scholarly journals A case of COVID-19 in a patient with a univentricular heart post total cavopulmonary connection (Fontan) surgery

2020 ◽  
Vol 30 (9) ◽  
pp. 1350-1352
Author(s):  
Niall Linnane ◽  
Des W. Cox ◽  
Adam James

AbstractCoronavirus disease 2019 (COVID-19) has caused a global pandemic which has affected patients and healthcare systems around the world. Patients with underlying health conditions seem to be more severely affected. There are limited reports of patients with univentricular circulations and COVID 19; thus, we report a case of COVID-19 in a patient with a univentricular circulation.

2021 ◽  
Author(s):  
Mohammed Ali

BACKGROUND cardiovascular diseases (CVDs) have become prevalent in the world. They cause millions of deaths globally with the World Health Organization putting the figure at 17.9 million people every year. These statistics indicate the need for healthcare systems to leverage contemporary advanced technology to detect and diagnose CVDs and provide appropriate and timely care to reduce mortality rates. OBJECTIVE To conduct a scoping review exploring individual use of smartwatches with self-monitoring ECG functionality for diagnosing arrhythmias. METHODS Source were selected from six credible bibliographic databases: PubMed, Medline, EMBASE, PsycInfo, CINAHL, and Google Scholar. Intervention-related terms were used to identify relevant sources. Additionally, a forward search strategy was used to search the databases and identify appropriate peer-reviewed journals. RESULTS The research returned 230 sources, out of which 40 met the inclusion criterion. The studies revealed that increased research, development, and adoption of smartwatches and other wearable devices have intensified in the past two decades. The studies showed that using smartwatches can detect cardiac arrhythmias although this depends on the algorithms and biometric sensors utilized in the smartwatches. Watches with advanced algorithms, PPG, and EKG functionalities exhibit high accuracy, sensitivity, and specificity, detecting AFib and other arrhythmias with high efficacy. Therefore, the best way for technology companies to improve their watches’ accuracy is to design and use advanced algorithms and combine PPG, EKG, activity, and biochemical sensors. Conclusion: The contemporary healthcare space is replete with wearable and non-wearable ¬systems and devices central to detecting health conditions and informing the relevant stakeholders to take corrective actions. Smartwatches are wearable devices used chiefly by patients, health, and fitness enthusiasts to detect and monitor a series of conditions, such as heart rate. Their use has fostered timely detection of cardiac arrhythmias, and therefore, caregivers and policy-makers should emphasize their use. CONCLUSIONS Technological systems have proliferated many human spaces in the last three decades, including education, healthcare, and entertainment. Their use has improved operational efficiency, reduced costs, saved lives, and increased organizations’ bottom lines. Healthcare systems use technological devices and appliances to diagnose patients, perform surgeries, improve pharmacy operations, and reduce medical errors. That way, most healthcare facilities provide quality care, attaining positive clinical outcomes. The contemporary healthcare space is replete with wearable and non-wearable ¬systems and devices central to detecting health conditions and informing the relevant stakeholders – caregivers, patients, and family members – to take corrective actions. Smartwatches are wearable devices used chiefly by patients, health, and fitness enthusiasts to detect and monitor a series of conditions, such as heart rate. They are highly effective in detecting cardiac arrhythmias, and therefore, caregivers and policy-makers should emphasize their use.


2005 ◽  
Vol 13 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Jian-Ping Xu ◽  
Xin-Jin Luo ◽  
Jun-Ming Chu ◽  
Shou-Jun Li ◽  
Ying-Long Liu

The aim of this study was to evaluate an off-pump technique for total cavopulmonary connection. Between May 2000 and June 2004, 16 patients underwent total cavopulmonary connection without cardiopulmonary bypass. There were 8 males and 8 females, with a mean age of 9.8 ± 6.2 years and a mean weight of 27.7 ± 14.9 kg. Preoperative percutaneous oxygen saturation was 75% ± 6%, and pulmonary arterial pressure was 12.6 ± 2.7 mm Hg. Postoperative outcomes were retrospectively compared with a group of 17 patients who underwent total cavopulmonary connection with an extracardiac conduit under cardiopulmonary bypass. Two patients died early postoperatively. Chylothorax occurred in 2 patients and 3 underwent reoperation for fenestration between the extracardiac conduit and the right atrium in the early postoperative period. All survivors were acyanotic. On discharge from hospital, the percutaneous oxygen saturation breathing air was 95% ± 3%. Patients in the off-pump group demonstrated significantly shorter extubation time and intensive care unit stay. This connection technique is easy to perform and helpful in the early management of patients with a functional univentricular heart. However, much remains to be learned about this unique physiologic system.


