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  • Open Access

    ARTICLE

    Catheter‐associated bloodstream infection incidence and outcomes in congenital cardiac surgery

    Brena Sue Haughey1, Shelby Coral White2, Michael David Seckeler2

    Congenital Heart Disease, Vol.14, No.5, pp. 811-813, 2019, DOI:10.1111/chd.12809

    Abstract Objective: Catheter‐associated bloodstream infections complicate and prolong hos‐ pitalizations. The incidence of catheter‐associated bloodstream infections in children undergoing congenital cardiac surgery has not been reported. This study sought to define the incidence of catheter‐associated bloodstream infections after congenital cardiac surgery in neonates and infants ≤12 months old and compare hospital out‐ comes and costs to those who underwent surgery and did not have a catheter‐associ‐ ated bloodstream infections.
    Design: Retrospective review of hospital admissions between October 2013 and November 2015 for neonates and infants ≤12 months old at admission with ICD‐9 codes for congenital cardiac surgery from… More >

  • Open Access

    ARTICLE

    Health care‐associated infections are associated with increased length of stay and cost but not mortality in children undergoing cardiac surgery

    Sarah Tweddell, Rohit S. Loomba, David S. Cooper, Alexis L. Benscoter

    Congenital Heart Disease, Vol.14, No.5, pp. 785-790, 2019, DOI:10.1111/chd.12779

    Abstract Introduction: Health care‐associated infections (HAIs) increase mortality, length of stay, and cost in hospitalized patients. The incidence of and risk factors for developing HAIs in the pediatric population after cardiac surgery have been studied. This study evaluates the impact of HAIs on length of stay, inpatient mortality, and cost of hospitalization in the pediatric population after cardiac surgery.
    Methods: TheKids’InpatientDatabasewasqueriedforanalysis.Patientsunder18years of age who underwent cardiac surgery from 1997 to 2012 were included. HAIs were defined as central line‐associated blood stream infections, catheter‐associated urinary tract infections, ventilator‐associated pneumonias, and surgical wound infections. Univariate analysis compared admissions with and… More >

  • Open Access

    Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization

    Jeannine M. Hoch1, Oluwatosin Fatusin2, Gayane Yenokyan3, W. Reid Thompson2, Maureen A. Lefton‐Greif4

    Congenital Heart Disease, Vol.14, No.3, pp. 438-445, 2019, DOI:10.1111/chd.12742

    Abstract Background: Tube feedings are often needed to achieve the growth and nutrition goals associated with decreased morbidity and mortality in patients with single ventricle anat‐ omy. Variability in feeding method through the interstage period has been previously described, however, comparable information following stage 2 palliation is lacking.
    Objectives: To identify types of feeding methods following stage 2 palliation and their influence on length of stay.
    Design: Secondary analysis of the National Pediatric Cardiology Quality Improvement Collaborative registry was performed on 932 patients. Demographic data, medical characteristics, postoperative complications, type of feeding method, and length of stay for stage… More >

  • Open Access

    ARTICLE

    S100B and its relation to cerebral oxygenation in neonates and infants undergoing surgery for congenital heart disease

    Jan Hinnerk Hansen1, Lydia Kissner1, Jana Logoteta1, Olaf Jung1, Peter Dütschke2, Tim Attmann3, Jens Scheewe3, Hans‐Heiner Kramer1,4

    Congenital Heart Disease, Vol.14, No.3, pp. 427-437, 2019, DOI:10.1111/chd.12741

    Abstract Objectives: Neonates and infants undergoing surgery for congenital heart disease are at risk for developmental impairment. Hypoxic‐ischemic brain injury might be one contributing factor. We aimed to investigate the perioperative release of the astro‐ cyte protein S100B and its relation to cerebral oxygenation.
    Methods: Serum S100B was measured before and 0, 12, 24, and 48 hours after sur‐ gery. Cerebral oxygen saturation was derived by near‐infrared spectroscopy. S100B reference values based on preoperative samples; concentrations above the 75th per‐ centile were defined as elevated. Patients with elevated S100B at 24 or 48 hours were compared to cases… 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 >

  • Open Access

    ARTICLE

    Dysrhythmias in patients with a complete atrioventricular septal defect: From surgery to early adulthood

    Charlotte A. Houck1,2, Reinder Evertz3, Christophe P. Teuwen1, Jolien W. Roos‐Hesselink1, Janneke A. E. Kammeraad4, Anthonie L. Duijnhouwer3, Natasja M. S. de Groot3, Ad J. J. C. Bogers2

