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Fetal-to-Neonatal Transition of an Infant with Transposition of the Great Arteries and Intact Ventricular Septum: A Case Report.
Biomed Hub
December 2024
Division of Paediatric Cardiology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre (LUMC), Leiden, The Netherlands.
Introduction: Transposition of the great arteries (TGA), especially with intact ventricular septum (TGA-IVS), presents unique challenges during fetal-to-neonatal transition, which can contribute to developing persistent pulmonary hypertension of the newborn (PPHN).
Case Presentation: A male newborn with TGA-IVS, delivered via caesarean section, presented with hypoxemia and tachycardia immediately after birth (preductal SpO: 50-60%, post-ductal SpO: 70-75%). Echocardiography revealed a floppy interatrial septum and two interatrial connections with bidirectional shunting.
Percutaneous Atrial Septostomy in Adult Patients on Veno-Arterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock: A Canadian Single-Center Experience.
J Clin Med
December 2024
Quebec Heart and Lung Institute, Laval University, Quebec City, QC G1V 4G5, Canada.
Patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) frequently develop left ventricular (LV) distension and pulmonary edema due to an increased LV afterload. A balloon atrial septostomy (BAS) is a technique used to alleviate LV pressure and facilitate left atrial decompression. While primarily performed in pediatric populations, this procedure's feasibility in adult patients is less studied.
View Article and Find Full Text PDFThe Need for Preoperative Prostaglandin E1 for d-Transposition After Balloon Atrial Septostomy.
CJC Pediatr Congenit Heart Dis
October 2024
Division of Cardiology, Faculty of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Article Synopsis
- The study investigates the controversial role of prostaglandin E1 (PGE) in infants with d-transposition of the great arteries (dTGA) undergoing arterial switch operation (ASO) following balloon atrial septostomy (BAS).
- Out of 35 dTGA cases reviewed, 65% required PGE infusion, with a significant 60% of these infants needing PGE to be restarted after initially stopping.
- The findings suggest that keeping PGE until oxygen saturation reaches at least 80% may lower the risk of rebound hypoxia, without increasing adverse effects from the medication.
Interventional Strategies for Children with Progressive Pulmonary Hypertension Despite Optimal Therapy. An Official American Thoracic Society Clinical Practice Guideline.
Am J Respir Crit Care Med
November 2024
Cincinnati Children's Hospital Medical Center, Cardiothoracic Surgery, Cincinnati, Ohio, United States.
Background: Pulmonary hypertension in children often progresses despite optimal therapy. This document provides an evidence-based clinical practice guideline for the management of children with progressive pulmonary hypertension despite optimal therapy.
Methods: A multidisciplinary panel identified pertinent questions regarding the management of children with pulmonary hypertension that has progressed despite optimal therapy, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop clinical recommendations.
Staged Norwood operation for patients with hypoplastic left heart syndrome and cor triatriatum: a report of two cases.
Gen Thorac Cardiovasc Surg Cases
March 2024
Department of Pediatric Cardiac Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, 350-1298, Japan.
Two patients with hypoplastic left heart syndrome (HLHS) concomitant with cor triatriatum underwent the staged Norwood procedure following hybrid palliation. Cor triatriatum was diagnosed after birth in both cases. Case 1 with aortic stenosis and mitral atresia underwent bilateral pulmonary artery banding at 2 days of age.
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