BioMedica ◽  
2020 ◽  
Vol 36 (2S) ◽  
pp. 142-148
Author(s):  
Moniba Rafique ◽  
Iqra Rafique

<p>The world is facing a severe and acute public health emergency due to the ongoing COVID-19 global pandemic. How individual countries respond in the coming weeks will be critical in influencing the trajectory of national epidemics. The mortality and morbidity rates reported so far and healthcare demands anticipated, are based on data from China and other high-income countries; marked variations in underlying health conditions of general public, capacity and strength of healthcare systems and vision of policy makers will likely result in different patterns in low income settings. This review is focusing on variations in pattern and outcome of SARS-COV-2 in Asian region in comparison with some neighboring countries. In conclusion, the aged population with co-morbidities has deadly outcome. As asymptomatic carriers are source of transmission of disease to vulnerable subjects, therefore, we need to continuously develop, monitor and implement prophylactic and therapeutic strategies to combat this deadly virus over the next months to years. A possible explanation of different outcome in different country can be ascribed by the presence of comorbidities, average age of population that are infected with virus and the use of some drugs that induce the cell expression of receptors for the virus.</p>


Author(s):  
Jenny Alenius Dahlqvist ◽  
Urban Wiklund ◽  
Marcus Karlsson ◽  
Katarina Hanséus ◽  
Eva Strömvall Larsson ◽  
...  

AbstractArrhythmia is related to heart rate variability (HRV), which reflects the autonomic nervous regulation of the heart. We hypothesized that autonomic nervous ganglia, located at the junction of the superior vena cava’s entrance to the heart, may be affected during the bidirectional Glenn procedure (BDG), resulting in reduced HRV. We aimed to investigate changes in heart rate and HRV in a cohort of children with univentricular heart defects, undergoing stepwise surgery towards total cavopulmonary connection (TCPC), and compare these results with healthy controls. Twenty four hours Holter-ECG recordings were obtained before BDG (n = 47), after BDG (n = 47), and after total cavopulmonary connection (TCPC) (n = 45) in patients and in 38 healthy controls. HRV was analyzed by spectral and Poincaré methods. Age-related z scores were calculated and compared using linear mixed effects modeling. Total HRV was significantly lower in patients before BDG when compared to healthy controls. The mean heart rate was significantly reduced in patients after BDG compared to before BDG. Compared to healthy controls, patients operated with BDG had significantly reduced heart rate and reduced total HRV. Patients with TCPC showed reduced heart rate and HRV compared with healthy controls. In patients after TCPC, total HRV was decreased compared to before TCPC. Heart rate was reduced after BDG procedure, and further reductions of HRV were seen post-TCPC. Our results indicate that autonomic regulation of cardiac rhythm is affected both after BDG and again after TCPC. This may be reflected as, and contribute to, postoperative arrhythmic events.


2012 ◽  
Vol 23 (3) ◽  
pp. 335-343 ◽  
Author(s):  
Andrew M. Atz ◽  
Thomas G. Travison ◽  
Brian W. McCrindle ◽  
Lynn Mahony ◽  
Andrew C. Glatz ◽  
...  

AbstractBackgroundA superior cavopulmonary connection is commonly performed before the Fontan procedure in patients with a functionally univentricular heart. Data are limited regarding associations between a prior superior cavopulmonary connection and functional and ventricular performance late after the Fontan procedure.MethodsWe compared characteristics of those with and without prior superior cavopulmonary connection among 546 subjects enrolled in the Pediatric Heart Network Fontan Cross-Sectional Study. We further compared different superior cavopulmonary connection techniques: bidirectional cavopulmonary anastomosis (n equals 229), bilateral bidirectional cavopulmonary anastomosis (n equals 39), and hemi-Fontan (n equals 114).ResultsA prior superior cavopulmonary connection was performed in 408 subjects (75%); the proportion differed by year of Fontan surgery and centre (p-value less than 0.0001 for each). The average age at Fontan was similar, 3.5 years in those with superior cavopulmonary connection versus 3.2 years in those without (p-value equals 0.4). The type of superior cavopulmonary connection varied by site (p-value less than 0.001) and was related to the type of Fontan procedure. Exercise performance, echocardiographic variables, and predominant rhythm did not differ by superior cavopulmonary connection status or among superior cavopulmonary connection types. Using a test of interaction, findings did not vary according to an underlying diagnosis of hypoplastic left heart syndrome.ConclusionsAfter controlling for subject and era factors, most long-term outcomes in subjects with a prior superior cavopulmonary connection did not differ substantially from those without this procedure. The type of superior cavopulmonary connection varied significantly by centre, but late outcomes were similar.


