Assessment of Suspected Vascular Rings and Slings and/or Airway Pathologies Using Magnetic Resonance Imaging Rather Than Computed Tomography.

Background: Congenital cardiovascular malformations (CCVM) may cause infrequently airway pathologies (AP) in children and are of prognostic and therapeutic relevance. While computed tomography (CT) is considered first-line imaging modality in many centres, we started using magnetic resonance imaging (MRI) more and more in the last years to detect CCVM and AP to avoid radiation in this patient group.

Objective: The aim of this retrospective study was to determine and to compare the diagnostic accuracy of CT and MRI when used to detect CCVM and/or AP.

Fibromuscular dysplasia of the coronary arteries: a rare cause of death in infants and young children.

Fibromuscular dysplasia is a common vascular disease, which mainly affects the renal arteries. In this study, we report the case of a 1-day-old infant who presented with severe left ventricular dysfunction immediately after birth, and subsequently died 3 days postnatally. At autopsy, an extensive myocardial infarction of the left ventricle and the septum was found, caused by an isolated fibromuscular dysplasia of left coronary artery.

Perioperative management of a child with glutaric aciduria type I undergoing cardiac surgery.

Patients with glutaric aciduria type I are at risk for acute striatal injury precipitated by catabolic stress. Here, we report the successful interdisciplinary anesthetic and perioperative management of a child with glutaric aciduria type I undergoing cardiac surgery with extracorporeal circulation. Given the central focus on prevention of acute striatal injury, our anesthetic strategy emphasized avoiding a high protein load, high-dose inotropics, especially epinephrine (associated with impaired glucose utilization), deliberate hyperventilation, and other interventions associated with systemic inflammatory response.

Extracorporeal life support with an integrated left ventricular vent in children with a low cardiac output.

Background: The aim of this study was to evaluate our experience in central extracorporeal life support with an integrated left ventricular vent in children with cardiac failure.

Methods: Eight children acquired extracorporeal life support with a left ventricular vent, either after cardiac surgery (n = 4) or during an acute cardiac illness (n = 4). The ascending aorta and right atrium were cannulated.

Comparison of inhaled nitric oxide with aerosolized iloprost for treatment of pulmonary hypertension in children after cardiopulmonary bypass surgery.

Objectives: Pilot study to compare the effect of inhaled nitric oxide (iNO) and aerosolized iloprost in preventing perioperative pulmonary hypertensive crises (PHTCs).

Background: Guidelines recommend the use of iNO to treat PHTCs, but treatment with iNO is not an ideal vasodilator. Aerosolized iloprost may be a possible alternative to iNO in this setting.

Long-term outcome after external tracheal stabilization due to congenital tracheal instability.

Background: Long-segment tracheobronchial malacia may cause life-threatening dysfunction of the airway system at different levels. This study presents the long-term follow-up (1992 through 2008) of patients who received surgical treatment with external tracheal stabilization in our institution.

Methods: Eleven patients fulfilled the inclusion criteria.

The evolution of the pulmonary arterial sling syndrome, with particular reference to the need for reoperations because of untreated tracheal stenosis.

Background: We present a group of infants and children with pulmonary arterial sling and tracheal stenosis. In some of the patients, the anomalously located pulmonary artery had previously been reimplanted, but without simultaneous repair of the trachea.

Methods: From 1992 to 2007, we reimplanted the left pulmonary artery in 13 children with a pulmonary arterial sling.

Modified sliding tracheal plasty using the bridging bronchus for repair of long-segment tracheal stenosis.

A child with severe respiratory distress, previously operated on at age 4 months for pulmonary sling and atrial septal defect, underwent reoperation at age 4 years because of long-segment congenital tracheal stenosis complicated by an abnormal branching of the trachea-bridging bronchus. We review the anatomy of that rare pathomorphology and describe a slide tracheoplasty that uses the bridging bronchus for treatment of this complex anomaly.

Varicella-related deaths in children and adolescents--Germany 2003-2004.

Aim: Although varicella is acknowledged as a rare cause of death in children, there are few comprehensive data with respect to the clinical course leading to death.

Methods: A nationwide, active surveillance was carried out in Germany for children up to age 17 years who were admitted to a paediatric hospital for varicella or associated complications, including deaths.

Results: A total of 10 children with varicella-associated death were reported over period of 2 years, yielding a mortality rate of 0.

Replacement of valved right ventricular to pulmonary artery conduits: an observational study with focus on right ventricular geometry.

Objective: Timing of the operation for exchange of right ventricular (RV) to pulmonary artery (PA) conduits is a matter of considerable debate. We aimed to study the course of right ventricular dimension in patients undergoing conduit exchange.

Patients And Methods: We retrospectively studied all patients who underwent implantation and or replacement of RV/PA conduits during the time period between 1990 and 2005.

Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants.

Objective: The present article aims to describe our experience with patients who underwent simultaneous repair of congenital tracheal stenosis and cardiac anomalies.

Methods: Between January 2000 and December 2003, 9 infants underwent simultaneous surgical repair of a congenital tracheal stenosis and congenital heart disease. The intraoperative findings revealed localized tracheal stenosis in 3 patients.

A case of pulmonary artery sling associated with long-segment funnel trachea and bronchus suis.

An infant with pulmonary sling syndrome associated with an abnormal branching of the trachea, bronchus suis, complicated by long segment intrathoracic tracheal stenosis (ie, "funnel trachea") and concomitant tracheomalacia underwent reoperation at 5 months of age. We review the anatomy of this rare entity and describe the surgical technique to avoid the residual stenosis.