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  • Open Access

    ARTICLE

    Readmissions after adult congenital heart surgery: Frequency and risk factors

    Yuli Y. Kim1, Wei He2, Thomas E. MacGillivray3, Oscar J. Benavidez2

    Congenital Heart Disease, Vol.12, No.2, pp. 159-165, 2017, DOI:10.1111/chd.12433

    Abstract Objective: Despite their clinical importance, 30-day readmission after adult congenital heart surgery has been understudied. They sought to determine the frequency of unplanned readmissions after adult congenital heart surgery and to identify any potential associated risk factors.
    Design: Retrospective cohort study using State Inpatient Databases for Washington, New York, Florida, and California from 2009 to 2011.
    Setting: Federal and nonfederal acute care hospitals.
    Patients: Admissions of patients age 18–49 years with International Classification of Diseases, Ninth Revision, Clinical Modification codes indicating adult congenital heart surgery.
    Outcome Measures: Readmission was defined as any nonelective hospitalization for a given patient ≤30 days… More >

  • Open Access

    ARTICLE

    Cerebral tissue oxygenation index and lactate at 24 hours postoperative predict survival and neurodevelopmental outcome after neonatal cardiac surgery

    Safwat A. Aly1, David Zurakowski2, Penny Glass3, Kami Skurow-Todd4, Richard A. Jonas5, Mary T. Donofrio4

    Congenital Heart Disease, Vol.12, No.2, pp. 188-195, 2017, DOI:10.1111/chd.12426

    Abstract Importance: There are no well-established noninvasive biomarkers for identifying patients at risk for poor outcome after surgery for congenital heart disease. Few studies have assessed prognostic accuracy of cerebral tissue oxygenation index (cTOI) measured by near infrared spectroscopy (NIRS).
    Objective: To assess the utility of noninvasive NIRS monitoring as a predictor of outcomes after neonatal cardiac surgery through measurement of cTOI. To examine the utility of noninvasive NIRS monitoring in combination with lactate concentration and inotropic score in prediction of outcomes after neonatal cardiac surgery.
    Design: Prospective longitudinal cohort study.
    Setting: Operating room and cardiac intensive care unit, Children’s… More >

  • Open Access

    ARTICLE

    Neurocognitive and executive functioning in adult survivors of congenital heart disease

    Leda Klouda1, Wayne J. Franklin1, Anita Saraf1,2, Dhaval R. Parekh1, David D. Schwartz3

    Congenital Heart Disease, Vol.12, No.1, pp. 91-98, 2017

    Abstract Objective: Congenital heart disease (CHD) can affect the developing central nervous system, resulting in neurocognitive and behavioral deficits. Preoperative neurological abnormalities as well as sequelae of the open heart operations required to correct structural abnormalities of the heart contribute to these deficits. There are few studies examining the neurocognitive functioning of adults with CHD. This study sought to investigate multiple domains of neurocognitive functioning in adult survivors of CHD who had childhood cardiac surgery with either moderate or severe disease complexity.
    Design: A total of 48 adults (18–49 years of age) who had undergone cardiac surgery for… More >

  • Open Access

    ARTICLE

    “Frontiers in Fontan failure: A summary of conference proceedings”

    Camden Hebson1,2, Wendy Book1, Robert W. Elder3, Ryan Ford4, Maan Jokhadar1, Kirk Kanter5, Brian Kogon5, Adrienne H. Kovacs6, Rebecca D. Levit1, Michael Lloyd1, Kevin Maher2, Preeti Reshamwala4, Fred Rodriguez III1,2, Rene Romero7, Thor Tejada1, Anne Marie Valente8, Gruschen Veldtman9, Michael McConnell1,2

    Congenital Heart Disease, Vol.12, No.1, pp. 6-16, 2017

    Abstract “Frontiers in Fontan Failure” was the title of a 2015 conference sponsored by Children’s Healthcare of Atlanta and Emory University School of Medicine. In what is hoped to be the first of many such gatherings, speakers and attendees gathered to discuss the problem of long-term clinical deterioration in these patients. Specific focuses included properly defining the problem and then discussing different treatment strategies, both medical and surgical. The health of the liver after Fontan palliation was a particular point of emphasis, as were quality of life and future directions. More >

  • Open Access

    ARTICLE

    Surgical outcome in pediatric patients with Ebstein’s anomaly: A multicenter, long-term study

    Lianne M. Geerdink1,2, Gideon J. du Marchie Sarvaas3, Irene M. Kuipers4, Willem A. Helbing5, Tammo Delhaas6, Henriette ter Heide7, Lieke Rozendaal8, Chris L. de Korte9, Sandeep K. Singh10, Tjark Ebels11, Mark G. Hazekamp12, Felix Haas13, Ad J. J. C. Bogers14, Livia Kapusta1,15

    Congenital Heart Disease, Vol.12, No.1, pp. 32-39, 2017

    Abstract Objective: Surgical outcomes of pediatric patients with Ebstein’s anomaly are often described as part of all-age-inclusive series. Our objective is to focus on patients treated surgically in childhood (0-18 y). We study the intended treatment (biventricular or 1.5 ventricle repair or univentricular palliation), freedom from unplanned reoperation and survival of this specific age group, in a nationwide study.
    Design: Records of all Ebstein’s anomaly patients born between 1980 and 2013 were reviewed. Demographic variables, intraoperative procedures and postoperative outcomes were analyzed.
    Results: Sixty-three patients underwent 109 operations. Median follow-up after diagnosis was 121 months (range 0-216 months). Twenty-nine… More >