    Congenital Heart Disease, Vol.14, No.2, pp. 280-287, 2019, DOI:10.1111/chd.12724

    Abstract Objective: Outcomes after surgical repair of complete atrioventricular septal defect (cAVSD) have improved. With advancing age, the risk of development of dysrhythmias may increase. The aims of this study were to (1) examine development of sinus node dysfunction (SND), atrial and ventricular tachyarrhythmias, and (2) study progression of atrioventricular conduction abnormalities in young adult patients with repaired cAVSD.
    Study design: In this retrospective multicenter study, 74 patients (68% female) with a cAVSD repaired in childhood were included. Patients’ medical files were evaluated for occurrence of SND, atrioventricular conduction block (AVB), atrial and ventricular tachyarrhythmias.
    Results: Median age at… More >

  • Open Access

    ARTICLE

    Vasopressor magnitude predicts poor outcome in adults with congenital heart disease after cardiac surgery

    Joseph T. Poterucha1, Saraschandra Vallabhajosyula2, Alexander C. Egbe2, Joseph S. Krien3, Devon O. Aganga4, Kimberly Holst5, Adele W. Golden6, Joseph A. Dearani5, Sheri S. Crow4

    Congenital Heart Disease, Vol.14, No.2, pp. 193-200, 2019, DOI:10.1111/chd.12717

    Abstract Background: High levels of vasoactive inotrope support (VIS) after congenital heart surgery are predictive of morbidity in pediatric patients. We sought to discern if this relationship applies to adults with congenital heart disease (ACHD).
    Methods: We retrospectively studied adult patients (≥18 years old) admitted to the intensive care unit after cardiac surgery for congenital heart disease from 2002 to 2013 at Mayo Clinic. Vasoactive medication dose values within 96 hours of admis‐ sion were examined to determine the relationship between VIS score and poor out‐ come of early mortality, early morbidity, or complication related morbidity.
    Results: Overall, 1040… More >

  • Open Access

    ARTICLE

    Right thoracotomy for aortic valve replacement in the adolescents with bicuspid aortic valve

    Raffaele Giordano1, Massimiliano Cantinotti2, Giuseppe Comentale1, Luigi Di Tommaso1, Gabriele Iannelli11, Emanuele Pilato1, Gaetano Palma1

    Congenital Heart Disease, Vol.14, No.2, pp. 162-166, 2019, DOI:10.1111/chd.12680

    Abstract Background: In this study, we compared our experience about early and midterm follow‐up outcomes for right anterolateral minithoracotomy (RAMT) vs full sternot‐ omy (FS) in surgical aortic valve replacement (AVR) among adolescents with bicuspid aortic valve (BAV).
    Methods: Patients were retrospectively enrolled from January 2008 to December 2017. Inclusion criteria were patients with BAV who had to undergo to AVR. They were divided in two groups: RAMT and FS. The choice of RAMT was based on indi‐ vidual surgeon’s preferences or when expressly requested by patient that was in‐ formed of nonconventional approach.
    Results: We enrolled 61 patients,… More >

  • Open Access

    ABSTRACT

    Multi-Modality Image-Based Modeling Approach for Cardiovascular Disease: Simulation, Assessment, Prediction, and Virtual Surgery

    Dalin Tang1,2,*

    Molecular & Cellular Biomechanics, Vol.16, Suppl.1, pp. 11-11, 2019, DOI:10.32604/mcb.2019.05170

    Abstract Medical imaging and image-based modeling have made considerable progress in recent years in cardiovascular research, such as identifying atherosclerotic plaque morphological and mechanical risk factors which may be used in developing improved patient screening strategies, and performing virtual heart surgery seeking optimal surgical procedures for best post-surgical outcome. We will report recent progress in using multi-modality image-based models to predict vulnerable plaque progression and vulnerability change. In particular, we will report our recent results using IVUS+OCT data to obtain more accurate stress/strain calculations. Inflammation and cap erosion will affect cap material properties. If OCT image… More >

  • Open Access

    ARTICLE

    An Integrated Suture Simulation System with Deformation Constraint Under A Suture Control Strategy

    Xiaorui Zhang1,2,3,*, Jiali Duan1, Jia Liu2, Norman I. Badler3

    CMC-Computers, Materials & Continua, Vol.60, No.3, pp. 1055-1071, 2019, DOI:10.32604/cmc.2019.03915

    Abstract Current research on suture simulation mainly focus on the construction of suture line, and existing suture simulation systems still need to be improved in terms of diversity, soft tissue effects, and stability. This paper presents an integrated liver suture surgery system composed of three consecutive suture circumstances, which is conducive to liver suture surgery training. The physically-based models used in this simulation are based on different mass-spring models regulated by a special constrained algorithm, which can improve the model accuracy, and stability by appropriately restraining the activity sphere of the surrounding mass nodes around the… More >

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