Treatment of cyanotic heart diseases in children

Cyanotic heart diseases are relatively rare, but they are severe and heterogeneous congenital heart diseases, which require complex surgery. Development of different advanced surgical procedures, such as arterial switch operation (ASO), Fontan and its modifications, Norwood etc. operations, as well as better perioperative care significantly improved survival rate and quality of life of these children. The study group included 308 children treated for cyanotic heart disease in Yugoslavia, in the period January 2000 to July 2004. Some of them (239, 77.6%) were treated at the University Children?s Hospital in Belgrade, and others (69, 22.4%) in different institutions abroad. The age of the operated patients varied between 1 day and 19 years (median 12 months). The patients (pts) were divided into four groups, according to the disease and type of the operation. In the whole group of 308 patients treated due to cyanotic heart disease, there were 232 (75.3%) cases with open heart surgery and 76 (24.7%) with closed procedures. The mortality rate was significantly different between disease/operation groups, and age groups. Average mortality rates differed from 11.8% for palliative procedures to 12.5% for complete corrections. Mortality rate and achieved surgical results in treatment of chil?dren with cyanotic heart diseases were significantly worse than those published by leading cardiac surgery centers in the world. However, there is a clear tendency in introducing new surgical procedures, lowering the age at which the operation is done and decreasing the mortality rates.

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Valvular heart diseases. Operative methods and results in repeated open heart surgery for valvular heart disease.

Japanese Journal of Cardiovascular Surgery ◽

10.4326/jjcvs.20.968 ◽

1991 ◽

Vol 20 (5) ◽

pp. 968-970

Author(s):

T. Hata

Keyword(s):

Heart Disease ◽

Valvular Heart Disease ◽

Heart Surgery ◽

Heart Diseases ◽

Open Heart Surgery ◽

Open Heart ◽

Operative Methods ◽

Valvular Heart Diseases

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To Compare two Different Doses of Tranexemic Acid in Congenital Cyanotic Heart Disease Patients Undergoing Open Heart Surgery

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v4i6.42 ◽

2016 ◽

Author(s):

Sanjeeta Umbarkar ◽

Keyword(s):

Heart Disease ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Cyanotic Heart Disease ◽

Congenital Cyanotic Heart Disease ◽

Different Doses

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Mortality rates due to diseases of the circulatory system in Karachay-Cherkess republic in 2006 and 2014

Kazan medical journal ◽

10.17750/kmj2015-611 ◽

2016 ◽

Vol 97 (4) ◽

pp. 611-618

Author(s):

I V Samorodskaya ◽

E V Bolotova ◽

F Y Bidzhieva

Keyword(s):

Myocardial Infarction ◽

Heart Disease ◽

Mortality Rate ◽

Age Groups ◽

Circulatory System ◽

Mortality Rates ◽

Recurrent Myocardial Infarction ◽

Circulatory System Diseases ◽

Causes Of Deaths ◽

Standardized Mortality Rate

Aim. To study mortality rates due to diseases of the circulatory system and certain nosological forms in Karachay-Cherkess Republic in 2006 and 2014.Methods. The data of the Russian Federation Federal State Statistics Service on the number of deaths according to a short nomenclature of causes of deaths were analyzed. The nosological structure was studied, proportion of each of the causes of death in the total number of deaths from circulatory system diseases was defined. The names of groups of short nomenclature of causes of deaths in 2006 and 2014 were compared. Non-standardized and standardized mortality rates were calculated.Results. Standardized mortality rate due to circulatory diseases decreased by 29.3% in 2014 in comparison with 2006. The decline in mortality due to circulatory system diseases was noted in all age groups, except for the age group 25-29 years (+18.5%) and 60-64 years (+4.2%). Deaths due to primary and recurrent myocardial infarction decreased (by 46.2%) in all age groups except the age of 40-44 years and 80-84 years, in which the mortality rate due to primary and recurrent myocardial infarction increased by 12.5 and 49.4%, respectively. The mortality from ischemic heart disease increased in age 35-39 years (by 11.3%) and 40-44 years (39.4%). In other age groups, the mortality from ischemic heart disease decreased, the maximum reduction was reported in age 65-69 years (54.8%). Standardized mortality rate due to cerebrovascular diseases decreased by 44.06% in 2014 in comparison with 2006.Conclusion. Taking into account significant contribution to the mortality structure due to circulatory system diseases number of deaths, causes of which are not clearly classified and cause problems with clinical interpretation, this issue requires attention of cardiologists, in terms of both health care delivery and specification of the patients’ health status.

