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Oncotic pressure and paediatric cardiopulmonary bypass: establishing baseline data for complex congenital cardiac surgery and its relation to risk stratification.

Abstract Objectives: Colloid osmotic pressure (COP) is a major determinant of fluid shift in paediatric patients undergoing corrective surgery for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). However, very..

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Avoiding use of total circulatory arrest in the practice of congenital heart surgery

Abstract Deep hypothermic circulatory arrest (DHCA) technique has been an important armamentarium in the correction of congenital heart diseases. There have been many controversies and concerns associated with DHCA, particularly..

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Total circulatory arrest as a support modality in congenital heart surgery: review and current evidence

Abstract The use of total circulatory arrest (TCA)/deep hypothermic circulatory arrest (DHCA) as a support modality in congenital heart surgery is a time-tested strategy. However, with technological advances, the widespread..

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Systemic inflammatory response syndrome after pediatric congenital heart surgery: Incidence, risk factors, and clinical outcome

Abstract BACKGROUND Systemic inflammatory response syndrome (SIRS) is frequent after cardiac surgery, but data on its incidence and perioperative risk factors are scarce for children with congenital heart disease. METHODS..

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Mechanical Circulatory Support Devices for Pediatric Patients With Congenital Heart Disease

Abstract The use of mechanical circulatory support (MCS) devices is a viable therapeutic treatment option for patients with congestive heart failure. Ventricular assist devices, cavopulmonary assist devices, and total artificial..

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A derived and validated score to predict prolonged mechanical ventilation in patients undergoing cardiac surgery

Abstract Objectives Prolonged  after cardiac surgery imposes a significant burden on the patient in terms of morbidity as well as a financial burden on the hospital. We undertook a retrospective analysis..

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Clinical equivalency of cardiopulmonary bypass and extracorporeal membrane oxygenation support for pediatric tracheal reconstruction

Abstract Objective Pediatric surgery for congenital tracheal stenosis continues to be a therapeutic challenge, and it often requires cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) for intra-operative extracorporeal cardiorespiratory..

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Vitamin D Status After Cardiopulmonary Bypass in Children With Congenital Heart Disease

Abstract Deficiency in 25-hydroxyvitamin D (25OHD) is associated with increased morbidity and mortality in the critically ill. Children who underwent surgery for congenital heart disease under cardiopulmonary bypass (CPB) are..

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Brain in Congenital Heart Disease Across the Lifespan

Abstract The number of patients surviving with congenital heart disease (CHD) has soared over the last 3 decades. Adults constitute the fastest-growing segment of the CHD population, now outnumbering children...

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Thromboelastography—does it impact blood component transfusion in pediatric heart surgery?

Abstract Background The administration of blood products during pediatric cardiac surgery is common. We sought to determine if thromboelastography (TEG) is a cost-effective tool to reduce blood product transfusion in..

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Report of the National Heart, Lung, and Blood Institute Working Group

Abstract The National Heart, Lung, and Blood Institute convened a working group in January 2015 to explore issues related to an integrated data network for congenital heart disease research. The..

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The Kidney in Critical Cardiac Disease: Proceedings From the 10th International Conference of the Pediatric Cardiac Intensive Care Society

Abstract The field of cardiac intensive care continues to advance in tandem with congenital heart surgery. The focus of intensive care unit care has now shifted to that of morbidity..

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“Just-In-Time” Simulation Training Using 3-D Printed Cardiac Models After Congenital Cardiac Surgery

Abstract Background: High-fidelity simulation using patient-specific three-dimensional (3D) models may be effective in facilitating pediatric cardiac intensive care unit (PCICU) provider training for clinical management of congenital cardiac surgery patients...

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How Suitable Are Registry Data for Recurrence Risk Calculations? Validation of Diagnoses on 1,593 Families With Congenital Heart Disease

Abstract Background: Congenital heart disease (CHD) occurs in approximately 1% of all live births, and 3% to 8% of these have until now been considered familial cases, defined as the..

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Postoperative Abdominal NIRS Values Predict Low Cardiac Output Syndrome in Neonates

Abstract Background: The development of low cardiac output syndrome (LCOS) after cardiopulmonary bypass (CPB) occurs in up to 25% of neonates and is associated with increased morbidity. Invasive cardiac output..

