scholarly journals Ross operation in children and young adults: the Alder Hey case series

2004 ◽  
Vol 4 (1) ◽  
Author(s):  
Shahzad Gull Raja ◽  
Marco Pozzi
Keyword(s):  
Young Adults ◽  
Case Series ◽  
Ross Operation ◽  
Children And Young Adults ◽  
Alder Hey

Recycling of the Pulmonary Autograft During Reverse Ross Operation: From Pulmonary Valve to Neoaortic Valve and Back

2019 ◽  
Vol 10 (2) ◽  
pp. 242-244
Author(s):  
Martin Schmiady ◽  
Dominique Bettex ◽  
Michael Hübler ◽  
Martin Schweiger
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Operative Technique ◽  
Pulmonary Valve ◽  
Ross Procedure ◽  
Ross Operation ◽  
Pulmonary Autograft ◽  
Hemodynamic Profile ◽  
Children And Young Adults

The Ross operation is the operation of choice for children and young adults who require aortic valve replacement. Although the allograft does not require anticoagulation and has a superior hemodynamic profile compared to other valve substitutes, concerns regarding allograft and autograft longevity have risen in the last decade. We present a case illustrating an alternative operative technique for patients with failed Ross procedure in which the autograft is recycled in order to avoid a two-allograft replacement.

University of Wisconsin experience treating adult ALL with the BFM regimen

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 16501-16501
Author(s):  
S. C. Medlin ◽  
B. Kahl ◽  
W. Longo ◽  
E. Williams ◽  
J. Lionberger ◽  
...  
Keyword(s):  
Overall Survival ◽  
Young Adults ◽  
High Risk ◽  
Lymphoblastic Leukemia ◽  
Case Series ◽  
Adult Patients ◽  
Entire Group ◽  
Severe Toxicity ◽  
Risk Patients ◽  
Children And Young Adults

16501 Background: Berlin-Frankfurt-Munster therapy (BFM) is an effective regimen for acute lymphoblastic leukemia (ALL) in children and young adults (Lancet 2:921–924,1988). Treating children and young adults at higher risk for relapse with an augmented BFM was shown to increase both event free and overall survival (NEJM 338:23,1663–1671,1998). Outcomes using standard BFM or augmented BFM in adults are unknown. Methods: This is a case-series of 29 adult patients treated with the BFM regimen. Patients were stratified into low, intermediate and high-risk groups based upon the following characteristics: age, white blood cell count, adverse cytogenetics and absence of CD 10. Low risk patients received the standard BFM regimen. Intermediate risk patients were given augmented BFM if less than 50 years old, standard BFM if older than age 50. High-risk patients received augmented BFM. Cranial irradiation was omitted in most patients (25/29). Events were defined as relapse, death from any cause, and stopping treatment for any reason. Results: Fifteen patients (median age 38, range 19–70) were treated with standard BFM and 14 patients (median age 37, range 21–72) with augmented BFM. Complete remission at day 28 was 93% (27/29). For the entire group, the 3-year overall survival was 60% with a 3-year event free survival of 45%. Patients treated with augmented BFM experienced a 3-year EFS, PFS, OS of 26%, 43%, and 48% respectively. Patients treated with standard BFM had a 3-year EFS, PFS, OS of 60%, 78%, and 78% respectively. Toxicity was common with significant neuropathy and neutropenic fever occurring in 83% and 48% respectively. Septic shock occurred in 17% of patients. Severe toxicity resulted in 1 death and discontinuation of BFM in 3 patients. The entire regimen was completed in 33 % of those treated with augmented BFM and 71% of those treated with standard BFM. Conclusion: Standard BFM is an effective and tolerable regimen for treatment of adult ALL. Augmented BFM is a difficult regimen for adult patients to complete. For both regimens, the 3-year PFS and OS compare favorably to other published regimens. No significant financial relationships to disclose.

scholarly journals Cardiovascular and metabolic risk of antipsychotics in children and young adults: a multinational self-controlled case series study

2021 ◽  
Vol 30 ◽  
Author(s):  
Kenneth K. C. Man ◽  
Shih-Chieh Shao ◽  
Yu-Chuan Chang ◽  
Mei-Hung Chi ◽  
Han Eol Jeong ◽  
...  
Keyword(s):  
Young Adults ◽  
Cardiovascular Events ◽  
Case Series ◽  
Real World Evidence ◽  
Case Series Study ◽  
Increased Risk ◽  
Children And Young Adults ◽  
Exposure Windows ◽  
The Uk

Abstract Aims The risk of antipsychotic-associated cardiovascular and metabolic events may differ among countries, and limited real-world evidence has been available comparing the corresponding risks among children and young adults. We, therefore, evaluated the risks of cardiovascular and metabolic events in children and young adults receiving antipsychotics. Methods We conducted a multinational self-controlled case series (SCCS) study and included patients aged 6–30 years old who had both exposure to antipsychotics and study outcomes from four nationwide databases of Taiwan (2004–2012), Korea (2010–2016), Hong Kong (2001–2014) and the UK (1997–2016) that covers a total of approximately 100 million individuals. We investigated three antipsychotics exposure windows (i.e., 90 days pre-exposure, 1–30 days, 30–90 days and 90 + days of exposure). The outcomes were cardiovascular events (stroke, ischaemic heart disease and acute myocardial infarction), or metabolic events (hypertension, type 2 diabetes mellitus and dyslipidaemia). Results We included a total of 48 515 individuals in the SCCS analysis. We found an increased risk of metabolic events only in the risk window with more than 90-day exposure, with a pooled IRR of 1.29 (95% CI 1.20–1.38). The pooled IRR was 0.98 (0.90–1.06) for 1–30 days and 0.88 (0.76–1.02) for 31–90 days. We found no association in any exposure window for cardiovascular events. The pooled IRR was 1.86 (0.74–4.64) for 1–30 days, 1.35 (0.74–2.47) for 31–90 days and 1.29 (0.98–1.70) for 90 + days. Conclusions Long-term exposure to antipsychotics was associated with an increased risk of metabolic events but did not trigger cardiovascular events in children and young adults.

