BACKGROUND: Surgical management of patients with complete atrioventricular septal defect (AVSD) has advanced over the last decades. Definitive early surgical repair for AVSD has become the treatment of choice at many centers. This trend has contributed to the recent decline in postoperative mortality and good long-term results. METHODS: We reviewed ...

BACKGROUND: A midterm retrospective analysis of the transaortic primary suture repair of perimembranous or conal ventricular septal defects with aortic valve prolapse was conducted. METHODS: From January 1998 to January 2006, 56 patients underwent transaortic repair of perimembranous or conal ventricular septal defects using the direct suture technique. The mean ...

Cartilage defects occur in approximately 12% of the population and can result in significant function impairment and reduction in quality of life. Evidence for the variety of surgical treatments available is inconclusive. This study aimed to compare the clinical outcomes of patients with symptomatic cartilage defects treated with matrix-induced autologous ...

BACKGROUND: We evaluated the safety and feasibility of intraoperative device closure of atrial septal defect in infants. METHODS: From January 2005 to September 2009, we enrolled 32 infants with secundum-type atrial septal defect in our institution. Patients were divided into two groups: 17 patients in group I had intraoperative device ...

The rigid coupling between the delivery wire and the right atrial disk has been occasionally encountered during transcatheter closure of atrial septal defect (ASD). Therefore the device frequently makes a perpendicular angle, and the leading edge of left atrial disk slips through the defect and prolapses into right atrium (RA) ...

The objective of this study was to evaluate the long-term outcome of total repair for tetralogy of Fallot. Between April 1986 and December 2007, a total of 734 patients underwent total repair for tetralogy of Fallot. There were 444 males and 290 females. The median age and weight were 17.2 ...

The Evolution mechanical dilator sheath is a new lead extraction tool that uses a rotational mechanism and a bladed tip to overcome fibrosis. The purpose of this study was to report our initial experience with the Evolution system. Between March 2008 (our first use of Evolution) and September 2009, the ...

The arterial switch operation (ASO) for neonates is the standard management for transposition of the great arteries (TGA) with an intact ventricular septum (IVS). Patients presenting for late ASO are at risk due to the possibility of left ventricle (LV) involution. This study aimed to assess the early postoperative course ...

To determine outcomes of patients undergoing a bidirectional cavo-pulmonary shunt (BCPS) in the Fontan era. From 1990 to 2000, 212 patients underwent a BCPS in a single institution at a mean age of 2.6+/-5 years. Hospital mortality was 6% (13 patients). Five patients were lost to follow-up (3%). After a ...

The incidence of percutaneous closure of secundum atrial septal defects (ASD) and patent foramen ovale (PFO), which has become an established therapy, is constantly increasing. In this study, which is the first in the Greek literature, we present the immediate and mid-term results from this intervention in our center. From ...

We sought to prove that device closure of atrial septal defect (ASD) in older patients not only improves cardiac function but also results in symptomatic relief by improving functional class. Atrial septal defect accounts for approximately 10% of all congenital cardiac defects. It is possible that ASD closure in older ...

BACKGROUND: Intestinal inflammation is a component of the pathophysiology of protein-losing enteropathy after the Fontan operation. Oral controlled-release budesonide is 90% metabolized at first pass through the liver, has high enteric anti-inflammatory activity and relatively low systemic effects, and may be an ideal agent for use in treating this disease. ...

BACKGROUND: Alcohol septal ablation (ASA) is a catheter-based intervention that has been used as an alternative to surgical myectomy in highly symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). METHODS: This retrospective study was designed to evaluate the incidence of major complications in the mid-term follow-up of low-dose (1-2.5 ml of ...

BACKGROUND: Prominent azygos veins (PAVs) have been described with interrupted inferior venae cavae (IVCs) with heterotaxy. At the authors' institution, cases of PAVs with uninterrupted IVCs have been noted. The aim of this study was to determine the occurrence rate of PAVs and associated lesions by echocardiography. METHODS: All patients ...

The aim of the present study was to report our additional experience with transcatheter closure of the patent ductus arteriosus in 65 consecutive patients using the new Amplatzer duct occluder. The median patient age was 3.6 years (range 0.2to 12), and the median weight was 10.5 kg (range 4 to ...

INTRODUCTION: Implantable cardioverter defibrillator (ICD) therapy of life-threatening arrhythmias in pediatric patients is feasible; however, recent studies report a high incidence of inappropriate shock deliveries. METHODS: The data of all recipients of an ICD at the Charité, Department of Pediatric Cardiology, between January 2001 and November 2007 were retrospectively analyzed ...

BACKGROUND: Ventricular septal defect (VSD) is the most commonly recognized congenital heart defect. With the development of device closure for intracardiac defects, we sought to evaluate current expectations for surgical closure of isolated VSD. METHODS: Between January 1, 2000, and December 31, 2006, 215 patients underwent isolated VSD repair at ...