2021 ◽  
Vol 2091 (1) ◽  
pp. 012023
Author(s):  
A A Galiastov ◽  
D V Telyshev

Abstract The cardiovascular system (CVS) is a complex mechanism capable of reacting and regulating various changes in external and internal parameters. A particular problem is the study of CVS with univentricular heart. We studied the hemodynamic response of the CVS to the use of various configurations of bypassing the right side of the heart. During our research, we selected three different configurations of the total cavopulmonary connection. All configurations were made from Clear Flex 50 and tested in an experimental workbench. According to the research results, the TCPC-3 configuration is the most optimal. It has symmetrical output values of flows and pressures and there is no significant increase in inlet pressure. The results of this study can be used to optimize the control of the parameters of the ventricular assist device and the total artificial heart.


Author(s):  
Navneet Khurana ◽  
Neha Sharma ◽  
Shailendra Patil ◽  
Asmita Gajbhiye

<p>ABSTRACT<br />Plants have been considered to be useful as a medicine for treating different ailments and improving health conditions, since ancient times. The<br />plants as herbal drugs lay down an important foundation of different, well recognized, ancient, and traditional healthcare systems in India as well as<br />other parts of the world. In India, plants constitute an important and indispensable role in different ancient healthcare systems such as Ayurveda,<br />Siddha, Unani, Naturopathy, and Homeopathy. In Ayurveda system of medicine, one of the Rasayana plants having a great medicinal importance is<br />Sida cordifolia belonging to the family Malvaceae. It is an annual undershrub found throughout the tropical and subtropical regions of India. It has<br />been used since ancient times for various ailments in Ayurveda system of medicine. It has numerous folklore uses in different pathological conditions.<br />The plant also reported to possess a number of important pharmacological activities. The present review focused on all these folklore use of this herb<br />along with its reported pharmacological activities.<br />Keywords: Sida cordifolia, Ayurveda, Parkinson’s disease, Analgesic, Anti-inflammatory.</p>


2020 ◽  
Vol 10 (19) ◽  
pp. 6910
Author(s):  
Andrey Porfiryev ◽  
Aleksandr Markov ◽  
Andrey Galyastov ◽  
Maxim Denisov ◽  
Olga Burdukova ◽  
...  

Simulation of the human body normal operating conditions is the important issue in the engineering process of designing biomedical devices intended for implantation. As an example of such process the Fontan procedure aims to support the human body function. It is a standard palliative treatment method for patients with a functionally univentricular heart. Nevertheless, this procedure has significant drawbacks. For instance, overload of the only functional ventricle leads to the inevitability of the heart transplantation. Herein, we perform simulation and experimental characteristics of the pediatric total cavopulmonary connection (TCPC) influence on the blood flow. We investigate and design three different types of pediatric TCPC configurations; we detect fluorescent particles via a high-speed camera in order to analyze distribution of the blood flow velocity modulus in different types of TCPCs. Finally, we evaluate hydraulic power losses for various cases. This work is particularly relevant for the improvement of existing TCPCs quality that can extend the life of Fontan patients. Moreover, it also applies to the reduction of morbidity and mortality of the patients waiting for a heart transplantation.


2020 ◽  
Author(s):  
Mihaela van der Schaar ◽  
Ahmed M. Alaa ◽  
Andres Floto ◽  
Alexander Gimson ◽  
Stefan Scholtes ◽  
...  

AbstractThe COVID-19 global pandemic is a threat not only to the health of millions of individuals, but also to the stability of infrastructure and economies around the world. The disease will inevitably place an overwhelming burden on healthcare systems that cannot be effectively dealt with by existing facilities or responses based on conventional approaches. We believe that a rigorous clinical and societal response can only be mounted by using intelligence derived from a variety of data sources to better utilize scarce healthcare resources, provide personalized patient management plans, inform policy, and expedite clinical trials. In this paper, we introduce five of the most important challenges in responding to COVID-19 and show how each of them can be addressed by recent developments in machine learning (ML) and artificial intelligence (AI). We argue that the integration of these techniques into local, national, and international healthcare systems will save lives, and propose specific methods by which implementation can happen swiftly and efficiently. We offer to extend these resources and knowledge to assist policymakers seeking to implement these techniques.


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