Cardiac surgery-associated acute kidney injury in neonatal Norwood procedure: incidence, risk factors and impact on mortality and outcomes.

Objectives: Acute kidney injury commonly complicates congenital heart surgery with cardiopulmonary bypass, increasing morbidity and mortality. This study aimed to evaluate risk factors for postoperative acute kidney injury and its impact on outcomes after the Norwood procedure.

Methods: Neonates undergoing the Norwood procedure from 2001 to 2022 were reviewed.

Postoperative atrioventricular block after surgery for congenital heart disease: incidence, recovery and risks.

Objectives: We aimed to determine the incidence of postoperative complete atrioventricular block, the time to recovery or permanent pacemaker implantation and the predictors for postoperative atrioventricular block after congenital heart surgery.

Methods: Patients who underwent open-heart surgery from January 2001 to January 2024 were analysed and predictors of atrioventricular block were identified using a logistic regression model.

Results: Among 9765 congenital heart surgeries, 333 (3.

Apixaban for Prevention of Thromboembolism in Pediatric Heart Disease.

Background: Children with heart disease frequently require anticoagulation for thromboprophylaxis. Current standard of care (SOC), vitamin K antagonists or low-molecular-weight heparin, has significant disadvantages.

Objectives: The authors sought to describe safety, pharmacokinetics (PK), pharmacodynamics, and efficacy of apixaban, an oral, direct factor Xa inhibitor, for prevention of thromboembolism in children with congenital or acquired heart disease.

Bioactive adrenomedullin (bio-ADM) is associated with endothelial dysfunction in infants and children with complex congenital heart disease undergoing open-heart surgery on cardiopulmonary bypass.

Objectives: Children with congenital heart disease (CHD) undergoing cardiac surgery on cardiopulmonary bypass (CPB) are at risk for systemic inflammation leading to endothelial dysfunction associated with increased morbidity. Bioactive adrenomedullin (bio-ADM) is a peptide regulating vascular tone and endothelial permeability. The aim of this study was to evaluate the dynamics of plasma bio-ADM in this patient cohort and its role in capillary leak.

Clinical and haemodynamic variables associated with intensive care unit length of stay and early adverse outcomes after the Norwood procedure.

Objectives: This study was performed to determine the clinical and haemodynamic variables associated with early adverse outcomes after the neonatal Norwood procedure.

Methods: Patients who underwent the neonatal Norwood procedure between 2001 and 2019 were included. The patient diagnosis, morphological characteristics and haemodynamic parameters were analysed to identify factors associated with length of stay (LOS) in the intensive care unit (ICU) and mortality during the stay.

Factors influencing length of intensive care unit stay following a bidirectional cavopulmonary shunt.

Objectives: The goal of this study was to identify the risk factors for prolonged length of stay (LOS) in the intensive care unit (ICU) after a bidirectional cavopulmonary shunt (BCPS) procedure and its impact on the number of deaths.

Methods: In total, 556 patients who underwent BCPS between January 1998 and December 2019 were included in the study.

Results: Eighteen patients died while in the ICU, and 35 died after discharge from the ICU.

Early extubation improves outcome following extracardiac total cavopulmonary connection.

Objectives: The aim of this study was to investigate the impact of an early extubation strategy on the outcome following extracardiac total cavopulmonary connection.

Methods: From 1999 through 2017, 458 patients underwent extracardiac total cavopulmonary connection; 257 (56%) patients were managed with an early extubation strategy adopted in 2009 (group A). Their outcome was compared with those of 201 (44%) patients treated before 2009 (group B).

Predicted clinical factors associated with the intensive care unit length of stay after total cavopulmonary connection.

Objectives: A longer length of stay (LOS) in the intensive care unit (ICU) after the total cavopulmonary connection (TCPC) is thought to be a predictive sign of late Fontan failure. This study was performed to determine the clinical risk factors for ICU LOS.

Methods: In total, 483 patients who underwent a TCPC between May 1994 and December 2016 were included the study.

Neutrophil gelatinase-associated lipocalin reflects inflammation and is not a reliable renal biomarker in neonates and infants after cardiopulmonary bypass: a prospective case-control study.

Unlabelled: Introduction Acute kidney injury is a frequent complication after cardiac surgery with cardiopulmonary bypass in infants. Neutrophil gelatinase-associated lipocalin has been suggested to be a promising early biomarker of impending acute kidney injury. On the other hand, neutrophil gelatinase-associated lipocalin has been shown to be elevated in systemic inflammatory diseases without renal impairment.

Early postoperative extubation of unstable patients following total cavopulmonary connection: impact on circulation and outcome.

Objectives: We aimed to investigate whether early postoperative extubation following the Fontan operation is universally feasible and can be used as a management tool in unstable patients.

Methods: All patients undergoing the Fontan operation in our centre between 2004 and 2013 (n=253) were analysed. Until 2008, patients were extubated according to standard criteria and comprised group 1.

