scholarly journals The effect of pre-hospital discharge care program on mothers’ knowledge and reported practice for children with congenital heart surgery

2018 ◽  
Vol 8 (9) ◽  
pp. 122
Author(s):  
Fatma Ahmed Elsobky ◽  
Samah Abdalha Mohamed Amer ◽  
Ahlam Elahmady Mohamed Sarhan
Keyword(s):  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Heart Defects ◽  
Care Program ◽  
Congenital Heart Surgery ◽  
Care Practice ◽  
Discharge Care ◽  
Significant Difference

Heart surgery in children is done to repair heart defects for a child born with congenital heart defects and heart diseases. The aim of the study was to evaluate the effect of pre-hospital discharge care program on mothers’ knowledge and reported practice regarding discharge care of children with congenital heart surgery. The study was conducted in the Heart Surgery Department at Abo-EL Riesh University Children Hospital. The sample included 30 mothers and their children that were available during the period of data collection. Three tools were used to collect data including: Tool I: Interviewing questioner sheet of the participants categorized into two parts. Part I and part II: Personal characteristics of the children and their mothers. Tool II: Assessment of mothers’ knowledge regarding care of children after congenital heart surgery. Tool III: Mother’s reported care practice checklist. Results: The results of the present study revealed that there was a highly significant difference in all items of care knowledge (activity, food, medication and follow-up) before, after immediately and after one month from discharge program with highly significant statistically (p < .001). Discharge program improve mothers’ knowledge and practice regarding care of their children after congenital heart surgery. Recommendations: Comprehensive, multidisciplinary discharge planning should deign early and should include the mothers and children contain education regarding congenital heart surgery care.

Novel approach for Recanalization and Limb Saving Following Acute Thrombosis of Upper Limb Arteries in Two Neonates After Congenital Heart Surgery

2020 ◽  
Author(s):  
Jameel Al- Ata ◽  
Gaser Abdelmohsen ◽  
Saud Bahaidarah ◽  
Naif Alkhushi ◽  
Zaher Zaher
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Output ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Congenital Heart Surgery ◽  
Low Cardiac Output ◽  
Vascular Thrombosis ◽  
Acute Thrombosis ◽  
Novel Approach

IntroductionNeonates with congenital heart disease are at a high risk of vascular thrombosis. Thrombosis may occur due to vascular injury, increased blood viscosity secondary to polycythemia associated with congenital cyanotic heart diseases, or stasis of blood flow associated with low cardiac output (Schmidt B & Andrew M., Pediatrics 1995; 96: 939–943. Veldman A et al.,Vasc Health Risk Manag 2008; 4: 1337–1348).

scholarly journals Open heart surgery in Nigerian children the need for international and regional collaboration: the Balyesa and Enugu experience

2021 ◽  
Vol 6 (2) ◽  
pp. 044-047
Author(s):  
FA Ujunwa ◽  
AS Ujuanbi ◽  
JM Chinawa ◽  
D Alagoa ◽  
B Onwubere
Keyword(s):  
Success Rate ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Heart Defects ◽  
Open Heart Surgery ◽  
Case Fatality ◽  
Open Heart ◽  
Cardiac Intervention ◽  
Regional Collaboration

Background: Children with congenital heart diseases (CHD) often require palliative or definitive surgical heart interventions to restore cardiopulmonary function. Lack of early cardiac intervention contributes to large numbers of potentially preventable deaths and sufferings among children with such conditions. Objectives: The aim of this study is to highlight our experience and the importance of international and regional collaboration in open heart surgery among children with CHD and capacity building of home cardiac teams in Bayelsa and Enugu States. Materials and Methods: In November 2016, a memorandum of understanding (MOU) was signed between the managements of FMC, Yenagoa, Bayelsa State, UNTH, Enugu and an Italian-based NGO- Pobic Open Heart International for collaboration in the area of free open-heart surgery for children with CHDs and training of home cardiac teams from both institutions either in Nigeria or in Italy. Patients for the program were recruited from Bayelsa and Enugu States with referrals from all over the country with combined screening and selection done in UNTH. Selected patients were operated on and funded free of charge by the Italian NGO. Hands-on training of the home cardiac teams and cardiac intervention was done twice yearly in Nigeria. Result: From inception of the program in November, 2016 to May, 2019 a total of 47 children (21 Males, 26 Females; Age range 6 months to 14 yrs) with various types of congenital heart defects have benefitted from the program with 41 surgeries done in UNTH & 6 in Italy (complex pathologies) at no cost to the recipients. Also, home cardiac teams from UNTH and FMC, Yenagoa have gained from on-site capacity training & retraining from the Italian cardiac team both in Nigeria & in Italy. The Success rate was 95.7% (44) and Case Fatality rate was 4.3% (2). Conclusion: There is a great efficacy in early cardiac intervention. This is with respect to a high success rate and minimal Case Fatality seen in this study. This was achieved through Regional and international collaboration.