BACKGROUND: Surgical and perioperative improvements permit earlier repair of partial and transitional atrioventricular septal defects (AVSD). We sought to describe contemporary outcomes in a multicenter cohort. METHODS: We studied 87 patients undergoing primary biventricular repair of partial or transitional AVSD between June 2004 and February 2006 across seven North American ...

BACKGROUND: From December 2001 to February 2008, right vertical infraaxillary thoracotomy (RVIAT) was used to perform ventricular septal defect (VSD) closure in selected patients. This retrospective study reviews our results and experiences. METHODS: The study included 274 patients (143 females, 131 males) undergoing VSD closure through a RVIAT approach. Patients ...

Although implantable cardioverter-defibrillators (ICDs) are used in sudden cardiac death (SCD) prevention in high-risk patients with hypertrophic cardiomyopathy (HCM), long-term results as well as precise risk stratification are discussed in a limited number of reports. The aim of the study was to assess the incidence of ICD intervention in HCM ...

BACKGROUND: Construction of a total cavopulmonary anastomosis using an intra-atrial lateral tunnel Fontan (LTF) is known to yield good early and midterm results. Given the current controversy regarding indications for a total extracardiac conduit Fontan, we reviewed the long-term outcomes after a LTF operation and compared them with recently published ...

The outcomes of 3 different methods of repair of left ventricular pseudoaneurysm after myocardial infarction were analyzed retrospectively. The operations were carried out in 22 patients between 1985 and 2008. Repair procedures included primary closure with Teflon-pledgeted sutures, and Dacron or pericardial patches. Overall hospital mortality was 27.3% (2 patients ...

The fossil record of Jurassic theropod dinosaurs closely related to birds remains poor. A new theropod from the earliest Late Jurassic of western China represents the earliest diverging member of the enigmatic theropod group Alvarezsauroidea and confirms that this group is a basal member of Maniraptora, the clade containing birds ...

BACKGROUND: The arteriovenous fistula (AVF) provides an effective vascular access for hemodialysis; however, the associated hemodynamic effects may alter cardiac structure and function. The objective of this study is to evaluate the effect of AVF closure on functional and structural echocardiographic findings. STUDY DESIGN: Prospective observational study. SETTING & PARTICIPANTS: ...

The study aimed to investigate the intermediate-term effects of transcatheter atrial septal defect (ASD) closure on cardiac remodeling in children and adult patients. Between December 2003 and February 2009, 117 patients (48 males, 50 adults) underwent transcatheter ASD closure with the Amplatzer septal occluder (ASO). The mean age of the ...

AIMS: Persistent iatrogenic atrial septal defect (iASD) after transseptal puncture for pulmonary vein isolation (PVI) has been described recently as a complication of PVI. No data exists evaluating systematically the incidence and clinical implications of iASDs after PVI using a remote robotic navigation system (RNS) with sheaths with a distinct ...

The physiologic effects of a fenestration are to decrease "Fontan pressure" and systemic oxygen saturation, but to improve both cardiac index and systemic oxygen delivery. Several nonrandomized studies have shown that a fenestration improves clinical outcomes by decreasing the duration of postoperative effusions and the length of hospital stay. The ...

In this study, we investigate the efficacy of repairing an osteochondral defect in rabbit knee joints by administering bevacizumab, a humanized monoclonal anti-vascular endothelial growth factor (VEGF) antibody. An osteochondral defect was created on the patellar groove of 20 Japanese white rabbits that were classified into two recipient groups: group ...

To investigate the long-term outcome of surgical treatment for congenitally corrected transposition of the great arteries (CCTGA), in patients with biventricular repair with the right ventricle as systemic ventricle. A total of 32 patients with CCTGA were operated between January 1972 and October 2008. These operations comprised 18 patients with ...

We describe the 10-year outcome of the first-in-human series of 12 patients with hypertrophic cardiomyopathy treated with alcohol septal ablation. There was no 30-day mortality. Survival free of death, internal cardiac defibrillator discharge for treatment of ventricular fibrillation or tachycardia, severe New York Heart Association (NYHA) class III/IV and/or Canadian ...

As limited data exist, we sought to review the safety and outcome of cardiac surgery in the adult Down syndrome population. We reviewed the data of all patients >or=18 years old with Down syndrome who underwent cardiac surgery (1969-2008) at our hospital. Fifty patients underwent 57 surgeries (mean age 33 ...

OBJECTIVE: Most devices devices available for percutaneous closure of Fontan fenestrations tend to be bulky. The aim of this study was to evaluate a low profile custom made device and assess its efficacy and safety. PATIENTS AND METHODS: A 15 mm PFO star was used as the basis. The following ...

BACKGROUND: In this study, we assessed our surgical strategy, tighter pulmonary artery banding (PAB) during the neonatal period, as an initial step followed by early application of bidirectional cavopulmonary shunts (BCPS) in infancy, to treat functionally single ventricles with unobstructed pulmonary blood flow. METHODS: On the basis of our surgical ...

During the past 15 years, closure of a secundum atrial septal defect (ASD) has moved from a surgical to a percutaneous transcatheter approach. Few long-term studies of the efficacy and safety of closure of an ASD by an Amplatzer septal occluder (ASO) exist. To examine the long-term results of secundum ...

