oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Senning operation for correction of the transposition of the great arteries, results, long-term outcome and quality of life  [PDF]
Miguel Angel Maluf
World Journal of Cardiovascular Diseases (WJCD) , 2012, DOI: 10.4236/wjcd.2012.23036
Abstract: Objective: Long-term results after the Senning operation for transposition of the great arteries are little known. Sinus node dysfunction and systemic ventricular dysfunction are crucial in patient survival. We evaluated the results, long term outcome and quality of life in a group of 39 patients. Methods: The study was a retrospective analysis, of 39 (39/40 = 97.5%) surgical surviving patients, submitted to Senning operation, with a mean follow-up time of 14.7 +/– 3.1 years. Electrocardiogram, echocardiogram, and chest radiograph series were performed every 6 months. Thirty six patients of this series underwent Holter study and ergometric test, to evaluate the physical capacity. Three patients living overseas were excluded. Results: There was only one late death (1/39) (late mortality = 2.5%): a 16 year-old patient had a no cardiac death. The actuarial survival was 95.0% (38/40) (simple or with little VSD, TGA). The probability of staying in sinus rhythm, in 39 surviving patients was 77.1% (30) or normal right ventricular function was 76.5% (29), 10 to 20 years after operation. The incidence of sinus node and right ventricular dysfunction increased gradually over time. No re-operations and pacemaker implantation, was performed. Functional class: I = 30 (85.7%) cases and functional class II = 5 (14.3%) cases. Conclusions: Patients with simple TGA submitted to Senning procedure in our experience, presented during late follow-up: 1—Low incidence of right ventricular dysfunction and active arrhythmias; 2—Low mortality and no sudden death recorded; 3—Good quality of life and 4—Satisfactory surgical results (free of re-operation or definitive pacemaker implantation).
Accessory mitral valve tissue causing severe left ventricular outflow tract obstruction in a post-Senning patient with transposition of the great arteries
Prashanth Panduranga,Thomas Eapen,Salim Al-Maskari,Abdullah Al-Farqani
Heart International , 2011, DOI: 10.4081/hi.2011.e6
Abstract: Accessory mitral valve tissue is a rare congenital anomaly associated with congenital cardiac defects and is usually detected in the first decade of life. We describe the case of an 18-year old post-Senning asymptomatic patient who was found to have accessory mitral valve tissue on transthoracic echocardiography producing severe left ventricular outflow tract obstruction.
One-year outcome of Senning operation in children with transposition of the great vessels
Shahmohammadi A,Mortezaian H,Alipour MR
Tehran University Medical Journal , 2011,
Abstract: "nBackground: Nowadays, the treatment of choice for anatomical correction of transposition of great arteries is arterial switch but some children are not good candidates for this operation. In these cases atrial switch or Senning procedure is an accepted method, thus outcome of this procedure needs to be better delineated."n "nMethods: This prospective study included 65 patients that underwent Senning operation in Shahid Rajaee Hospital in Tehran, Iran from 2002 to 2009 and were followed-up for one year."n "nResults: The early and late mortality rates were 16.9% and 1.5%, respectively. 51.8% of early deaths were due to simple Senning procedure, 38.9% due to a Senning with the closure of ventricular septal defect, with or without the repair of pulmonary artery stenosis, 9.3% related to palliative Senning and one late death due to simple Senning. The most common arrhythmia was accelerated junctional rhythm (18.5%). 15% of cases had Senning pathway obstruction and 1.7% had baffle leaks. Regardless of the mortalities, three patients (5.7%) had significant tricuspid regurgitation. Right ventricular systolic dysfunction was found in 13.3% of the cases, primarily in Senning with ventricular septal defect closure (37.5%). One case (1.9%) had visible cyanosis and three (5.7%) had exertional dyspnea but 94.3% of cases remained in functional class I."n "nConclusion: Since the majority of deaths following Senning procedure occur during the first month, especially on the second day post-operatively, assiduity during early post-operative period is crucial. Tricuspid regurgitation or right ventricular systolic dysfunction was not detected in most patients, suggesting optimistic prognosis for these patients.