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Trends in mortality rate in patients with congenital heart disease undergoing noncardiac surgical procedures at children’s hospitals

Scientific Reports ◽

10.1038/s41598-021-81161-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Viviane G. Nasr ◽

Steven J. Staffa ◽

David Faraoni ◽

James A. DiNardo

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Mortality Rate ◽

Surgical Procedures ◽

Congenital Heart ◽

Mortality Rates ◽

Administrative Database ◽

Children's Hospitals ◽

Children’S Hospitals ◽

Surgical Data

AbstractAdvances made in pediatric cardiology, cardiac surgery and critical care have significantly improved the survival rate of patients with congenital heart disease (CHD) leading to an increase in children with CHD presenting for noncardiac surgical procedures. This study aims (1) to describe the trend and perioperative mortality rates in patients with CHD undergoing noncardiac surgical procedures at children’s hospitals over the past 5 years and (2) to describe the patient characteristics and the most common type of surgical procedures. The Pediatric Health Information System (PHIS) is an administrative database that contains inpatient, observation, and outpatient surgical data from 52 freestanding children’s hospitals. Thirty-nine of the 52 hospitals submitted data on all types of patient encounters for the duration of the study from 2015 to 2019. The total numbers of non-cardiac surgical encounters among patients with history of a CHD diagnosis significantly increased each year from 38,272 in 2015 to 45,993 in 2019 (P < 0.001). Despite the increase in case numbers, there has been a significant decline in mortality rates to the most recent incidence of 1.06% in 2019. Careful patient selection and medical optimization of patients aligned with specific expertise at dedicated children’s hospitals may lead to improvement in mortality rate. Future studies comparing the outcomes of patients with cardiac disease based on hospital type and volume as well as type of providers may help determine the future of care including potential need for regionalization of noncardiac care for this vulnerable patient population.

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Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v13i3.18404 ◽

2017 ◽

Vol 13 (3) ◽

pp. 327-329

Author(s):

Uttam Kumar Sarkar ◽

Anish Chatterjee ◽

Suprit Basu ◽

Atanu Pan ◽

Sumit Periwal

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Heart Surgery ◽

Heart Diseases ◽

Health Planning ◽

Tertiary Care ◽

Open Heart Surgery ◽

Complex Congenital Heart Disease ◽

Versus Complex

Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically suspected to have heart disease from January 2015 to September 2016 at Dr.B.C.Roy P.G.I.P.S. Kolkata and echocardiographically categorized.Results:A VSD was the commonest acyanotic heart disease (17. 08%).Tetralogy of Fallot (TOF) was commonest complex cyanotic heart disease (10.64%), VSD +ASD was the commonest combined lesion (8.12%). Simple heart lesions (63.1%) were commoner than complex (36.9%) congenital heart diseases.Conclusion:Health policy makers should give due care to manage Congenital Heart Disease either catheter based or surgically keeping in mind about 63.1% of the lesions are simple cardiac lesions and 36.9% lesions are complex cardiac lesion where complex surgery is required.

