scholarly journals In Hospital Outcomes after Bidirectional Cavopulmonary Anastomosis: 18 Year Experience from a Single Center

2020 ◽  
Vol 17 (2) ◽  
pp. 13-19
Author(s):  
Raamesh Koirala ◽  
Nirmal Panthee ◽  
Sidhartha Pradhan ◽  
Nivesh Rajbhandari ◽  
Daman Kiran Shrestha ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Double Outlet Right Ventricle ◽  
Single Center ◽  
Hospital Records ◽  
Cardiac Lesion ◽  
First Case ◽  
Cavopulmonary Anastomosis ◽  
Cardiac Lesions ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
Cavopulmonary Shunt

Background: Bidirectional cavopulmonary shunt (BCPS) is used for the interim palliation of a variety of cyanotic cardiac lesions. It is a standard palliative step for patients with functionally univentricular hearts in hope of achieving Fontan completion. At our center, first case of BCPS was performed on February 7, 2002. Here, we share our experience with BCPS over last 18 years. Methods: This is a retrospective analysis of all patients undergoing BCPS from February 2002 to July 2019. Patients who underwent BCPS as a part of one-and-half ventricular repair for Ebstein’s anomaly were excluded. Baseline, intraoperative, and postoperative variables were collected from hospital records. Results: A total of 326 patients with mean age of 5.7±5.8 years (median 3.5 years; range: 1.5 months-32 years) underwent BCPS over last 18 years. Majority (61%) were males. Double outlet right ventricle (DORV) was the most common primary cardiac lesion (30%) followed by tricuspid atresia (23%). Mean ICU stay was 3.9±4.8 days, with hospital stay of 7.8±5.9 days. In-hospital mortality was 15%. Patients who died had low body weight (11.8±10.7 kg vs 16.0±11.6 kg; p=0.019), and longer cardiopulmonary bypass time (101±64 min vs 76±42 min; p=0.001). Oxygen saturation improved significantly at the time of discharge (79.2±9.5% vs 68.6±13.7%; p=0.000). Conclusion: This is the first report of its kind to analyze the outcomes of BCPS in our center. We have discussed the evolution of BCPS surgery in our center and presented our outcomes. Our in-hospital mortality remains high, and we need to strive towards reducing the mortality.

the clinical impact of antegrade pulmonary blood flow on the bidirectional cavopulmonary shunt in infants

2004 ◽  
Vol 14 (S3) ◽  
pp. 44-47 ◽  
Author(s):  
lucia migliazza ◽  
francesco seddio ◽  
francesco paolo annecchino ◽  
giancarlo crupi
Keyword(s):  
Blood Flow ◽  
Pulmonary Blood Flow ◽  
Ventricular Dysfunction ◽  
Fontan Procedure ◽  
Volume Overload ◽  
Clinical Impact ◽  
Cavopulmonary Anastomosis ◽  
Alternative Sources ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
Cavopulmonary Shunt

the bidirectional cavopulmonary anastomosis is commonly used in the palliation of patients with a functionally univentricular physiology. the management of alternative sources of flow of blood to the lungs, as well as the magnitude of acceptable accessory blood flow at the time of surgery, nonetheless, remains controversial. these issues are particularly significant when a cavopulmonary anastomosis is performed in infants who may become candidates for a fontan procedure. indeed, a long-standing volume overload, which is invariably associated with the maintenance of accessory sources of pulmonary blood flow, may result in systemic ventricular dysfunction. these observations prompted us to review the influence of antegrade pulmonary blood flow in the management of infants undergoing a cavopulmonary anastomosis.

The pathological diagnosis of pulmonary atresia with abnormal ventriculoarterial connections in the fetus

1993 ◽  
Vol 3 (4) ◽  
pp. 430-434
Author(s):  
Lona Jane Mary Jeffrey ◽  
Siew Yen Ho ◽  
Deborah Peta Murray Moncrieff ◽  
Leslie David Ross ◽  
John Malcolm Pearce
Keyword(s):  
Left Ventricle ◽  
Pulmonary Atresia ◽  
Ventricular Septum ◽  
Postnatal Life ◽  
Intact Ventricular Septum ◽  
Cardiac Lesion ◽  
Complete Transposition ◽  
First Case ◽  
Structural Abnormalities ◽  
Cardiac Lesions

AbstractPulmonary atresia with abnormal ventriculoarterial connections in the presence of an intact ventricular septum is rare even in postnatal life. Two cases are described in which this combination of lesions was diagnosed in previable fetuses at autopsy. Both pregnancies were terminated for gross structural abnormalities discovered on antenatal ultrasound scans. In the first case, the pulmonary atresia was associated with intact ventricular septum, a double outlet left ventricle and hypoplasia of the tricuspid valve, right ventricle and arterial duct, a combination of lesions that would appear to be unique. In the second case, there was complete transposition and a hypoplastic left ventricle. The severity of the cardiac lesions in both fetuses was such that it is unlikely that either would have survived to term. In the first case no other malformation was present, but in the second there was also a large encephalocoele secondary to early amnion rupture, and a single umbilical artery. The association of the cardiac lesion with early amnion rupture in this second fetus would appear to be a chance event.