scholarly journals Treatment of systemic inflammatory response syndrome following on-pump pediatric congenital heart surgery

2021 ◽  
Vol 10 (2) ◽  
pp. 113-124
Author(s):  
D. V. Borisenko ◽  
A. A. Ivkin ◽  
D. L. Shukevich
Keyword(s):  
Cardiopulmonary Bypass ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Defects ◽  
Surgical Techniques ◽  
Congenital Heart Surgery ◽  
Systemic Inflammatory Response ◽  
Preventive Strategies

Highlights. The article discusses the pathophysiological aspects of cardiopulmonary bypass and the mechanisms underlying the development of the systemic inflammatory response in children following congenital heart surgery. We summarize and report the most relevant preventive strategies aimed at reducing the systemic inflammatory response, including both, CPB-related methods and pharmacological ones.The growing number of children with congenital heart defects requires the development of more advanced technologies for their surgical treatment. However, cardiopulmonary bypass is required in almost all surgical techniques. Despite the tremendous progress and recent advances in cardiopulmonary bypass techniques, the systemic inflammatory response syndrome associated with these surgeries remains unresolved. The review summarizes the causes and mechanisms underlying its development. The most commonly used preventive strategies are reported, including standard and modified ultrafiltration, leukocyte filters, and pharmacological agents (systemic glucocorticoids, aprotinin, and antioxidants).The role of cardioplegia and hypothermia in the reduction of systemic inflammation is defined. Cardiac surgery centers around the world use a variety of techniques and pharmacological approaches, drawing on the results of randomized clinical studies. However, there are no clear and definite clinical guidelines aimed at reducing the systemic inflammatory response during cardiopulmonary bypass in children. It remains a significant problem for pediatric intensive care by aggravating their postoperative status, prolonging the length of the in-hospital stay, and reducing the survival rates.

Early outcomes of usage of cryoFORM® probe for cryomaze procedure in congenital heart surgery

2020 ◽  
Vol 30 (12) ◽  
pp. 1874-1879
Author(s):  
Firat H. Altin ◽  
Sevket Balli ◽  
Murat Cicek ◽  
Okan Yurdakok ◽  
Oktay Korun ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Electrophysiological Study ◽  
Congenital Heart Surgery ◽  
Maze Procedure ◽  
Right Atrial ◽  
Complex Anatomy ◽  
Pacemaker Placement ◽  
The Right

AbstractObjectives:This study aimed to evaluate the early outcomes of patients who underwent a concomitant therapeutic maze procedure for congenital heart surgery.Materials and Methods:Between 2019 and 2020, eight patients underwent surgical cryoablation by using the same type of cryoablation probe.Results:Three patients had atrial flutter, two had Wolf–Parkinson–White syndrome, two intra-atrial reentrant tachycardia, and one had atrial fibrillation. Four patients underwent electrophysiological study. Preoperatively, one patient was on 3, two were on 2, five were on 1 antiarrhythmic drug. Six patients underwent right atrial maze and two underwent bilateral atrial maze. Five out of six right atrial maze patients underwent right atrial reduction. Nine different lesion sets were used. Some of the lesions were combined and applied as one lesion. In Ebstein’s anomaly patients, the lesion from coronary sinus to displaced tricuspid annulus was delicately performed. The single ventricle patient with heterotaxy had junctional rhythm at the time of discharge and was the only patient who experienced atrial extrasystoles 2 months after discharge. Seven of the eight patients were on sinus rhythm. No patient needed permanent pacemaker placement.Conclusion:Cryomaze procedure can be applied in congenital heart diseases with acceptable arrhythmia-free rates by selecting the appropriate materials and suitable lesion sets. The application of cryomaze in heterotaxy patients can be challenging due to differences in the conduction system and complex anatomy. Consensus with the electrophysiology team about the choice of the right–left or biatrial maze procedure is mandatory for operational success.

