7 research outputs found
Patch Materials for Pulmonary Artery Arterioplasty and Right Ventricular Outflow Tract Augmentation: A Review
Patch augmentation of the right ventricular outflow tract (RVOT) and pulmonary artery (PA) arterioplasty are relatively common procedures in the surgical treatment of patients with congenital heart disease. To date, several patch materials have been applied with no agreed upon clinical standard. Each patch type has unique performance characteristics, cost, and availability. There are limited data describing the various advantages and disadvantages of different patch materials. We performed a review of studies describing the clinical performance of various RVOT and PA patch materials and found a limited but growing body of literature. Short-term clinical performance has been reported for a multitude of patch types, but comparisons are limited by inconsistent study design and scarce histologic data. Standard clinical criteria for assessment of patch efficacy and criteria for intervention need to be applied across patch types. The field is progressing with improvements in outcomes due to newer patch technologies focused on reducing antigenicity and promoting neotissue formation which may have the ability to grow, remodel, and repair
Early Experience and Lessons Learned Using Implanted Hemodynamic Monitoring in Patients With Fontan Circulation
Background Data on the use of implanted hemodynamic monitoring (IHM) in patients with Fontan circulation are limited. This study reports our experience using the CardioMEMS HF system in adults with Fontan circulation. Methods and Results This singleâcenter, retrospective study evaluated heart failure hospitalizations, procedural complications, and deviceârelated complications in patients with Fontan circulation referred for IHM placement (2015â2022). The association of pulmonary artery pressure (by most recent catheterization and median IHM pressure within 30âdays of placement) with both death and followâup Model for EndâStage Liver Disease Excluding International Normalized Ratio score were evaluated. Of 18 patients referred for IHM placement, 17 were successful (median age, 30 [range 21â48] years, 6 women). Procedural complications (access site hematomas, pulmonary artery staining) occurred in 3 patients, without deviceârelated procedural complications. In followâup (median, 35 [range, 6â83] months), 1 patient developed a pulmonary embolism (possibly deviceârelated). Heart failure hospitalizations/year were similar before and after IHM (median, 1 [interquartile range, 0â1.0] versus 0.6 [0â2.3]; P=0.268), though only 46% of heart failure hospitalizations had associated IHM transmissions. IHM pressures were associated with Model for EndâStage Liver Disease Excluding International Normalized Ratio scores (R2=0.588, P<0.001), though catheterization pressures were not (R2=0.140, P=0.139). The longâterm mortality rate was 53% in this cohort. On unadjusted survival analysis, IHM pressures â„18âmmâHg were associated with mortality (log rank P=0.041), which was not reproduced with catheterization pressures (log rank P=0.764). Conclusions In patients with Fontan circulation, IHM did not reduce heart failure hospitalizations, though patient adherence to transmission was low. Deviceârelated complications were low. IHM pressures may better represent realâlife conditions compared with catheterization given associations with mortality and Model for EndâStage Liver Disease Excluding International Normalized Ratio score
mRNA Coronavirus Disease 2019 Vaccine-Associated Myopericarditis in Adolescents: A Survey Study
In this survey study of institutions across the US, marked variability in evaluation, treatment, and follow-up of adolescents 12 through 18 years of age with mRNA coronavirus disease 2019 (COVID-19) vaccine-associated myopericarditis was noted. Only one adolescent with life-threatening complications was reported, with no deaths at any of the participating institutions
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mRNA Coronavirus Disease 2019 Vaccine-Associated Myopericarditis in Adolescents: A Survey Study.
In this survey study of institutions across the US, marked variability in evaluation, treatment, and follow-up of adolescents 12 through 18 years of age with mRNA coronavirus disease 2019 (COVID-19) vaccine-associated myopericarditis was noted. Only one adolescent with life-threatening complications was reported, with no deaths at any of the participating institutions
mRNA Coronavirus-19 Vaccine-Associated Myopericarditis in Adolescents: A Survey Study
In this survey study of institutions across the US, marked variability in evaluation, treatment, and follow-up of adolescents 12 through 18 years of age with mRNA coronavirus disease 2019 (COVID-19) vaccine-associated myopericarditis was noted. Only one adolescent with life-threatening complications was reported, with no deaths at any of the participating institutions