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1.
Zhonghua Yi Xue Za Zhi ; 100(12): 928-932, 2020 Mar 31.
Artículo en Chino | MEDLINE | ID: mdl-32234168

RESUMEN

Objective: To analyze the influencing factors of acute kidney injury (AKI) in patients after cardiac surgery using levosimendan or dobutamine, and explore the effect of positive inotropic drugs on AKI. Methods: The clinical data of 417 patients undergoing cardiac surgery from January to June 2018 in Beijing Anzhen Hospital and treated with levosimendan or dobutamine during perioperative period were retrospectively reviewed and collected. Patients were divided into AKI group and non-AKI group according to whether AKI occurred. Univariate logistic regression analysis was used to analyze the factors related to the occurrence of AKI. The statistically significant factors (P<0.05) were further included in the multivariate logistic regression analysis. Results: Totally, 417 patients were enrolled in the study, with a mean age of (58.2±10.4) years old and a male rate of 65.0% (n=271), and the AKI incidence rate was 25.2% (105/417). Univariate logistic regression analysis showed that male, chronic kidney disease, high serum creatinine level in preoperative period, aortic obstruction time ≥ 120 minutes and extracorporeal circulation time ≥ 120 minutes were risk factors for AKI (all P<0.05). Vasodilator and levosimendan treatment during perioperative period were protective factors (P<0.05). Multivariate logistic regression analysis showed that chronic kidney disease (OR=17.291, 95%CI: 4.335-68.960, P<0.001) and high serum creatinine level (OR=1.097, 95%CI: 1.074-1.121, P<0.001) in preoperative period were independent risk factors for AKI. Perioperative application of levosimendan (OR=0.533, 95%CI: 0.288-0.984, P=0.044) was an independent protective factor. Conclusions: Risk factors for AKI after cardiac surgery include chronic kidney disease and high serum creatinine level in preoperative period. The use of levosimendan during preoperative period has the potential effect to protect against AKI.


Asunto(s)
Lesión Renal Aguda , Procedimientos Quirúrgicos Cardíacos , Anciano , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Periodo Posoperatorio , Estudios Retrospectivos , Factores de Riesgo
4.
Kardiologiia ; 60(1): 35-42, 2020 Feb 04.
Artículo en Ruso | MEDLINE | ID: mdl-32245353

RESUMEN

Objective Investigate the influence of the sympathetic denervation of the pulmonary trunk and the orifices of the pulmonary arteries on the degree of pulmonary hypertension (PH) and outcomes of the surgical treatment of atrial fibrillation (AF) in patients with mitral valve defects, complicated AF, and high PH.Material and methods We analyzed the surgical treatment of 140 patients with mitral valve defect, concomitant AF, and high PH - pulmonary artery systolic pressure (PASP) gradient more than 40 mm Hg. The group of interest included 51 patients (46 patients with severe mitral stenosis and five patients with grade 4 mitral valve regurgitation). All patients underwent mitral valve correction (47 valve replacement surgeries and 4 valve-sparing interventions), biatrial Maze IV procedure, and additionally, denervation of the pulmonary trunk and the orifices of the pulmonary arteries. The control group included 89 patients diagnosed with mitral valve defect, AF, and PH with PASP > 40 mm Hg. However, unlike in patients of interest, denervation of the pulmonary arteries was not performed.Results Circular radiofrequency denervation of the pulmonary trunk and the orifices of the pulmonary arteries using a clamp-destructor is an effective and safe method, significantly reduces secondary PH (p=0.018), promotes reverse remodeling of the heart chambers, left atrium in particular (p=0.01), and improves outcomes of the Maze IV procedure (p=0.022) by restoring sinus rhythm in patients with mitral valve defects, complicated AF, and high PH.Conclusion This technique must be studied further involving a more significant number of patients, analyzing long-term results, and using this technique in patients with non-valvular causes of secondary PH.


