Tuesday, November 17, 2015

Intraluminal PA band - Surgically placed, Balloon dilatable.

Feasibility and related outcome of intraluminal pulmonary artery banding

Stany Sandrio et al. EJCTS 2015;48:470-480.

Pericardial patch with a fenestration is placed inside MPA. Needs cardiopulmonary bypass to perform this surgery.
Two types: One patch with a fenestration, or Two patches sewn together at the fenestration and then, sutured inside MPA to create an hour-glass appearance.

Balloon dilatation of this patch is possible.
Significant number of patients needed ECMO support after the procedure.
Total patients 32 in the study.



Trusler rule: JTCVS 1984;88(5 Pt 1): 645-53.

Sunday, October 11, 2015

Evrolimus therapy for Rhabdomyoma

From Wagner R. et al. Echocardiography 2015. Online accessed September 2015. DOI:10.1111/echo.1 3015.

Newborn. Treated with Evrolimus (1 mg/m2 once daily). Resolution after 3 weeks of treatment. Trough level of Evrolimus was monitored. Lymphopenia and hypertriglyceridemia was noted when higher dose was used for the first 2 days.

Sunday, September 13, 2015

Congenital heart defects and receipt of special education services

Tiffany Riehle-Colarusso et al.
Pediatrics 2015;136:496-503.

Compared with children without birth defects, children with CHD were 50% more likely to receive special education services (Adjusted Prevalence Rate Ratio 1.5)

Special education categories:
Intellectual disability (aPRR 3.8)
Sensory impairment (aPRR 3.0)
Other health impairment (aPRR 2.8)
Significant developmental delay (aPRR 1.9)
Specific learning disability (1.4)

Saturday, August 22, 2015

Sildenafil - liquid preparation

Click on the image to enlarge
(10 mg/ml)


New therapy for high LDL - PCSK9 inhibitor

From an advertisement by AmGen in Cardiology News August 2015:
New therapy for high LDL level.
PCSK9 inhibitor
PCSK9 (Proprotein convertase subtilisin/kexin type 9) degrades LDL receptors in hepatocytes.
Injection Praluent (Alirocumab) 75 mg or 150 mg. self-administer, q2weeks, recently approved by FDA.



Hyperkalemia therapy - Patriomer

From Cardiology News Aug 2015
Patiromer - a pottasium binding polymer. Binds with K in GI tract and enables excretion in stool.
JAMA 2015:314:129-30.

New Heart Failure Medication - Sacubitril (Neprilysin inhibitor)

From Cardiology News Aug 2015:
RE: FDA approval for a combination medication (Sacubitril + Valsartan)
Sacubitril - a neprilysin inhibitor
Valsartaion - an angiotensin receptor blocker

Tuesday, June 16, 2015

ARVD criteria

Importance of CMR within the task force criteria for the diagnosis of ARVC in children and adolescents.
Etoom Y, et al. JACC 2015;65:987-995.

Pulmonary arterial capacitance

Pulmonary arterial capacitance is an important predictor of mortality in heart failure with a preserved ejection fraction.
Al-Naamani et al. JACC: Heart Failure 2015;3(6):467-74.

Several definitions are explained in the introduction of this article.
Pulmonary hypertension secondary left heart disease is defined as mean PAP > 25 mmHg and mean PAWP > 15 mmHg.

Transpulmonary gradient > 12 mmHg is considered "disproportionate" increase in mean PAP relative to mean PAWP.

These two groups (disproportionate vs. proportionate increase in mPAP) may be better discriminated by diastolic pressure gradient > or = 7 mmHg vs. < 7 mmHg (ref:  Vachiery JL et al. Pulmonary hypertension due to left heart disease. JACC 2013 Dec;62(25 Suppl):D100-8).




Thursday, January 1, 2015

Sodium abnormalities

Review article: NEJM 2015;372:55-65.

Disorders of Plasma Sodium - Causes, Consequences, and Correction.

Abstract

This review considers the causes and consequences of an abnormal plasma sodium concentration and offers a framework for correcting it.
PMID:
 
25551526
 
[PubMed - as supplied by publisher]

Acute Kidney Injury detection after heart surgery in children

JACC 2014;64:2753-62

Combining functional and tubular damage biomarkers improves diagnostic precision of acute kidney injury after cardiac surgery.
Rajit K. Basu, et al. JACC 2014;64:2753-62.

Objective: Combining two biomarkers will improve precision of acute kidney injury (AKI) diagnosis after heart surgery in children.

Methods: n=345 children after cardiopulmonary bypass (CPB). Two biomarkers: Plasma Cystatin C & uNGAL were measured 2 hr after initiation of CPB.

Conclusion: Composites of plasma Cystatin C and uNGAL are superior to serum creatinine for predicting discrete characteristics of AKI.
(Click on the image to enlarge)