The Ross Operation in Children and Young Adults: A Fifteen-Year, Single-Institution Experience

2011 ◽  
Vol 91 (6) ◽  
pp. 1936-1942 ◽  
Author(s):  
Joseph B. Clark ◽  
Linda B. Pauliks ◽  
Ashley Rogerson ◽  
Allen R. Kunselman ◽  
John L. Myers
Keyword(s):  
Young Adults ◽  
Single Institution ◽  
Ross Operation ◽  
Children And Young Adults

scholarly journals Aortic Valve Replacement and the Ross Operation in Children and Young Adults

2016 ◽  
Vol 67 (24) ◽  
pp. 2858-2870 ◽  
Author(s):  
Mansour T.A. Sharabiani ◽  
Dan M. Dorobantu ◽  
Alireza S. Mahani ◽  
Mark Turner ◽  
Andrew J. Peter Tometzki ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Ross Operation ◽  
Children And Young Adults

scholarly journals Visual hallucinations and sight loss in children and young adults: a retrospective case series of Charles Bonnet syndrome

2020 ◽  
pp. bjophthalmol-2020-317237
Author(s):  
Lee Jones ◽  
Mariya Moosajee
Keyword(s):  
Visual Acuity ◽  
Young Adults ◽  
Clinical Management ◽  
Management Strategies ◽  
Case Series ◽  
Retrospective Case ◽  
Charles Bonnet Syndrome ◽  
Sight Loss ◽  
Psychological Harm ◽  
Children And Young Adults

Background/AimsCharles Bonnet syndrome (CBS) is a complication of sight loss affecting all ages; yet, few childhood cases have been reported. Our aim is to raise awareness of this under-reported association occurring in children and young adults in order to prevent psychological harm in this age group.MethodsA retrospective case series reviewing medical notes of patients <25 years of age with sight loss and reported CBS at a single centre hospital eye service in London, United Kingdom. Search of electronic patient records identified 13 patients experiencing hallucinatory events over a 9-year period. Outcomes were patient demographics including ocular diagnosis, visual acuity at time of onset, characteristics of hallucinations, clinical management strategies and patient-reported affliction.ResultsEight patients were diagnosed with progressive inherited retinal diseases, primarily Stargardt disease (N=5). Clinical history indicated patients had significantly reduced best-corrected visual acuity (BCVA) in at least one eye at onset; median (IQR) worse eye BCVA was 1.0 (0.86–1.6) logarithm of minimum angle of resolution(LogMAR). CBS significantly affected patients’ personal lives including education, diet and sleep. Clinical management was varied, mostly relating to reassurance at the point of contact.ConclusionWe describe the clinical features of young patients with CBS, with management strategies and aspects of negative outcomes. High potential caseload and risk of psychological harm merit further research. Increased awareness among healthcare professionals and patient education to forewarn susceptible individuals may reduce the overall impact and improve coping with symptoms.

scholarly journals Subcoronary Ross/Ross–Konno operation in children and young adults: initial single-centre experience

2020 ◽  
Vol 59 (1) ◽  
pp. 226-233 ◽  
Author(s):  
Peter Murin ◽  
Viktoria H.M Weixler ◽  
Jasmin Moulla-Zeghouane ◽  
Olga Romanchenko ◽  
Anastasia Schleiger ◽  
...  
Keyword(s):  
Young Adults ◽  
Aortic Valve ◽  
Aortic Root ◽  
Somatic Growth ◽  
Left Ventricular ◽  
Mortality And Morbidity ◽  
Excellent Outcome ◽  
Ross Operation ◽  
Children And Young Adults ◽  
Konno Operation

Abstract OBJECTIVES We sought to evaluate the outcome after modified subcoronary Ross/Ross–Konno operation in children and young adults. METHODS Between January 2013 and January 2019, a total of 50 patients with median age of 6.3 years (range 0.02–36.5 years, 58% males), including 10 infants (20%), received modified subcoronary Ross/Ross–Konno operation at our institution. Survival, morbidity, reinterventions, aortic valve function and aortic root dimensions were analysed. RESULTS At a median follow-up of 31.2 months (range 14.4–51 months), there were 1 early death and 1 late death, both in the infant group. The overall survival at 5 years after the operation was 95%. Two patients needed aortic valve replacement, 11 and 15 months after their Ross operation. At 5 years, freedoms from reoperation on the autograft and on the right ventricle to pulmonary artery conduit were 94% and 97%, respectively. Freedom from aortic valve regurgitation greater than mild was 97% at 5 years. Median dimensions of the aortic root at all levels remained in normal range at last visit. Forty-four patients (95%) were in New York Heart Association class I with normal left ventricular function. CONCLUSIONS The initial experience with the subcoronary Ross/Ross–Konno operation in children and young adults showed excellent outcome. The mortality and morbidity among infants remain significant. The described technique is reproducible and might be advantageous in situations when prosthetic supporting techniques interfere with somatic growth.

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