Asunto(s)
Fibrilación Atrial , Procedimientos Quirúrgicos Cardíacos , Implantación de Prótesis de Válvulas Cardíacas , Hipertensión Pulmonar , Insuficiencia de la Válvula Mitral , Humanos , Válvula Mitral , Arteria Pulmonar , Simpatectomía , Resultado del Tratamiento
5.
J Cardiothorac Surg ; 15(1): 56, 2020 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-32245388

RESUMEN

BACKGROUND: Left atrial appendage occlusion (LAAO) represents a treatment alternative to anticoagulation in patients with atrial fibrillation. We evaluate a novel device for epicardial LAAO in a translational canine model. METHODS: Nine hounds (n = 9) were used to assess usability, safety, and efficacy of the TigerPaw Pro (TPP) device for epicardial LAAO. Following baseline imaging (intra-cardiac echocardiography (ICE) and angiography) and intraoperative visual inspection, usability was tested via a ``closure/re-opening`` maneuver followed by deployment of a total of twenty TPP devices (n = 20) on the left and right atrial appendages respectively. Procedural safety was evaluated by assessing for adverse-events via direct Epicardial inspection and endocardial imaging. Efficacy evaluation included assessment of device positioning, presence of residual stumps and completeness of closure. Post-mortem evaluation was performed to confirm safety and efficacy. RESULTS: Usability testing of all TPP devices was successful (n = 20;100%, delivery-time range 22-120 s) without any procedural adverse-events (tissue damage or tears, bleeding, vessel-impingement, structural impact). All devices fully traversed the ostium (n = 18) or appendage body (n = 2), and conformed smoothly to adjacent cardiac anatomy. In nineteen deployments (n = 19;95%), all device connector pairs were fully engaged, while in one TPP device the most distal pair remained unengaged. ICE and post-mortem inspections revealed complete closure of all appendage ostia (n = 18;100%) and only in one case a small residual stump was detected. Intraoperative safety findings were further confirmed post-mortem. Devices created a nearly smooth line of closure via symmetric endocardial tissue-coaptation. CONCLUSIONS: In this preclinical model, the TPP demonstrated good ease of use for ostial access, ability to re-position (after engagement) and rapid deployment, while achieving safe and effective LAAO.


Asunto(s)
Apéndice Atrial/cirugía , Fibrilación Atrial/cirugía , Procedimientos Quirúrgicos Cardíacos/instrumentación , Animales , Fibrilación Atrial/complicaciones , Modelos Animales de Enfermedad , Perros , Estudios de Factibilidad , Femenino , Masculino , Pericardio/cirugía , Grapado Quirúrgico/instrumentación , Resultado del Tratamiento
8.
Medicine (Baltimore) ; 99(9): e19302, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118748

RESUMEN

Perioperative anxiety could negatively affect surgery outcomes, and cardiac diseases have long been known to be an independent risk factor for anxiety development. However, little is known about preoperative anxiety in Nepalese adult cardiac patients waiting for surgery. The primary objectives of this study were to: (1) clarify the levels of preoperative anxiety in Nepalese adult cardiac patients waiting for open heart surgery; (2) identify factors associated with preoperative anxiety; and (3) evaluate any possible factors associated with patients' desire to obtain information related to their heart surgery.This is a prospective observational study for patients already scheduled for cardiac surgery at a core medical institution in Kathmandu, Nepal. We collected sociodemographic and clinical characteristics of the patients from their medical charts, and assessed their preoperative anxiety using the Amsterdam Preoperative Anxiety and Information Scale. We performed descriptive analyses of the collected data. Further, we employed regression models to assess to the objectives of the study.In total, 140 patients participated, and data of 123 (87.9%) were used for analysis. 58.5% of the participants had preoperative anxiety. Female gender (OR 0.31, 95% CI 0.15-0.65, P < .001) and past anesthesia exposure (OR 2.38, 95% CI 1.01-5.62, P < .05) were identified as risk factors for developing anxiety before cardiac surgery. Further, female gender (IRR 0.80, 95% CI 0.67-0.94, P < .001), higher education levels (IRR 1.18, 95% CI 1.01-1.40, P < .05), and higher preoperative anxiety (IRR 1.44, 95% CI 1.21-1.73, P < .001) could lead to higher levels of desire to acquire information related to the procedure.The study concluded that more than a half of the cardiac surgery patients experiences preoperative anxiety; female gender and having past anesthesia exposure are the risk factors. Anxious patients have more desire to acquire knowledge about the procedure. Thus, the evaluation and adequate management of preoperative anxiety should be proposed in high-risk groups.


