OBJECTIVE: Biventricular repair of complete atrioventricular septal defect (CAVSD) with small left ventricle aims to restore the normal loading conditions of the left ventricle. This report retrospectively evaluates the outcome of biventricular repair in 19 children with CAVSD and a small left ventricle. METHODS: Our computer database was searched for ...

Fenestrated atrial septal defects (F-ASDs) may pose a challenge to device closure; recently, a cribriform device with a minimal connecting intrawaist diameter and large, equal left- and right-sided discs has been designed to cover more than one adjacent defect. This study demonstrates the feasibility and technical aspects of closing F-ASDs ...

BACKGROUND: The Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation study demonstrated that implantable cardioverter defibrillators (ICDs) significantly reduce the risk of sudden cardiac death in patients with nonischemic cardiomyopathy and an ejection fraction of 35% or less, with no statistically significant decrease in overall mortality. The impact of ICD placement and ...

Modifications of the Fontan operation can afford excellent palliation for many patients with a variety of forms of single ventricle. In properly selected patients who are good candidates, early and late survival can be as high as 95-97%. However, mortality is considerably higher for patients with risk factors for poor ...

BACKGROUND: It would be useful to identify patients at high risk of implantable cardioverter defibrillator (ICD) therapy via additional antiarrhythmic measures to minimize the morbidity of ICD therapies. OBJECTIVE: We assessed baseline characteristics for predictors of device therapy in a general ICD population. We also compared the likelihood of therapy ...

INTRODUCTION: We report a series of operated tetralogy of Fallot (TOF) patients focusing on complications and outcomes. MATERIALS AND METHODS: Data from TOF patients seen at our centre's adult congenital heart disease clinic was analysed. RESULTS: There were 21 patients: the mean age was 32.2 +/- 12.4 years; the age ...

Fish oil has a cardioprotective effect in adults with ischemic heart disease. The authors examined the effects of fish oil in children with idiopathic dilated cardiomyopathy (DCM). Eighteen DCM patients (group I) and 12 healthy children (group III) were given fish oil (10 mL/d). Their cardiac findings were compared with ...

OBJECTIVE: Compare the surgical outcomes of the lateral tunnel and the extracardiac conduit total cavopulmonary connections at a single center during a l0-year period. MATERIAL AND METHOD: From October 1995 through October 2005, 27 total cavopulmonary connections (TCPC) were performed. fourteen patients were the lateral tunnel and thirteen patients were ...

BACKGROUND: Extracardiac conduit total cavopulmonary connection has shown good early results; however, its long-term outcome has yet to be reported. METHODS: Of 282 patients who underwent extracardiac conduit total cavopulmonary connection since 1994, 126 patients who have been followed up for more than 5 years were included in this retrospective ...

OBJECTIVES: The CardioSEAL VSD registry was created to track safety of the device to close high-risk Ventricular Septal Defect (VSD). BACKGROUND: This is the first report from the multi-centered CardioSEAL VSD registry reviewing demographics and initial results. METHODS: Centers recruited patients with VSD who were high-risk for surgery due to ...

OBJECTIVE: This review evaluates the outcome of a treatment strategy using dual-chamber pacemakers for neonates with congenital heart block. METHODS: From 1989 to 2006, 10 neonates had dual-chamber epicardial pacemaker placement for congenital heart block. Mean age and weight were 4.4 +/- 5.6 days and 2.8 +/- 0.6 kg. Four ...

OBJECTIVE: Temporary pacing wires have been associated with serious postoperative complications. Recommendations for their routine use after open heart surgery are decades old, and may not reflect current surgical techniques and outcomes. METHODS: The electronic web-enabled medical records of all patients undergoing congenital cardiac surgery from February, 2002, through December, ...

OBJECTIVE: This study aims to report our experience using intraoperative device closure of secundum atrial septal defects and to evaluate the feasibility and clinical outcome of this technique. METHODS: One hundred patients with secundum atrial septal defects (mean age, 29 +/- 16 years; age range, 5-71 years; mean weight, 54 ...

Percutaneous closure of atrial septal defect (ASD) and patent foramen ovale (PFO) has become increasingly utilized. The indications and results of percutaneous closure are diverse. AIM: To assess the indications, results, and complications of percutaneous closure of ASD and PFO in our tertiary center. METHOD: Case note review and retrospective ...

INTRODUCTION: Novel transcatheter techniques to control interatrial communications exist. Devices with restrictive fenestrations can be implanted to maintain patency of an atrial septostomy, or reduce an interatrial communication. Experience with these devices in children is limited. PATIENTS AND METHODS: Fenestrated atrial septal devices were implanted into 10 children (5 male, ...

Fenestrating the Fontan circuit during total cavopulmonary anastomosis is commonly performed to reduce postoperative mortality and morbidity. The resulting systemic desaturation may progressively increase leading to symptoms. We report the case of a symptomatic eight year old, whose Fontan circuit fenestration was closed using a patent ductus arteriosus occluder. The ...