Standardizing Discharge Furosemide Duration Following Congenital Heart Surgery

2021 ◽  
pp. 215013512110493
Author(s):  
Mira Trivedi ◽  
Carlos Eduardo Diaz-Castrillon ◽  
Evonne Morell
Keyword(s):  
Quality Improvement ◽  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Average Duration ◽  
Diuretic Therapy ◽  
Total Duration ◽  
Congenital Heart Surgery ◽  
Practice Change ◽  
Improvement Project

Background: Pediatric cardiothoracic surgery has evolved over the last several decades with shorter bypass times and less need for hypothermic arrest. Diuretics have been commonly used in the post-operative period with no guidelines on duration following cardiopulmonary bypass. As a result, we conducted a single-center quality improvement project to reduce overuse of diuretics in post-operative patients without causing an increase in complications. We devised an early diuretic wean protocol that was implemented upon patient discharge. Methods: All patients who underwent uncomplicated congenital heart surgery after November 2018 were considered for the protocol. We defined an early diuretic wean protocol with a total duration of ten days of single diuretic therapy following hospital discharge. Patients were evaluated in clinic two weeks following discharge, after completion of diuretic therapy, to assess for clinical symptoms and development of effusions. Results: Retrospective pre-protocol data found the average duration a patient was on diuretics was 32 days following hospital discharge from uncomplicated congenital heart surgery. Following implementation of the protocol, there was a decrease in the total duration to 14 days, demonstrating a 56% decrease. With this practice change, there was no notable increase in adverse events. Conclusions: With implementation of the protocol, practice variability was minimized and the average post-operative diuretic duration was decreased without an increase in pleural and/or pericardial effusions or readmissiosn rates. Future directions and ongoing changes include expanding to a multicenter quality improvement collaborative focusing on decreasing the average duration of furosemide to less than five days after hospital discharge.

Pre-Hospital Discharge Car Safety Seat Testing in Infants Following Congenital Heart Surgery

2007 ◽  
Vol 29 (2) ◽  
pp. 313-316 ◽  
Author(s):  
J. M. Simsic ◽  
K. Masterson ◽  
B. E. Kogon ◽  
P. M. Kirshbom ◽  
K. R. Kanter
Keyword(s):  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Car Safety ◽  
Safety Seat

scholarly journals Outcomes of home mechanical ventilation with tracheostomy after congenital heart surgery

2021 ◽  
pp. 1-5
Author(s):  
Bahar Temur ◽  
İsmet E Emre ◽  
Selim Aydın ◽  
Mehmet A Önalan ◽  
Serdar Başgöze ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Median Duration ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Total Mortality ◽  
Congenital Heart Surgery ◽  
Home Mechanical Ventilation ◽  
Significant Difference

Abstract Objective: After congenital heart surgery, some patients may need long-term mechanical ventilation because of chronic respiratory failure. In this study, we analysed outcomes of the patients who need tracheostomy and home mechanical ventilation. Methods: Amongst 1343 patients who underwent congenital heart surgery between January, 2014 and June, 2018, 45 needed tracheostomy and HMV. The median age of these patients was 6.4 months (12 days–6.5 years). Nineteen patients underwent palliation while 26 patients underwent total repair. Post-operative diaphragm plication was performed in five patients (11%). Median duration of mechanical ventilation before tracheostomy was 32 days (8–154 days). The patients were followed up with their home ventilators in ward and at home. Mean follow-up time was 36.24 ± 11.61 months. Results: The median duration of ICU stay after tracheostomy was 27 days (range 2–93 days). Follow-up time in ward was median 30 days (2–156 days). A total of 12 patients (26.6%) were separated from the ventilator and underwent decannulation during hospital stay. Thirty-two patients (71.1%) were discharged home with home ventilator support. Of them, 15 patients (46.9%) were separated from the respiratory support in median of 6 weeks (1 week–11 months) and decannulations were performed. Total mortality was 31.1%. in which four patients are still HMV dependent. There was no significant difference for decannulation between total repair and palliation patients. Conclusion: HMV via tracheostomy is a useful option for the treatment of children who are dependent on long-term ventilation after congenital heart surgery although there are potential risks.

scholarly journals Pediatric Cardiac Surgical Patterns of Practice and Outcomes in Japan and Europe

2021 ◽  
Vol 12 (3) ◽  
pp. 312-319
Author(s):  
Jürgen Hörer ◽  
Yasutaka Hirata ◽  
Hisateru Tachimori ◽  
Masamichi Ono ◽  
Vladimiro Vida ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Septal Defect ◽  
Congenital Heart Surgery ◽  
Atrioventricular Septal Defect ◽  
Postoperative Length ◽  
Surgery Mortality ◽  
Patterns Of Practice

