Interventions on patent ductus arteriosus and its impact on congenital heart disease

2020 ◽  
Vol 30 (11) ◽  
pp. 1566-1571
Author(s):  
Mariam Zaidi ◽  
Nilofer Sorathia ◽  
Hannah Abbasi ◽  
Arwa Khashkhusha ◽  
Amer Harky
Keyword(s):  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Surgical Techniques ◽  
Limiting Factor ◽  
Pulmonary Resistance ◽  
Management Options ◽  
Cardiac Defects ◽  
Multicentre Trials ◽  
Recovery Times

AbstractThe ductus arteriosus (DA) connects the pulmonary artery to the aorta to bypass the pulmonary circulation in utero. It normally closes within 24–72 hours after birth due to increased pulmonary resistance from an increase in oxygen partial pressure with the baby’s first breath. Medical treatment can help close the DA in certain situations where closure is delayed. However, in duct-dependent cardiac defects, the presence of the DA is crucial for survival and as such medical and surgical techniques have evolved to prevent closure. This review aims to outline the two main management options for keeping a ductus arteriosus patent. This includes stenting the PDA and shunting via a modified Blalock–Taussig shunt. Whilst both techniques exist, multicentre trials have found equal mortality end points but significantly reduced morbidity with stenting than shunting. This is also reflected by shorter recovery times, reduced requirement for extracorporeal membrane oxygenation (ECMO), and improved quality of life, although stent longevity remains a limiting factor.

Adult congenital heart disease

2019 ◽  
pp. 363-412
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Surgical Techniques ◽  
Adult Congenital ◽  
Cardiac Status ◽  
Surgical Treatments

Congenital heart disease (CHD) is the most common congenital anomaly, affecting around 1–2% of newborns. Over the last generation, advances in medical, interventional, and surgical techniques have revolutionized the care of CHD patients. Most patients of all levels of CHD complexity are now expected to survive into adulthood. Few interventional or surgical treatments for CHD are truly curative and serial diagnostic evaluation, repeat intervention, and lifelong follow up is required to ensure optimal cardiac status and quality of life. Cardiac MRI (CMR) and echocardiography are the standard techniques utilized for routine interval assessment and follow-up of patients with all forms of ACHD.

scholarly journals Pattern of Congenital Heart Disease In Children Attending Central Teaching Pediatric Hospital, Baghdad

2020 ◽  
Vol 15 (2) ◽  
pp. 82-86
Author(s):  
Husam T Al-Zuhairi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Cardiac Defects ◽  
Common Cause ◽  
Congenital Cardiac Defects ◽  
Modes Of Presentation ◽  
Patent Ductus

Background: Congenital cardiac defects have a wide spectrum of severity in infants. About 30-40% of patients with congenital cardiac defects will be symptomatic in the 1st year of life, while the diagnosis was established in 60% of patients by the 1st month of age. Objectives: To identify the occurrence of specific types of CHD among hospitalized patients and to evaluate of growth of patients by different congenital heart lesions. Methods: A retrospective study, done on ninety-six patients (51 male and 45 female) with congenital heart disease (CHD) admitted to central teaching hospital of pediatrics, Baghdad from 1st September 2009 to 30th of August 2010. Results: The most common congenital heart diseases (CHD) were ventricular septal defect (VSD), tetralogy of Fallot (TOF), patent ductus arteriosus (PDA), transposition of great arteries (TGA), pulmonary Stenosis( PS), and Atrial septal defect (ASD).The most common modes of presentation were respiratory infection and heart failure in acyanotic patients and cyanosis in cyanotic groups. The study showed that only patent ductus arteriosus and atrial septal defects were more common in female while all other lesions were equal male to female ratio or slightly more common in male. The effect of acyanotic congenital heart disease on growth (Wt) is more common than cyanotic congenital heart disease. Conclusions: VSD is the most common type of congenital heart disease and the most common cause of morbidity, while ASD is the least common cause of morbidity in patients with congenital heart disease. The most common modes of presentation of patients with CHD are respiratory infection and heart failure in acyanotic CHD while cyanosis is the most common presentation in cyanotic group.

Mechanisms of injury and methods of protection of the brain during cardiac surgery in neonates and infants

1993 ◽  
Vol 3 (3) ◽  
pp. 317-330 ◽  
Author(s):  
William J. Greeley ◽  
Frank H. Kern ◽  
James R. Mault ◽  
Lynn A. Skaryak ◽  
Ross M. Ungerleider
Keyword(s):  
Congenital Heart ◽  
Heart Defects ◽  
Circulatory Arrest ◽  
Surgical Techniques ◽  
Developmental Abnormalities ◽  
Cardiac Morbidity ◽  
Neonates And Infants ◽  
Total Circulatory Arrest

With substantial effort and research devoted to improving surgical techniques and myocardial protection, superb results have been achieved for repair of complex congenital heart defects in children. As a result, investigative efforts now have begun to examine the quality of life for patients surviving these operations. Because these neonates and infants are exposed to severe physiologic extremes of temperature (15–18 °C) and severe alterations from normal perfusion (total circulatory arrest), the nature of long-term neuropsychological outcome has been a prominent concern. Recent preliminary reports suggest that transient and permanent neuropsychologic injury occur in as many as 25% of all infants undergoing hypothermic cardiopulmonary bypass with circulatory arrest.'Since improved surgical techniques have significantly reduced rates of operative mortality and cardiac morbidity, one of the greatest risks remaining for the patient with congenital heart disease may be long term neuropsychologic and developmental abnormalities.

