Etiquetas Archivo: congenital heart surgery

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Association Between Past and Present Operative Mortality in Congenital Heart Surgery: An Analysis of The Society of Thoracic Surgeons Congenital…

Abstract Background Mortality after congenital heart surgery is an important metric across benchmarking, quality, and reporting initiatives. All rely on estimates from prior years, and how well these reflect current..

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The effects of pulsatile versus nonpulsatile flow on cerebral pulsatility index, mean flow velocity at the middle cerebral artery, regional…

Abstract Objective The objective of this retrospective review was to evaluate whether or not pulsatile flow improves cerebral hemodynamics and clinical outcomes in pediatric congenital cardiac surgery patients. Methods This..

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Retrospective Comparison of Recombinant Activated Factor VII Versus 4-Factor Prothrombin Complex Concentrate in Cardiac Surgical Patients

Abstract Objectives To compare the incidences of postoperative thrombotic complications, transfusion of blood products, and chest tube output in congenital cardiac surgical patients who received either recombinant activated factor VII..

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Assessment of the factors that affect fast-track or early extubation following pediatric cardiac surgery

Abstract Background: This study aims to evaluate the early extubation rate and the factors affecting early extubation in pediatric patients undergoing cardiac surgery. Methods: Between August 1st, 2020 and December 1st, 2021,..

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Warm versus cold-blood cardioplegia in paediatric congenital heart surgery: a randomized trial

Abstract Objectives Intermittent cold blood cardioplegia is commonly used in children whereas intermittent warm blood cardioplegia is widely used in adults. We aimed to compare clinical and biochemical outcomes with..

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The characteristics of blood transfusion and analysis of preoperative factors associated with intraoperative blood transfusion in congenital heart surgery: a…

Abstract Purpose Blood transfusion is a common and life-saving procedure in congenital heart surgery (CHS), and it is critical for patients to identify risk factors prior to surgery. Our objective..

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Impact of a Multidisciplinary Research Team Approach to Prevent Avoidable Mistakes for Neonatal CPB Population

Abstract Significant progress has been made in neonatal cardiopulmonary bypass (CPB) over the years. At Penn State Health Children’s Hospital, we have established a multidisciplinary research team that brings clinicians,..

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A Technique for Safe Redo Sternotomy in Patients with Aortic Proximity to the Sternum

Abstract The risk of redo sternotomy is greatly elevated in the setting of aortic proximity to the sternum. Current strategies to avoid catastrophic neurologic injury upon sternal reentry include establishment..

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Blood pressure variability during pediatric cardiac surgery is associated with acute kidney injury

Abstract Background Blood pressure variability (BPV), defined as the degree of variation between discrete blood pressure readings, is associated with poor outcomes in acute care settings. Acute kidney injury (AKI)..

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The role of three-dimensional printed cardiac models in the management of complex congenital heart diseases

Abstract Background Three-dimensional printing is a process enabling computer-assisted conversion of imaging data from patients into physical “printed” replicas. This has been extrapolated to reconstructing patient-specific cardiac models in . The..

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C-reactive protein and procalcitonin after congenital heart surgery utilizing cardiopulmonary bypass: When should we be worried?

Abstract Introduction To assess the efficacy of C-reactive protein (CRP) and procalcitonin (PCT) at identifying infection in children after congenital heart surgery (CHS) with cardiopulmonary bypass (CPB). Materials and Methods..

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Adverse Outcomes Prediction for Congenital Heart Surgery: A Machine Learning Approach

Abstract Objective: Risk assessment tools typically used in congenital heart surgery (CHS) assume that various possible risk factors interact in a linear and additive fashion, an assumption that may not..

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Initial experience with del Nido cardioplegia solution at a Pediatric and Congenital Cardiac Surgery Program in Brazil

Abstract Objective: The aim of this study was to evaluate outcome measures between our standard multidose cardioplegia protocol and a del Nido cardioplegia protocol in congenital heart surgery patients. Methods:..

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Lessons Learned From the First Pilot Study of the Compensatory Reserve Index After Congenital Heart Surgery Requiring Cardiopulmonary Bypass

Abstract Background: Early warning systems that utilize dense physiologic data and machine learning may aid prediction of decompensation after congenital heart surgery (CHS). The Compensatory Reserve Index (CRI) analyzes changing..

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Updating an Empirically Based Tool for Analyzing Congenital Heart Surgery Mortality

Abstract Objectives: STAT Mortality Categories (developed 2009) stratify congenital heart surgery procedures into groups of increasing mortality risk to characterize case mix of congenital heart surgery providers. This update of..

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Impact of miniaturized cardiopulmonary bypass circuits on ultrafiltration during congenital heart surgery

Abstract   Objective: To investigate whether the miniaturized cardiopulmonary bypass (CPB) system decreased the usage of ultrafiltration (UF), and to explore whether the non-UF with miniaturized CPB strategy could get..

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Empirical Vancomycin Dosing in Pediatric Patients with Congenital Heart Disease and the Impact of Cardiopulmonary Bypass on Trough Concentrations

Abstract Objectives To determine the optimal vancomycin dosing regimen to achieve empirical goal trough concentrations in pediatric patients with congenital heart disease and to examine the impact of cardiopulmonary bypass..

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Ninety-two days of extracorporeal membrane oxygenation support following congenital heart surgery

Abstract We report on a case involving a 10-month-old infant who received prolonged ECMO therapy following cardiac surgery for multiple ventricular septal defects (VSD). The patient was successfully weaned from..

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2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American…

Preamble Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated scientific evidence into clinical practice guidelines (guidelines) with recommendations to improve cardiovascular health. These..

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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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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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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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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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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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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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Bloodless priming of the cardiopulmonary bypass circuit: determinants of successful transfusion-free operation in neonates and infants with a maximum body…

Abstract We currently perform open-heart procedures using bloodless priming of cardiopulmonary bypass circuits regardless of a patient’s body weight. This study presents results of this blood-saving approach in neonates and..

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An Absorbable Hydrogel Spray Reduces Postoperative Mediastinal Adhesions After Congenital Heart Surgery

Abstract Background Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a..

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