Objectives: The Japan Cardiovascular Surgery Database–Congenital section (JCVSD-Congenital) and the European Congenital Heart Surgeons Association (ECHSA) Congenital Heart Surgery Database (CHSD) share the same nomenclature. We aimed at comparing congenital cardiac surgical patterns of practice and outcomes in Japan and Europe using the JCVSD-Congenital and ECHSA-CHSD. Methods and Results: We examined Japanese (120 units, 63,365 operations) and European (96 units, 90,098 operations) data in JCVSD-Congenital and ECHSA-CHSD from 2011 to 2017. Patients’ age and weight, periprocedural times, mortality at hospital discharge, and postoperative length of stay were calculated for ten benchmark operations. There was a significantly higher proportion of ventricular septal defect closures and Glenn operations and a significantly lower proportion of coarctation repairs, tetralogy of Fallot repairs, atrioventricular septal defect repairs, arterial switch operations, truncus repairs, Norwood operations, and Fontan operations in JCVSD-Congenital compared to ECHSA-CHSD. Postoperative length of stay was significantly longer following all benchmark operations in JCVSD-Congenital compared to ECHSA-CHSD. Mean STAT mortality score (Society of Thoracic Surgeons European Association for Cardio-Thoracic Surgery mortality score) was significantly higher in JCVSD-Congenital (0.78) compared to ECHSA-CHSD (0.71). Mortality at hospital discharge was significantly lower in JCVSD-Congenital (4.2%) compared to ECHSA-CHSD (6.0%, P < .001). Conclusions: The distribution of the benchmark procedures and age at the time of surgery differ between Japan and Europe. Postoperative length of stay is longer, and the mean complexity is higher in Japan compared to European data. These comparisons of patterns of practice and outcomes demonstrate opportunities for continuing bidirectional transcontinental collaboration and quality improvement.

scholarly journals Effects of Remifentanil and Sufentanil Anesthesia on Cardiac Function and Serological Parameters in Congenital Heart Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zhigang Qin ◽  
Younian Xu
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Treatment Group ◽  
Cardiac Function ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Control Group ◽  
Muscle Rigidity ◽  
Significant Difference

In this study, we have investigated feasibility of remifentanil and sufentanil anesthesia in children with congenital heart disease surgery and its effects on cardiac function and serological parameters. For this purpose, a retrospective study was conducted on 120 children with congenital heart disease who underwent repair of ventricular septum or atrial septum in our hospital, specifically from January 2016 to January 2018, and 60 patients in each group were randomly divided into the control and treatment groups, respectively. The control group was anesthetized with sufentanil, and the treatment group was anesthetized with remifentanil. The heart function, serological indexes, and adverse reactions were observed and compared. We have observed that there was no significant difference in HR levels between these groups ( P > 0.05 ), but SDP and DBP values of the two groups were decreased after anesthetic induction ( P < 0.05 ). ACH, cortisol, and lactic acid in the treatment group were significantly lower than those in the control group, and the difference was statistically significant ( P < 0.05 ). The incidence of bradycardia, nausea and vomiting, hypotension, muscle rigidity, and respiratory depression in the treatment group was 16.67% lower than that in the control group ( P < 0.05 ). Remifentanil has less influence on hemodynamics and a better analgesic effect than fentanyl in inhibiting stress response in congenital heart surgery, which provides reference and basis for children congenital heart surgery.

scholarly journals Congenital Heart Surgery: Analysis of 102 Cases

2016 ◽  
Vol 30 (2) ◽  
pp. 58-60
Author(s):  
AKM Manzurul Alam ◽  
Istiaq Ahmed ◽  
Manzil Ahmed ◽  
Al Mamun Hossain
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Septal Defect ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Signs And Symptoms ◽  
Congenital Heart Surgery ◽  
Corrective Surgery ◽  
Life Threatening

Congenital heart diseases (CHDs) are a group of problems in the structure of the heart that is present at birth. Signs and symptoms depend on the specific type of problem. Symptoms can vary from none to life-threatening. CHD is prevalent throughout the world including Bangladesh. It is the leading cause of birth defect-related death. Most of the patients with CHDs need corrective surgery and life-long follow up with heart care. In this series, 102 cases of CHD patients were operated, 82 of them were of atrial septal defect (ASD), 12 ventricular septal defect (VSD), 2 Tetralogy of Fallot (TOF) and 6 patent ductus arteriosus (PDA). Operative and post-operative periods were uneventful. There were no major complications including death.Bangladesh Heart Journal 2015; 30(2) : 58-60

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