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  1. Article ; Online: Perioperative and Anesthetic Considerations in Vascular Rings and Slings.

    Wadle, Michael / Joffe, Denise / Backer, Carl / Ross, Faith

    Seminars in cardiothoracic and vascular anesthesia

    2024  , Page(s) 10892532241234404

    Abstract: Vascular rings represent an increasingly prevalent and diverse set of congenital malformations in which the aortic arch and its primary branches encircle and constrict the esophagus and trachea. Perioperative management varies significantly based on the ... ...

    Abstract Vascular rings represent an increasingly prevalent and diverse set of congenital malformations in which the aortic arch and its primary branches encircle and constrict the esophagus and trachea. Perioperative management varies significantly based on the type of lesion, its associated comorbidities, and the compromise of adjacent structures. Multiple review articles have been published describing the scope of vascular rings and relevant concerns from a surgical perspective. This review seeks to discuss the perioperative implications and recommendations of such pathology from the perspective of an anesthesia provider.
    Language English
    Publishing date 2024-02-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2012371-1
    ISSN 1940-5596 ; 1089-2532
    ISSN (online) 1940-5596
    ISSN 1089-2532
    DOI 10.1177/10892532241234404
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Perioperative and Anesthetic Considerations in Pediatric Valvar and Subvalvar Aortic Stenosis.

    Ross, Faith / Everhart, Kelly / Latham, Greg / Joffe, Denise

    Seminars in cardiothoracic and vascular anesthesia

    2023  Volume 27, Issue 4, Page(s) 292–304

    Abstract: Aortic stenosis (AS) is a common form of left ventricular outflow tract obstruction (LVOTO) in children with congenital heart disease. This review specifically considers the perioperative features of valvar (VAS) and subvalvar AS (subAS) in the pediatric ...

    Abstract Aortic stenosis (AS) is a common form of left ventricular outflow tract obstruction (LVOTO) in children with congenital heart disease. This review specifically considers the perioperative features of valvar (VAS) and subvalvar AS (subAS) in the pediatric patient. Although VAS and subAS share some clinical features and diagnostic approaches, they are distinct clinical entities with separate therapeutic options, which range from transcatheter intervention to surgical repair. We detail the pathophysiology of AS and highlight the range of treatment strategies with a focus on anesthetic considerations for the care of these patients before, during, and after intervention.
    MeSH term(s) Child ; Humans ; Ventricular Outflow Obstruction ; Aortic Valve Stenosis/surgery ; Heart Defects, Congenital/surgery ; Anesthetics ; Treatment Outcome
    Chemical Substances Anesthetics
    Language English
    Publishing date 2023-07-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2012371-1
    ISSN 1940-5596 ; 1089-2532
    ISSN (online) 1940-5596
    ISSN 1089-2532
    DOI 10.1177/10892532231189933
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Novel Transcatheter Approach to Treat Primum Atrial Septal Defects.

    Condos, Gregory J / McCabe, James M / Joffe, Denise C / Sheu, Richard D

    CASE (Philadelphia, Pa.)

    2024  Volume 8, Issue 3Part A, Page(s) 180–185

    Abstract: Degenerative common AVC defect can mimic rheumatic MV stenosis.•Closure of primum ASD can be achieved percutaneously.•Live 3D multiplanar TEE is crucial for procedural guidance. ...

    Abstract •Degenerative common AVC defect can mimic rheumatic MV stenosis.•Closure of primum ASD can be achieved percutaneously.•Live 3D multiplanar TEE is crucial for procedural guidance.
    Language English
    Publishing date 2024-03-08
    Publishing country United States
    Document type Case Reports
    ISSN 2468-6441
    ISSN (online) 2468-6441
    DOI 10.1016/j.case.2023.12.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The Year in Review: Anesthesia for Congenital Heart Disease 2021.

    Ross, Faith J / Joffe, Denise C / Landsem, Leah M / Latham, Gregory J

    Seminars in cardiothoracic and vascular anesthesia

    2022  Volume 26, Issue 2, Page(s) 129–139

    Abstract: This review focuses on the literature published during the calendar year 2021 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease. Four major themes are discussed, including cardiovascular disease in ... ...

    Abstract This review focuses on the literature published during the calendar year 2021 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease. Four major themes are discussed, including cardiovascular disease in children with COVID-19, aortic valve repair and replacement, bleeding and coagulation, and enhanced recovery after surgery (ERAS).
    MeSH term(s) Adult ; Anesthesia ; Anesthesiology ; COVID-19 ; Cardiac Surgical Procedures ; Child ; Heart Defects, Congenital/surgery ; Humans
    Language English
    Publishing date 2022-05-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2012371-1
    ISSN 1940-5596 ; 1089-2532
    ISSN (online) 1940-5596
    ISSN 1089-2532
    DOI 10.1177/10892532221095038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Device Closure of a Sinus Venosus Atrial Septal Defect.