Asunto(s)
Ansiedad/diagnóstico , Procedimientos Quirúrgicos Cardíacos/psicología , Adulto , Ansiedad/clasificación , Ansiedad/psicología , Procedimientos Quirúrgicos Cardíacos/métodos , Procedimientos Quirúrgicos Cardíacos/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nepal , Estudios Prospectivos , Psicometría/instrumentación , Psicometría/métodos , Factores de Riesgo , Encuestas y Cuestionarios
10.
Medicine (Baltimore) ; 99(13): e19675, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32221097

RESUMEN

Chronic obstructive pulmonary disease (COPD) has a major impact on mortality and morbidity in patients undergoing cardiac surgery. Mortality risk increases by 50% in patients who were re-intubated or required prolonged mechanical ventilation after the operation. The aim of this study was to assess the impact of COPD on the prediction of postoperative complications and outcome including intensive care unit (ICU) and hospital stay, postoperative morbidity and mortality in patients undergoing all types of cardiac surgery.We performed a retrospective cohort analysis of prospectively collected data from a tertiary cardiac surgery department of a university hospital between 2014 and 2016. We divided patients undergoing cardiac surgery into 2 sub-groups - the first - with a clinical diagnosis of COPD (n = 198) and the second comprised all other non-COPD patients (n = 2980).Among patients with COPD a longer intubation time (P = .039), longer ICU stay (P < .001) and longer hospitalization time (P = .006) was noted as compared with non-COPD patients. Patients with COPD required reintubation more often than non-COPD patients, reintubation occurring twice, 19 (9.60%) versus 144 (4.83%) P = .002, reintubation occurring 3 or more times, 7 (3.54%) versus 34 (1.14%) P = .006. Mortality within 30 days after surgery was higher in patients with pulmonary problems before surgery (P = .003). Multivariable logistic regression analysis corrected for interfering variables showed an increased risk of postoperative bronchoconstriction (odds ratio [OR] = 4.40, P = .002), respiratory failure (OR = 1.67, P = .018), atrial fibrillation (OR = 1.45, P = .023), and use of hemofiltration (OR = 1.60, P = .029) for patients with COPD.Patients with COPD undergoing all types of cardiac surgery are at increased risk of respiratory complications and mortality. The occurrence of COPD was associated with longer ICU and hospital stay. In COPD patients, undergoing cardiac surgery, treatment strategies aimed at preventing reintubation and early weaning mechanical ventilation must be employed to reduce postoperative complications.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/efectos adversos , Cardiopatías/epidemiología , Cardiopatías/cirugía , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Anciano , Procedimientos Quirúrgicos Cardíacos/métodos , Comorbilidad , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Intubación Intratraqueal/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores de Riesgo
12.
Surg Clin North Am ; 100(2): 219-236, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32169177

RESUMEN

Robotic minimally invasive direct coronary artery bypass is the most common robotic coronary procedure performed worldwide. It can be used to treat isolated left anterior descending (LAD) stenosis or can be coupled with percutaneous coronary intervention to diseased non-LAD targets in patients with multivessel disease. Virtually all types of mitral valve repair can be performed using the robot; valve replacement can also be undertaken. The robot can be used to repair atrial septal defects and resect cardiac myxoma. Increased cost of the robotic procedure may be offset by fewer perioperative complications, shorter hospital stay, and faster postoperative recovery.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Puente de Arteria Coronaria , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos , Insuficiencia de la Válvula Mitral/cirugía , Revascularización Miocárdica , Intervención Coronaria Percutánea
13.
Monaldi Arch Chest Dis ; 90(1)2020 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-32124586