  • Open Access

    ARTICLE

    Comparative Evaluation of Flow Quantification across the Atrioventricular Valve in Patients with Functional Univentricular Heart after Fontan’s Surgery and Healthy Controls: Measurement by 4D Flow Magnetic Resonance Imaging and Streamline Visualization

    Hoi Lam She*, Arno A.W. Roest, Emmeline E. Calkoen, Pieter J. van den Boogaard, Rob J. van der Geest, Mark G. Hazekamp§, Albert de Roos, Jos J.M. Westenberg

    Congenital Heart Disease, Vol.12, No.1, pp. 40-48, 2017

    Abstract Purpose. To evaluate the inflow pattern and flow quantification in patients with functional univentricular heart after Fontan’s operation using 4D flow magnetic resonance imaging (MRI) with streamline visualization when compared with the conventional 2D flow approach.
    Method. Seven patients with functional univentricular heart after Fontan’s operation and twenty-three healthy controls underwent 4D flow MRI. In two orthogonal two-chamber planes, streamline visualization was applied, and inflow angles with peak inflow velocity (PIV) were measured. Transatrioventricular flow quantification was assessed using conventional 2D multiplanar reformation (MPR) and 4D MPR tracking the annulus and perpendicular to the streamline inflow at… More >

  • Open Access

    ARTICLE

    BIO-HEAT TRANSFER SIMULATION OF SQUARE AND CIRCULAR ARRAY OF RETINAL LASER IRRADIATION

    Arunn Narasimhan*, Kaushal Kumar Jha

    Frontiers in Heat and Mass Transfer, Vol.2, No.3, pp. 1-8, 2011, DOI:10.5098/hmt.v2.3.3005

    Abstract Pan Retinal photocoagulation (PRP), a retinal laser surgical process, is simulated using a three-dimensional bio-heat transfer numerical model. Spots of two different type of array, square array of 3 × 3 spots and a circular array of six spots surrounding a central spot, are sequentially irradiated. Pennes bio-heat transfer model is used as the governing equation. Finite volume method is applied to find the temperature distribution due to laser irradiation inside the human eye. Each spot is heated for 100 ms and subsequently cooled for 100 ms with an initial laser power of 0.2 W. More >

  • Open Access

    ARTICLE

    Effect of Meniscus Replacement Fixation Technique on Restoration of Knee Contact Mechanics and Stability

    D.D. D’Lima*, P.C. Chen, O. Kessler, H.R. Hoenecke*, C.W. Colwell Jr.∗§

    Molecular & Cellular Biomechanics, Vol.8, No.2, pp. 123-134, 2011, DOI:10.3970/mcb.2011.008.123

    Abstract The menisci are important biomechanical components of the knee. We developed and validated a finite element model of meniscal replacement to assess the effect of surgical fixation technique on contact behavior and knee stability. The geometry of femoral and tibial articular cartilage and menisci was segmented from magnetic resonance images of a normal cadaver knee using MIMICS (Materialise, Leuven, Belgium). A finite element mesh was generated using HyperWorks (Altair Inc, Santa Ana, CA). A finite element solver (Abaqus v6.9, Simulia, Providence, RI) was used to compute contact area and stresses under axial loading and to… More >

  • Open Access

    ARTICLE

    Two-Layer Passive/Active Anisotropic FSI Models with Fiber Orientation: MRI-Based Patient-Specific Modeling of Right Ventricular Response to Pulmonary Valve Insertion Surgery

    Dalin Tang*, Chun Yang, Tal Geva‡,§, Pedro J. del Nido

    Molecular & Cellular Biomechanics, Vol.4, No.3, pp. 159-176, 2007, DOI:10.3970/mcb.2007.004.159

    Abstract A single-layer isotropic patient-specific right/left ventricle and patch (RV/LV/Patch) combination model with fluid-structure interactions (FSI) was introduced in our previous papers to evaluate and optimize human pulmonary valve replacement/insertion (PVR) surgical procedure and patch design. In this paper, an active anisotropic model with two-layer structure for ventricle wall and tissue fiber orientation was introduced to improve previous isotropic model for more accurate assessment of RV function and potential application in PVR surgery and patch design. A material-stiffening approach was used to model active heart contraction. The computational models were used to conduct ``virtual (computational)'' surgeries More >

  • Open Access

    ARTICLE

    Ablation of cytoskeletal filaments and mitochondria in live cells using a femtosecond laser nanoscissor

    Nan Shen1,2, Dabajyoti Datta1, Chris B. Schaffer1,3,4,5, Eric Mazur1,6

    Molecular & Cellular Biomechanics, Vol.2, No.1, pp. 17-26, 2005, DOI:10.3970/mcb.2005.002.017

    Abstract Analysis of cell regulation requires methods for perturbing molecular processes within living cells with spatial discrimination on the nanometer-scale. We present a technique for ablating molecular structures in living cells using low-repetition rate, low-energy femtosecond laser pulses. By tightly focusing these pulses beneath the cell membrane, we ablate cellular material inside the cell through nonlinear processes. We selectively removed sub-micrometer regions of the cytoskeleton and individual mitochondria without altering neighboring structures or compromising cell viability. This nanoscissor technique enables non-invasive manipulation of the structural machinery of living cells with several-hundred-nanometer resolution. Using this approach, we More >

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