OBJECTIVES: The aim of this study was to evaluate the longterm follow-up results of percutaneous transluminal septal myocardial ablation (PTSMA) in a large patient cohort. BACKGROUND: PTSMA by alcohol injection into septal branches has shown good acute and short-term results in symptomatic patients with hypertrophic obstructive cardiomyopathy. METHODS: A total ...

AIMS: The objective of this study is to establish factors associated with death after diagnosis of Ebstein's anomaly (EA) during childhood and adolescence. METHODS AND RESULTS: This study is a retrospective chart review. All paediatric patients were diagnosed with EA and followed in tertiary-care university hospitals between 1980 and 2005. ...

BACKGROUND: Currently available catheter techniques for closure of a patent foramen ovale (PFO) rely on the placement of an implantable closure device. The objective of the Paradigm I study was to evaluate the safety and feasibility of transcatheter closure of PFO using radiofrequency energy without an implanted device in patients ...

BACKGROUND: Temporary percutaneous epicardial pacing wires are routinely placed in children following cardiac surgery. There is uncertainty in clinical practice about the optimum timing for their removal, and practice varies widely both within and between different institutions. AIM: The aim of our study was to describe the use of temporary ...

OBJECTIVES: This study sought to discover the incidence of permanent pacemaker (PPM) placement for atrioventricular conduction block (AV block) after operative repair of perimembranous ventricular septal defect (PMVSD) in a large multi-institutional database and in the subgroup of patients comparable to those considered for transcatheter device closure of PMVSD. BACKGROUND: ...

OBJECTIVE: We retrospectively analyzed our experience in atrial septal defect repair with varied minimally invasive surgical approaches. METHODS: From 1997 to 2006, 64 patients underwent surgical repair of atrial septal defects in our center. Patients were grouped into four groups according to the approach used; group 1 (n = 16), ...

BACKGROUND: Transcatheter closure of PFO with nitinol devices may be problematic in young patients with migraine due the risk of late erosions. Alternative devices with less amount of metal as the last generation devices may be preferable in such cases. We present the results of transcatheter closure of PFO with ...

BACKGROUND: Children born with heterotaxy syndromes have poorer outcomes compared with children born with comparable cardiac lesions requiring similar surgical palliation. Heterotaxy has been reported as a separate risk factor for mortality and increased morbidity in a series of Fontan operations reported from single centres. Little is known, however, about ...

BACKGROUND: We used the right atrial free wall as a patch to close atrial septal defects (ASD) and report its results. METHODS: Between July 1998 and April 2006, 87 patients (mean age, 21.9 +/- 13.9 years; range, 7 months to 54 years), underwent closure of ASD with an autologous right ...

OBJECTIVES: To identify the determinants of appropriate and inappropriate implantable cardioverter-defibrillator (ICD) discharges in patients with hypertrophic cardiomyopathy (HCM). DESIGN: Retrospective cohort study. SETTING: ICD clinic at an academic hospital. PATIENTS: 61 patients with HCM who received ICDs for the primary or secondary prevention of sudden cardiac death (SCD). OUTCOME ...

BACKGROUND: The study was conducted to assess the need for fenestration for completion of a total cavopulmonary connection (TCPC) with the most recent modification of an extracardiac conduit. METHODS: The extracardiac approach was introduced to our institution in January 1999. Between June 2000 and June 2006, 132 consecutive patients were ...

OBJECTIVE: Transvenous permanent cardiac pacing (TPCP) has become a frequently used therapeutic modality in children. The purpose of this study was to evaluate the outcome of pediatric TPCP regarding problems and complications. METHODS: Records of 155 patients (mean age 9.2+/-4.7 years) who underwent implantation of TPCP between 1993 and 2003 ...

BACKGROUND: Fontan takedown to an intermediate palliative circulation is an important treatment option for patients with acute or subacute failure of a Fontan circulation from a variety of causes. Little is known about the subsequent outcome of these patients or their potential candidacy for a second attempt at Fontan completion. ...

We report our results on surgical treatment of complete atrioventricular septal defects using the two-patch technique. Forty patients with complete atrioventricular septal defects were operated on in the period from November 1995 to January 2004 and retrospectively analyzed. The age at the time of surgery ranged from 4 months to ...

OBJECTIVES: Implantation of an additional HV-P/S lead versus extraction of the defective HV-P/S lead and implantation of a new one is one possible therapeutic approach in cases of a defective high-voltage pace/sense lead (HV-P/S). No information is available on potential differences in clinical outcome in these different approaches. METHODS: Between ...

BACKGROUND: The arterial switch operation (ASO) has become the treatment of choice in patients with simple or complex transposition of the great arteries (TGA). The purpose of this study was to assess early and mid-term outcome after ASO in a single centre. PATIENTS AND METHODS: Between 1995 and December 2005, ...

With improvements in technology and surgical technique, pediatric cardiologists are challenging surgeons to close symptomatic ventricular septal defects (VSDs) in ever smaller patients. Although delaying surgery may facilitate operative repair, early intervention decreases the period of time these patients require therapy to prevent heart failure, maintains growth, and minimizes exposure ...