RESUMEN

Iron deficiency (ID) is recognized as an important comorbidity in patients undergoing cardiac surgery; however, it still remains under-diagnosed and under-treated in clinical practice. This study aims at comparing efficacy and the effects on exercise capacity of intravenous ferric carboxymaltose (FCM) versus ferric gluconate (FG) in patients with ID anemia (IDA) resulting from cardiac surgery. We retrospectively analyzed data from our records of in-hospital patients with IDA after cardiac surgery undergoing cardiac rehabilitation. Group I was treated with FG, group II with FCM. Efficacy measures included changes (baseline vs discharge) in hemoglobin (Hb) and in distance traveled at six-minutes walking test (6MWT). Data from 74 in-patients (mean age 67.5±10.4 years, 43% women) were analyzed. At discharge, patients treated with FCM showed higher levels of Hb (11.1±1.2g/dl vs 10.2±1.1 g/dl; p=0.001), greater distance traveled at 6MWT (279.2±108.8 meters vs 236.3±72.7 meters; p=0.048), and lower in-hospital rehabilitation length of stay (20.3±7 vs 25.3±11.7 days; p=0.043) as compared to FG group. At multivariate analysis, the most powerful predictors of Hb increase >1 g/dl at discharge were transferrin levels (p=0.019) and treatment with FCM (p<0.001). FCM replacement therapy and iron serum levels were the most powerful predictors of 6MWT distance improvement (>100 meters) at discharge (p=0.13 and p=0.003, respectively). In patients with IDA following cardiac surgery, intravenous FCM is effective in restoring Hb levels and in improving exercise capacity after cardiac surgery.


Asunto(s)
Anemia Ferropénica/tratamiento farmacológico , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Tolerancia al Ejercicio , Compuestos Férricos/uso terapéutico , Hematínicos/uso terapéutico , Maltosa/análogos & derivados , Anciano , Anemia Ferropénica/etiología , Femenino , Humanos , Infusiones Intravenosas , Masculino , Maltosa/uso terapéutico , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
14.
Monaldi Arch Chest Dis ; 90(1)2020 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-32162894

RESUMEN

Left ventricular pseudoaneurysms (LVP) are rare but may arise after myocardial infarction, trauma or cardiac surgery, tending to expand and rupture over the time. We show the case of a 75-year-old patient with a recurrent giant ventricular pseudoaneurysm, who presented to the emergency department with sustained ventricular tachycardia. Pseudoaneurysmatic lesion was investigated through echocardiography, angiography and Cardiac Computed Tomography, in order to evaluate the size and spatial orientation of the pseudoaneurysm and to set a tailored treatment. At emergency department, sustained ventricular tachycardia may be the first and unique clinical presentation of ventricular pseudoaneurysm late recurrence, whose management requires a multimodality imaging approach to guide surgical correction.


Asunto(s)
Aneurisma Falso , Ventrículos Cardíacos , Taquicardia Ventricular/etiología , Anciano , Aneurisma Falso/complicaciones , Aneurisma Falso/diagnóstico por imagen , Angiografía , Procedimientos Quirúrgicos Cardíacos , Ecocardiografía , Aneurisma Cardíaco , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Masculino , Recurrencia , Tomografía Computarizada por Rayos X
15.
G Ital Cardiol (Rome) ; 21(4): 278-285, 2020 Apr.
Artículo en Italiano | MEDLINE | ID: mdl-32202560

RESUMEN

Prognosis of advanced heart failure (HF) patients, often elderly, frail and with multiple comorbidities, has significantly improved due to recent advancements in interventional cardiology. A multidisciplinary approach is essential in order to better identify patients that could benefit from invasive procedures, avoiding futility. For patients with HF, the Multidimensional Prognostic Index could help the clinician in predicting not only the prognosis but also future quality of life. For cardiac surgical candidates, predictive scores should combine traditional mortality scores with geriatric parameters including nutritional status, screening of delirium, disabilities and comorbidities, in order to help the Heart Team in taking the right approach (i.e. conservative vs invasive strategies). Similarly, the indication to the implantation of a cardioverter-defibrillator or to ablative procedures should consider both the complication rates and the real impact on the quality of life considering the expected net clinical benefit.In the terminal stages of HF the therapeutic target should be oriented to a palliative care approach. In this perspective, the figure of the palliativist plays a role of growing interest and should be integrated into the HF multidisciplinary team.


