Lower mini-sternotomy in congenital heart disease: just a cosmetic improvement?

Objectives: Lower mini-sternotomy represents a minimally invasive surgical technique that has been utilized for the repair of a wide variety of congenital heart defects with excellent surgical and cosmetic outcomes. However, clinical improvements provided for this technique beyond cosmetic results are controversial. The aim of our study is to report our results with lower mini-sternotomy for the repair of congenital heart malformations and compare them with a matched group with a full median sternotomy approach.

The safety and efficacy of antifibrinolytic therapy in neonatal cardiac surgery.

Background: Neonates undergoing open-heart surgery are particularly at risk of postoperative bleeding requiring blood transfusion. Aprotinin has attained high efficacy in reducing the requirement for a blood transfusion following a cardiopulmonary bypass, but is seldom studied in the neonatal age group. The aim of this study was to compare the efficacy and adverse effects of aprotinin and tranexamic acid in neonates undergoing open-heart surgery at a single centre.

Hantavirus pulmonary syndrome, Southern Chile, 1995-2012.

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995-2012.

Case fatality rate and associated factors in patients with 22q11 microdeletion syndrome: a retrospective cohort study.

Objective: Chromosome 22q11.2 deletion is the most commonly occurring known microdeletion syndrome. Deaths related to the syndrome have been reported, but the magnitude of death has not been quantified.

Mechanisms of tricuspid regurgitation in patients with hypoplastic left heart syndrome undergoing tricuspid valvuloplasty.

Objectives: Tricuspid regurgitation (TR) remains a risk factor for morbidity and mortality through staged palliation in patients with hypoplastic left heart syndrome (HLHS). Reports on the mechanisms associated with TR in patients with HLHS are limited. Thus, we sought to describe our experience with tricuspid valve (TV) repair in these patients, focusing on the mechanisms of TR and corresponding surgical techniques.

Outcomes of adolescents and adults undergoing primary Fontan procedure.

Patients who have undergone the Fontan procedure in later adolescence and adulthood represent a unique population at risk for significant morbidity and mortality. The optimal strategy for long-term management of such patients is unknown. The aim of this study was to evaluate outcomes of patients who had undergone Fontan surgery later in life, focusing on late survivorship, mode of death, and predictors of mortality.

Valve-sparing tetralogy of Fallot repair with intraoperative dilation of the pulmonary valve.

Deleterious long-term effects of pulmonary regurgitation after tetralogy of Fallot (TOF) repair have become evident during the last two decades. Subsequently, different groups have developed strategies aimed at preserving the pulmonary valve function. However, the results of these approaches are not well known.

Novel microfluidic platform for automated lab-on-chip testing of hypercoagulability panel.

Current methods for hypercoagulability panel testing require large blood volumes and long turn-around testing times. A novel microfluidic platform has been designed to perform automated multiplexed hypercoagulability panel testing at near patient, utilizing only a single droplet of blood sample. We test the hypothesis that this novel platform could be utilized to perform specific multiplexed ELISA-based hypercoagulability panel testing for antithrombin III, protein C, protein S and factor VIII antigens, as well as anticardiolipin/human anti-β2-glycoprotein-1 IgG antibodies--on blood samples.

Right ventricular papillary muscle approximation as a novel technique of valve repair for functional tricuspid regurgitation in an ex vivo porcine model.

Objectives: Annuloplasty for functional tricuspid regurgitation may sometimes be ineffective because of chamber dilation and valve tethering. This study compared a novel technique, right ventricle (RV)-papillary muscle approximation, with annuloplasty in experimentally-produced tricuspid regurgitation.

Methods: RVs of isolated porcine hearts (n = 10) were statically pressurized, which led to RV dilation and central tricuspid regurgitation.

Changes in left atrioventricular valve geometry after surgical repair of complete atrioventricular canal.

Objective: The most common reason for late surgical reintervention after repair of complete atrioventricular canal defects is the development of left atrioventricular valve regurgitation. We sought to determine the changes in left atrioventricular valve geometry after surgical repair that may predispose to regurgitation.

Methods: Atrioventricular valve measurements were obtained by 2-dimensional echocardiography at 3 different time points (preoperative, early postoperative, and midterm postoperative [6-12 months]).

Right ventricle and tricuspid valve function at midterm after the Fontan operation for hypoplastic left heart syndrome: impact of shunt type.

This study aimed to evaluate clinical outcomes including hemodynamics, right ventricle (RV) function, and tricuspid valve (TV) function in patients with hypoplastic left heart syndrome (HLHS) at midterm after completion of staged palliation based on the source of pulmonary blood flow provided at stage 1. The records of all patients with HLHS who completed Fontan palliation between 2001 and 2007 were retrospectively reviewed. The outcome variables were RV dysfunction, TV, and neo-atrioventricular (neo-AV) regurgitation (from latest echocardiogram), cardiac index (CI), pulmonary vascular resistance (PVR), pulmonary artery pressure (PAp), and right ventricular end-diastolic pressure (RVEDp) (from latest catheterization).

Evaluating failing Fontans for heart transplantation: predictors of death.

Background: Late complications of the Fontan operation represent a significant management challenge. Failing Fontan patients have two modes of presentation: impaired ventricular function (IVF) and those with preserved ventricular function (PVF) but with failing Fontan physiology (protein-losing enteropathy [PLE] and plastic bronchitis [PB]). This study evaluated whether failing Fontan patients referred for heart transplantation had a different outcome based on the mode of presentation.

Stereoscopic vision display technology in real-time three-dimensional echocardiography-guided intracardiac beating-heart surgery.

Objective: Stereoscopic vision display technology has been shown to be a useful tool in image-guided surgical interventions. However, the concept has not been applied to 3-dimensional echocardiography-guided cardiac procedures. We evaluated stereoscopic vision display as an aid for intracardiac navigation during 3-dimensional echocardiography-guided beating-heart surgery in a model of atrial septal defect closure.

Measuring emotion in the voice during psychotherapy interventions: a pilot study.

The voice as a representation of the psychic world of patients in psychotherapeutic interventions has not been studied thoroughly. To explore speech prosody in relation to the emotional content of words, voices recorded during a semi-structured interview were analyzed. The subjects had been classified according to their childhood emotional experiences with caregivers and their different attachment representations.

A proposal for a new tibial guide system for posterior cruciate ligament reconstruction.

Posterior cruciate ligament reconstruction is always a challenge to the orthopaedic surgeon. It is difficult when the anterior cruciate ligament (ACL) is intact. We propose a new guide system through the posteromedial portal, avoiding ACL damage.