Transcatheter Closure of Atrial Septal Defects using the GORE(®) Septal Occluder in Children Less Than 10 kg of Body Weight.

The GORE(®) Septal Occluder (GSO) is a well-evaluated device for interventional ASD closure with closure rates comparable to the Amplatzer(®) Septal Occluder (ASO), but there are no published reports of its use in small children weighing less than 10 kg. This may be due to the necessity of a large-sized introducing sheath of at least 10 Fr and therefore the assumed risk of complications in vascular access. The GSO is an alternative option for interventional ASD closure in children weighing less than 10 kg.

Intra- or extracardiac Fontan operation? A simple strategy when to do what.

Introduction: The complete Fontan circulation is the definite palliation for many complex congenital cardiac lesions. After bi-directional Glenn anastomosis (BDG), two well-established techniques - intracardiac tunneling and extracardiac prosthesis - are available for completion, although the choice of technique is still a matter of debate.

Material And Methods: We retrospectively reviewed the surgical and clinical records of patients with single ventricle physiology, who underwent intracardiac (group I) or extracardiac (group II) Fontan palliation after BDG.

Continuous regional myocardial blood flow measurement: validation of a near-infrared laser Doppler device in a porcine model.

Objective: RMBF measurement is a major concern in various clinical and experimental settings, but no validated device for RMBF is currently available.

Methods:   An LVP-triggered laser Doppler to measure RMBF was validated by simultaneous fluorescent MS RMBF in a porcine LAD flow reduction model (n = 10 pigs). The laser probe was positioned on the left ventricle's anterior wall.

Mid-term results of a modified arterial switch operation using the direct reconstruction technique of the pulmonary artery.

Background: There is ongoing discussion as to whether it is beneficial to avoid pulmonary sinus augmentation in the arterial switch operation. We report a single-surgeon series of mid-term results for direct pulmonary artery anastomosis during switch operation for transposition of the great arteries (TGA).

Methods: This retrospective study includes 17 patients with TGA, combined with an atrial septal defect, patent foramen ovale or ventricular septal defect.

Significance of patient categorization for perioperative management of children with tetralogy of Fallot, with special regard to co-existing malformations.

Background: The aim of our study was to facilitate perioperative calculation of potential risk factors on the outcome of corrective surgery for children with tetralogy of Fallot.

Methods: The medical records of 81 (44 female and 37 male) out of a total of 87 patients undergoing complete surgical repair of tetralogy of Fallot between 1988 and 2004 at the Children's Hospital of the Johannes Gutenberg University of Mainz were reviewed. PATIENTS were divided into four categories, depending on the severity of pulmonary stenosis and cyanosis, as well as on the type of pulmonary circulation.

Cardiac myxomas: short- and long-term follow-up.

Background: Cardiac myxomas are the most frequently encountered benign intracardiac tumors, that, if left untreated, are inexorably progressive and potentially fatal. Patients with cardiac myxoma can be treated only by surgical removal. This study summarizes our experience over 22 years with these tumors.

Surgical treatment of aortic coarctation in adults: Beneficial effect on arterial hypertension.

Background: The aim of this study was to determine the outcome after surgical repair of aortic coarctation in adults, analysing its effect on arterial blood pressure.

Methods: Twenty-five adults (9 women, 16 men), mean age 43.4 years (19 to 70 years), underwent aortic coarctation surgical repair.

Anomalous origin of the left coronary artery from the pulmonary artery: mid-term results after surgical correction.

Objectives: Children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) are at risk for myocardial infarction and death. This retrospective study shows the mid-term follow-up after the use of aortic implantation and alternative methods to achieve coronary transfer.

Methods: Since 1990 seven consecutive children underwent primary repair of ALCAPA.

[Development of the Fontan procedure as therapeutic concept for children with complex congenital heart disease].

The spectrum of congenital heart defects reaches from very simple to extremely complex anomalies. 3 decades earlier, the prognosis of children with univentricular heart defects was poor. The Fontan procedure has been offered to patients with a variety of complex cyanotic heart diseases and has resulted in decreased mortality.

Late results after PTCA for coronary stenosis after the arterial switch procedure for transposition of the great arteries.

Background: The arterial switch operation has become the surgical approach of choice for d-transposition of the great arteries, but there is an increased awareness of adverse sequelae in some survivors. Long-term patency and normal function of the translocated coronary arteries must be achieved. It is reported that dependent of the prior coronary status, 3% to 11% of all survivors have proximal coronary stenosis or complete occlusion develop after arterial switch operations.

Aortic valve papillary fibroelastoma.

Cardiac papillary fibroelastoma (CPF) is a rare primary benign cardiac tumor. Before the use of echocardiography, the lesion was identified at autopsy or incidentally during cardiac surgery. CPF is the third most common primary cardiac tumor after atrial myxoma and lipoma, and is the most common tumor of the valvular endothelium.

Assessment of chronic aortic dissection: contribution of different ECG-gated breath-hold MRI techniques.

Objective: Our objective was to evaluate the impact of different rapid MRI techniques for the assessment and follow-up of chronic aortic dissections.

Materials And Methods: Fifty-three patients (41 postoperative Stanford type A, 12 type B dissections) were scanned at 1.5 T during a 3-year period.

Gene expression profiling of human stenotic aorto-coronary bypass grafts by cDNA array analysis.

Objective: Aorto-coronary bypass graft disease with its increasing clinical signification represents an unsolved problem in cardiological and heart surgery practice. Late occlusion of autologous saphenous vein grafts is due to medial and neointimal thickening secondary to migration and proliferation of smooth muscle cells (SMCs) and the subsequent formation of atherosclerotic plaques. This study is aimed at identifying differentially expressed genes in human stenotic bypass grafts to detect unknown pathomechanism and to identify novel targets for prophylactic treatment options.

Changes in lymphocyte subsets after cardiac surgery in children.

Unlabelled: Children undergoing cardiopulmonary bypass (CPB) operations have an increased risk of developing severe infections. Impairment of the immune system may contribute to the development of sequelae such as capillary leaks, pulmonary dysfunction and auto-immune reactions. The objective of this study was to investigate the impact of cardiac surgery with CPB on the immune system of infants and young children.