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A clinical study of normothermic open heart surgery

International Surgery Journal ◽

10.18203/2349-2902.isj20173105 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2429

Author(s):

Ishtiak Ahmed Mir ◽

Ravinder Kumar ◽

Madhu Digra ◽

Dinesh Kumar

Keyword(s):

Heart Surgery ◽

Heart Diseases ◽

Enzyme Level ◽

Pulmonary Stenosis ◽

Pulmonary Veins ◽

Open Heart Surgery ◽

Age Groups ◽

Open Heart ◽

Aortic Cross Clamp Time ◽

Number Of Patients

Background: Normothermic open heart surgery is a new approach which is envisaged for better myocardial protection during cardiac surgery based on the concept that chemically arrested heart is perfused continuously with blood and maintained at 37ºC.Methods: This study was conducted in 50 patients at Super Specialty Hospital, Jammu in the Department of CTVS for a period of one year from 2015 to 2016. The patients of all age groups and both sexes were taken up for surgery which included patients of congenital and acquired heart diseases. All patients were undergone thorough history taking, investigations like cardiac enzymes estimation, LFT, RFT, echocardiography, ECG. Cardioplegia used during surgery consisted of warm oxygenated blood, KCL, sodium bicarbonate, hydrocortisone, Mannitol.Results: Majority of patients were in age group of 11-20 years which comprised 30% of all patients. the male and female patients were equal and ratio was 1:1. Per-operative diagnosis was same as pre-operative echocardiographic diagnosis except that one (2%) patient had ASD with partial anomalous pulmonary veins opening into right atrium. One patient (2%) had single ventricle with pulmonary stenosis. Maximum number of patients underwent mitral valve replacement followed by ASD repair. Mean aortic cross-clamp time was 62 patients and mean total CPB was 71.5 minutes. Mean value of volume of blood cardioplegia used was 1100 ml and for priming solution it was 1500 ml. Cardiac enzyme level showed peak rise above normal after 24 hours after surgery in majority of patients.Conclusions: Normothermic open heart surgery can be used in any diverse surgical procedure safely and effectively.

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Outcome in an Urban Pediatric Trauma System with Unified Prehospital Emergency Medical Services Care

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00041601 ◽

1995 ◽

Vol 10 (1) ◽

pp. 19-23 ◽

Cited By ~ 11

Author(s):

Michael J. VanRooyen ◽

Edward P. Sloan ◽

John A. Barrett ◽

Robert F. Smith ◽

Hernan M. Reyes

Keyword(s):

Head Injury ◽

Mortality Rate ◽

Trauma Center ◽

Pediatric Trauma ◽

Trauma System ◽

Age Groups ◽

Mortality Rates ◽

Trauma Centers ◽

Field Triage ◽

Pediatric Trauma Center

AbstractHypothesis:Pediatric mortality is predicted by age, presence of head trauma, head trauma with a low Glasgow Coma Scale (GCS) score, a low Pediatric Trauma Score (PTS), and transport directly to a pediatric trauma center.Population:Studied were 1,429 patients younger than 16 years old admitted to or declared dead on arrival (DOA) in a pediatric trauma center from January through October, 1988. The trauma system, which served 3-million persons, included six pediatric trauma centers.Methods:Data were obtained by a retrospective review of summary statistics provided to the Chicago Department of Health by the pediatric trauma centers.Results:Overall mortality was 4.8% (68 of 1429); 32 of the patients who died (47.1%) were DOA. The in-hospital mortality rate was 2.6%. Head injury was the principal diagnosis in 46.2% of admissions and was a factor in 72.2% of hospital deaths. The mortality rate was 20.3% in children with a GCS≤10 and 0.4% when the GCS was >10 (odds ratio [OR] = 67.0, 95% CI = 15.0–417.4). When the PTS was ≤ 5, mortality was 25.6%; with a PTS > 5, the mortality was 0.2% (OR = 420.7, 95% CI = 99.3–2,520). Although transfers to a pediatric trauma center accounted for 73.6% of admissions, direct field triage to a pediatric trauma center was associated with a 3.2 times greater mortality risk (95% CI = 1.58–6.59). Mortality rates were equal for all age groups. Pediatric trauma center volume did not influence mortality rates.Conclusions:Head injury and death occur in all age groups, suggesting the need for broad prevention strategies. Specific GCS and PTS values that predict mortality can be used in emergency medical services (EMS) triage protocols. Although the high proportion of transfers mandates systemwide transfer protocols, the lower mortality in these patients suggests appropriate EMS field triage. These factors should be considered as states develop pediatric trauma systems.

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