Ramírez MS, Calderón CJ

Language: Spanish
References: 10
Page: 128-132
PDF size: 60.80 Kb.

ABSTRACT

The present is a brief report about the advances in treatment of complex congenital heart defects at our institution, including the importance of prenatal detection, improved perioperative management, the surgical technique, the anesthesia control extended into the postoperative period, the extraordinary advances in cardiopulmonary bypass technology, and postoperative management. The operative mortality now is low for many cardiac defects, as result of a team of experienced surgeons, anesthesiologists, cardiologists, and nurses working together in the treatment of these patients. The issue of concern is now on the assessment of hemodynamic and neurodevelopmental status in the long-term follow-up. Further improvements in the surgical management of infants with complex congenital heart defects are required, and evaluation of these new techniques will likely come from prospective, randomized trials with large patient cohorts and long-term follow-up.

REFERENCES

1. Medeiros A, Iturralde P, Márquez M, Ramírez S, de Micheli A, Guevara M, Buendía A: Trastornos del ritmo y conducción permanentes en pacientes operados de comunicación interatrial. Arch Inst Cardiol Mex 2000; 70 (1): 46-54.

2. Medeiros A, Iturralde P, Guevara-Valdivia ME, Ramírez S, Rodríguez L, Rodríguez I, et al: Ablación transquirúrgica del Flúter atrial en pacientes sometidos a cierre de comunicación interauricular. Estudio piloto. Arch Cardiol Mex 2001; 71(3): 221-6.

3. Newburger JW, Jonas RA, Wernovsky G, Wypij D, Hickey PR, Kuban KC, et al: A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart surgery. N Engl J Med 1993; 329: 1057-1064.

4. Bellinger DC, Wypij D, Kuban KC, Rappaport LA, Hickey PR, Wernovsky G, et al: Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 1999; 100: 526-532.

5. Hövels-Gürich HH, Seghaye MC, Schnitker R, Wiesner M, Huber W, Minkenberg R, et al: Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 2002; 124: 448-458.

6. Barbero-Marcial M. Jatene AD: Surgical management of the anomalies of the pulmonary arteries in the tetralogy of Fallot with pulmonary atresia. Semin Thorac Cardiovasc Surg 1990; 2: 93-107.

7. Barbero-Marcial M: Classification of pulmonary atresia with ventricular septal defect. Ann Thorac Surg 2001; 72: 316-327.

8. Chauvaud S, Fuzellier JF, Berrebi A, Lajos P, Marino JP, Mihaileanu S, Carpentier A: Bi-directional cavopulmonary shunt associated with ventricle and valvuloplasty in Ebstein’s anomaly: benefits in high risk patients. Eur J Cardiothorac Surg 1998; 13: 514-519.

9. Carpentier A, Chauvaud S, Macé L, Relland J, Mihaileanu S, Marino JP, et al: A new reconstructive operation for Ebsteins’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg 1988; 96: 92-101.

10. Chauvaud S, Berrebi A, d’Attlellis N, Mousseaux E, Hernigou A, Carpentier A: Ebstein’s anomaly: repair based on functional analysis. Eur J Cardiothorac Surg 2003; 23: 525-31.