scholarly journals Vitamin D Deficiency and Its Response to Supplementation as “Stoss Therapy” in Children with Cyanotic Congenital Heart Disease Undergoing Open Heart Surgery

2019 ◽  
Vol 03 (01) ◽  
pp. 17-23
Author(s):  
Manoj Kumar Sahu ◽  
Chalattil Bipin ◽  
Harsha Vardhan Niraghatam ◽  
Ameya Karanjkar ◽  
Sarvesh Pal Singh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
Postoperative Convalescence

Abstract Background Data from many studies suggest that patients with congenital heart disease are vitamin D (vitD) deficient. Following cardiac surgery as a result of intraoperative institution of cardiopulmonary bypass (CPB), serum vitD levels become even low. This may affect postoperative convalescence in terms of mechanical ventilation, inotropic support, infection, and so forth. Objective We intended to study the prevalence of vitD deficiency pre and post cardiac surgery and the effect of vitD supplementation (stoss therapy) on postoperative convalescence of the children with tetralogy of Fallot (TOF) undergoing intracardiac repair (ICR). Methodology In this randomized controlled trial (RCT), 60 children younger than 18 years with TOF and serum vitD levels < 20ng/dL were randomized into two groups. The study group received vitD supplementation as “stoss therapy” at 10,000 units/kg body weight. All these children underwent ICR with CPB. Demographic data, preoperative, intraoperative, and postoperative variables were compared between the study and the control groups. Results Prevalence of severe vitD deficiency was 93.1%. When compared with the control group, study group showed higher serum vitD levels in the immediate preoperative period (p = 0.001), postoperative period following CPB (p = 0.012), and on the first postoperative day (p = 0.003). No statistically significant difference was observed in postoperative mechanical ventilation (p = 0.35), intensive care unit (ICU) stay (p = 0.15), and inotropic duration (p = 0.19). Conclusion Children with TOF are highly deficient of vitD, its level falls further after CPB, and supplementing vitD preoperatively does not influence postoperative recovery pattern. Supplementation of vitD as “stoss therapy” was useful in raising the serum levels before and after cardiac surgery.

Abstract 10903: Extraction Outcomes in Patients With Congenital Heart Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Erin A Fender ◽  
Ammar M Killu ◽  
David O Hodge ◽  
Bryan C Cannon ◽  
Paul A Friedman ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Lead Extraction ◽  
Control Group ◽  
Cardiac Devices ◽  
Device Infection ◽  
Significant Difference ◽  
And Gender

Introduction: Patients with congenital heart disease (CHD) frequently require implantable cardiac devices. Device infection or malfunction may necessitate lead extraction. Extraction may be challenging due to long lead dwell times, anatomic abnormalities, and prior cardiac surgery. Little is known about extraction outcomes in the CHD population. Methods and Results: This retrospective study included 41 CHD patients and 82 age and gender matched controls that underwent lead extractions at two centers between 2001-2014. Only patients with leads older than 12 months were included. There were 79 leads in CHD patients and 150 in controls. Patients with CHD had a mean age of 39±17 years at extraction and on average their leads had been implanted for 81±84 months, this was not significantly different from the control group. Eighty eight percent of CHD patients had 1 or more cardiac surgeries as compared to only 22% of controls (p<0.001). The number of abandoned leads was also significantly different with 16 abandoned leads in the CHD group and 3 in controls (p<0.001). There was no statistically significant difference in extraction techniques between the groups. Complete extraction was achieved in 94% of patients in both groups. There were no CHD group complications. Control group complications included 3 SVC lacerations requiring sternotomy (one was fatal), and 1 ventricular perforations with tamponade requiring sternotomy. None of these patients had a history of cardiac surgery. The average age of leads in patients with a complication was 15.3 years which was older than the mean lead age seen in the CHD and control populations which was 6.75 and 4.6 years respectively. Conclusions: Lead extraction can be safely performed in patients with CHD. Despite anatomic abnormalities and previous cardiac surgery, the outcome of lead extraction in patients with CHD is comparable to controls. Prior cardiac surgery may lower the risk for extraction complications.