OBJECTIVE: Down syndrome is frequently associated with complete atrioventricular septal defect. The aim of this retrospective study was to evaluate the impact of Down syndrome on morphologic features, surgical management, and perioperative and long-term mortality in patients with complete atrioventricular septal defect. METHODS: Between October 1974 and March 2005, 476 ...

BACKGROUND: Percutaneous transcatheter closure of patent interatrial communications after presumed paradoxical embolism is used as an alternative to surgery or long-term anticoagulation for the treatment of patients who are at risk for recurrent thromboembolism. To avoid atherosclerotic events to be judged as recurrent paradoxical embolism, we prospectively excluded all patients ...

OBJECTIVES: We report on the feasibility, effectiveness, and long-term outcome of transcatheter closure of multiple ASD's using multiple ASO devices. BACKGROUND: Little is known about the use and long-term outcome of multiple Amplatzer Septal Occluder (ASO) devices to close multiple atrial septal defects (ASD's). METHODS: From May 1997 to June ...

AIMS: Coronary sinus (CS) leads used for cardiac resynchronization have undergone development in the last years. However, dislocation rate remained high. We explain a simple method to stabilize the CS lead position. METHODS AND RESULTS: Thirty-five patients (11 females, aged 60 +/- 9.2 years) were treated with this method. An ...

BACKGROUND: Biventricular repair (BVR) can be achieved in aortic atresia with ventricular septal defect (VSD) by creating a double outlet left ventricle, Damus-Kaye-Stansel procedure and placement of a right ventricular-pulmonary artery conduit. This study is a review of 15 years experience with this "Damus-Rastelli" technique to assess clinical outcomes in ...

Pulmonary arterial hypertension (PAH) associated with congenital heart defect (CHD), and especially Eisenmenger syndrome, is associated with impaired exercise tolerance and reduced quality of life. In this study, we describe medium-term follow-up of adult patients with PAH associated with CHD, treated in a single center with different types of advanced ...

Erosion and exposure of pacemaker (PPM) and implantable cardiac defibrillator (ICD) devices are potentially dire complications, which have classically required the removal of the entire generator and lead systems. This study evaluates a series of cases wherein debridement, irrigation, pocket change, and local flap coverage were used for the successful ...

OBJECTIVE: To study patients who underwent surgical closure of a congenital ventricular septal defect (VSD) and presenting at adult age. METHODS AND RESULTS: A retrospective study was carried out of 28 patients (15 male) operated upon between 1980 and 2004. Patients were investigated by echocardiography, ECG and assessed for quality ...

AIM: We evauated the outcome of patients with left ventricular pseudoaneurysms, focusing on those treated surgically. METHODS: Between June 1990 and March 2007, 7 patients underwent surgery because of left ventricular pseudoaneursym following myocardial infarction, at our institution. The median time interval between myocardial infarction and the diagnosis of left ...

BACKGROUND: Left ventricular outflow tract (LVOT) obstruction in the setting of hypertrophic cardiomyopathy (HCM) confers negative adverse outcomes. Current nonpharmacologic treatment options include surgical myectomy and percutaneous transcoronary ablation of septal hypertrophy (TASH). While TASH negates a more invasive procedure, concern remains with particular regard to the arrhythmogenic potential of ...

BACKGROUND: This study sought to assess risk factors for late mortality after the Rastelli operation for patients with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction. METHODS: Records of 39 patients who underwent the Rastelli operation between 1977 and 2004 were reviewed. Median age ...

The aim of the research was to investigate different techniques and different approaches in treating secondary rhinoplasty. 15 (13 female and 2 male) repeated operations on combined defects were performed. The age varied from 19-45 years. Patients were divided into three groups. The first group consisted of 7 patients with ...

OBJECTIVE: Our treatment strategy for pulmonary atresia with ventricular septal defect (VSD) and major aortopulmonary collateral arteries is a staged repair that comprises the first complete unifocalization (UF) with 'unification' of intrapulmonary arteries and then the definitive repair. The purpose of this study is to evaluate the outcome of our ...

BACKGROUND: Left ventricular mobile thrombi carry high risk of embolism and need early treatment in which the appropriate treatment is still controversial. Because most patients with mobile thrombi have low ejection fraction and also accompanying heart failure symptoms, decision of surgical treatment is not always easy and thus effective medical ...

AIMS: To determine the impact of surgical myectomy on ventricular arrhythmias in obstructive hypertrophic cardiomyopathy (HCM). Left ventricular outflow tract obstruction (LVOTO) correlates with adverse outcomes, including sudden cardiac death (SCD) in patients with HCM. Surgical myectomy is the primary treatment strategy for relief of symptoms owing to LVOTO and ...

BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by abnormal angiogenesis with resultant telangiectasia formation in mucocutaneous tissues, visceral organs, and the central nervous system. The most common manifestation of HHT is epistaxis resulting from trauma to thin-walled telangiectasias. Many patients with HHT experience worsened epistaxis due ...

To compare the short- and mid-term outcomes of surgical (SUR) vs. transcatheter closure of secundum atrial septal defect (ASD) using Amplatzer septal occluder (ASO) in adults with a very similar spectrum of the disease; and to identify predictors for the primary end point. Single-center, concurrent comparative study. Surgically treated patients ...