Intraoperative renal near-infrared spectroscopy indicates developing acute kidney injury in infants undergoing cardiac surgery with cardiopulmonary bypass: a case-control study.

Introduction: Acute kidney injury (AKI) is a frequent complication after cardiac surgery with cardiopulmonary bypass in infants. Renal near-infrared spectroscopy (NIRS) is used to evaluate regional oximetry in a non-invasive continuous real-time fashion, and reflects tissue perfusion. The aim of this study was to evaluate the relationship between renal oximetry and development of AKI in the operative and post-operative setting in infants undergoing cardiopulmonary bypass surgery.

A Comparative Histopathological Study of Heparin Coated and Uncoated Polytetrafluoroethylene Shunts in Children With Congenital Heart Defect.

Objective: Recently, heparin coated polytetrafluoroethylene (PTFE) shunts are available and are believed to improve inherent shunt problems such as thrombosis and excessive and incomplete neointima formation or occlusion. We aimed at comparing the potential histopathological differences in the neointima (in) between uncoated (UCS) PTFE shunts and heparin coated (HCS) PTFE shunts.

Materials And Methods: Thirteen shunts (six UCS and seven HCS) were analyzed.

Continuous infusion of clonidine in ventilated newborns and infants: a randomized controlled trial.

Objectives: To assess the influence of an infusion of clonidine 1 μg/kg/hr on fentanyl and midazolam requirement in ventilated newborns and infants.

Design: Prospective, double-blind, randomized controlled multicenter trial. Controlled trials.

Two consecutive open heart operations in a small child with heparin-induced thrombocytopenia type II using anticoagulation with heparin and tirofiban.

We report the use of the platelet glycoprotein IIb/IIIa antagonist tirofiban for cardiac surgery in a small child with active heparin-induced thrombocytopenia type II, including description of the postoperative course.

Neonatal balloon aortic valvuloplasty-predictive value of current risk score algorithms for treatment strategies.

Background: Neonatal valvular aortic stenosis (AoS) represents a spectrum of different degrees of hypoplasia and malformation of all left heart structures. Uncertainty exists on threshold values for biventricular circulation of newborns with critical AoS. Our aim was to assess the predictive value of current risk scores for treatment strategies in critical AoS.

Transcutaneous Melody valve implantation in "tricuspid position" after a Fontan Björk (RA-RV homograft) operation results in biventricular circulation.

A modified Fontan operation (Fontan Björk [Bjork VO, Olin CL, Bjarke BB, Thoren CA. Right atrial-right ventricular anastomosis for correction of tricuspid atresia. J Thorac Cardiovasc Surg 1979;77:452--8]) for absent right atrio-ventricular connection was done by using a homograft between the right atrium and the right ventricle in some patients.

Management of emergencies in adults with congenital cardiac disease.

The aim of the study was to assess the quantity and nature of emergencies affecting adults with congenital cardiac disease (CCD) and evaluate infrastructural requirements for adequate management. There is an increasing number of adults with CCD requiring specialized complex care. This multicenter study evaluated all emergency admissions to 1 of 5 centers for adults with CCD within 1 year.

Aortic valvuloplasty in pediatric patients substantially postpones the need for aortic valve surgery: a single-center experience of 188 patients after up to 17.5 years of follow-up.

Background: Aortic valvuloplasty (AoVP) is an established procedure regarded as a valid alternative for surgical management of congenital aortic valve stenosis. However, its long-term efficacy in preventing or postponing aortic valve surgery remains uncertain for the individual patient. Therefore, the aim of this study was to study the long-term results of AoVP in pediatric patients and its efficacy in preventing or postponing aortic valve surgery.

Replacement of the systemic atrioventricular valve with a mechanical prosthesis in children aged less than 6 years: late clinical results of survival and subsequent replacement.

Objective: We analyzed the survival, clinical course, and role of prosthesis-patient mismatch after systemic atrioventricular valve replacement in children.

Methods: From 1974 to 2006, 69 patients underwent systemic atrioventricular valve replacement (median age 1.2 years, range 1.

Transcatheter closure of a non-restrictive patent ductus arteriosus with an Amplatzer muscular ventricular septal defect occluder.

We report on successful occlusion of a large unrestrictive PDA in an adult patient with pulmonary hypertension.

Resolution of persistent late postoperative chylothorax after coil occlusion of aortopulmonary collaterals.

We report on successful treatment of persistent late postoperative chylothorax with coil occlusion of significant aortopulmonary collaterals in a young infant with functionally univentricular heart after bidirectional cavopulmonary connection.

Stenting of a restrictive foramen ovale in a patient with hypoplastic left heart syndrome.

Neonates with a severely restrictive foramen ovale and hypoplastic left heart syndrome (HLHS) present as an emergency. We report the case of a newborn in whom left atrial decompression was successfully achieved by stent implantation into the foramen ovale on the first day of life.