scholarly journals Predictive role of perioperative neutrophil to lymphocyte ratio in pediatric congenital heart disease associated with pulmonary arterial hypertension

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoqiang Yin ◽  
Mei Xin ◽  
Sheng Ding ◽  
Feng Gao ◽  
Fan Wu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Congenital Heart ◽  
Prolonged Mechanical Ventilation ◽  
Pulmonary Arterial ◽  
Mechanical Ventilation Time

Abstract Background We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery. Methods A retrospective observational study involving 190 children from January 2013 to August 2019 was conducted. Perioperative clinical and biochemical data were collected. Results We found that pre-operative NLR was significantly correlated with AST, STB, CR and UA (P < 0.05), while post-operative NLR was significantly correlated with ALT, AST, BUN (P < 0.05). Increased post-operative neutrophil count and NLR as well as decreased lymphocyte count could be observed after cardiac surgery (P < 0.05). Level of pre-operative NLR was significantly correlated with mechanical ventilation time, ICU stay time and total length of stay (P < 0.05), while level of post-operative NLR was only significantly correlated to the first two (P < 0.05). By using ROC curve analysis, relevant areas under the curve for predicting prolonged mechanical ventilation time beyond 24 h, 48 h and 72 h by NLR were statistically significant (P < 0.05). Conclusion For patients with CHD-PAH, NLR was closely related to early post-operative complications and clinical outcomes, and could act as a novel marker to predict the occurrence of prolonged mechanical ventilation.

scholarly journals Evaluation of the school success in children with the diagnosis of congenital heart disease who underwent an intervention

2014 ◽  
Author(s):  
Gülben İrem Kanberoğlu ◽  
Önder Doksöz ◽  
Özlem Bağ ◽  
Serpil Ece Aras Öztürk
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Academic Success ◽  
Patient Group ◽  
Social Life ◽  
Congenital Heart ◽  
School Success ◽  
Control Group ◽  
Significant Difference ◽  
Behavioral Attitudes

OBJECTIVE: Congenital heart disease is one of the most common childhood diseases that affect both the children's and their families social life, quality of life and the children's academic achievement. The aim of this study is to evaluate the school performance of children suffering from congenital heart disease who underwent surgical or catheter based interventions. METHODS: The study group included 50 patients with congenital heart disease underwent surgical or catheter based interventions attending to secondary school (aged 12-15 years old) and 50 healthy controls. The academic success validation from official school grades of lessons Turkish, Mathematics, Science, Social Sciences lessons and behavioral attitudes were obtained from the Ministry of Education ‘’e-school’’ parent information system printouts. The patient group consisted of both cyanotic and acyanotic patients and each groups were compared with controls. RESULTS: Turkish, mathematics, physical education classes and behavioral attitudes note in the patient group was significantly lower than in the control group. The school success in Cyanotic group was significantly lower than the control group in Turkish, mathematics, education lessons and behavioral attitudes grades. Significant difference was not determined in science and social science lessons. CONCLUSION: Cyanotic group's success in mathematic and turkish lessons are lower in children with congenital heart disease especially in cyanotic group. We suggest that providing supportive teaching pragrammes for children with congenital hearth disease are needed in order to maintain academic success.

scholarly journals Effects of Remifentanil and Sufentanil Anesthesia on Cardiac Function and Serological Parameters in Congenital Heart Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zhigang Qin ◽  
Younian Xu
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Treatment Group ◽  
Cardiac Function ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Control Group ◽  
Muscle Rigidity ◽  
Significant Difference

