Use of extracorporeal membrane oxygenation for adults in cardiac arrest (E-CPR): a meta-analysis of observational studies.

Published data on the use of extracorporeal membrane oxygenation (ECMO) as a supportive measure during or immediately after cardiopulmonary resuscitation (CPR) in adults (older than 18 years) shows mixed results. To assess the clinical outcomes of the use of ECMO in this modality and to look for predictors of mortality, we performed a meta-analysis (MA) of individual patients collected from observational studies. An electronic PubMed search restricted to English-language publications between 1990 and 2007, using a consensus restrictive criterion, retrieved 141 titles.

Berlin heart as a bridge to recovery for a failing Fontan.

We report the temporary use of a Berlin Heart ventricular assist device (Berlin Heart AG, Berlin, Germany) for cardiac support of an 18-month-old girl with rapidly progressive ventricular failure after completion of a fenestrated Fontan. After 6 months of cardiac assistance with a single pneumatic pump, catheterization data showed improvement of the ventricular function and the ventricular assist device was successfully removed. A follow-up echocardiogram 6 months after hospital discharge demonstrated marked improvement of ventricular function.

Development of an observational tool on computer use during rounds.

We present an observational tool to capture computer usage patterns during rounds to inform designs of information and communication technology to support clinical discourse during rounds. The tool captures choreography and logistics of information exchanges supported by clinical information systems during rounds. We developed the tool as part of an ongoing video-recording study of communication to under-stand how, when, and why computers are used during multidisciplinary clinical rounds.

Extracorporeal membrane oxygenation after cardiac arrest in children: what do we know?

The use of extracorporeal membrane oxygenation (ECMO) as a resuscitative measure during or after manual cardiopulmonary resuscitation (CPR) shows sharply contrasting results. To assess the added value of ECMO in this situation and looking for predictors of mortality we performed a meta-analysis of individual patients collected from observational studies. An electronic Pubmed search restricted to English language publications between 1990 and 2007 using a consensus restrictive criterion retrieved 462 titles.

Transient dynamic subaortic stenosis in premature neonates after patent ductus arteriosus ligation.

We describe 2 premature infants with PDA that did not respond to medical therapy and required surgical ligation. Both infants developed transient dynamic subaortic obstruction that resolved without specific therapy. This may have occurred due to sudden changes in the left ventricular volume.

A novel approach to tricuspid valve replacement: the upside down stentless aortic bioprosthesis.

Background: Tricuspid valve replacement (TVR) is a rarely needed operation. Choices between mechanical and biological prosthesis still generate controversy. We present our initial clinical experience with a stentless aortic root placed inverted in the tricuspid annulus.

Total right ventricular dependent coronary circulation in pulmonary atresia with intact ventricular septum.

This report describes the case of a full-term gestational female with a prenatal diagnosis of pulmonary atresia with intact ventricular septum. Cardiac ultrasound at birth confirmed the diagnosis with no evidence of coronary artery fistulas. The patient died 6 hours after a central aortic to pulmonary artery shunt had been created with bypass support.

Nonheparinized partial cardiopulmonary bypass for repair of traumatic aortic rupture.

Traumatic aortic rupture requires rapid, definitive repair for optimal outcome, particularly with respect to distal neurologic function. Over the past 10 years, the R Adams Cowley Shock Trauma Center of the University of Maryland has used partial cardiopulmonary bypass without systemic heparization exclusively for all repairs of the descending aorta. A heparin-bonded circuit allows for controlled distal perfusion and obviates the need for heparinization.

Management of traumatic aortic rupture: a 30-year experience.

Objective: To present the authors' 30-year experience with traumatic aortic rupture (TAR).

Summary Background Data: TAR is a highly lethal injury. Most institutions manage a small number of cases, and most surgeons receive only modest exposure during training.