    Joffe, Denise C / Landsem, Leah / Steinberg, Zachary L / Morray, Brian

    A&A practice

    2022  Volume 16, Issue 2, Page(s) e01566

    MeSH term(s) Heart Septal Defects, Atrial/diagnostic imaging ; Heart Septal Defects, Atrial/surgery ; Humans ; Septal Occluder Device
    Language English
    Publishing date 2022-02-16
    Publishing country United States
    Document type Journal Article
    ISSN 2575-3126
    ISSN (online) 2575-3126
    DOI 10.1213/XAA.0000000000001566
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The Year in Review: Anesthesia for Congenital Heart Disease 2020.

    Landsem, Leah M / Ross, Faith J / Joffe, Denise C / Latham, Gregory J

    Seminars in cardiothoracic and vascular anesthesia

    2021  Volume 25, Issue 2, Page(s) 107–119

    Abstract: This review focuses on the literature published during the calendar year 2020 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease. Five major themes are discussed, including COVID-19 in children with ... ...

    Abstract This review focuses on the literature published during the calendar year 2020 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease. Five major themes are discussed, including COVID-19 in children with heart disease, race and outcome disparities in congenital heart disease, Norwood procedure and outcomes, Fontan procedure and outcomes, and neurotoxicity/neurologic outcomes. A total of 59 peer-reviewed articles are discussed.
    MeSH term(s) Adult ; Anesthesia/methods ; COVID-19/complications ; COVID-19/physiopathology ; Child ; Fontan Procedure ; Health Status Disparities ; Heart Defects, Congenital/epidemiology ; Heart Defects, Congenital/surgery ; Humans ; Norwood Procedures
    Language English
    Publishing date 2021-05-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2012371-1
    ISSN 1940-5596 ; 1089-2532
    ISSN (online) 1940-5596
    ISSN 1089-2532
    DOI 10.1177/10892532211011325
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Perioperative and Anesthetic Considerations in Tetralogy of Fallot With Pulmonary Atresia.

    Quinlan, Casey A / Latham, Gregory J / Joffe, Denise / Ross, Faith J

    Seminars in cardiothoracic and vascular anesthesia

    2021  Volume 25, Issue 3, Page(s) 218–228

    Abstract: Tetralogy of Fallot with pulmonary atresia (ToF-PA) is a rare diagnosis that includes an extraordinarily heterogeneous group of complex anatomical findings with significant implications for physiology and prognosis. In addition to the classic findings of ...

    Abstract Tetralogy of Fallot with pulmonary atresia (ToF-PA) is a rare diagnosis that includes an extraordinarily heterogeneous group of complex anatomical findings with significant implications for physiology and prognosis. In addition to the classic findings of ToF, this particular diagnosis is characterized by complete failure of forward flow from the right ventricle to the pulmonary arterial system. As such, pulmonary blood flow is entirely dependent on shunting from the systemic circulation, most frequently via a patent ductus arteriosus, major aortopulmonary collaterals, or a combination of the two. The pathophysiology of ToF-PA is largely attributable to the abnormalities of the pulmonary vasculature. Ultimately, these patients require operative intervention to create a reliable, controlled source of pulmonary blood flow and ideally complete intracardiac repair. Even after operative correction, these patients remain at risk for pulmonary arterial stenoses and pulmonary hypertension. Although there have been significant advances in surgical and interventional management of ToF-PA leading to dramatic improvements in survival and long-term functional status, there is ongoing debate about the optimal management strategy given the risk of development of irreversible abnormalities of the pulmonary vasculature and the morbidity and mortality associated with sometimes multiple, complex operative interventions often occurring early in infancy. This review will discuss the findings in patients with ToF-PA with a focus on the perioperative and anesthetic management and will highlight challenges faced by the anesthesiologist in caring for these patients.
    MeSH term(s) Anesthetics ; Collateral Circulation ; Heart Septal Defects ; Humans ; Infant ; Pulmonary Atresia/surgery ; Retrospective Studies ; Tetralogy of Fallot/surgery
    Chemical Substances Anesthetics
    Language English
    Publishing date 2021-08-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2012371-1
    ISSN 1940-5596 ; 1089-2532
    ISSN (online) 1940-5596
    ISSN 1089-2532
    DOI 10.1177/10892532211027395
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Encouraging results of blood conservation in neonatal open-heart surgery.

    Bohuta, Lyubomyr / Charette, Kevin / Chan, Titus / Joffe, Denise / Koth, Andrew / Greene, Christina L / Mauchley, David / McMullan, D Michael

    The Journal of thoracic and cardiovascular surgery

    2023  Volume 167, Issue 3, Page(s) 1154–1163

    Abstract: Objective: To report early outcomes of blood conservation in neonatal open-heart surgery.: Methods: Ninety-nine patients undergoing neonatal open-heart surgery during the implementation of a blood conservation program between May 2021 and February ... ...