In this study, we have investigated feasibility of remifentanil and sufentanil anesthesia in children with congenital heart disease surgery and its effects on cardiac function and serological parameters. For this purpose, a retrospective study was conducted on 120 children with congenital heart disease who underwent repair of ventricular septum or atrial septum in our hospital, specifically from January 2016 to January 2018, and 60 patients in each group were randomly divided into the control and treatment groups, respectively. The control group was anesthetized with sufentanil, and the treatment group was anesthetized with remifentanil. The heart function, serological indexes, and adverse reactions were observed and compared. We have observed that there was no significant difference in HR levels between these groups ( P > 0.05 ), but SDP and DBP values of the two groups were decreased after anesthetic induction ( P < 0.05 ). ACH, cortisol, and lactic acid in the treatment group were significantly lower than those in the control group, and the difference was statistically significant ( P < 0.05 ). The incidence of bradycardia, nausea and vomiting, hypotension, muscle rigidity, and respiratory depression in the treatment group was 16.67% lower than that in the control group ( P < 0.05 ). Remifentanil has less influence on hemodynamics and a better analgesic effect than fentanyl in inhibiting stress response in congenital heart surgery, which provides reference and basis for children congenital heart surgery.

STUDY OF CONSANGUINITY AS A RISK FACTOR FOR CONGENITAL HEART DISEASE IN PEDIATRIC AGE GROUP.

2021 ◽  
pp. 126-128
Author(s):  
Vinita Tiriya ◽  
Aditi Lingayat ◽  
Aziz Farookh ◽  
Amit Rathod
Keyword(s):  
Congenital Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Control Group ◽  
Study Group ◽  
Age Group ◽  
Female Ratio

Introduction: Congenital heart diseases (CHDs) are multifactorial in etiology. Consanguinity could increase the likelihood of Congenital Heart Disease. So, we studied correlation between parental consanguineous marriages with CHDs in children aged 0-12 years. Material and method:Conrmed cases of CHDs diagnosed by clinical examination and echocardiography in age group of 0- 12 years were enrolled in study group. Children without any CHDs matched for age but not for gender, ethnicity or social class were enrolled in control group. Results: During study period,50 patients (male 26, female 24) were enrolled in study group and 50 patients (male 27, female 23) in control group. In study group,43 (86%) parents of patients found to have consanguinity while in the control group, 20 (40%) parents of patients were found to have consanguinity. Most common congenital heart disease seen was Ventricular Septal Defect in 19 (38%) patients. Mortality rate was 8% in study group and 2% in control group. Conclusion:Most common age group in patients with CHD was 0-1 years. Male to female ratio was equal in (1.08:1) in patients with CHD. Commonest symptom in patients with CHD was respiratory distress and fever. Maximum CHD patient's parent had rd 3 degree consanguineous marriage. We found Consanguinity as a risk factor for congenital heart disease in Hindus and Muslims. Most common congenital heart disease was Ventricular Septal Defect. In the present study majority of the patients of CHD survived.

scholarly journals Use of Peritoneal Dialysis after Surgery for Congenital Heart Disease in Children

2012 ◽  
Vol 32 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Catarina R. Santos ◽  
Patrícia Q. Branco ◽  
Augusta Gaspar ◽  
Margarida Bruges ◽  
Rui Anjos ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Peritoneal Dialysis ◽  
Odds Ratio ◽  
Congenital Heart ◽  
Kidney Injury ◽  
Common Complication ◽  
Very Young Children

Acute kidney injury (AKI) is a common complication in children after surgery for congenital heart disease, and peritoneal dialysis (PD) is usually the renal replacement therapy (RRT) of choice, especially in very young children. The aim of the present study was to describe our experience of using PD to treat AKI after cardiac surgery.We retrospectively analyzed children 1 week to 16 years of age undergoing cardiac surgery during 2000 – 2008 and found the incidence of AKI treated with PD to be 2.3%. In the 23 patients treated with PD (13 male; average age: 29 ± 48.4 months; weight: 9.1 ± 8.1 kg), the indications for PD initiation were oliguria ( n = 13), anuria ( n = 9), and acidosis ( n = 1). The average time between cardiac surgery and AKI was 4.8 ± 16.8 hours, and between AKI and PD initiation, it was 12 ± 16.8 hours. Patients were treated for a mean of 4.8 ± 3.8 days. Two patients developed peritonitis, and mechanical dysfunction of the PD catheter occurred in 1 patient. In-hospital mortality was 43.4%. Patients treated with PD weighed less ( p = 0.004) and had longer bypass time ( p = 0.004), inotrope use ( p = 0.000), and mechanical ventilation ( p = 0.000). However, in a regression analysis, only cardiopulmonary bypass time (odds ratio: 1.021; 95% confidence interval: 0.998 to 1.027; p = 0.032) remained predictive of a subsequent need for PD.We conclude that PD is an efficacious RRT for AKI in children undergoing cardiac surgery and that, in this setting, bypass time is the strongest predictor of a subsequent need for RRT.