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Evaluation of Adults With Congenital Heart Disease

Abstract The clinical approach to adults with congenital heart diseases (ACHDs) is unique in cardiovascular medicine because these patients encompass a broad range of presentations. Each patient, despite having similar..

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Transparency and Public Reporting of Pediatric and Congenital Heart Surgery Outcomes in North America

Abstract Health care is embarking on a new era of increased transparency. In January 2015, the Society of Thoracic Surgeons (STS) began to publicly report outcomes of pediatric and congenital..

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Changes in thrombin generation in children after cardiac surgery and ex-vivo response to blood products and haemostatic agents

Abstract Impaired haemostasis has been reported in children with congenital heart disease undergoing cardiopulmonary bypass. As thrombin generation encompasses all phases of the coagulation process, this analysis might provide the best assessment..

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Current status of brain protection during surgery for congenital cardiac defect

Abstract The long-term neurodevelopmental outcome has been a great concern for cardiac surgeons although it is still unclear. There are some risks regarding the neurological and neuropsychological deficits before, during..

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Are We Overdiagnosing Acute Kidney Injury in Pediatric Patients Following Cardiac Surgery?

Abstract Background: The use of two diagnostic criteria in the current literature has led to some degree of ambiguity in the precise diagnosis of acute kidney injury in pediatric patients..

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Hyperbilirubinemia after cardiac surgery: An observational study

Abstract Background We aimed to assess the incidence and perioperative risk factors for hyperbilirubinemia after cardiac surgery, and determine its influence on early operative outcome. Methods This prospective observational study..

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Fontan Physiology Revisited

Abstract The Fontan operation places the systemic and pulmonary circulations in series, driven by a single ventricular chamber. It has become the treatment strategy of choice for palliating single-ventricle congenital..

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Combined Cerebral and Renal Near-Infrared Spectroscopy After Congenital Heart Surgery

Abstract The maintenance of an adequate oxygen supply to tissues after congenital heart surgery is essential for good outcomes. The objective of this study was to assess the usefulness of..

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Developments in Pediatric Ventricular Assist Device Support

Abstract Mechanical support devices have revolutionized the management of circulatory failure. This has been met by a dramatic increase in ventricular assist device (VAD) utilization in children over the last..

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Aprotinin versus tranexamic acid in children undergoing cardiac surgery: an observational study

Abstract OBJECTIVES: The upcoming release of aprotinin in paediatric cardiac surgery prompted a re-evaluation of its use in comparison to tranexamic acid (TXA) focusing on their effect on exposure to..

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Acute kidney injury and fluid overload in infants and children after cardiac surgery

Abstract Acute kidney injury is a common and serious complication after congenital heart surgery, particularly among infants. This comorbidity has been independently associated with adverse outcomes including an increase in..

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Recent Advances in Congenital Heart Surgery: Alternative Perfusion Strategies for Infant Aortic Arch Repair

Abstract Purpose of Review This paper will discuss current cannulation strategies for infant aortic arch repair and compare them to more traditionally used techniques. Recent Findings Aortic arch reconstruction in..

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Postoperative Acute Kidney Injury in Young Adults With Congenital Heart Disease

Abstract Background There is an increasing number of young adults living with  (CHD). The goal of this study was to ascertain the frequency of  (AKI) as well as the risk factors and..

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Double-Blind, Randomized, Placebo-Controlled Trial Comparing the Effects of Antithrombin Versus Placebo on the Coagulation System in Infants with Low Antithrombin…

Abstract Objectives To determine whether precardiopulmonary bypass (CPB) normalization of  levels in infants to 100% improves heparin sensitivity and  during CPB and has beneficial effects into the . Design Randomized, double-blinded, placebo-controlled prospective..

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Lactate clearance in infants undergoing surgery for congenital heart disease

Abstract Measurement of lactate concentrations during cardiac surgery with cardiopulmonary bypass (CPB) is a reliable monitoring tool for the assessment of the adequacy of perfusion, and a predictor of poor..

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