    Abstract Objective: To report early outcomes of blood conservation in neonatal open-heart surgery.
    Methods: Ninety-nine patients undergoing neonatal open-heart surgery during the implementation of a blood conservation program between May 2021 and February 2023 were reviewed. Patients either received traditional blood management (blood prime, n = 43) or received blood conservation strategies (clear prime, n = 56). Baseline characteristics and outcomes were compared between groups.
    Results: There was no difference in body weight (median, 3.2 kg vs 3.3 kg; P = .83), age at surgery (median, 5 days vs 5 days; P = .37), distribution of The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Mortality Categories categories or duration of cardiopulmonary bypass. Patients in the clear prime group had higher preoperative hematocrit (median, 41% vs 38%; P < .01), shorter postoperative mechanical ventilation time (median, 48 hours vs 92 hours; P = .02) and postoperative intensive care unit length of stay (median, 6 days vs 9 days; P < .01) than patients in the blood prime group. Fourteen patients (25%) in the clear prime group, including 1 Norwood patient, were discharged without any transfusion. Among patients within the clear prime group, hospitalizations without blood exposure were associated with higher preoperative hematocrit (median, 43% vs 40%; P = .02), shorter postoperative mechanical ventilation times (median, 22 hours vs 66 hours; P = .01) and shorter postoperative hospital stays (median, 10 days vs 15 days; P = .02).
    Conclusions: Bloodless surgery is possible in a significant proportion of neonates undergoing open-heart surgery, including the Norwood operation, even in the early stages of experience. Early clinical results are favorable but long-term follow-up and continued efforts are warranted to prove safety and reproducibility.
    MeSH term(s) Infant, Newborn ; Humans ; Reproducibility of Results ; Cardiac Surgical Procedures/adverse effects ; Blood Transfusion/methods ; Cardiopulmonary Bypass/methods ; Length of Stay ; Heart Defects, Congenital/surgery ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2023-07-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2023.07.032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Current perspectives on treatment of perioperative hemodynamic instability and hypotension.

    Joffe, Denise C / Latham, Gregory J / Ross, Faith J

    Paediatric anaesthesia

    2019  Volume 29, Issue 5, Page(s) 457–466

    Abstract: Overall, there are numerous causes of hypotension in the perioperative period. The approach to definitive treatment must be tailored to the child's unique anatomy and physiology, as well as the current factors presumed to be eliciting the hypotensive ... ...

    Abstract Overall, there are numerous causes of hypotension in the perioperative period. The approach to definitive treatment must be tailored to the child's unique anatomy and physiology, as well as the current factors presumed to be eliciting the hypotensive state. It is imperative to consider both routine and lesion-specific etiologies to the current hypotensive episode. Lastly, when employing pharmacologic therapy for hypotension, there are often multiple combinations of medications that can reasonably be used to achieve the desired hemodynamic effects.
    MeSH term(s) Anesthesia/adverse effects ; Child ; Child, Preschool ; Hemodynamics ; Humans ; Hypotension/diagnosis ; Hypotension/therapy ; Infant ; Infant, Newborn ; Perioperative Period
    Language English
    Publishing date 2019-02-19
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 1086049-6
    ISSN 1460-9592 ; 1155-5645
    ISSN (online) 1460-9592
    ISSN 1155-5645
    DOI 10.1111/pan.13583
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  10. Article ; Online: The Role of Novel Transcatheter Procedures in Patients With Congenital Heart Disease.

    Joffe, Denise C / Sheu, Richard / Keeshan, Britton C / Burbano-Vera, Nelson

    Journal of cardiothoracic and vascular anesthesia

    2020  Volume 35, Issue 7, Page(s) 2180–2193

    Abstract: The development of percutaneous structural interventions in patients with acquired heart disease is happening at an exponential rate, and some of this technology is being used to treat patients with congenital heart disease. This review describes the ... ...

    Abstract The development of percutaneous structural interventions in patients with acquired heart disease is happening at an exponential rate, and some of this technology is being used to treat patients with congenital heart disease. This review describes the pathophysiology of valvular abnormalities specific to congenital heart disease and discusses the application of structural procedures in this population. Although the overall experience has been encouraging, especially in high-risk patients, this article will highlight the reasons that a cautious approach to adoption of this technology is necessary in these patients.
    MeSH term(s) Cardiac Catheterization ; Heart Defects, Congenital/surgery ; Heart Valve Diseases/surgery ; Heart Valve Prosthesis Implantation ; Humans
    Language English
    Publishing date 2020-07-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2020.07.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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