scholarly journals Lactate clearance for initiating and weaning off extracorporeal membrane oxygenation in a child with regressed left ventricle after arterial switch operation

2016 ◽  
Vol 19 (1) ◽  
pp. 188 ◽  
Author(s):  
SarveshPal Singh ◽  
Sandeep Chauhan ◽  
AK Bisoi ◽  
Manoj Sahoo
Keyword(s):  
Left Ventricle ◽  
Extracorporeal Membrane Oxygenation ◽  
Arterial Switch Operation ◽  
Lactate Clearance ◽  
Arterial Switch ◽  
Membrane Oxygenation ◽  
Switch Operation

scholarly journals Central Extracorporeal Membrane Oxygenation to Lung Transplantation after Remote Arterial Switch Operation

2021 ◽  
Author(s):  
Adam Stephens ◽  
Dean McKenzie ◽  
Jeffrey Heinle ◽  
Ernestina Melicoff,-Portillo ◽  
Carolina Gazzaneo ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Lung Transplantation ◽  
Arterial Switch Operation ◽  
Arterial Switch ◽  
Membrane Oxygenation ◽  
Switch Operation

scholarly journals Primary Arterial Switch Operation for TGA/IVS and Regressed Left Ventricle: How and When to Use Left Ventricular Assist Device

2019 ◽  
Vol 11 (1) ◽  
pp. 97-100
Author(s):  
Dhananjay P. Malankar ◽  
Sachin Patil ◽  
Shivaji Mali ◽  
Shyam Dhake ◽  
Amit Mhatre ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Arterial Switch Operation ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Arterial Switch ◽  
Switch Operation ◽  
Left Ventricular Assist

Purpose: Numerous attempts have been made to extend the boundaries of arterial switch operation (ASO) in children presenting late with transposition of great arteries with intact ventricular septum (TGA/IVS) and regressed left ventricle (rLV). Many children tolerate the delayed ASO uneventfully, whereas others need mechanical circulatory support (MCS) to sustain the systemic circulation while the left ventricle undergoes retraining. Description: In this article, we describe six consecutive children with TGA/IVS and rLV who underwent primary ASO. Results: Three were managed medically, while three required MCS in the form of Centrimag left ventricular assist device (LVAD). All patients survived the operation and were discharged home in a stable condition. Conclusions: Primary ASO can be safely performed in children with TGA/IVS and rLV, provided the center has MCS options. Supporting the rLV with LVAD is feasible and can be achieved safely.

Pulmonary artery banding and venous bidirectional cava-pulmonary shunt for two-stage arterial switch procedure in late referral of patients with transposition of the great arteries and intact ventricular septum: midterm results

2019 ◽  
Vol 29 (5) ◽  
pp. 649-654
Author(s):  
Ayhan Cevik ◽  
Ali Rıza Karaci ◽  
Bulent Polat ◽  
Murat Erturk ◽  
Yalım Yalcin ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Pulmonary Artery ◽  
Arterial Switch Operation ◽  
Pulmonary Artery Banding ◽  
Pulmonary Shunt ◽  
Left Ventricle Mass ◽  
Arterial Switch ◽  
Group I ◽  
Switch Operation ◽  
Left Ventricle Dysfunction

AbstractObjective:Two-stage arterial switch operation and left ventricle retraining are necessary for the patients with left ventricle dysfunction and transposition of great vessels with intact ventricular septum (TGA-IVS) who are referred late.Material and methods:Forty-seven patients with the diagnosis of TGA-IVS and left ventricle dysfunction who underwent arterial switch operation in our centre between July 2013 and August 2017 were analysed retrospectively. The inclusion criteria for left ventricle retraining were patients older than 2 months of age at presentation, having an echocardiographic left ventricle mass index of less than 35 g/m², and having an echocardiographic “banana-shaped” left ventricle geometric appearance. The patients were divided into two groups: pulmonary artery banding and Blalock Taussig shunt were performed as the initial surgical procedure for later arterial switch operation in Group I (n = 19) and pulmonary artery banding and bidirectional cava-pulmonary shunt in Group 2 (n = 28).Results:The average age was found to be 122.3 ± 45.6 days in Group I and 145.9 ± 37.2 days in Group II. There was no statistically significant difference (p = 0.232 versus p = 0.373) between the average left ventricle mass index of the two groups neither before the first stage nor the second stage (26.6 ± 4.8 g/m² versus 25.0 ± 4.9 g/m² and 70.5 ± 12 g/m² versus 673.8 ± 12.0 g/m², respectively). The average time interval for the left ventricle to retrain was 97.7 ± 42.9 days for Group I and 117.3 ± 40.3 days for Group II, significantly lower in Group I (p = 0.027). The time spent in ICU, length of the period during which inotropic support was required, and the duration of hospital stay were significantly higher in Group I (p<0.001, p < 0.001, and p < 0.00, respectively).Conclusion:Pulmonary artery banding and bidirectional cava-pulmonary shunt can be performed as a safe and effective alternative to pulmonary artery banding and arterial Blalock Taussig shunt for patients with TGA-IVS in whom arterial switch operation is needed beyond the neonatal period. This approach involves a shorter hospital stay and fewer post-operative complications.

