PubMed Central (PMC3 - NLM DTD)
Archive of life sciences journal literature at the U.S. National Institutes of Health (NIH), developed and managed by NIH's National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM).
The pressures of surgicel® in cardiac surgery - Arora, Niket Dilip; Varghese, Roy; Pavithran, Sreeja; Kothandam, Sivakumar
Surgicel® is bioabsorbable hemostatic mesh, frequently packed around oozing surgical bed. We report two morbidities due to it. Following transannular patch repair for Fallot's tetralogy, Surgicel® was packed around distal main pulmonary artery. Echocardiography in the intensive care unit (ICU) showed right ventricular dysfunction due to extrinsic obstruction and complete occlusion of left pulmonary artery (LPA) flows. Another patient with arterial switch operation had postoperative fibrillatory cardiac arrest, needing resuscitation with internal cardiac massage. The arrest was triggered by coronary ischemia due to periaortic compression. Both instances were caused by hygroscopic nature of Surgicel®, which absorbed blood, swelled, and compressed...
Infantile pericardial round cell tumor - Sridevi, KH; Awasthy, Neeraj; Singh, Virender; Rana, Seema; Sharma, Rajesh
Cardiac malignancies presenting in infancy are rare. Desmoplastic small round cell tumor (DSRCT) is a rare occurrence in this age group. No case of intrapericardial DSRCT has been reported in the literature in infants.
Isolation of the right subclavian artery in a patient with d-transposition of the great arteries - Arunamata, Alisa; Perry, Stanton B; Kipps, Alaina K; Vasanawala, Shreyas S; Axelrod, David M
Isolation of the right subclavian artery (RSCA) is rare, and this finding in association with d-transposition of the great arteries (d-TGA) is extremely unusual. We present a case of an isolated RSCA in a newborn with d-TGA in whom the clinical presentation was diagnostic. We discuss the imaging modalities used to confirm the diagnosis, the embryological basis of the finding, and the surgical repair.
Tricuspid atresia and pulmonary atresia in a child with Rubinstein-Taybi syndrome - Loomba, Rohit S; Geddes, Gabrielle
Rubinstein-Taybi syndrome is a well-characterized condition causing distinctive physical characteristics, intellectual disability, and multiple congenital malformations. Cardiac abnormalities are found in a third of individuals with this condition and usually consist of isolated septal defects or patent ductus arteriosus, although more complex congenital lesions have been described. We present the first reported case of tricuspid atresia and pulmonary atresia with hypoplasia of the right ventricle in the setting of Rubenstein-Taybi syndrome.
PRKAG2 mutation: An easily missed cardiac specific non-lysosomal glycogenosis - Aggarwal, Varun; Dobrolet, Nancy; Fishberger, Steven; Zablah, Jenny; Jayakar, Parul; Ammous, Zineb
Mutations in PRKAG2 gene that regulates the γ2 subunit of the adenosine monophosphate (AMP) dependent protein kinase have been associated with the development of atrioventricular (AV) accessory pathways, cardiac hypertrophy, and conduction system abnormalities. These patients can potentially be misdiagnosed as hypertrophic cardiomyopathy (HOCM) and/or Wolf-Parkinson White (WPW) syndrome due to similar clinical phenotype. Early recognition of this disease entity is very important as ablation of suspected accessory pathways is not effective and the natural history of the disease is very different from HOCM and WPW syndrome.
Stent implantation of left main coronary artery stenosis in an infant: Effective long-term treatment? - Paech, Christian; Dähnert, Ingo; Riede, Frank Thomas
Coronary artery stenosis is a rare phenomenon in children. Coronary stent implantation is generally not considered a standard treatment option due to technical difficulties and potential complications in this group of patients. Nevertheless, several pediatric cases reporting successful implantation with acceptable short-term experiences have been described. The following case presents a successful stent implantation for left main coronary artery (LMCA) stenosis early after surgery for anomalous left coronary artery from pulmonary artery (ALCAPA) at the age of 6 months. The excellent mid-term results and notably the procedure's potential as a longterm treatment in small children are highlighted. A 6-month-old infant...
Critical thrombotic obstruction of transverse aortic arch in a neonate - Vadlamudi, Karunakar; Bakhru, Shweta; Koneti, Nageswara Rao; Jagannath, BR
A 3-day-old neonate presented with features suggestive of coarctation of aorta. Echocardiography showed a large organized thrombus in the transverse arch causing obstruction to theaortic arch and carotids with partial recanalization. Patient underwent surgical thromboendarterectomy with arch reconstruction. The evaluation did not reveal any hematological abnormalities and suspected to be due to fetal thromboembolism. Patient improved well, and no neurological deficits were observed during follow-up.
A life-threatening infective pseudoaneurysm of the left ventricle in a toddler - Krishna, Mani Ram; Kottayil, Brijesh P; Sunil, Gopalraj Sumangala; Kumar, Raman Krishna
Pseudoaneurysms of the ventricle are an uncommon occurrence in children. They may be secondary to previous cardiac surgery or infection of the pericardial space. Infective pseudoaneurysms require urgent surgery because rupture of the pseudoaneurysm may have catastrophic consequences. The outcome with surgery is excellent. We report a toddler with ruptured pseudoaneurysm secondary to purulent pericarditis who recovered with an emergency surgical closure of the opening of the pseudo-aneurysm.
Supravalvular aortic stenosis with sudden cardiac death - Vaideeswar, Pradeep; Regi, Preet
Sudden cardiac death (SCD) most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS) due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.
Moore's law, Dabbawalas, and pediatric cardiac care in Sri Lanka - Samarasinghe, Duminda
Sri Lanka is an island nation in Indian Ocean that provides free healthcare to all citizens through government healthcare system. It has commendable health indices in the region. Pediatric cardiac services have rapidly progressed over past few years helping to further bring down infant and under-five mortality rates. Lady Ridgeway Hospital for Children (LRH) is the only tertiary care referral center for children with heart disease in the country. Currently it performs approximately 1,000 cardiac catheterizations and 1,000 cardiac surgeries every year. Target is to double the surgical output to treat all children with heart diseases in a timely and...
Surgery for transposition of great arteries: A historical perspective - Marathe, Supreet P; Talwar, Sachin
The history of surgery for transposition of great arteries (TGA) has paralleled the history of cardiac surgery. In fact, it began before the birth of open heart surgery when the palliative Blalock–Hanlon septectomy was first performed in 1948. The atrial switch, which was an attempt to correct the physiology of transposition, had significant shortcomings. The arterial switch sought to address them. This has emerged as an anatomically as well as physiologically appropriate solution. Today we continue to pursue technical refinements as well as try to expand the indications of the arterial switch. This review traces the various milestones in this...
Teaching focused echocardiography for rheumatic heart disease screening - Engelman, Daniel; Kado, Joseph H; Reményi, Bo; Colquhoun, Samantha M; Watson, Caroline; Rayasidamu, Sera C; Steer, Andrew C
Screening for rheumatic heart disease (RHD) requires workers skilled in echocardiography, which typically involves prolonged, specialized training. Task shifting echocardiographic screening to nonexpert health workers may be a solution in settings with limited human resources. An 8-week training program was designed to train health workers without any prior experience in focused echocardiography for RHD screening. Seven health workers participated. At the completion of training, the health workers performed unsupervised echocardiography on 16 volunteer children with known RHD status. A pediatric cardiologist assessed image quality. Participants provided qualitative feedback. The quality of echocardiograms were high at completion of training (55 of...