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Reimplantation of Thymus at the First Superior Cavo-Pulmonary Anastomosis and Its Outcome.
Cureus
December 2024
Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, IND.
During bidirectional cavo-pulmonary anastomosis (bidirectional Glenn; BDG), the thymic tissue is often excised to facilitate the exposure of the superior vena cava and its junction with the innominate vein. Subsequently, it is discarded. Since the last two decades, the lead author (ST) has pursued anchoring the excised thymus in its position by suturing it to the opposite unexcised thymic lobe.
View Article and Find Full Text PDFCatheter-Based Fontan Completion Without Prior Surgical Preparation: Is This the Way Forward?
JACC Case Rep
November 2024
Department of Cardiothoracic Surgery, Apollo Children's Hospital, Chennai, Tamilnadu, India.
We report 3 cases of transcatheter Fontan completion in conventional Glenn anastomosis patients without surgical preparation by creating a tunnel between the pulmonary artery and right atrium. Cavocaval anastomosis is established by placing a covered stent graft within the scaffold created with the uncovered stents at the pulmonary artery-right atrium and inferior vena cava-right atrium junction.
View Article and Find Full Text PDFA cavalpulmonary assist device utilising impedance pumping enhanced by peristaltic effect.
Int J Artif Organs
October 2024
Department of Engineering, Durham University, Durham, UK.
Background: Fontan procedure, the standard surgical palliation to treat children with single ventricular defects, causes systemic complications over years due to lack of pumping at cavopulmonary junction. A device developed specifically for cavopulmonary support is thus considered, while current commercial ventricular assist devices (VAD) induce high shear rates to blood, and have issues with paediatric suitability.
Aim: To demonstrate the feasibility of a small, valveless, non-invasive to blood and pulsatile rotary pump, which integrates impedance and peristaltic effects.
Hypovolemic Shock And The Need For Invasive Mechanical Ventilation On A Patient With Congenital Heart Disease.
Port J Card Thorac Vasc Surg
July 2024
Intensive Care Medicine, Hospital São João, Porto, Portugal.
Article Synopsis
- VA-ECMO techniques have advanced and are particularly beneficial for patients with reversible low cardiac output, such as the case of a 21-year-old male with congenital heart disease who experienced severe shock following an upper gastrointestinal bleed.
- Initial treatments included intubation, fluid resuscitation, and emergency endoscopy to control active bleeding, but the patient's condition worsened, leading to the need for VA-ECMO support due to severe ventricular dysfunction and high lactate levels.
- After optimizing care in the ICU and adjusting ventilation strategies, the patient's condition stabilized, allowing for extubation and the discontinuation of certain medications, reflecting a positive recovery trajectory.
Fontan Junctional Rhythm-Innocent Bystander or Silent Killer?
JAMA Cardiol
June 2024
Ahmanson/UCLA Adult Congenital Heart Disease Program, UCLA Health System, Los Angeles, California.
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