Transposition of the great arteries
Paula Martins, Eduardo Castela
Orphanet Journal of Rare Diseases , 2008, DOI: 10.1186/1750-1172-3-27
Abstract: The diagnosis is confirmed by echocardiography, which also provides the morphological details required for future surgical management. Prenatal diagnosis by foetal echocardiography is possible and desirable, as it may improve the early neonatal management and reduce morbidity and mortality. Differential diagnosis includes other causes of central neonatal cyanosis. Palliative treatment with prostaglandin E1 and balloon atrial septostomy are usually required soon after birth. Surgical correction is performed at a later stage. Usually, the Jatene arterial switch operation is the procedure of choice. Whenever this operation is not feasible, adequate alternative surgical approach should be implemented. With the advent of newer and improved surgical techniques and post operative intensive care, the long-term survival is approximately 90% at 15 years of age. However, the exercise performance, cognitive function and quality of life may be impaired.Transposition of the great arteries; physiologically uncorrected transposition; complete transposition; atrioventricular concordance with ventriculoarterial discordance. The European paediatric cardiac code for this disease is 01.05.01.The transposition of the great arteries was first described by Mathew Baillie in 1797, in the second edition of the book "The Morbid Anatomy of Some of the Most Important Parts of the Human Body". However, the term transposition was only applied in 1814, by Farre, meaning that aorta and pulmonary trunk were placed (positio) across (trans) the ventricular septum.In fact, this congenital cardiac malformation is characterised by atrioventricular concordance and ventriculoarterial discordance. In other words, the morphological right atrium is connected to the morphological right ventricle which gives rise entirely to or most of the aorta; the morphological left atrium is connected to the morphological left ventricle from where the pulmonary trunk emerges [1].The term congenitally corrected transposition
Palliation for transposition of great arteries
VO Adegboye, SI Omokhodion, O Ogunkunle, AI Brimmo, OA Adepo
Nigerian Journal of Surgical Research , 2003,
Abstract: Background: At the University College Hospital Ibadan we have no facility for total surgical correction of transportation of the great arteries (TGA). This prospective study reviews the palliative procedures we have used in the management of TGA. Method: Patients with the diagnosis of TGA were evaluated for morphological type. The choice of palliative procedure was made in some of the patients with morphological type in mind. No fixed criteria were used for allocating patients to Blalock-Hanlon (B-H), atrial septectomy while pulmonary banding (PB) and Blalock-Taussig (B-T) shunt have definite indications. Results: Fourteen consecutive patients with TGA were palliated. The ages of these patients ranged between 3 to 11 months (6.8 ± 2.4 months), there were 8 males to 6 females (1.3:1). Six patients had B-H atrial septectomy and 2(33.3%) died within 48 hours, 4 patients had B-T shunt and there were no mortality, 4 patients had PB and 2 (50.0%) died within 72 hours. The overall operative mortality was 28.6%. All the 10 survivors had improvement of their clinical features and fall in packed cell volume during the period of follow-up, which lasted 5 to 13 months (mean 9.3 ± 1.2 months). All patients had delayed wound healing. Conclusion: Appropriate and timely palliative surgery has a place in patients with TGA as an interim care. Key Words: Palliative surgery, transposition, great arteries Nigerian Journal of Surgical Research Vol.5(1&2) 2003: 129-133
Transposition of Great Arteries: New Insights into the Pathogenesis  [PDF]
Marta Unolt,Carolina Putotto,Lucia M. Silvestri,Dario Marino,Alessia Scarabotti,Valerio Massaccesi,Angela Caiaro,Paolo Versacci,Bruno Marino
Frontiers in Pediatrics , 2013, DOI: 10.3389/fped.2013.00011
Abstract: Transposition of great arteries (TGA) is one of the most common and severe congenital heart diseases (CHD). It is also one of the most mysterious CHD because it has no precedent in phylogenetic and ontogenetic development, it does not represent an alternative physiological model of blood circulation and its etiology and morphogenesis are still largely unknown. However, recent epidemiologic, experimental, and genetic data suggest new insights into the pathogenesis. TGA is very rarely associated with the most frequent genetic syndromes, such as Turner, Noonan, Williams or Marfan syndromes, and in Down syndrome, it is virtually absent. The only genetic syndrome with a strong relation with TGA is Heterotaxy. In lateralization defects TGA is frequently associated with asplenia syndrome. Moreover, TGA is rather frequent in cases of isolated dextrocardia with situs solitus, showing link with defect of visceral situs. Nowadays, the most reliable method to induce TGA consists in treating pregnant mice with retinoic acid or with retinoic acid inhibitors. Following such treatment not only cases of TGA with d-ventricular loop have been registered, but also some cases of congenitally corrected transposition of great arteries (CCTGA). In another experiment, the embryos of mice treated with retinoic acid in day 6.5 presented Heterotaxy, suggesting a relationship among these morphologically different CHD. In humans, some families, beside TGA cases, present first-degree relatives with CCTGA. This data suggest that monogenic inheritance with a variable phenotypic expression could explain the familial aggregation of TGA and CCTGA. In some of these families we previously found multiple mutations in laterality genes including Nodal and ZIC3, confirming a pathogenetic relation between TGA and Heterotaxy. These overall data suggest to include TGA in the pathogenetic group of laterality defects instead of conotruncal abnormalities due to ectomesenchymal tissue migration.