scholarly journals The Effect of Family-centered Care Model on Sleep Quality and Medication Compliance of Children With Simple Congenital Heart Disease After Transcatheter Intervention

2021 ◽  
Author(s):  
Wang-Sheng Dai ◽  
Wen-Peng Xie ◽  
Jian-Feng Liu ◽  
Qiang Chen ◽  
Hua Cao
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Sleep Quality ◽  
Congenital Heart ◽  
Medication Compliance ◽  
Control Group ◽  
Study Group ◽  
Family Centered Care ◽  
Centered Care ◽  
Family Centered

Abstract Objective: This study aimed to explore the effect of a family-centered care model on the sleep quality and medication compliance of children with simple congenital heart disease undergoing transcatheter interventional. Methods: 50 children with simple congenital heart disease who underwent transcatheter interventional in the cardiac surgery department of a provincial hospital in China from January 2020 to December 2020 were selected, and the children were randomly divided into the study group (n=25) and the control group (n=25) by a random number table method. The children in the control group were given routine care, and the children in the study group were given family-centered care on the basis of the control group. One month later, the sleep quality and medication compliance of all children were retrospectively studied. The Pittsburgh Sleep Quality Index was used to assess the children’s sleep quality, and the Chinese revised version of Morisky Medication Adherence Scale was used to evaluate the children’s medication compliance. Results: The sleep quality score of the study group was significantly lower than that of the control group, and the medication compliance score of the study group was significantly higher than that of the control group. The differences were statistically significant (P<0.05).Conclusion: The family-centered care model was beneficial to improve the sleep quality and medication compliance of children with simple congenital heart disease after transcatheter intervention, and provided important reference information for the postoperative follow-up of such children.

scholarly journals The level of superoxide dismutase and catalase in acyanotic congenital heart disease children with heart failur

2021 ◽  
Vol 16 (1) ◽  
pp. 150-156
Author(s):  
Henry Wicaksono ◽  
Mahrus A Rahman ◽  
Roedi Irawan ◽  
I Ketut Alit Utamayasa ◽  
Teddy Ontoseno ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Superoxide Dismutase ◽  
Heart Disease ◽  
Congenital Heart ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
The Difference ◽  
Acyanotic Congenital Heart Disease

Background: The most common complication in acyanotic congenital heart disease (CHD) is heart failure which definitive diagnosis and therapy remain unsatisfactory. Heart failure’s progression is often associated with oxidative stress process. Superoxide dismutase (SOD) is the first line antioxidant of defense against superoxide anion. While Catalase (CAT) breaks down hydrogen peroxide into water and oxygen molecules which complements previous detoxification carried out by SOD. Objective: This study aimed to compare the differences of SOD and CAT levels in acyanotic CHD patients between those with and without heart failure. Methods: A case-control study was conducted on three to ten years old children with a left-to-right shunt acyanotic CHD with and without heart failure in the Pediatric Cardiology outpatient clinic, ward, and emergency room of Dr. Soetomo Hospital Surabaya from April-July 2020. Echocardiography was used to establish the diagnosis of CHD, while Pediatric Heart Failure Score (PHFS) criteria was used to indicate heart failure. T-test was undertaken for analysing the difference between both groups. Results: The total samples were 41 children, consisted of 29 subjects in the case group (CHD with heart failure) and 12 subjects in the control group (without heart failure). The level of SOD in CHD with heart failure was lower (74.670+15.705) than those without it (109.163+3.111) (p<0.05). In contrast, level of CAT in CHD with heart failure was higher (25.895) than those without it (13.976) (p<0.05). Conclusion: There was a significant difference of SOD and CAT levels in acyanotic CHD between those with and without heart failure.

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