Background. Right ventricular pacing (RVP) has been associated with adverse outcomes, including heart failure and death. Minimizing RVP has been proposed as a therapeutic goal for a variety of pacing devices and indications. Objective. Quantify survival according to frequency of RVP in veterans with pacemakers. Methods. We analyzed electrograms from ...

Early postoperative hyperlactatemia is seen in some children after surgical repair of secundum atrial septal defect despite apparently normal cardiac output. The objective of the study was to investigate the intraoperative risk factors for hyperlactatemia in patients undergoing atrial septal defect repair. A retrospective review of 68 consecutive patients who ...

OBJECTIVE: This study was conducted to analyze the factors affecting the intermediate outcome following the Fontan procedure in the current era. METHODS: Between January 1992 and December 2008, 189 patients underwent Fontan procedure at a median age of 3.4 years (0.4-37 years). Single left ventricle was present in 77 (40%) ...

OBJECTIVES: We aimed to evaluate the clinical feasibility and safety of a novel wire-maintaining technique (WMT) for transcatheter closure of perimembranous ventricular septal defects (PmVSDs). BACKGROUND: Transcatheter device closure of PmVSDs has been increasingly performed and this procedure is now offered as primary therapy at many institutions. METHODS: A total ...

BACKGROUND: Interventional closure of atrial septal defects (ASD) and surgical tunnel fenestrations in Fontan patients has become the procedure of choice for many years. Recently, the BioSTAR Occluder, a modification of the Starflex device with a resorbable matrix has become available. PATIENTS: Ten Biostar devices were implanted in nine children ...

The secundum type of atrial septal defect (ASD) is a common congenital cardiac anomaly. Transcatheter closure of the defect is the preferable therapeutic approach to avoid potential future complications. This work extends the data collected so far regarding the electrocardiographic, morphologic, hemodynamic, and mechanical changes following the procedure. From April ...

Background. The Medtronic Sprint Fidelis ICD lead is prone to failure and the rate of failure seems to be increasing. The aim of this study was to investigate the rate of Sprint Fidelis lead failure, the characteristics, the mode of presentation and possible predictors of lead failure.Methods and Results. The ...

To evaluate the use of intracardiac echocardiography probe through oesophageal route (ICE-TEE) for the monitoring of percutaneous foramen ovale (PFO) closure procedure. The study was conducted in 50 patients divided into two groups: in group I (n = 24), accuracy of ICE-TEE in assessing the inter-atrial septum (IAS) was compared ...

INTRODUCTION: Implantable cardioverter defibrillator (ICD) therapy is increasingly used in children. The purpose of this multicenter study is to evaluate mid-term clinical outcome and to identify predictors for device discharge in pediatric ICD recipients. METHODS AND RESULTS: From 1995 to 2006, 45 patients in The Netherlands under the age of ...

INTRODUCTION: Remote monitoring is increasingly becoming the new standard of care for implantable cardioverter defibrillator (ICD) follow-up. We sought to determine whether remote monitoring of ICDs improves patient outcomes compared with quarterly device interrogations in clinic. METHODS AND RESULTS: In this single-center pilot clinical trial, adult patients with an ICD ...

OBJECTIVE: We devised a new technique for interventional closure of atrial septal defect (ASD) using the Amplatzer Septal Occluder (ASO), and validated this by comparing it with a cohort using the conventional method. BACKGROUND: Transcatheter closure of ASD is a widely accepted modality of treatment. Although the outcome is good, ...

This study aims to compare the outcome of the two co-existing modifications of staged total cavopulmonary connection (TCPC) - the intra-atrial lateral tunnel (ILT) and the extracardiac conduit (ECC). We included 209 patients after staged TCPC (102 ILT and 107 ECC), operated on between 1988 and 2008. Medical and surgical ...

OBJECTIVES: The purpose of this study was to determine whether intrinsic histological abnormalities of the pulmonary trunk (PT) are present from birth and interact with palliative surgery and/or repair. BACKGROUND: Little is known about PT histology in patients with tetralogy of Fallot (TOF), especially in the era of surgical intervention ...

AIMS: To assess the impact on clinical practice of the major published studies, we report the information collected by the Italian Pacemaker Registry (IPR) in the quinquennium 2003-07. METHODS AND RESULTS: The IPR collected prospectively main epidemiological, clinical, and electrocardiographic data of patients treated by pacemaker (PM) in Italy on ...

We report our experience in managing late presenters (older than 4 weeks) with dextro-transposition of great arteries and intact ventricular septum (d-TGA/IVS) in an effort to achieve successful arterial switch operation (ASO) in a third world setting. We retrospectively reviewed the charts of all late presenters with d-TGA/IVS. Patients were ...

BACKGROUND: Left ventricular free wall rupture (LVFWR) is still one of the often fatal complications of acute myocardial infarction. Surgical repair is mandatory even with high operative mortality. The optimal surgical technique is controversial since the results depend on type of rupture. We present our mid-term surgical experience according to ...