Factors associated with perioperative mortality in children and adolescents operated for tetralogy of Fallot: A sub-Saharan experience.

Background: Patients with tetralogy of Fallot are now surviving to adulthood with timely surgical intervention. However, many patients in low-income countries have no access to surgical intervention. This paper reports the surgical access and perioperative mortality in a sub-Saharan center that was mainly dependent on visiting teams.

Outcome in Children Operated for Membranous Subaortic Stenosis: Membrane Resection Plus Aggressive Septal Myectomy Versus Membrane Resection Alone.

Background: The optimal surgical procedure for treatment of fibromembranous subaortic stenosis has been a subject of debate. We report our experience with patients treated for membranous subaortic stenosis using membrane resection alone and membrane resection plus aggressive septal myectomy.

Methods: Patients followed in the pediatric cardiology clinic of a university hospital, who had undergone surgery for subaortic stenosis between 2002 and 2013 were reviewed.

Pulmonary artery aneurysm with patent arterial duct: resection of aneurysm and ductal division.

Congenital or acquired aneurysm of the pulmonary artery (PA) is rare. Although aneurysms are described following surgical treatment of patent ductus arteriosus (PDA), occurrence of this lesion in association with PDA without previous surgery is extremely uncommon. An eight-year-old patient with PDA and aneurysm of the main PA is described in this report.

The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes.

Breakfast skipping is associated with obesity and an increased risk of type 2 diabetes. Later chronotypes, individuals who have a preference for later bed and wake times, often skip breakfast. The aim of the study was to explore the relationships among breakfast skipping, chronotype, and glycemic control in type 2 diabetes patients.

Chronotype is independently associated with glycemic control in type 2 diabetes.

Objective: To examine whether chronotype and daily caloric distribution are associated with glycemic control in patients with type 2 diabetes independently of sleep disturbances.

Research Design And Methods: Patients with type 2 diabetes had a structured interview and completed questionnaires to collect information on diabetes history and habitual sleep duration, quality, and timing. Shift workers were excluded.

Successful treatment of plastic bronchitis with low fat diet and subsequent thoracic duct ligation in child with fontan physiology.

Plastic bronchitis is a rare condition characterized by the formation and expectoration of long, branching bronchial casts that develop in the tracheobronchial tree and cause airway obstruction. Plastic bronchitis has become increasingly recognized as a feared complication of the Fontan operation with a mortality of up to 50%. We report an 11 year old boy who developed severe plastic bronchitis following Fontan repair and the successful long-term control of cast formation utilizing a low-fat diet and subsequent thoracic duct ligation.

Straightened sternal wire causes iatrogenic pectus carinatum after cardiac surgery.

Pectus carinatum is a protrusion deformity of the anterior chest wall that is most likely caused by a disproportionate growth of the costal cartilages compared with the remainder of the thoracic skeleton. A young boy had previously undergone corrective congenital heart operation, after which a prominent sternal protrusion was noted. During the past year, the protrusion had greatly increased in size and had become recurrently infected.

Improved current era outcomes in patients with heterotaxy syndromes.

Objective: Patients with heterotaxy syndrome have a myriad of visceral and cardiac malformations historically resulting in significant morbidity and mortality. We sought to assess whether current era management strategies have improved outcomes in patients with visceral heterotaxy.

Methods: A retrospective review (1994-2008) of our database identified 45 consecutive heterotaxy patients who underwent surgical palliation.

Third-degree burns due to intraoperative use of a Bair Hugger warming device.

We report the case of a 3-year-old boy who underwent correction of transposition of the great arteries who developed burns from use of a patient warming device. His repair had been delayed because he was from a developing country, and he was offered surgery as part of a humanitarian effort. Postoperatively he was noted to have second- and third-degree burns from use of a Bair Hugger (Augustine Medical, Eden Prairie, MN) warming system after cardiopulmonary bypass.

Effect of variations in pressure and flow on the geometry of isolated canine carotid arteries.

A study is described in which the effects of hemodynamics on arterial geometry are investigated in vitro. A novel perfusion apparatus is employed to deliver pulsatile flow through excised canine carotid arteries under carefully controlled conditions. Data of perfused vessel diameter and arterial wall thickness are derived from the radial displacement of the pulsating vessel as measured using a scanning laser micrometer whose accuracy is determined to be 0.

Experimental determination of mechanical shear stress about an anastomotic junction.

The present study is undertaken to determine whether the elastic tube model originally developed by Kuchar and Ostrach (Biomedical Fluid Mechanics Symposium, pp. 45-69, 1966) accurately provides a first approximation of the biomechanics of the anastomotic junction. The experimental protocol involves the use of canine carotid arteries as the host vessel and several graft materials including autogenous and prosthetic substitutes.

Characterization in vitro of the biomechanical properties of anastomosed host artery-graft combinations.

An in vitro investigation is described in which the biomechanical properties of several host artery-graft combinations are characterized under realistic hemodynamic environments. Canine carotid arteries served as the host vessel and were anastomosed to one of the following graft materials: 4 mm I.D.

Streptokinase in the treatment of subclavian vein thrombosis.

During the past 2 years, streptokinase has been used to treat subclavian or axillary vein thrombosis in seven patients of whom two were considered "effort" thromboses and five resulted from use of a central venous catheter. All patients had venography performed before treatment to document the thrombosis, and venography was repeated after streptokinase therapy to determine the status of clot dissolution. Streptokinase was given either systemically or in a lowered dose locally, with low-dose therapy chosen whenever a catheter could be threaded up to the clot through an antecubital vein.

Use of autoperfusion for distant procurement of heart-lung allografts.

Heart-lung transplantation has been limited to on-site organ procurement because current methods of lung preservation are unreliable for periods in excess of one hour. A method of dynamic heart-lung preservation has been evaluated as a possible means for distant procurement for human transplantation. Canine and bovine heart-lung blocks were removed and preserved by autoperfusion for periods of two to nine hours.