Publications by authors named "C Degroff"
Purpose: High takeoff of the right coronary artery suspected by echocardiography is widely considered a normal variant. However, in our experience, some patients initially thought to have a high takeoff of the coronary artery were later found to have an anomalous coronary origin with high-risk features. The aim of this study was to test the hypothesis that high takeoff of the right coronary artery suspected by echocardiography may indicate the presence of an anomalous coronary artery lesion with an intramural course requiring further investigation.
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- * The overall one-year mortality rate for the cohort was 9%, with different operative mortality rates and outcomes observed across the three pathways: standard risk (2.6%), high-risk noncardiac (10%), and high-risk cardiac with advanced support.
- * The findings suggest that a tailored management approach can lead to favorable outcomes, particularly in high-risk patients, with a considerable number successfully undergoing cardiac transplantation and surviving beyond one year.
In adults, arterial stiffness has been linked to the development of target end-organ damage, thought to be related to abnormal transmission of pulse pressure. Increased arterial stiffness and endothelial dysfunction have been hypothesized to contribute to the development of microvascular dysfunction and coronary allograft vasculopathy (CAV), an important comorbidity after heart transplantation. However, little data exists regarding arterial stiffness in pediatric heart transplantation and its influence on development of coronary allograft vasculopathy is not well understood.
View Article and Find Full Text PDFA Comprehensive Approach to the Management of Patients With HLHS and Related Malformations: An Analysis of 83 Patients (2015-2021).
World J Pediatr Congenit Heart Surg
September 2022
Article Synopsis
- - Patients with hypoplastic left heart syndrome (HLHS) have high risks during Norwood palliation, prompting a specialized management strategy to improve survival and heart donor usage; this study reviews outcomes of 83 neonates and infants treated from 2015 to 2021.
- - Standard-risk patients primarily received Norwood palliation, while high-risk patients were treated with a Hybrid Stage 1 approach—some combined with ventricular assist devices (VAD)—to optimize their chances for eventual heart transplantation.
- - The one-year survival rate was 90.4%; most standard-risk patients survived and progressed to further surgical stages, while a significant number of high-risk patients also successfully transitioned to transplantation, underscoring the effectiveness of this comprehensive management
The Fontan procedure is the final stage in the palliative surgical approach to patients with single-ventricle physiology. These patients have an increased risk for thromboembolic disease in the Fontan circuit, which can be evaluated by chest computed tomography angiography (CTA) in acute settings. However, false-positive results are common secondary to unusual streaming patterns in the Fontan circuit.
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