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  • Open Access

    ARTICLE

    Cardiac Surgery with Cardiopulmonary Bypass in Low-Weight or Preterm Neonates: A Retrospective Study Analyzing Early Outcome

    Alain J. Poncelet1,*, Maureen Peers de Nieuwburgh2, Stéphane Moniotte2, Geoffroy de Beco1, Karlien Carbonez2, Jean E. Rubay1, Thierry Detaille3, Laurent Houtekie3, Mona Momeni4

    Congenital Heart Disease, Vol.18, No.2, pp. 151-168, 2023, DOI:10.32604/chd.2023.022636

    Abstract Background: Most outcome studies in congenital cardiac surgery for “low weight” neonates include patients undergoing surgery without cardiopulmonary bypass (CPB). The primary objective of our study was to identify risk factors for in-hospital mortality in neonates weighing less than 3 Kg and undergoing surgery with CPB. In addition, we compared the effect of early surgery with CPB (before 37W-gestational age (GA)) for congenital heart disease to delayed surgery until a corrected GA of 37 weeks in an attempt to promote weight gain. Methods: Retrospective single-center study including all patients operated between 1997 and 2017. Uni- and multivariable analysis were used… More >

  • Open Access

    ARTICLE

    Improvement in perioperative care in pediatric cardiac surgery by shifting the primary focus of treatment from cardiac output to perfusion pressure: Are beta stimulants still needed?

    Amir-Reza Hosseinpour1, Mathieu van Steenberghe1, Marc-André Bernath2, Stefano Di Bernardo3, Marie-Hélène Pérez4, David Longchamp4, Mirko Dolci2, Yann Boegli2, Nicole Sekarski3, Javier Orrit1, Michel Hurni1, René Prêtre1, Jacques Cotting4

    Congenital Heart Disease, Vol.12, No.5, pp. 570-577, 2017, DOI:10.1111/chd.12485

    Abstract Objective: An important aspect of perioperative care in pediatric cardiac surgery is maintenance of optimal hemodynamic status using vasoactive/inotropic agents. Conventionally, this has focused on maintenance of cardiac output rather than perfusion pressure. However, this approach has been abandoned in our center in favor of one focusing primarily on perfusion pressure, which is presented here and compared to the conventional approach.
    Design: A retrospective study.
    Setting: Regional center for congenital heart disease. University Hospital of Lausanne, Switzerland.
    Patients: All patients with Aristotle risk score ≥8 that underwent surgery from 1996 to 2012 were included. Patients operated between 1996 and 2005… More >

  • Open Access

    REVIEW

    Peri-procedural risk stratification and management of patients with Williams syndrome

    R. Thomas Collins II1,2, Margaret G. Collins3, Michael L. Schmitz2,4, Justin T. Hamrick4

    Congenital Heart Disease, Vol.12, No.2, pp. 133-142, 2017, DOI:10.1111/chd.12447

    Abstract Williams syndrome (WS) is a congenital, multisystem disorder affecting the cardiovascular, connective tissue, and central nervous systems in 1 in 10 000 live births. Cardiovascular involvement is the most common cause of morbidity and mortality in patients with WS, and noninvasive and invasive procedures are common. Sudden cardiovascular collapse in patients with WS is a well-known phenomenon, especially in the peri-procedural period. Detailed guidelines for peri-procedural management of patients with WS are limited. The goal of this review is to provide thoughtful, safe and effective management strategies for the peri-procedural care of patients with WS with careful consideration of hemodynamic… More >

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