Novel technique of monocuspid reconstruction of pulmonary valve in children requiring transannular patch for right ventricular outflow tract relief during tetralogy of Fallot surgery.

Unlabelled: Tetralogy of Fallot (TOF) repair involves the placement of a transannular patch (TAP) to relieve right ventricular outflow tract (RVOT) obstruction. TAP results in free pulmonary regurgitation (PR) after surgery. PR is responsible for most of the long-term complications in patients with operated TOF.

Preoperative Determinants of Outcomes of Infant Heart Surgery in a Limited-Resource Setting.

We studied the effect of preoperative determinants on early outcomes of 1028 consecutive infant heart operations in a limited-resource setting. Comprehensive data on pediatric heart surgery (January 2010-December 2012) were collected prospectively. Outcome measures included in-hospital mortality, prolonged ventilation (>48 hours), and bloodstream infection (BSI) after surgery.

Impact of the International Quality Improvement Collaborative on outcomes after congenital heart surgery: a single center experience in a developing economy.

Background: The International Quality Improvement Collaborative (IQIC) for Congenital Heart Surgery in Developing Countries was initiated to decrease mortality and major complications after congenital heart surgery in the developing world.

Objective: We sought to assess the impact of IQIC on postoperative outcomes after congenital heart surgery at our institution.

Methods: The key components of the IQIC program included creation of a robust worldwide database on key outcome measures and nurse education on quality driven best practices using telemedicine platforms.

Thymic artery: uncommon origin from proximal aortic arch or distal ascending aorta.

Internal thoracic and inferior thyroid arteries mainly supply the thymus. However, very few studies have been reported on the arterial variations of the thymus. The first author, a cardiac surgeon, happened upon a thymic artery arising from either proximal aortic arch or distal ascending aorta in a few cases during routine cardiac surgery in infants and neonates.

Off-pump atrial septostomy with thoracoscopic scissors under transesophageal echocardiography guidance.

Selected children with congenital heart defects undergoing palliative closed heart procedures require a cardiopulmonary bypass (CPB) run only for the purpose of creating an inter-atrial communication. We report a simple technique of atrial septostomy using thoracoscopy scissors under transesophageal echocardiography guidance without the need for CPB.

Elevated red cell distribution width is associated with delayed postoperative recovery after correction of Tetralogy of Fallot.

Objective: To study the impact of red cell distribution width (RDW) on postoperative recovery after correction of Tetralogy of Fallot (TOF).

Background: Increased RDW indicates dysregulated erythropoiesis and predicts survival in critical illnesses that include idiopathic pulmonary artery hypertension and chronic heart failure. Myocardial injury and oxidative stress induced by cardiopulmonary bypass potentially contribute to prolonged recovery in post TOF repair patients.

Tricuspid valve mycetoma in an infant successfully treated by excision and complex tricuspid valve repair followed by fluconazole therapy.

Background: Fungal valve endocarditis in children is an uncommon and lethal disease. The risk increases with use of central venous catheters (CVC), total parenteral nutrition (TPN), and use of broad-spectrum antibiotics during the neonatal period. Due to high mortality, a combination of surgery and antifungal therapy is usually recommended for treatment.

Mitral valve repair in infants and children.

A number of children are born with myxomatous deformity of the mitral valve, causing mitral regurgitation. Traditional techniques of repair may be daunting in these children because apart from their small size, their valves appear grossly deformed and the tissues are friable. Techniques to circumvent these problems and ensure a predictable and satisfactory outcome are described.