Asunto(s)
Estimulación Cardíaca Artificial , Procedimientos Quirúrgicos Cardíacos , Insuficiencia Cardíaca/terapia , Cuidados Paliativos , Reemplazo de la Válvula Aórtica Transcatéter , Anciano , Anciano Frágil , Humanos , Selección de Paciente , Calidad de Vida
16.
Artículo en Ruso | MEDLINE | ID: mdl-32119211

RESUMEN

The demographic and clinical data of 520 patients with infectious endocarditis treated in 2005-2017 was analyzed with the purpose to assess current trends in epidemiology and approaches to surgical correction of infectious endocarditis. The analysis established increasing of absolute number of patients with infectious endocarditis, their average age and number of female patients. The incidence of early prosthetic endocarditis and its hospital mortality decreased. The study determined increasing of number of emergency interventions, more frequent valve-preserving operations, increasing of number of interventions for perivascular lesions and more frequent application of bioprostheses.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Endocarditis Bacteriana , Endocarditis , Prótesis Valvulares Cardíacas , Procedimientos Quirúrgicos Cardíacos/mortalidad , Endocarditis/mortalidad , Endocarditis Bacteriana/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos
17.
Am Heart J ; 222: 147-156, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32062173

RESUMEN

Tranexamic acid (TxA) reduces perioperative blood transfusion in cardiac surgery; however, the optimal dose of TxA remains unknown. METHODS AND RESULTS: This large-scale, double-blind, randomized controlled trial with a 1-year follow-up enrolls patients undergoing elective cardiac surgery with cardiopulmonary bypass. Patients are randomly assigned 1:1 into either the high-dose TxA group (intravenous bolus [30 mg/kg] after anesthesia followed by intravenous maintenance [16 mg/kg/h] throughout the operation, and a pump prime dose of 2 mg/kg) or the low-dose TxA group (intravenous bolus and maintenance are 10 mg/kg and 2 mg/kg/h, respectively, and a pump prime dose of 1 mg/kg). The primary efficacy end point is the rate of perioperative allogeneic red blood cell (RBC) transfusion defined as the number (%) of patients who will receive at least 1 RBC unit from operation day to discharge. The primary safety end point is the 30-day rate of the composite of perioperative seizures, renal dysfunction, myocardial infarction, ischemic stroke, deep vein thrombosis, pulmonary embolism, and all-cause mortality. The secondary end points are perioperative allogeneic RBC transfusion volume, the non-RBC blood transfusion rate, postoperative bleeding, reoperation rate, mechanical ventilation duration, intensive care unit stay, hospital length of stay, total hospitalization cost, each component of composite primary safety end point, and the 6-month/1-year follow-up mortality and morbidity. We estimated a sample size of 3,008 participants. CONCLUSIONS: The study is designed to identify a TxA dose with maximal efficacy and minimal complications. We hypothesize that the high dose has superior efficacy and noninferior safety to the low dose.


Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control , Procedimientos Quirúrgicos Cardíacos/métodos , Puente Cardiopulmonar/métodos , Hemorragia Posoperatoria/prevención & control , Ácido Tranexámico/administración & dosificación , Administración Intravenosa , Adolescente , Adulto , Anciano , Antifibrinolíticos/administración & dosificación , Transfusión Sanguínea/estadística & datos numéricos , China/epidemiología , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Incidencia , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Hemorragia Posoperatoria/epidemiología , Pronóstico , Tasa de Supervivencia/tendencias , Adulto Joven
19.
West Afr J Med ; 37(1): 58-61, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32030713

