Three techniques of general intravenous anesthesia were compared, using mathematical parameters of the heart rhythm, hemodynamic and sympathoadrenal system responses, arterial blood Hb saturation with O2 (SaO2) and thermometry. It has been established that anesthesia with dipidolor ensures adequate protection against the operation stress both in patients with tetralogy of Fallot previously subject to interarterial anastomoses and patients with tetralogy of Fallot without anastomoses. Combined fentanyl and ketamine anesthesia ensures an adequate protection against the operation stress only in patients with tetralogy of Fallot without anastomoses. A more marked response of sympathetic autonomous nervous system and hemodynamics in patients with tetralogy of Fallot previously subject to anastomoses is, probably, mediated by a more intensive analgesic sequestration in the lungs in the presence of functioning anastomoses, which attenuates the analgetic effect. Anesthesia in patients with tetralogy of Fallot previously subject to interaortic anastomoses should be performed using higher doses of narcotic analgesics.
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Iran J Med Sci
December 2024
Neonatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Inadequate pulmonary blood flow in tetralogy of Fallot (TOF) can lead to the development of major aortopulmonary collateral arteries (MAPCA), which interferes with surgical repair. The present study evaluated the features of MAPCAs among patients with TOF and their treatment approaches. Besides, perioperative parameters and mortality rates of our TOF patients with and without MAPCA were compared.
View Article and Find Full Text PDFAlthough the long-term outcomes of the surgical grafts are well defined and reported, the data regarding the mid-and long-term results of the balloon-expandable percutaneous valves in the native right ventricular outflow tract (RVOT) is limited. We retrospectively evaluated 42 patients who underwent PPVI (Sapien® XT valve) to native RVOT due to severe pulmonary regurgitation (PR) and/or moderate to severe pulmonary stenosis (PS) between August 2015 and November 2020. The median patient age at the time of PPVI was 13.
View Article and Find Full Text PDFAnn Pediatr Cardiol
December 2024
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Introduction: 22q11.2 deletion is associated with conotruncal anomalies and immunological aberrations. Given the common embryonic origin of conotruncus and thymus, conotruncal anomalies may be associated with immunological aberrations irrespective of 22q11.
View Article and Find Full Text PDFCardiol Young
January 2025
Department of Paediatric Cardiology, University Children's Hospital, Jagiellonian University Medical College, Krakow, Poland.
CHDs affecting the right ventricular outflow tract often require repeated surgical or transcatheter interventions due to pulmonary insufficiency or stenosis. This study presents percutaneous implantation of large self-expanding valves in patients with complex right ventricular outflow tract anatomy after prior pulmonary branch stenting.
View Article and Find Full Text PDFJACC Clin Electrophysiol
January 2025
Montreal Heart Institute, Montreal, Québec, Canada.
Background: Ventricular tachycardia (VT) substrate characteristics before transcatheter pulmonary valve replacement (TPVR) in repaired tetralogy of Fallot (rTOF) are unknown.
Objectives: In this study, the authors sought to evaluate substrates for sustained monomorphic VT before TPVR in rTOF.
Methods: Retrospective (2017 to 2021) and prospective (commencing 2021) rTOF patients with native right ventricular outflow tract referred for electrophysiology study (EPS) before TPVR were included.
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