The mendelian basis of congenital heart defects

1996 ◽  
Vol 6 (4) ◽  
pp. 264-271 ◽  
Author(s):  
Bruno Dallapiccola ◽  
Bruno Marino ◽  
Maria Cristina Digilio ◽  
Rita Mingarelli ◽  
Giuseppe Novelli ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Defects ◽  
Single Gene ◽  
Cardiovascular Development ◽  
Cardiac Defects ◽  
Congenital Heart Malformations ◽  
Molecular Studies ◽  
Gene Defects ◽  
Chromosomal Map

AbstractThe revolution in molecular genetics is contributing to the understanding of normal and abnormal cardiovascular development and morphogenesis. Recent investigations have shown that a growing number of congenital heart malformations is due to single gene defects. The combined contribution of clinical and molecular studies is providing the chromosomal map of the genes related to these isolated cardiac defects, and to syndromes characteristically associated with specific cardiac malformations. These advances are relevant to clinical practice, since the accumulated knowledge can improve the quality of management of affected patients.

Growth and management of mixed Pinus sylvestris - Quercus robur stands in Flanders, Belgium

1993 ◽  
Vol 58 ◽  
Author(s):  
D. Maddelein ◽  
J. Neirynck ◽  
G. Sioen
Keyword(s):  
Pinus Sylvestris ◽  
Natural Regeneration ◽  
Quercus Robur ◽  
Good Growth ◽  
Pedunculate Oak ◽  
Selection System ◽  
Management Options ◽  
Stand Management ◽  
Pine Stands

Mature  Scots pine (Pinus sylvestris  L.) stands are dominating large parts of the Flemish forest area. Broadleaved  species regenerate spontaneously under this pine canopy. This study studied  the growth and development of two planted pine stands with an older natural  regeneration, dominated by pedunculate oak (Quercus  robur L.), and discussed management options for  similar stands.     The results indicated a rather good growth of the stands, with current  annual increments of 5 m3.ha-1.yr-1. The pine overstorey is growing into valuable sawwood  dimensions, while the broadleaved understorey slowly grows into the  upperstorey. The quality of the regeneration is moderate but can be improved  by silvicultural measurements (pruning, early selection).     In both stands, an interesting (timber production, nature conservation)  admixture of secondary tree species is present in the regeneration. Stand  management is evolving from the classical clearcut system towards a  combination of a type of selection and group selection system.

A retrospective analysis of a pediatric tele-echocardiography service to treat, triage, and reduce trans-Pacific transport

2017 ◽  
Vol 24 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Christopher A Rouse ◽  
Brandon T Woods ◽  
C Becket Mahnke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
The United States ◽  
Critical Congenital Heart Disease ◽  
Medical Centers ◽  
Prompt Diagnosis ◽  
Patent Ductus

Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.

Advantages of a mini right axillary thoracotomy for congenital heart defect repair in children

2021 ◽  
pp. 1-6
Author(s):  
Jannika Dodge-Khatami ◽  
Ali Dodge-Khatami
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Global Health ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Median Sternotomy ◽  
Axillary Approach ◽  
Post Operative Pain ◽  
The Right

Abstract Objectives: The mini right axillary thoracotomy is an alternative surgical approach to repair certain congenital heart defects. Quality-of-life metrics and clinical outcomes in children undergoing either the right axillary approach or median sternotomy were compared. Methods: Patients undergoing either approach for the same defects between 2018 and 2020 were included. Demographic details, operative data, and outcomes were compared between both groups. An abbreviated quality of life questionnaire based on the Infant/Toddler/Child Health Questionnaires focused on the patient’s global health, physical activity, and pain/discomfort was administered to all parents/guardians within two post-operative years. Results: Eighty-seven infants and children underwent surgical repair (right axillary thoracotomy, n = 54; sternotomy, n = 33) during the study period. There were no mortalities in either group. The right axillary thoracotomy group experienced significantly decreased red blood cell transfusion, intubation, intensive care, and hospital durations, and earlier chest tube removal. Up to 1 month, parents’ perception of their child’s degree and frequency of post-operative pain was significantly less after the right axillary thoracotomy approach. No difference was found in the patient’s global health or physical activity limitations beyond a month between the two groups. Conclusions: With the mini right axillary approach, surrogates of faster clinical recovery and hospital discharge were noted, with a significantly less perceived degree and frequency of post-operative pain initially, but without the quality of life differences at last follow-up. While providing obvious cosmetic advantages, the minimally invasive right axillary thoracotomy approach for the surgical repair of certain congenital heart lesions is a safe alternative to median sternotomy.

scholarly journals Strategies for the management of pulmonary arterial hypertension in patients with congenital heart disease

2020 ◽  
Vol 4 (S1) ◽  
Author(s):  
Nathalie Liew ◽  
Zoya Rashid ◽  
Robert Tulloh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Congenital Heart ◽  
Standard Management ◽  
Advanced Therapies ◽  
Pulmonary Arterial ◽  
The Uk

Abstract Background Pulmonary hypertension (PH) is commonly seen in adults who have congenital heart disease (CHD). Therapy is available for pulmonary arterial hypertension (PAH) and has greatly benefitted many patients with PAH related to CHD (PAH-CHD) over the last 15 years, with evidence of improved quality of life and prognosis in those with Eisenmenger syndrome and repaired PAH-CHD. In this review, we describe the standard management and advanced therapies for PAH, which are available in specialist PH centres around the UK and Ireland, and how these are used in PAH-CHD. Decisions around the choice of therapy are governed by commissioning and available evidence. Conclusion We explain the different pathways for action and the variety of medications now at our disposal to help this important group of patients.

Sign in / Sign up

Export Citation Format

Share Document