Response of the oxygen pulse during exercise in children with atrial repair for transposition of the great arteries  [cached]
Buys R,Dockx K,Gewillig M,Reybrouck T
Research Reports in Clinical Cardiology , 2012,
Abstract: Roselien Buys,1,2,* Kimberly Dockx,1,* Marc Gewillig,3 Tony Reybrouck1,21Department of Rehabilitation Sciences, 2Department of Cardiovascular Rehabilitation, University of Leuven, Leuven, Belgium; 3Department of Pediatric Cardiology, University Hospital Gasthuisberg, Leuven, Belgium*These authors contributed equally to this paperBackground: The oxygen pulse equals stroke volume times arterial–venous oxygen difference and is calculated by dividing oxygen uptake (VO2) by heart rate (HR). In children with a Senning repair for the transposition of the great arteries (TGA), the response of both HR and VO2 to exercise is impaired. Our aim was to assess the oxygen pulse response during exercise in patients who underwent a Senning operation, comparing it with healthy controls.Methods: Twenty-one children with a Senning repair (mean age 12.5 ± 1.7 years) and a control group of 31 healthy children (mean age 13.2 ± 2.0 years) performed a graded maximal exercise test on a treadmill, during which HR and VO2 were measured. Oxygen pulse was calculated by dividing VO2 by HR. Right ventricular function was quantitatively assessed by cardiac ultrasound.Results: Senning patients had a lower peak oxygen pulse than the control (P = 0.0024) (8.45 ± 1.90 mL beats-1 versus 11.7 ± 3.93 mL beats-1), as with the peak VO2 (P < 0.001) (35.8 ± 5.67 mL min-1 kg-1 versus 46.6 ± 8.02 mL min-1 kg-1) and peak HR (171 ± 14 beats min-1 versus 188 ± 11 beats min-1). During submaximal exercise, oxygen pulse and VO2 were also significantly lower in Senning patients when compared to the control group (P = 0.027). In seven Senning patients (33%), the oxygen pulse did not increase any further after the first exercise levels. These patients had lower right ventricular function compared to the control group (P = 0.04).Conclusion: Children with a Senning repair for TGA have a reduced peak VO2, peak HR, and peak oxygen pulse. Their oxygen pulse starts off at a lower level, reaches its plateau earlier, and is related to right ventricular function. This variable can be considered a complementary parameter to assess cardiovascular exercise performance.Keywords: transposition of the great arteries, Senning repair, oxygen pulse, cardiopulmonary exercise testing
Response of the oxygen pulse during exercise in children with atrial repair for transposition of the great arteries
Buys R, Dockx K, Gewillig M, Reybrouck T
Research Reports in Clinical Cardiology , 2012, DOI: http://dx.doi.org/10.2147/RRCC.S33328
Abstract: ponse of the oxygen pulse during exercise in children with atrial repair for transposition of the great arteries Original Research (870) Total Article Views Authors: Buys R, Dockx K, Gewillig M, Reybrouck T Published Date November 2012 Volume 2012:3 Pages 57 - 62 DOI: http://dx.doi.org/10.2147/RRCC.S33328 Received: 26 April 2012 Accepted: 22 June 2012 Published: 30 November 2012 Roselien Buys,1,2,* Kimberly Dockx,1,* Marc Gewillig,3 Tony Reybrouck1,2 1Department of Rehabilitation Sciences, 2Department of Cardiovascular Rehabilitation, University of Leuven, Leuven, Belgium; 3Department of Pediatric Cardiology, University Hospital Gasthuisberg, Leuven, Belgium *These authors contributed equally to this paper Background: The oxygen pulse equals stroke volume times arterial–venous oxygen difference and is calculated by dividing oxygen uptake (VO2) by heart rate (HR). In children with a Senning repair for the transposition of the great arteries (TGA), the response of both HR and VO2 to exercise is impaired. Our aim was to assess the oxygen pulse response during exercise in patients who underwent a Senning operation, comparing it with healthy controls. Methods: Twenty-one children with a Senning repair (mean age 12.5 ± 1.7 years) and a control group of 31 healthy children (mean