Thoracic duct redirection to left atrium - Fontan

High-Risk Cardiac Disease in Pregnancy

Uri Elkayam, Sorel Goland, Petronella Pieper and Candice Silverside.
(UCLA, Jeruselam, Groningen - Netherlands & Toronto)

Good review articles covering most important lesions.

Part I - JACC 2016;68(4): 396-410.
Part II - JACC 2016;68(5): 502-16.

Late Causes of Death After Pediatric Cardiac Surgery

Alireza Raissadati et al. JACC 2016;68:487-98.
From Finland.

1953-2009
Divided into two surgical era: 1953-89 & 1990-2009.

Cardiac causes of mortality:
Heart failure
Pulmonary hypertension
Sudden death (Aortic rupture, Arrhythmia, MI - majority were unexplained)
Death after reoperation

Non-cardiac causes of mortality:
Respiratory disease (esp. pneumonia associated with mental disability)
Neurologic and infectious diseases
Neoplasm (more common compared to general population)
Accidents (alcohol-related)

Food label update

New food label will show "Added Sugar" separetely.

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.

Click here to blog post describing Trusler Rule

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.

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)