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Search Results (3)
  • Open Access

    ARTICLE

    Efficacy of Descending Aortic Retrograde Flow Area to Forward Flow Area Ratio on Echocardiography in Perioperative Management after Blalock-Thomas-Taussig Shunt

    Kentaro Kogawa1,2,*, Reiji Ito2, Daishi Hirano2, Kenji Hoshino1,2

    Congenital Heart Disease, Vol.20, No.4, pp. 451-461, 2025, DOI:10.32604/chd.2025.068006 - 18 September 2025

    Abstract Objective: To investigate the usefulness of the descending aortic retrograde flow area to forward flow area (dAO RF) ratio using echocardiography in managing pulmonary blood flow during the perioperative period following Blalock-Thomas-Taussig shunt (BTTS) surgery. Methods: This retrospective study analyzed patient characteristics, surgical procedures, and perioperative courses. The dAO RF ratio was measured upon admission to the pediatric intensive care unit (PICU) and 12, 24, 48, and 72 h post-surgery. Blood pressure, percutaneous oxygen saturation, arterial blood gas values, and lactate levels were measured at the same time as the dAO RF ratio. Results: Seventy-one cases were… More >

  • Open Access

    ARTICLE

    Preoperative Risk Assessment and Perioperative Management of Adults with Congenital Heart Disease Undergoing Non-Cardiac Surgery

    Michela Palma, Giancarlo Scognamiglio*, Flavia Fusco, Assunta Merola, Anna Correra, Diego Colonna, Emanuele Romeo, Berardo Sarubbi

    Congenital Heart Disease, Vol.15, No.1, pp. 33-49, 2020, DOI:10.32604/CHD.2020.011523 - 17 June 2020

    Abstract Adults with congenital heart disease (ACHD) constitute a growing population with complex cardiac physiopathology and frequent extra-cardiac involvement. The recent dramatic improvement of their life expectancy has resulted in an increasing proportion of ACHD patients requiring non-cardiac surgery. While a large body of evidence demonstrated the importance of an accurate risk assessment in patients with acquired heart disease before noncardiac surgery in order to reduce perioperative morbidity and mortality and detailed algorithms have been released by international societies, no specific guidelines are available for the perioperative management in this population. Nonetheless, understanding the complex anatomy… More >

  • Open Access

    ARTICLE

    Anticipatory perioperative management for patent ductus arteriosus surgery: Understanding postligation cardiac syndrome

    Regan E. Giesinger1, Adrianne R. Bischoff3, Patrick J. McNamara1,2

    Congenital Heart Disease, Vol.14, No.2, pp. 311-316, 2019, DOI:10.1111/chd.12738

    Abstract Ligation of a hemodynamically significant ductus arteriosus results in significant changes in loading conditions which have predictable consequences. Postligation cardiac syndrome, defined as hypotension requiring inotropic support and failure of oxygenation and ventilation, may occur 6‐12 hours following ligation due to left ven‐ tricular systolic and diastolic failure, respectively. Afterload is the primary driver of this decompensation. In this review, we describe the pathophysiological changes in loading conditions associated with postligation cardiac syndrome and other contrib‐ utors to cardiovascular dysfunction following ductal ligation. We present strategies for perioperative optimization and a physiology‐based algorithm for postoperative More >

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