Systemic venous collateral channel causing desaturation after bidirectional cavopulmonary anastomosis: percutaneous closure

2010 ◽  
Vol 21 (1) ◽  
pp. 107-109 ◽  
Author(s):  
Satish Karur ◽  
Jayaranganath Mahima ◽  
Manjunath Cholenahally Nanjappa
Keyword(s):  
Vascular Plug ◽  
Caval Vein ◽  
Excellent Outcome ◽  
Bidirectional Glenn ◽  
Inferior Caval Vein ◽  
Bidirectional Glenn Shunt ◽  
Cavopulmonary Anastomosis ◽  
Bidirectional Cavopulmonary Anastomosis ◽  
Collateral Channel ◽  
Cavopulmonary Shunt

AbstractAn infant with cyanotic cardiac disease that was palliated with a bidirectional cavopulmonary shunt developed progressive and worsening cyanosis 5 years after the surgical procedure. A large venous collateral was found to be decompressing the bidirectional Glenn shunt from the superior caval vein to the inferior caval vein and was percutaneously closed with a vascular plug. The unusually large venous collateral, and the excellent outcome associated with percutaneous procedure are discussed.

scholarly journals Candida Endocarditis in Patients with Candidemia: A Single-Center Experience of 14 Cases

2020 ◽  
Vol 185 (6) ◽  
pp. 1057-1067
Author(s):  
Florian Hitzenbichler ◽  
Tobias Joha ◽  
Michaela Simon ◽  
Jirka Grosse ◽  
Karin Menhart ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Treatment Preference ◽  
Healthcare Associated Infections ◽  
Single Center ◽  
Single Center Experience ◽  
Pet Ct ◽  
Persistent Candidemia ◽  
Fdg Pet Ct ◽  
Healthcare Associated ◽  
High Treatment

AbstractA retrospective, single-center analysis of 14 cases of Candida endocarditis (from 355 candidemia cases during the years 2012–2019) revealed a high in-hospital mortality (57.1%), a high proportion of healthcare-associated infections (13/14) and a high treatment preference for echinocandins. Transthoracic echocardiography and 18F-FDG PET/CT had a sensitivity of 54.5% and 57.1%, respectively. Patients were older than previously described and most patients with Candida endocarditis had persistent candidemia for ≥ 3 days despite antifungal therapy.

scholarly journals Prognostic Value of Inflammatory Biomarkers in Patients with Severe COVID-19: A Single-Center Retrospective Study

2021 ◽  
Vol 16 ◽  
pp. 117727192110270
Author(s):  
Gönül Açıksarı ◽  
Mehmet Koçak ◽  
Yasemin Çağ ◽  
Lütfiye Nilsun Altunal ◽  
Adem Atıcı ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Mortality ◽  
Prognostic Value ◽  
Current Knowledge ◽  
Area Under The Curve ◽  
Prognostic Nutritional Index ◽  
Inflammatory Biomarkers ◽  
Single Center ◽  
Discriminative Ability ◽  
Lymphocyte Ratio

Background: The current knowledge about novel coronavirus-2019 (COVID-19) indicates that the immune system and inflammatory response play a crucial role in the severity and prognosis of the disease. In this study, we aimed to investigate prognostic value of systemic inflammatory biomarkers including C-reactive protein/albumin ratio (CAR), prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in patients with severe COVID-19. Methods: This single-center, retrospective study included a total of 223 patients diagnosed with severe COVID-19. Primary outcome measure was mortality during hospitalization. Multivariate logistic regression analyses were performed to identify independent predictors associated with mortality in patients with severe COVID-19. Receiver operating characteristic (ROC) curve was used to determine cut-offs, and area under the curve (AUC) values were used to demonstrate discriminative ability of biomarkers. Results: Compared to survivors of severe COVID-19, non-survivors had higher CAR, NLR, and PLR, and lower LMR and lower PNI ( P < .05 for all). The optimal CAR, PNI, NLR, PLR, and LMR cut-off values for detecting prognosis were 3.4, 40.2, 6. 27, 312, and 1.54 respectively. The AUC values of CAR, PNI, NLR, PLR, and LMR for predicting hospital mortality in patients with severe COVID-19 were 0.81, 0.91, 0.85, 0.63, and 0.65, respectively. In ROC analysis, comparative discriminative ability of CAR, PNI, and NLR for hospital mortality were superior to PLR and LMR. Multivariate analysis revealed that CAR (⩾0.34, P = .004), NLR (⩾6.27, P = .012), and PNI (⩽40.2, P = .009) were independent predictors associated with mortality in severe COVID-19 patients. Conclusions: The CAR, PNI, and NLR are independent predictors of mortality in hospitalized severe COVID-19 patients and are more closely associated with prognosis than PLR or LMR.

Measurement of Dead Space Fraction Upon ICU Admission Predicts Length of Stay and Clinical Outcomes Following Bidirectional Cavopulmonary Anastomosis*

2018 ◽  
Vol 19 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Claire L. Cigarroa ◽  
Sarah J. van den Bosch ◽  
Xiaoqi Tang ◽  
Kimberlee Gauvreau ◽  
Christopher W. Baird ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Dead Space ◽  
Icu Admission ◽  
Cavopulmonary Anastomosis ◽  
Bidirectional Cavopulmonary Anastomosis
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