Relationship between patient understanding and timeliness of penicillin prophylaxis in rheumatic heart disease prevention programmes in American Samoa.

Aim: While mostly eradicated in developed nations, rheumatic heart disease (RHD) is still the leading cause of preventable cardiovascular disease in children. RHD and its antecedent acute rheumatic fever remain endemic in many low to middle income countries, as well as in vulnerable communities in wealthy ones. Evidence-based interventions are particularly important in resource-poor settings.

Surgical Quality Predicts Length of Stay in Patients with Congenital Heart Disease.

Historically, the primary marker of quality for congenital cardiac surgery has been postoperative mortality. The purpose of this study was to determine whether additional markers (10 surgical metrics) independently predict length of stay (LOS), thereby providing specific targets for quality improvement. Ten metrics (unplanned ECMO, unplanned cardiac catheterization, revision of primary repair, delayed closure, mediastinitis, reexploration for bleeding, complete heart block, vocal cord paralysis, diaphragm paralysis, and change in preoperative diagnosis) were defined in 2008 and subsequently collected from 1024 consecutive index congenital cardiac cases, yielding 990 cases.

A defined management strategy improves early outcomes after the Fontan procedure: the PORTLAND protocol.

Background: Patients undergoing the Fontan procedure may have extended hospital stay due to various postoperative factors including prolonged chest tube drainage. Our aim was to determine the efficacy of our Fontan management protocol in reducing chest tube drainage and length of stay.

Methods: Patients who underwent a Fontan procedure at our institution from June 2008 to September 2013 were analyzed (n = 42).

Emergent use of extracorporeal membrane oxygenation during pediatric cardiac catheterization.

Objectives: The goal of this study was to evaluate the utility of extracorporeal membrane oxygenation (ECMO) to resuscitate patients following critical cardiac events in the catheterization laboratory.

Design: Retrospective review of medical records.

Setting: Cardiac intensive care unit and cardiac catheterization laboratory at a tertiary care children's hospital.

Management of coronary artery fistulae. Patient selection and results of transcatheter closure.

Objectives: We report short-term findings in 33 patients after transcatheter closure (TCC) of coronary artery fistulae (CAF) and compare our results with those reported in the recent transcatheter and surgical literature.

Background: Transcatheter closure of CAF has been advocated as a minimally invasive alternative to surgery.

Methods: We reviewed all patients presenting with significant CAF between January 1988 and August 2000.