cardiovascular-agents and Heart-Septal-Defects--Ventricular

The edge-to-edge mitral valve repair, first described by Alfieri in 1995 treats mitral regurgitation when standard reparative techniques are difficult, unlikely to succeed, or have failed. This study examines one institution's medium-term experience with this procedure.. This study involved patients undergoing edge-to-edge mitral valve repair at a single institution from 1997 to 2003. Preoperative and postoperative echocardiograms were compared. Postoperative morbidity was examined including need for reoperation and long-term medical management. Thirty-day survival and long-term actuarial survival were also determined.. Seventy-one patients comprised this study. Mitral regurgitation on echocardiogram went from 3.43 +/- 0.86 to 0.39 +/- 0.61 (p < 0.001) following repair. Thirty-day mortality was 3 of 71 (4.2%) patients. Actuarial survivals at 24 and 60 months were 84.5% and 58.3%, respectively; adjusted excluding noncardiac death they were 89.5% and 82.3%, respectively. Forty (56.3%) patients had concomitant ring placement and experienced similar survival to those repaired with the bow-tie stitch alone. Home telephone follow-up was conducted, and current medical therapy was determined on 51 patients; 59% were on a beta-blocker, 31% were on an angiotensin-converting enzyme (ACE) inhibitor, 27% were on a diuretic, and 22% were on digoxin. All were New York Heart Association (NYHA) class I or II. Three patients (4.2%) underwent mitral valve reoperation after a mean of 299 +/- 429 days. In no case did the bow-tie suture rupture.. Edge-to-edge mitral valve repair is a valuable tool in the armamentarium available to treat complex cases of mitral insufficiency or as an adjunct to standard repair techniques that fail to achieve an acceptable result.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cardiac Surgical Procedures; Cardiovascular Agents; Coronary Artery Bypass; Female; Follow-Up Studies; Heart Atria; Heart Septal Defects, Atrial; Heart Septal Defects, Ventricular; Humans; Life Tables; Male; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; New York City; Postoperative Complications; Reoperation; Retrospective Studies; Survival Analysis; Treatment Outcome

Twenty ventricular septal defect patients who underwent cardiopulmonary bypass (CPB) were divided into 1,6-diphosphate group and controlled group (10 cases each). Blood samples were taken at pre- and post-cardiopulmonary bypass 30 min, 6 h, and 24 h to determine lactate dehydrogenase enzyme(LDH), creatine kinase enzyme(CK) and its isoenzyme(CK-MB) levels. We found that 1,6-diphosphate decreased the increasing levels of LDH, CK, and CK-MB after cardiopulmonary bypass. It is suggested that 1,6-diphosphate may attenuate myocardial ischemia/reperfusion injuries during cardiopulmonary bypass.

Topics: Cardioplegic Solutions; Cardiopulmonary Bypass; Cardiovascular Agents; Creatine Kinase; Fructosediphosphates; Heart Septal Defects, Ventricular; Humans; Isoenzymes; L-Lactate Dehydrogenase; Myocardial Reperfusion Injury

Advances in surgical management strategies have substantially reduced fatality from congenital heart defects (CHD). Decreased infant mortality might be expected, consequentially to result in greater morbidity in older children due to complications later in childhood and adolescence. This study aims to evaluate the use of cardiovascular medication (CVM) as an indicator of disease burden in children born with CHD in the first 10 years of life.. Population-based cohort study.. Six population-based registries from the European Surveillance of Congenital Anomalies (EUROCAT) network participated. Data from live born children with major congenital anomalies (CA) born from 2000 to 2014 were linked to prescription databases. Four groups of children were analysed: CA, CHD, severe CHD (sCHD) and ventricular septal defect (VSD) without sCHD. Live born children without CA were included as reference group.. We obtained data on 61 038 children born with a CA, including 19 678 with CHD, 3392 with sCHD, 12 728 children with VSD without sCHD, and 1 725 496 reference children.. Children born with sCHD were the most likely to receive a CVM prescription (42.9%, 95% CI, 26.3 to 58.5) in the first year of life compared with 13.3% (6.7 to 22.0) of children with any CHD, 5.9% (3.7 to 8.7) of children with any CA and 0.1% (0.0 to 0.1) of reference children. Medication was less likely to be prescribed after the first year of life for sCHD; 18.8% (14.8 to 23.1) for children 1-4 years and 15.8% (12.0 to 20.1) 5-9 years. Children with sCHD were most likely to receive a diuretic (36.4%, 18.6 to 54.5), an antihypertensive (6.9%, 3.7 to 11.3) or a beta-blocker (5.5%, 2.9 to9.2).. Almost half of all children with sCHD were prescribed CVM in their first year of life. For all four groups of children with anomalies, the proportion of children with a CVM prescription decreased with age.

Topics: Adolescent; Cardiovascular Agents; Child; Cohort Studies; Drug Prescriptions; Female; Heart Defects, Congenital; Heart Septal Defects, Ventricular; Humans; Infant; Parturition; Pregnancy; Registries

Presently described is successful cesarean delivery in a pregnancy superimposed on long-term bosentan treatment in an Eisenmenger syndrome patient with cor triatriatum sinistrum, double-orifice mitral valve, and large ventricular septal defect resulting in single functioning ventricle with double outlets. Cesarean delivery was performed at 27th week of gestation without maternal or fetal morbidity. The infant had no congenital cardiovascular abnormality or any probable teratogenic effect of bosentan treatment during pregnancy.

Topics: Adult; Bosentan; Cardiovascular Agents; Cesarean Section; Cor Triatriatum; Eisenmenger Complex; Female; Heart Septal Defects, Ventricular; Humans; Infant, Extremely Premature; Infant, Newborn; Sulfonamides

With advances in transcatheter treatment options, percutaneous device closure of ventricular septal defects has become a safe and practical alternative to surgical repair. While outcomes have been excellent, late complete heart bock has been documented during follow up of pediatric patients. We report a case of late complete heart block complicating percutaneous device closure of a ventricular septal defect in a 37-year-old female requiring permanent pacemaker insertion. The patient underwent transcatheter closure of an atrial and ventricular septal defect in the context of treated pulmonary hypertension and significant intracardiac shunting. Seven months after the procedure, the patient was admitted with presyncope, with electrocardiographic monitoring confirming complete heart block. While previously only reported in the pediatric literature, awareness of the possibility of complete heart block should be considered during the late follow up of adult patients.

Topics: Adult; Balloon Occlusion; Bosentan; Cardiac Catheterization; Cardiovascular Agents; Female; Heart Block; Heart Septal Defects, Ventricular; Humans; Risk Factors; Sulfonamides; Time Factors