Milrinone

2003 ◽  
Vol 22 (4) ◽  
pp. 61-63 ◽  
Author(s):  
Susan Givens Bell
Keyword(s):  
Cardiac Output ◽  
High Risk ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Heart Defects ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output ◽  
Heart Defect ◽  
Major Factors

MANY NEONATES WHO UNDERGO SURGICAL REPAIR FOR congenital heart defects are at high risk for developing low cardiac output syndrome following surgery.1 A variety of causes contributes to diminished cardiac output. Four major factors are (1) age less than one month, (2) weight less than 2.5 kg, (3) preoperative condition, and (4) complexity of the heart defect.2

In-Hospital Mortality for Surgical Repair of Congenital Heart Defects: Preliminary Observations of Variation by Hospital Caseload

PEDIATRICS ◽  
1995 ◽  
Vol 95 (3) ◽  
pp. 323-330 ◽  
Author(s):  
Kathy J. Jenkins ◽  
Jane W. Newburger ◽  
James E. Lock ◽  
Roger B. Davis ◽  
Gerald A. Coffman ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Acute Care ◽  
Congenital Heart Defects ◽  
Congenital Heart Defect ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Heart Defects ◽  
Hospital Charges ◽  
Hospital Death ◽  
Heart Defect

Objective. To examine the impact of hospital caseload on in-hospital mortality for pediatric congenital heart surgery. Design. Population-based, retrospective cohort study. Setting. Acute care hospitals in California and Massachusetts. Patients. Children undergoing surgery for congenital heart disease, identified by the presence of procedure codes indicating surgical repair of a congenital heart defect in computerized statewide hospital discharge abstract databases. Cases were grouped into four categories based on the complexity of the procedure. Main outcome measures. Adjusted odds ratios (OR) for in-hospital death were estimated using generalized estimating equations that account for the intra-institutional correlation among patients. Results. A total of 2833 cases at 37 centers were identified. Compared with centers performing >300 cases per year, after controlling for patient characteristics, centers performing <10 cases per year had an OR for in-hospital death of 7.7 (95% confidence interval (CI) [1.6-37.8]); 10 to 100 cases, OR = 2.9 (95% CI [1.6-5.3]); 101 to 300 cases, OR = 3.0 (95% CI [1.8-4.9]). Independent risk factors for mortality included procedure complexity category (P < .0001), use of cardiopulmonary bypass (P < .0001), young age at surgery (P = .001), and transfer from another acute care hospital (P < .0001). Few differences were found by hospital caseload in length of stay or total hospital charges. Conclusions. For children with a congenital heart defect who underwent surgery in California in 1988 or Massachusetts in 1989, the risk of dying in-hospital was much lower if the surgery was performed at an institution performing >300 cases annually. This study was limited by the absence of clinical detail in discharge abstract databases. If these findings are corroborated by other studies, health care delivery strategies that direct children requiring surgical correction of congenital heart defects to high-volume centers may substantially reduce overall mortality.

scholarly journals Oral corticosteroids during pregnancy and offspring risk of congenital heart defects: a nationwide cohort study

2019 ◽  
Vol 49 (2) ◽  
pp. 638-647
Author(s):  
Amalie Bøggild Schmidt ◽  
Marie Lund ◽  
Giulia Corn ◽  
Nina Øyen ◽  
Jan Wohlfahrt ◽  
...  
Keyword(s):  
Propensity Score ◽  
Confidence Interval ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Oral Corticosteroid ◽  
Heart Defects ◽  
Prevalence Ratio ◽  
Heart Defect ◽  
Causal Pathway ◽  
Oral Corticosteroids

Abstract Background Pre-pregnancy diabetes is a strong risk factor for congenital heart defects (CHDs), suggesting a role for glucose in the causal pathway. Oral corticosteroids may cause hyperglycemia and maternal use could affect embryonic heart development. The objective of this study was to determine the association between maternal intake of oral corticosteroids 0–8 weeks after conception and CHDs in offspring. Methods A register-based nationwide prevalence study including all live singleton births in Denmark, 1996–2016, was conducted. In total, 1 194 687 individuals and their mothers were identified and linked with information on offspring CHDs and the mothers’ use of oral corticosteroids in early pregnancy. Corticosteroid use was defined as a filled prescription for maternal use of oral corticosteroid 0–8 weeks after conception. CHDs were identified through International Classification of Diseases codes. The association was estimated by prevalence (odds) ratios using logistic regression and propensity score-matched analyses. Results Among 1 194 687 live births, 2032 had a mother who had used oral corticosteroids 0–8 weeks from conception. Of these offspring, 32 had a heart defect. Among the offspring of never-users of oral corticosteroids, 10 534 had a heart defect. The adjusted prevalence ratio was 1.29 (95% confidence interval, 0.90–1.84) comparing offspring prevalence of heart defects in oral corticosteroid users with that in oral corticosteroid never-users. Propensity score-matched analysis yielded similar results (prevalence ratio 1.38; 95% confidence interval, 0.95–2.02). Conclusions This study supports that there is no association between maternal use of oral corticosteroids in the first 8 weeks after conception and CHDs.

scholarly journals Maternal Hypertension-Related Genotypes and Congenital Heart Defects

2020 ◽  
Author(s):  
Yunping Lei ◽  
Katherine L Ludorf ◽  
Xiao Yu ◽  
Renata H Benjamin ◽  
Xue Gu ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart Defect ◽  
Genetic Risk ◽  
Congenital Heart ◽  
Heart Defects ◽  
Hispanic Women ◽  
Genetic Risk Score ◽  
Heart Defect ◽  
Maternal Hypertension ◽  
The Relationship

Abstract BACKGROUND Maternal hypertension has been associated with congenital heart defect occurrence in several studies. We assessed whether maternal genotypes associated with this condition were also associated with congenital heart defect occurrence. METHODS We used data from the National Birth Defects Prevention Study to identify non-Hispanic white (NHW) and Hispanic women with (cases) and without (controls) a pregnancy in which a select simple, isolated heart defect was present between 1999 and 2011. We genotyped 29 hypertension-related single nucleotide polymorphisms (SNPs). We conducted logistic regression analyses separately by race/ethnicity to assess the relationship between the presence of any congenital heart defect and each SNP and an overall blood pressure genetic risk score (GRS). All analyses were then repeated to assess 4 separate congenital heart defect subtypes. RESULTS Four hypertension-related variants were associated with congenital heart defects among NHW women (N = 1,568 with affected pregnancies). For example, 1 intronic variant in ARHGAP2, rs633185, was associated with conotruncal defects (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1–1.6). Additionally, 2 variants were associated with congenital heart defects among Hispanic women (N = 489 with affected pregnancies). The GRS had a significant association with septal defects (OR: 2.1, 95% CI: 1.2–3.5) among NHW women. CONCLUSIONS We replicated a previously reported association between rs633185 and conotruncal defects. Although additional hypertension-related SNPs were also associated with congenital heart defects, more work is needed to better understand the relationship between genetic risk for maternal hypertension and congenital heart defects occurrence.

Evaluation of the Aesculon cardiac output monitor by subxiphoidal Doppler flow measurement in children with congenital heart defects

2009 ◽  
Vol 26 (5) ◽  
pp. 412-415 ◽  
Author(s):  
Maren Tomaske ◽  
Walter Knirsch ◽  
Oliver Kretschmar ◽  
Christian Balmer ◽  
Katja Woitzek ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Congenital Heart Defects ◽  
Flow Measurement ◽  
Congenital Heart ◽  
Heart Defects ◽  
Doppler Flow ◽  
Cardiac Output Monitor
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