Arterial Switch Operation for Double-Outlet Left Ventricle

2014 ◽  
Vol 98 (4) ◽  
pp. e97-e99 ◽  
Author(s):  
Roy Varghese ◽  
Niket Arora ◽  
Ejaz Ahmed Sherrif ◽  
Anil Singhi ◽  
Kothandam Sivakumar
Keyword(s):  
Left Ventricle ◽  
Arterial Switch Operation ◽  
Arterial Switch ◽  
Switch Operation

Primary Intracardiac Repair of Double Outlet Right Ventricle and Ventricular Septal Defect without Pulmonary Stenosis

1995 ◽  
Vol 3 (3-4) ◽  
pp. 103-108
Author(s):  
KG Jaya Prasanna ◽  
Krishna Subramony Iyer ◽  
Rajesh Sharma ◽  
Balram Airan ◽  
Ivatury Mrityonjaya Rao ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Arterial Switch Operation ◽  
Pulmonary Stenosis ◽  
Double Outlet Right Ventricle ◽  
Arterial Switch ◽  
Intracardiac Repair ◽  
Switch Operation

From January 1991' to May 1994, 29 patients with double outlet right ventricle with ventricular septal defect, without pulmonary stenosis underwent primary intracardiac repair at the All India Institute of Medical Sciences, New Delhi. Patients were classified into 4 groups based on location of the ventricular septal defect. The ventricular septal defect was subaortic in 11, subpulmonary in 13, doubly committed subarterial in 1, and noncommitted in 4 patients. Surgical treatment consisted of intraventricular routing of the left ventricle to the aorta (17), and the left ventricle to the pulmonary artery followed by an arterial switch operation (12). There were 4 (13.9%) early deaths. Follow-up ranged from 3 months to 3 years (mean, 1.5 years). There was no late mortality. Three patients had residual ventricular septal defect, one of whom has undergone reoperation. One patient has a gradient of 25 mmHg across the left ventricular outflow tract. Double outlet right ventricle with subpulmonic ventricular septal defect was found to be a significant risk factor for early mortality (p = 0.03). The subgroup of double outlet right ventricle with subpulmonic ventricular septal defect who had a combination of single coronary artery and post arterial switch operation was particularly prone to pulmonary hypertensive crisis and hospital death (p = 0.002).

Successful Management of a COVID-19 Positive Infant With Transposition of the Great Arteries

2021 ◽  
pp. 215013512110006
Author(s):  
Tomasz J. Nabialek ◽  
Naga K. Puppala ◽  
Andrew Riordan ◽  
Ram Ramaraj ◽  
Phuoc Duong ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Prostaglandin E1 ◽  
Arterial Switch Operation ◽  
Left Ventricular ◽  
Intact Ventricular Septum ◽  
Successful Management ◽  
Membrane Oxygenation ◽  
Switch Operation ◽  
Atrial Septostomy

A six-week-old infant presented in extremis and was diagnosed with dextro-transposition of the great arteries, intact ventricular septum, features of left ventricular deconditioning, and abnormal coronary arteries. Treatment with prostaglandin E1 and balloon atrial septostomy was insufficient, necessitating extracorporeal membrane oxygenation (ECMO). Severe acute respiratory syndrome coronavirus-2 was detected. The arterial switch operation was delayed by eight days because of COVID-19. Although stable on ECMO, the infant was treated with remdesivir. Extracorporeal membrane oxygenation was not required postoperatively with chest closure on day 2 and extubation on day 5.

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