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Filter Results:

Year

  • 2012 (2)

Author

  • Caldarone, Christopher A. (2)
  • Gaynor, J. William (2)
  • Ohye, Richard G. (2)
  • Benson, D. Woodrow (1)
  • Bhatt, Ami B. (1)
  • Cheatham, John P. (1)
  • Cohen, Meryl S. (1)
  • Daniels, Curt J. (1)
  • Deal, Barbara J. (1)
  • Dubin, Anne M. (1)
  • Dunbar-Masterson, Carolyn (1)
  • Feinstein, Jeffrey A. (1)
  • Furck, Anke K. (1)
  • Ghanayem, Nancy S. (1)
  • Ivy, D. Dunbar (1)
  • Jacobs, Jeffrey P. (1)
  • Johnson, Beth Ann (1)
  • Kaltman, Jonathan (1)
  • Kaza, Aditya K. (1)
  • Lu, Minmin (1)
  • Marsden, Alison L. (1)
  • Martin, Gerard R. (1)
  • Maxey, Dawn M. (1)
  • Morales, David L. (1)
  • Mussatto, Kathleen A. (1)
  • Newburger, Jane (1)
  • Pahl, Elfriede (1)
  • Pasquali, Sara K. (1)
  • Pearson, Gail D. (1)
  • Peng, Lynn F. (1)
  • Pizarro, Christian (1)
  • Rhodes, John F. (1)
  • Rosenthal, Geoffrey L. (1)
  • Rudd, Nanacy A. (1)
  • Scheurer, Mark (1)
  • Silver, Eric (1)
  • Sleeper, Lynn A. (1)
  • Tabbutt, Sarah (1)
  • Tweddell, James (1)
  • Tweddell, James S. (1)
  • Tworetzky, Wayne (1)
  • Uzark, Karen (1)
  • Villafane, Juan (1)
  • Wells, Winfield (1)

Journal

  • Journal of Thoracic and Cardiovascular Surgery (1)
  • Journal of the American College of Cardiology (1)

Keyword

  • biomedicin (2)
  • cardiac (2)
  • cardiolog (2)
  • cardiovascular (2)
  • heart (2)
  • life (2)
  • scienc (2)
  • system (2)
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Author department

  • Peds: Children's Hrt Ctr (2)

Search Results for all work with filters:

  • Mahle, William
  • Health Sciences, General
  • Health Sciences, Medicine and Surgery
  • congenit

Work 1-2 of 2

Sorted by relevance

Article

Hypoplastic Left Heart Syndrome Current Considerations and Expectations

by Jeffrey A. Feinstein; D. Woodrow Benson; Anne M. Dubin; Meryl S. Cohen; Dawn M. Maxey; William Mahle; Elfriede Pahl; Juan Villafane; Ami B. Bhatt; Lynn F. Peng; Beth Ann Johnson; Alison L. Marsden; Curt J. Daniels; Nanacy A. Rudd; Christopher A. Caldarone; Kathleen A. Mussatto; David L. Morales; D. Dunbar Ivy; J. William Gaynor; James S. Tweddell; Barbara J. Deal; Anke K. Furck; Geoffrey L. Rosenthal; Richard G. Ohye; Nancy S. Ghanayem; John P. Cheatham; Wayne Tworetzky; Gerard R. Martin

2012

Subjects
  • Health Sciences, Medicine and Surgery
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

In the recent era, no congenital heart defect has undergone a more dramatic change in diagnostic approach, management, and outcomes than hypoplastic left heart syndrome (HLHS). During this time, survival to the age of 5 years (including Fontan) has ranged from 50% to 69%, but current expectations are that 70% of newborns born today with HLHS may reach adulthood. Although the 3-stage treatment approach to HLHS is now well founded, there is significant variation among centers. In this white paper, we present the current state of the art in our understanding and treatment of HLHS during the stages of care: 1) pre-Stage I: fetal and neonatal assessment and management; 2) Stage I: perioperative care, interstage monitoring, and management strategies; 3) Stage II: surgeries; 4) Stage III: Fontan surgery; and 5) long-term follow-up. Issues surrounding the genetics of HLHS, developmental outcomes, and quality of life are addressed in addition to the many other considerations for caring for this group of complex patients.

Article

Variation in perioperative care across centers for infants undergoing the Norwood procedure

by Sara K. Pasquali; Richard G. Ohye; Minmin Lu; Jonathan Kaltman; Christopher A. Caldarone; Christian Pizarro; Carolyn Dunbar-Masterson; J. William Gaynor; Jeffrey P. Jacobs; Aditya K. Kaza; Jane Newburger; John F. Rhodes; Mark Scheurer; Eric Silver; Lynn A. Sleeper; Sarah Tabbutt; James Tweddell; Karen Uzark; Winfield Wells; William Mahle; Gail D. Pearson

2012

Subjects
  • Health Sciences, Medicine and Surgery
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

Objectives: In the Single Ventricle Reconstruction trial, infants undergoing the Norwood procedure were randomly allocated to undergo a right ventricle-to-pulmonary artery shunt or a modified Blalock-Taussig shunt. Apart from shunt type, subjects received the local standard of care. We evaluated variation in perioperative care during the Norwood hospitalization across 14 trial sites. Methods: Data on preoperative, operative, and postoperative variables for 546 enrolled subjects who underwent the Norwood procedure were collected prospectively on standardized case report forms, and variation across the centers was described. Results: Gestational age, birth weight, and proportion with hypoplastic left heart syndrome were similar across sites. In contrast, all recorded variables related to preoperative care varied across centers, including fetal diagnosis (range, 55%-85%), preoperative intubation (range, 29%-91%), and enteral feeding. Perioperative and operative factors were also variable across sites, including median total support time (range, 74-189 minutes) and other perfusion variables, arch reconstruction technique, intraoperative medication use, and use of modified ultrafiltration (range, 48%-100%). Additional variation across centers was seen in variables related to postoperative care, including proportion with an open sternum (range, 35%-100%), median intensive care unit stay (range, 9-44 days), type of feeding at discharge, and enrollment in a home monitoring program (range, 1%-100%; 5 sites did not have a program). Overall, in-hospital death or transplant occurred in 18% (range across sites, 7%-39%). Conclusions: Perioperative care during the Norwood hospitalization varies across centers. Further analysis evaluating the underlying causes and relationship of this variation to outcome is needed to inform future studies and quality improvement efforts.
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