair in the first year of life. All cardiac views in the SAS (4CV, 3VV, LVOT, RVOT) were scored on technical correctness [range 0-5] by 2 fetal ec...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Conclusion: Surgical treatment in patients with CHD and DS usually does not require highly complex surgical procedures, but are affected by infectious complications, resulting in a longer ICU and h ospital length of stay with considerable mortality.
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
ConclusionsVRAMT can be considered as a safe and effective approach for the repair of VSD and CAVSD in selected patient groups, and the outcome data appear comparable to those of MS.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
This study highlights the importance of considering undiagnosed CHDs as a cause of sudden, unexpected death, particularly in young children. PMID: 29601638 [PubMed - as supplied by publisher]
Source: Journal of Forensic Sciences - Category: Forensic Medicine Authors: Tags: J Forensic Sci Source Type: research
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