RESUMEN

BACKGROUND: Transthoracic open surgical ligation (TTOSL) of patent ductus arteriosus (PDA) remains the most readily available and affordable treatment option in resource-poor countries such as Nigeria. OBJECTIVES: To determine the incidence and outcome of aortic valve regurgitation (AR) following TTOSL of PDA. METHODS: Retrospective audit of consecutive patients who underwent TTOSL of PDA over a 4½-year period (January 2015 to June 2019) at the OAUTHC, Ile-Ife, Nigeria. Hospital records including echocardiograms (pre-operative, immediate post-operative and follow-up performed a day after TTOSL, at 1, 3 and 12 months) were reviewed for presence and severity of AR. RESULTS: Twenty-six patients (11 males and 15 females) aged 3 months 24 years (Mean = 3.16 years) had TTOS PDA ligation. Only 3 (11.5%) patients had AR pre-operatively; 2 graded moderate AR and 1 graded mild. Twenty (76.9 %) patients had immediate post-operative AR; 4 (20.0%) of which were moderate and the others (80.0%) were mild. Eighteen (69.2%) patients still had AR post-operative day 1; 16 were mild and the rest 2 which were moderate were the same patients that had AR pre-operatively. At 3 months follow-up, 6 of 20 patients (30.0%) had AR; all were mild. Only 2 of 18 (11.1%) followed up for 12 months had AR. They both had had moderate AR pre-operatively which were now graded as mild. There was no mortality. CONCLUSION: Aortic regurgitation is common after TTOSL of PDA. However, in most instances, it is mild and transient.


Asunto(s)
Insuficiencia de la Válvula Aórtica/etiología , Procedimientos Quirúrgicos Cardíacos/métodos , Conducto Arterioso Permeable/cirugía , Adolescente , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/epidemiología , Niño , Preescolar , Conducto Arterioso Permeable/epidemiología , Ecocardiografía , Femenino , Humanos , Incidencia , Lactante , Masculino , Nigeria/epidemiología , Complicaciones Posoperatorias , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto Joven
20.
Zhonghua Er Ke Za Zhi ; 58(2): 96-100, 2020 Feb 02.
Artículo en Chino | MEDLINE | ID: mdl-32102144

RESUMEN

Objective: To investigate the safety and efficacy of transcatheter perforation of pulmonary valve by micro-guidewire and balloon dilation in the treatment of neonatal pulmonary atresia with intact ventricular septum (PA-IVS). Methods: The retrospective study included 21 neonates (14 males and 7 females) with PA-IVS who underwent transcatheter micro-guidewire pulmonary valve perforation and balloon dilation in Xinhua Hospital from January 2012 to December 2018. All patients underwent the pulmonary valve perforation by micro-guidewire through the Simmons catheter. During the follow-up period at 1, 3, 6, 12 months postoperatively and annually thereafter, the operative efficacy and the development of the right ventricle (RV) were evaluated by echocardiography. Statistical analyses were performed using t test. Results: A total of 21 neonates with PA-IVS were enrolled, and 13 cases were diagnosed prenatally. The median age of surgery was 6 days, the weight was (3.2±0.5) kg. The balloon/valve ratio was 1.19±0.12, and the RV pressure measured by catheter was (121±33) mmHg (1 mmHg=0.133 kPa) . The immediate postoperative RV pressure was (47±13) mmHg. The median follow-up time was 30 months. All the cases enrolled achieved biventricular circulation without death and serious complications. According to the last follow-up data including 16 cases who were followed up for 1 year or longer, the pulmonary artery transvalvular pressure was (29±15) mmHg. The postoperation ratio of right to left ventricular transverse diameter was significantly higher than that before operation (0.86+0.10 vs. 0.73+0.13, t=-2.96, P=0.006). Compared with preoperative data, the postoperation pulmonary valvular diameter Z-score was significantly higher (-1.41±0.89 vs. -2.83±1.06, t=-3.65, P=0.001) and the tricuspid valvular diameter Z-score was significantly higher (-0.52±0.29 vs. -1.34±0.81, t=-3.55, P=0.001). Conclusion: Transcatheter perforation of pulmonary valve by micro-guidewire and balloon dilation is a safe and effective initial therapy for neonatal PA-IVS.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Cateterismo/instrumentación , Cardiopatías Congénitas/cirugía , Tabiques Cardíacos/cirugía , Atresia Pulmonar/cirugía , Ablación por Catéter , Cateterismo/métodos , Dilatación , Femenino , Humanos , Recién Nacido , Masculino , Válvula Pulmonar/cirugía , Estudios Retrospectivos , Reemplazo de la Válvula Aórtica Transcatéter , Resultado del Tratamiento
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