[Coarctation of the aorta: 40-year follow-up after surgical repair--secondary publication].

Coarctation of the aorta (CoA) was previously considered cured after surgical repair. Among 229 patients operated for CoA in Aarhus between 1965 and 1985, 14 died at surgery and 35 died during 20-40 years of follow-up, mainly due to cardiovascular disease. The mortality among CoA patients was 4.

Surgical simulation--a new tool to evaluate surgical incisions in congenital heart disease?

We introduce a new concept for preoperative planning and surgical education in congenital heart disease: surgical simulation. Recent advances in three-dimensional image acquisition have provided a new means to virtually reconstruct accurate morphological models while computer visualisation hardware now allows simulation of elastic tissue deformations interactively. Incision simulation is performed in two patients with complex congenital heart disease to preoperatively evaluate potential corrective surgical strategies.

Medium-term follow-up of mechanical valves inserted in children.

Objective: We reviewed our experience with mechanical valves inserted between 1988 and 2002 in children aged 15 years or younger.

Methods: Hospital files were extracted retrospectively. Follow-up was completed by March 2005.

Surgical repair of coarctation of the aorta: up to 40 years of follow-up.

Objective: Coarctation of the aorta (CoA) was previously considered cured after surgical repair. Evidence for excess mortality and late morbidity has later accumulated, although studies with long-term follow-up remain sparse. The aim was to identify patients operated for CoA at Aarhus University Hospital, Denmark between 1965 and 1985 and to assess surgical and late mortality and cardiovascular morbidity in this cohort and possible predictors for an adverse outcome.

[Risk adjustment for surgery of congenital heart disease--secondary publication].

Risk adjustment for specialties covering many diagnoses is difficult. The Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) was created to compare the in-hospital mortality rate of groups of children undergoing surgery for congenital heart disease. We applied the classification to the operations performed at Skejby Sygehus (1996-2002) and found that RACHS-1 can be used to predict the in-hospital mortality rate and length of stay in the intensive care unit in a Danish center for congenital heart surgery.

The RACHS-1 risk categories reflect mortality and length of stay in a Danish population of children operated for congenital heart disease.

Objective: The Risk Adjusted classification for Congenital Heart Surgery (RACHS-1) was created in order to compare in-hospital mortality for groups of children undergoing surgery for congenital heart disease. The method was evaluated with two large multi-institutional data sets-the Paediatric Cardiac Care Consortium (PCCC) and Hospital Discharge (HD) data from three states in the USA. The RACHS-1 classification was later applied to a large German paediatric cardiac surgery population in Bad Oeynhausen (BO), where it was found that the RACHS-1 categories were also associated with length of stay.

Oral anticoagulation therapy in children: successfully controlled by self-management.

Background: Children with congenital heart disease and who are on oral anticoagulation therapy present special challenges due to, for example, rapid fluctuations in international normalized ratio (INR) values, interruption in daily life due to frequent hospital/doctor visits, and difficulties and pain to the child in the performance of venipuncture. We hypothesize that oral anticoagulation therapy can be successfully controlled by self-management for this subset of patients. The aim of this study was to assess the treatment quality of self-managed oral anticoagulation therapy as the proportion of time within the therapeutic INR target range in children with congenital heart disease.

Visualization of morphological details in congenitally malformed hearts: virtual three-dimensional reconstruction from magnetic resonance imaging.

In recent years, three-dimensional imaging has provided new opportunities for visualizing congenital cardiac malformations. We present the initial clinical experience using a recently implemented system, which employs some of new interactive, real-time, techniques. We show how three-dimensional rendering based on magnetic resonance imaging can provide detailed spatial information on both intrinsic and extrinsic cardiac relations, and hence how a virtual examination can potentially provide new means to a better understanding of complex congenital cardiac malformations.