Impact of an open-chest extracorporeal membrane oxygenation model for in situ simulated team training: a pilot study.

Objectives: To develop an affordable realistic open-chest extracorporeal membrane oxygenation (ECMO) model for embedded in situ interprofessional crisis resource management training in emergency management of a post-cardiac surgery child.

Methods: An innovative attachment to a high-fidelity mannequin (Laerdal Simbaby) was used to enable a cardiac tamponade/ECMO standstill scenario. Two saline bags with blood dye were placed over the mannequin's chest.

Bartonella henselae endocarditis of percutaneously implanted pulmonary valve.

Percutaneous pulmonary valve implantation (PPVI) has revolutionized the management of right ventricular outflow tract dysfunction after repaired congenital heart disease. Although the technology is considered to be safe with a relatively low complication rate, infection is a described complication, with five cases of culture-positive infective endocarditis of percutaneously implanted pulmonary valve having been reported to date worldwide. Herein is reported the first ever case of culture-negative endocarditis following PPVI, caused by Bartonella henselae, diagnosed five years after implantation in a 15-year-old patient with a repaired truncus arteriosus.

Fenestration closure in a calcified ventricular septal defect patch.

Ventricular septal defect closure with a fenestrated patch is a recognized rescue maneuver to decrease the risk of right ventricular failure after complete repair in patients with pulmonary atresia. If the fenestration needs surgical closure, severe calcification of the patch may make it extremely difficult. We describe the closure of such a defect in a 6-year-old boy, using a double Dacron patch sandwich.

Bartonella henselae endocarditis of percutaneously implanted pulmonary valve: a case report.

Percutaneous pulmonary valve implantation (PPVI) has revolutionized the management of right ventricular outflow tract dysfunction after repaired congenital heart disease. The technology is considered to be safe, with a relatively low complication rate. Infection is one of the described complications of PPVI, and to date five cases of culture-positive infective endocarditis of percutaneously implanted pulmonary valve have been reported worldwide.

Impact of shunt type on growth of pulmonary arteries after norwood stage I procedure: current best available evidence.

The past decade has seen a substantial improvement in the outcome following surgical palliation for hypoplastic left heart syndrome. This has been attributed to modifications in the surgical as well as postoperative management strategies. One such modification is the reemergence of the right ventricle to pulmonary artery (RV-PA) shunt as an alternative to the modified Blalock-Taussig (mBT) shunt as the source of pulmonary blood flow.

Severe bronchomalacia treated by combination of Nuss procedure and aortopexy: an unusual therapy combination.

Aortopexy is the treatment of choice for clinically significant tracheobronchomalacia from external vascular compression. When a marked chest depression is present, aortopexy may be less effective. We report 2 patients with pectus excavatum and vascular compression of the trachea who, despite their young age, benefited from combined Nuss bar insertion and aortopexy.

In young patients with rheumatic aortic regurgitation compared to non-rheumatics is a Ross operation associated with increased incidence of autograft failure?

A best evidence topic in cardiac surgery was written, according to a structured protocol. The question addressed was: in young patients with rheumatic aortic regurgitation compared to non-rheumatics is a Ross operation associated with increased incidence of autograft failure? The pulmonary autograft with its inherent advantages of viable autologous transplant, central laminar flow, freedom from prosthetic valve complications, side effects of anticoagulation, and growth potential is considered a well-accepted option for aortic valve replacement in young patients. However, the use of a pulmonary autograft in young patients with rheumatic aortic valve disease is controversial.

In hypoplastic left heart patients is Sano shunt compared with modified Blalock-Taussig shunt associated with deleterious effects on ventricular performance?

A best evidence topic in congenital cardiac surgery was written according to a structured protocol. The question addressed was: in hypoplastic left heart patients is Sano shunt compared with modified Blalock-Taussig (mBT) shunt associated with deleterious effects on ventricular performance? Sano shunt modification of Norwood procedure involves construction of a right ventricle to pulmonary artery (RV-PA) conduit as an alternative source of pulmonary blood flow. Compared with the mBT shunt, the RV-PA conduit provides a more stable haemodynamic state in the immediate postoperative period and is reported to be associated with lower interstage mortality.