Effectiveness of home care for fever treatment in older people: A case-control study compared with hospitalized care.

Aim: To examine whether the outcomes of fever treatment through home care differ from those through hospitalized care for older people who regularly receive home care in Japan.

Methods: A retrospective survey of medical record-based data for 679 older people who regularly received home care provided by a clinic in Japan. From these data, 61 fever cases (21 cases treated in the hospital and 40 treated at home and assigned to the hospitalized and home-care groups, respectively) were selected for analysis through a matching process.

Outcomes of swing-back aortic arch repair in arterial switch and Norwood operations.

The outcomes of the swing-back technique for aortic arch repair during the arterial switch and Norwood operations are not well reported. Between May 2004 and January 2011, we performed this technique during the arterial switch and Norwood operations in 2 and 4 patients, respectively. The median (range) patient age and body weight were 17 (12-147) days and 3.

[Successful application of cholangioscope as an intravascular endoscope in hybrid operation for a child].

We performed hybrid operation on a 3-year-old boy with thrombosis in the pulmonary arterial conduit which had been implanted concomitantly at the time of Fontan operation. We used a cholangioscope as a substitute of intravascular endoscope. It visualized the organized thrombus and the suture line in the conduit.

Second-Stage Palliation After Bilateral Pulmonary Artery Bands for HLHS and its Variants--Which is Better, Modified Norwood or Norwood Plus Bidirectional Glenn?

Background. The purpose of this study was to evaluate the surgical outcomes and pulmonary artery (PA) development associated with a new strategy wherein the modified Norwood (N) procedure is performed at 1-2 months after bilateral pulmonary artery banding (PAB). Methods.

Rapid two-stage Starnes procedure for a symptomatic neonate with Ebstein anomaly.

We present a rapid two-stage Starnes procedure for a seriously symptomatic neonate with the prenatal diagnosis of Ebstein anomaly. At 16 hours after birth, we performed an emergency operation consisting of main pulmonary artery ligation, plication of the right atrial and right ventricular wall, modified Blalock-Taussig shunt, and patent ductus arteriosus ligation, without cardiopulmonary bypass. At age 12 days, we then performed the Starnes procedure using a glutaraldehyde-treated autologous pericardial patch with a 4-mm fenestration to close the tricuspid valve orifice.

Pulmonary artery banding for functionally single ventricles: impact of tighter banding in staged Fontan era.

Background: In this study, we assessed our surgical strategy, tighter pulmonary artery banding (PAB) during the neonatal period, as an initial step followed by early application of bidirectional cavopulmonary shunts (BCPS) in infancy, to treat functionally single ventricles with unobstructed pulmonary blood flow.

Methods: On the basis of our surgical strategy, 68 consecutive patients underwent PAB and were divided into two groups, group 1 (January 1990 to June 2003; n = 30) and group 2 (July 2003 to August 2008; n = 38). The median age at PAB was 45 days in group 1 and 9 days in group 2.

Surgical treatment of an infant with myocardial ischemia due to an anomalous origin of the right coronary artery from the main pulmonary artery: report of a case.

An anomalous origin of the right coronary artery from the main pulmonary artery (ARCAPA) is a rare cardiac malformation, and only three cases of isolated ARCAPA in patients younger than 2 years of age have been reported. This report describes the surgical treatment of a 12-month-old girl with myocardial ischemia due to ARCAPA. The diagnosis was made by echocardiography.

A symptomatic neonate with tetralogy of Fallot, an absent pulmonary valve, and a single coronary artery with a major fistula.

We present a case with a rare combination of tetralogy of Fallot with an absent pulmonary valve, and a single coronary artery with a major fistula to the main pulmonary artery. Myocardial ischemia developed in response to increasing shunt flow through the coronary fistula, resulting in heart failure. We ligated the coronary fistula and plicated the anterior wall of the dilated pulmonary arteries during the neonatal period.

Bland-White-Garland syndrome with ventricular septal defect: late presentation.

Bland-White-Garland syndrome has been reported generally to occur in an isolated lesion. Here, we report a case of Bland-White-Garland syndrome associated with a ventricular septal defect. Late onset of myocardial ischemia was noted in this patient, which we think is related to increased coronary steal due to regression of pulmonary hypertension caused by narrowing of the ventricular septal defect.

Staged surgical approach in neonates with a functionally single ventricle and arch obstruction: pulmonary artery banding and aortic arch reconstruction before placement of a bidirectional cavopulmonary shunt in infants.

The success rate of right-heart bypass surgery in patients with a functionally single ventricle (f-SV) and systemic obstruction is low. In patients with a high risk of subaortic stenosis, we performed an initial step of pulmonary artery banding (PAB) and arch reconstruction before placing a bidirectional cavopulmonary shunt (BCPS) in infants with or without Damus-Kaye-Stansel (DKS) anastomosis. We assessed the success of right-heart bypass surgery.

Impact of 3-mm Blalock-Taussig shunt in neonates and infants with a functionally single ventricle.

Functionally single ventricle (f-SV) is susceptible to volume overload. Atrioventricular valve regurgitation (AVVR) tends to develop and ventricular function deteriorates due to excessive pulmonary blood flow following modified Blalock-Taussig shunt (mBTS). On the other hand, a small caliber graft has risks of early obstruction and poor growth of pulmonary vascular beds.

Long-term results of Konno procedure for complex left ventricular outflow tract obstruction.

Objective: The current study aims to evaluate the long-term outcomes of the Konno procedure.

Methods: The clinical records of 63 patients who had undergone the Konno procedure between February 1984 and March 2007 were reviewed. During this period, the Ross procedure was introduced in 1996.

[Novel coronary transfer technique for transposition of the great arteries with Planché type II coronary anatomy].

The arterial switch operation has evolved to become the treatment of choice for most of transposition of the great arteries and some types of double outlet right ventricle. Technical improvement in the coronary transfer is the major contribution to the evolution of this procedure. We proposed a novel technique of coronary transfer for the patients with rare but difficult coronary anatomy of Planché type II.

Successful application of pulmonary arterial patch for coronary angioplasty late after arterial switch operation.

Pulmonary artery is infrequently utilized as a material for coronary patch angioplasty in children. We applied a pulmonary arterial patch for coronary angioplasty on an 8-year-old boy with total occlusion of the left main coronary artery late after an arterial switch operation. The pulmonary arterial patch was easy to handle and the immediate result after the operation was satisfactory.

Konno procedure using atrioventricular groove patch plasty after arterial switch operation.

A patient with transposition of the great arteries accompanied by Shaher type 9 coronary anatomy experienced the development of progressive neoaortic valvular regurgitation with a small annulus, supravalvular stenosis, and neopulmonary valvular and supravalvular stenoses 15 years after an arterial switch operation. To implant a prosthetic valve clinically adequate in size, the Konno procedure was necessary. However, the right coronary anatomy precluded the original Konno procedure.

Progressive diffuse aortic stenosis after localized supravalvular aortic stenosis repair.

A 6-year-old boy presented with diffuse stenosis of the aortic arch. He had undergone patch augmentation for localized supravalvular aortic stenosis at 2 years of age. Before the initial operation, the aortic arch and descending aorta were noticed to be hypoplastic with a diameter of 60 to 73% of that of the aortic annulus, without a pressure gradient.

Surgery for unilateral absence of pulmonary artery using autologous tissue.

A 7-year-old girl with unilateral absence of the pulmonary artery underwent autologous tissue limited reconstructive surgery. The proximal portion of the artery was reconstructed by rotating a reverse U-shaped cut opposite the pulmonary arterial wall and covering the anterior surface with autologous pericardium. Follow-up catheterization at 5.