Background:The complexity of ventricular septal defects in early infancy led to development of new mini-invasive techniques based on collaboration of cardiac surgeons with interventional cardiologists, called hybrid procedures. Hybrid therapies aim t...
28 February 2013 in Videosurgery and Other Miniinvasive Techniques
We present a case of a severely ill newborn with complex coarctation, multiorgan failure and massive oedema, who was treated with emergency stenting of the isthmus on the second day of life, which was followed by surgical stent removal and repair of the arch on the 29 day, after stabilization...
Paediatric hybrid cardiovascular procedures are becoming increasingly popular due to the wide spectrum of cardiovascular abnormalities and a large population of patients who could benefit from hybrid therapy. Contemporary hybrid procedures are introduced in the settings where routine cardiac surgery or cardiac interventions would not allow satisfactory results. Combining cardiac surgery and interventional cardiology techniques appears more beneficial and less invasive for the patient. To present results of hybrid procedures performed in the treatment of selected congenital heart disease in our centre in 2008-2013. We retrospectively analysed consecutive 80 patients referred for hybrid procedures. Overall, 73 patients survived, with 4 early and 3 late deaths. Hybrid procedures in children with congenital heart disease combine the experience of cardiac surgery and interventional cardiology. Hybrid treatment is an alternative option for selected borderline patients. Initial results of hybrid treatment encourage further development of these methods and strategies to provide optimal benefits for the patients.
Background: Extracorporeal circulation is associated with systemic inflammatory response syndrome. Therefore, the diagnosis of infection should be differentiated from a typical postoperative course. Aim: The aim of the study was to evaluate the kinetics of inflammatory biomarkers in children in the first days after cardiac surgery with extracorporeal circulation. Methods: Prospective data were collected from 51 consecutive children referred for surgical treatment in Department of Paediatric Cardiac Surgery, St. Adalbertus Hospital in Gdansk, between February and August 2015. Blood samples were collected on the first, second, and third postoperative days and sent to the institutional laboratory for routine investigations: white blood cell count, serum C-reactive protein (CRP) and procalcitonin concentrations. Results: The highest levels of procalcitonin were on the first postoperative day (median 3.53 ng/mL), although the peak values of CRP concentration and white blood cell count were on the second postoperative day (96 mg/L and 17.3 G/L). In the group of patients with foreign material implantation (Contegra (R) or Gore-Tex (R)), the higher values of procalcitonin concentration and white blood cell count were measured in the subsequent postoperative days. Conclusions: The kinetics of analysed inflammatory biomarkers on the first days after cardiac surgery for congenital heart disease in children have different characteristics. The knowledge about the kinetics of inflammatory biomarkers could be useful in determining the possibility of evolving infections in the early postoperative period.
Since 2008 we have performed 10 hybrid procedures for perventricular muscular ventricular septal defects (mVSD) closure. The mean age was 8.5 months (range 2.7 to 17.8), the mean diameter of mVSD was 6.3 mm (range 4 to 10 mm). The postoperative course was uncomplicated and complete closure of the mVSD was accomplished in all patients. There was neither in-hospital nor late mortality, and the longest follow-up now exceeds three years (range 2 months to 3.1 years). doi: 10.1111/jocs.12106 (J Card Surg 2013;28:453–455)