ABSTRACT
The optimal training of the highly specialized congenital heart surgeon is a long and complex process, which is a significant challenge in most parts of the world. The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has established the Global Council on Education for Congenital Heart Surgery as a nonprofit organization with the goal of assessing current training and certification and ultimately establishing standardized criteria for the training, evaluation, and certification of congenital heart surgeons around the world. The Global Council and the WSPCHS have reviewed the present status of training and certification for congenital cardiac surgery around the world. There is currently lack of consensus and standardized criteria for training in congenital heart surgery, with significant disparity between continents and countries. This represents significant obstacles to international job mobility of competent congenital heart surgeons and to the efforts to improve the quality of care for patients with Congenital Heart Disease worldwide. The purpose of this article is to summarize and document the present state of training and certification in congenital heart surgery around the world.
Subject(s)
Cardiac Surgical Procedures , Heart Defects, Congenital , Thoracic Surgery , Certification , Child , Heart Defects, Congenital/surgery , Humans , Societies, MedicalABSTRACT
INTRODUCTION: In 1995 extracorporeal membrane oxygenation (ECMO) was introduced in Denmark as a treatment for critically ill infants. ECMO is primarily used in infants with severe meconium aspiration, but can be used for all kinds of pulmonary and cardiac failures as well. The purpose of our work was to evaluate the Danish ECMO-treatment. MATERIALS AND METHODS: We performed a retrospective study of 55 infants receiving ECMO, and the parents of the surviving children were sent questionnaires. All the completed questionnaires were returned except for one from a family that emigrated from Denmark. The statistical analyses are based on chi2-tests and 95% CI. RESULTS: Only in four cases was the treatment without complications. Thirty-one infants had technical complications and 48 had medical complications. Cerebral complications arose in 28 infants. Thirty-nine (71%) infants were alive at the time of the survey. 42% of the parents reported sequels or suspicion of sequels. The primary sequels were reduced hearing, which was observed in eight infants, and chronic lung disease, which was observed in seven. Only one child was severely disabled. CONCLUSION: The underlying diagnoses, mortality and disability correspond to the results in an English randomised study.
Subject(s)
Critical Illness/therapy , Extracorporeal Membrane Oxygenation , Critical Illness/mortality , Extracorporeal Membrane Oxygenation/adverse effects , Humans , Infant , Infant, Newborn , Meconium Aspiration Syndrome/mortality , Meconium Aspiration Syndrome/therapy , Retrospective Studies , Risk Factors , Surveys and QuestionnairesABSTRACT
Since the introduction of surgical treatment for coarctation aortae, presentation of the disease with postcoarctation mycotic pseudoaneurysm has become rare. We report an 18-year-old male with endarteritis caused by Staphylococcus aureus treated with appropriate antibiotics. Later the patient developed an irritative cough and problems with swallowing. CT and MRI of the chest demonstrated a postcoarctation pseudoaneurysm. After acute surgery with resection of the coarctation and pseudoaneurysm and insertion of a tube graft, the patient had an uneventful postsurgical course.
