Document Detail

Cardiac intensive care of the adult with congenital heart disease: basic principles in the management of common problems.
MedLine Citation:
PMID:  23803995     Owner:  NLM     Status:  In-Data-Review    
Although there has been an intense interest in the care of the adult with congenital heart disease (ACHD), these guidelines are usually not focused on the concepts of immediate postoperative care. The 2 most common perioperative complications are heart failure and atrial dysrhythmias. The broad etiological categories for ACHD and heart failure include primary pump failure (systolic dysfunction) and hypertrophy (diastolic dysfunction) of the right, left, or single ventricle. Some conditions with a pressure-loaded systemic right ventricle as well as patients with a functionally single ventricle may be particularly prone to develop heart failure; in others, right heart failure may occur in patients with Ebstein anomaly or with tetralogy of Fallot after corrective repair but with varying degrees of pulmonary insufficiency, and left heart failure can be a result of mitral or aortic insufficiency. The management of postoperative atrial tachycardia in the ACHD patient actually begins prior to surgery. Assessment of arrhythmia history, complete determination of risk, inducibility and arrhythmia substrate, preoperative planning of pacing sites, and optimal pacing strategies all assist to bring about optimal postoperative outcomes. Ideal perioperative care of the ACHD involves a multidisciplinary team of pediatric and adult cardiologists, pediatric and adult intensivists, cardiac surgeons, and nursing staff along with a myriad of adult subspecialists such as pulmonology, nephrology, endocrinology, and others including psychiatry.
James Perry; Michael Lanzberg; Wayne Franklin; Gary Webb; Anthony C Chang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal for pediatric & congenital heart surgery     Volume:  2     ISSN:  2150-136X     ISO Abbreviation:  World J Pediatr Congenit Heart Surg     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2013-06-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518415     Medline TA:  World J Pediatr Congenit Heart Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  430-44     Citation Subset:  -    
Rady Children's Hospital and UCSD School of Medicine, San Diego, CA, USA.
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