age 13.2 ± 2.0 years) performed a graded maximal exercise test on a treadmill, during which HR and VO2 were measured. Oxygen pulse was calculated by dividing VO2 by HR. Right ventricular function was quantitatively assessed by cardiac ultrasound. Results: Senning patients had a lower peak oxygen pulse than the control (P = 0.0024) (8.45 ± 1.90 mL beats-1 versus 11.7 ± 3.93 mL beats-1), as with the peak VO2 (P < 0.001) (35.8 ± 5.67 mL min-1 kg-1 versus 46.6 ± 8.02 mL min-1 kg-1) and peak HR (171 ± 14 beats min-1 versus 188 ± 11 beats min-1). During submaximal exercise, oxygen pulse and VO2 were also significantly lower in Senning patients when compared to the control group (P = 0.027). In seven Senning patients (33%), the oxygen pulse did not increase any further after the first exercise levels. These patients had lower right ventricular function compared to the control group (P = 0.04). Conclusion: Children with a Senning repair for TGA have a reduced peak VO2, peak HR, and peak oxygen pulse. Their oxygen pulse starts off at a lower level, reaches its plateau earlier, and is related to right ventricular function. This variable can be considered a complementary parameter to assess cardiovascular exercise performance.
Echocardiographic diagnosis of transposition of the great arteries associated with anomalous pulmonary venous connection
Lopes, Lilian Maria;Tavares, Gláucia Maria Penha;Mailho, Fred Luiz;Almeida, Vicente de Paulo Cavalcante de;Mangione, José Armando;
Arquivos Brasileiros de Cardiologia , 2001, DOI: 10.1590/S0066-782X2001000700007
Abstract: we report 2 cases of transposition of the great arteries associated with anomalous pulmonary venous connection emphasizing the clinical findings, the diagnosis, and the evolution of the association. one of the patients had the anomalous pulmonary venous connection in its total infradiaphragmatic form, in the portal system, and the other patient had a partial form, in which an anomalous connection of the left superior lobar vein with the innominate vein existed. at the time of hospital admission, the patients had cyanosis and respiratory distress with clinical findings suggesting transposition of the great arteries. the diagnosis in 1 of the cases, in which the anomalous connection was partial, was established only with echocardiography, without invasive procedures that would represent risk for the patient; in the other case, in which the anomalous connection was total, the malformation was only evidenced with catheterization. the patients underwent surgery for anatomical correction of the heart disease. only 1 patient had a good outcome.
Echocardiographic diagnosis of transposition of the great arteries associated with anomalous pulmonary venous connection
Lopes Lilian Maria,Tavares Gláucia Maria Penha,Mailho Fred Luiz,Almeida Vicente de Paulo Cavalcante de
Arquivos Brasileiros de Cardiologia , 2001,
Abstract: We report 2 cases of transposition of the great arteries associated with anomalous pulmonary venous connection emphasizing the clinical findings, the diagnosis, and the evolution of the association. One of the patients had the anomalous pulmonary venous connection in its total infradiaphragmatic form, in the portal system, and the other patient had a partial form, in which an anomalous connection of the left superior lobar vein with the innominate vein existed. At the time of hospital admission, the patients had cyanosis and respiratory distress with clinical findings suggesting transposition of the great arteries. The diagnosis in 1 of the cases, in which the anomalous connection was partial, was established only with echocardiography, without invasive procedures that would represent risk for the patient; in the other case, in which the anomalous connection was total, the malformation was only evidenced with catheterization. The patients underwent surgery for anatomical correction of the heart disease. Only 1 patient had a good outcome.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.