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  1. Article ; Online: Misclassification of Pulmonary Hypertension in Partial Anomalous Pulmonary Venous Return.

    Chin, Clifford W / Bichell, David P

    The Annals of thoracic surgery

    2022  Volume 114, Issue 6, Page(s) e447–e449

    Abstract: Partial anomalous pulmonary venous return is a rare congenital heart defect that can escape detection until adulthood and can be misdiagnosed as pulmonary hypertension and managed with vasodilators before the anomaly is identified. This report describes ... ...

    Abstract Partial anomalous pulmonary venous return is a rare congenital heart defect that can escape detection until adulthood and can be misdiagnosed as pulmonary hypertension and managed with vasodilators before the anomaly is identified. This report describes the cases of 3 patients with pulmonary hypertension whose hemodynamics and symptoms improved after repair of anomalous veins. Anomalous pulmonary veins are difficult to identify on a transthoracic echocardiogram, so a high index of suspicion and early use of additional imaging modalities are important to avoid a delayed diagnosis and progression to irreversible disease.
    MeSH term(s) Humans ; Adult ; Scimitar Syndrome/complications ; Scimitar Syndrome/diagnostic imaging ; Scimitar Syndrome/surgery ; Hypertension, Pulmonary/diagnosis ; Pulmonary Veins/abnormalities ; Heart Defects, Congenital/diagnosis ; Hemodynamics
    Language English
    Publishing date 2022-02-26
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2022.02.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 252: Show issues Location:
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  2. Article ; Online: Severe aortopulmonary collaterals are associated with lower transplant-free survival in patients undergoing staged single ventricle palliation.

    Chin, Clifford W / Nicholson, George T / Bichell, David P

    JTCVS open

    2023  Volume 16, Page(s) 844–854

    Abstract: Objective: To identify risk factors for aortopulmonary collateral (APC) development and assess the impact of severe APCs in children undergoing staged single ventricle palliation.: Methods: Children undergoing a bidirectional Glenn operation between ... ...

    Abstract Objective: To identify risk factors for aortopulmonary collateral (APC) development and assess the impact of severe APCs in children undergoing staged single ventricle palliation.
    Methods: Children undergoing a bidirectional Glenn operation between January 1, 2016, and March 31, 2021, at our center were included. All underwent angiography prior to Glenn and Fontan; APC flow was graded on a scale of 0 (no appreciable collateral flow) to 4 (severe burden). Demographic data, congenital diagnosis, clinical history, and outcomes were stratified by Glenn assessment; Fontan outcomes were stratified by pre-Fontan grade.
    Results: Sixty patients met the inclusion criteria, all of whom had angiographic evidence of APCs. There were 7 transplants and 9 deaths in the cohort. There were no significant differences in demographics among the patients. Right ventricular morphology was more common in patients with severe pre-Glenn collaterals (24 of 44 vs 2 of 6 vs 7 of 8;
    Conclusions: The ubiquity of APCs in this study demonstrates their prevalence in single ventricle disease. Right ventricular morphology and prolonged aortic cross-clamp duration are associated with higher burden. Greater severity was associated with decreased transplant-free survival. These data emphasize the negative long-term impact of these collaterals.
    Language English
    Publishing date 2023-09-19
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-2736
    ISSN (online) 2666-2736
    DOI 10.1016/j.xjon.2023.09.012
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  3. Article ; Online: Heart-Lung Transplant via an Eighth-Time Sternotomy.

    Riggs, Kyle W / Chin, Clifford W / Bryant, Roosevelt / Zafar, Farhan / Chin, Clifford / Schecter, Marc G / Morales, David L S

    World journal for pediatric & congenital heart surgery

    2019  Volume 12, Issue 1, Page(s) 136–138

    Abstract: We report a combined heart-lung transplantation following seven prior sternotomies in a patient born with a transitional atrioventricular septal defect. Previous surgeries to repair and replace the mitral valve led to pulmonary vein stenosis and ... ...

    Abstract We report a combined heart-lung transplantation following seven prior sternotomies in a patient born with a transitional atrioventricular septal defect. Previous surgeries to repair and replace the mitral valve led to pulmonary vein stenosis and pulmonary vascular disease. Eighth-time sternotomy and significant vascular adhesions led to a prolonged operation and to placing the heart-lung block anterior to the phrenic nerves. Despite this, the patient was ready for discharge after two weeks and continues to do well over nine months later. As more patients survive multiple cardiac palliations with some developing pulmonary vascular disease, heart-lung transplantation may become relevant again.
    MeSH term(s) Adolescent ; Echocardiography ; Heart Septal Defects/diagnosis ; Heart Septal Defects/surgery ; Heart-Lung Transplantation/methods ; Humans ; Male ; Sternotomy/methods ; Tomography, X-Ray Computed
    Language English
    Publishing date 2019-04-24
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2550261-X
    ISSN 2150-136X ; 2150-1351
    ISSN (online) 2150-136X
    ISSN 2150-1351
    DOI 10.1177/2150135118815876
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  4. Article ; Online: Contemporary Outcomes of Pediatric Restrictive Cardiomyopathy: A Single-Center Experience.

    Wittekind, Samuel G / Ryan, Thomas D / Gao, Zhiqian / Zafar, Farhan / Czosek, Richard J / Chin, Clifford W / Jefferies, John L

    Pediatric cardiology

    2018  Volume 40, Issue 4, Page(s) 694–704

    Abstract: Background: Pediatric restrictive cardiomyopathy (RCM) has high mortality in historical cohorts, and traditional management often involves early referral for heart transplantation (HTx). This study sought to determine outcomes of pediatric RCM at a ... ...

    Abstract Background: Pediatric restrictive cardiomyopathy (RCM) has high mortality in historical cohorts, and traditional management often involves early referral for heart transplantation (HTx). This study sought to determine outcomes of pediatric RCM at a center that has favored medical management over early listing for HTx.
    Methods: All patients (N = 43) with pure RCM phenotype (RCM, N = 26) and hypertrophic cardiomyopathy with restrictive physiology (RCM/HCM, N = 17) managed at our center over a 15-year period were investigated. Outcomes of those listed for HTx (N = 18) were compared to a benchmark of contemporaneous pediatric RCM patients in the UNOS database (N = 377). Proportional hazards models were used to determine predictors of adverse outcomes.
    Results: The mean age was 11 ± 9 years and 49% were male. 14 of 18 patients listed received HTx. Overall mortality (12%) was identical between the phenotypes; however, RCM patients were more likely to be listed (P = 0.001) and receive HTx (P = 0.02) compared to RCM/HCM. Prior to HTx, 60% had documented arrhythmia, 16% had cardiac arrest, and 7% required mechanical circulatory support. 4 of 17 patients with an ICD/PM received device therapies (four of five shocks appropriate for VT/VF, and two effective anti-tachycardia pacing interventions). Outcomes of those listed for HTx at our center were similar to the UNOS benchmark. In multivariate analysis, markers of congestive heart failure were associated with adverse outcomes.
    Conclusion: Heart failure and arrhythmia treatments can delay or possibly prevent the need for HTx in some cases of pediatric RCM. Survival post-HTx is not compromised using this approach.
    MeSH term(s) Adolescent ; Adult ; Arrhythmias, Cardiac/therapy ; Cardiomyopathy, Hypertrophic/complications ; Cardiomyopathy, Hypertrophic/mortality ; Cardiomyopathy, Hypertrophic/surgery ; Cardiomyopathy, Restrictive/complications ; Cardiomyopathy, Restrictive/mortality ; Cardiomyopathy, Restrictive/surgery ; Child ; Child, Preschool ; Databases, Factual ; Female ; Heart Failure/surgery ; Heart Transplantation/statistics & numerical data ; Humans ; Longitudinal Studies ; Male ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2018-12-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800857-7
    ISSN 1432-1971 ; 0172-0643
    ISSN (online) 1432-1971
    ISSN 0172-0643
    DOI 10.1007/s00246-018-2043-0
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1528: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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