The Experts below are selected from a list of 222 Experts worldwide ranked by ideXlab platform

Pedro J Del Nido - One of the best experts on this subject based on the ideXlab platform.

  • biventricular repair for common Atrioventricular Canal defect with parachute left Atrioventricular valve
    European Journal of Cardio-Thoracic Surgery, 2016
    Co-Authors: Patrick Olivier Myers, Pedro J Del Nido, Victor Bautistahernandez, Gerald R Marx, Sitaram M Emani, Frank A Pigula, Michele Borisuk, Christopher W Baird
    Abstract:

    Parachute left Atrioventricular (AV) valve can complicate repair of common Atrioventricular Canal (CAVC), and single-ventricle palliation is sometimes preferred. The goal of this study is to review our single institutional experience in biventricular repair in this patient group.

  • biventricular conversion after single ventricle palliation in unbalanced Atrioventricular Canal defects
    The Annals of Thoracic Surgery, 2013
    Co-Authors: Meena Nathan, Gerald R Marx, Sitaram M Emani, Frank A Pigula, Hua Liu, Francis Fynnthompson, Christopher A Baird, John E Mayer, Pedro J Del Nido
    Abstract:

    Background Management of unbalanced common Atrioventricular Canal (UCAVC) defect by a single-ventricle (SV) approach frequently results in poor outcomes, especially in trisomy 21 patients. In this report we describe our results with conversion to biventricular circulation in UCAVC patients with SV palliation. Methods Retrospective review of patients with UCAVC undergoing biventricular conversion from prior SV palliation between 2003 and 2011 was conducted. Mortality and freedom from reinterventions were analyzed using nonparametric methods. Results Sixteen children with UCAVC (8 patients [50%] were left dominant) and prior SV palliation underwent conversion to biventricular circulation between 2003 and 2011. Median follow-up was 18 months (range, 3 to 94 months). Surgical indications included worsening cyanosis, severe Atrioventricular valve regurgitation, or failing bidirectional Glenn or Fontan physiology. All patients had either unequal distribution of the common Atrioventricular valve of greater than 60% or one hypoplastic ventricle. By magnetic resonance imaging or computed tomography, 8 patients with right dominant Atrioventricular Canal had a median left ventricular end-diastolic volume of 32 mL/m 2 (range, 22 to 35 mL/m 2 ). Eight patients with a left dominant Atrioventricular Canal had a median right ventricular end-diastolic volume of 42 mL/m 2 (range, 26 to 64 mL/m 2 ). Eleven patients (69%) had trisomy 21, and 3 patients (19%) had heterotaxy. Stages of palliation included stage I in 2 patients, bidirectional Glenn in 10 patients, hemi-Fontan in 2 patients, and Fontan in 2 patients. There was 1 (6%) operative (right ventricle dominant) and 1 (6%) late death (left ventricle dominant). Eight patients required reinterventions, 3 (19%) surgical and 6 (38%) catheter-based. On follow-up, all had improvement in cyanosis and symptoms. Conclusions Biventricular conversion from failing SV palliation in UCAVC can be accomplished with an acceptable early and late morbidity and mortality, although need for reintervention was not uncommon.

  • changes in left Atrioventricular valve geometry after surgical repair of complete Atrioventricular Canal
    The Journal of Thoracic and Cardiovascular Surgery, 2012
    Co-Authors: Elisabeth Kaza, Gerald R Marx, Aditya K Kaza, Steven D Colan, Hugo Loyola, Douglas P Perrin, Pedro J Del Nido
    Abstract:

    Objective The most common reason for late surgical reintervention after repair of complete Atrioventricular Canal defects is the development of left Atrioventricular valve regurgitation. We sought to determine the changes in left Atrioventricular valve geometry after surgical repair that may predispose to regurgitation. Methods Atrioventricular valve measurements were obtained by 2-dimensional echocardiography at 3 different time points (preoperative, early postoperative, and midterm postoperative [6–12 months]). Left Atrioventricular valve annulus area and left ventricular volume were calculated; vena contracta of the regurgitant jet orifice was measured. All measurements were normalized relative to an appropriate power of body surface area. Results From January 2000 to January 2008, 101 patients with complete Atrioventricular Canal repair were included. Left Atrioventricular valve annulus was noted to remodel from an elliptical shape to a circular shape after surgery. Left Atrioventricular valve annulus area increased early postoperatively (systole: 4.1 ± 0.2 cm 2 /m 2 vs 6.1 ± 0.3 cm 2 /m 2 , P  001; diastole: 7.2 ± 0.4 cm 2 /m 2 vs 10.0 ± 0.5 cm 2 /m 2 , P  001, pre- vs postoperative, respectively). This increase was sustained in the midterm postoperative period (systole: 6.1 ± 0.3 cm 2 /m 2 , P  = .85, vs diastole: 10.0 ± 0.4 cm 2 /m 2 , P  = .78, early vs midterm postoperative). Left ventricular volume increased in the early and midterm postoperative periods compared with preoperative (systole: 16.9 ± 1.2 mL/m 2 vs 26.2 ± 1.7 mL/m 2 , P  001; diastole: 35.0 ± 2.4 mL/m 2 vs 52.5 ± 3.2 mL/m 2 , P  001). Conclusions Complete Atrioventricular Canal repair leads to left Atrioventricular valve annular shape change with increased area and circular shape. The change in left Atrioventricular valve annulus shape appeared to be mainly due to increased circumference in the posterior free wall of the annulus. These findings may provide a mechanism for the progression of central regurgitation seen after complete Atrioventricular Canal repair and a potential solution.

Zhang Kai-lun - One of the best experts on this subject based on the ideXlab platform.

  • Surgical treatment of unroofed coronary sinus syndrome with Atrioventricular Canal defect
    Chinese Journal of Thoracic and Cardiovascular Surgery, 2006
    Co-Authors: Zhang Kai-lun
    Abstract:

    Objective Unroofed coronary sinus syndrome (UCSS) is a rare cardiac anomaly.It is usually associated with other cardiovascular anomalies, especially persistent left superior vena cava (PLSVC). It is difficult to dignosis preoperatively. Methods 8 patients underwent surgical repair for the Atrioventricular Canal defect with unroofed coronary sinus from Jan, 2001 to Aug, 2005 in our hospital (Partial Atrioventricular Canal defect in 6 cases and complete Atrioventricular Canal defect in 2). There were 5 males and 3 females with age ranged from 1～35 years old. Persistent left superior vena cava (PLSVC) directly drains into the left atrium (LA)was found in all cases. 1 case of PLSVC was ligated. 4 cases were used extracardiac conduit to connect PLSVC to right arium. 3 cases were reconstructed the intra-atrial tunnel to drain PLAVC and to collect coronary veins concomitantly. Results There was no death and severe complications in this group. The follow-up results were satisfactory. Conclusion Atrioventricular Canal defect are friquently associated with unroofed coronary sinus syndrome, we use 3 methods to deal with the different PLAVC with a good result.

Patrick Olivier Myers - One of the best experts on this subject based on the ideXlab platform.

  • biventricular repair for common Atrioventricular Canal defect with parachute left Atrioventricular valve
    European Journal of Cardio-Thoracic Surgery, 2016
    Co-Authors: Patrick Olivier Myers, Pedro J Del Nido, Victor Bautistahernandez, Gerald R Marx, Sitaram M Emani, Frank A Pigula, Michele Borisuk, Christopher W Baird
    Abstract:

    Parachute left Atrioventricular (AV) valve can complicate repair of common Atrioventricular Canal (CAVC), and single-ventricle palliation is sometimes preferred. The goal of this study is to review our single institutional experience in biventricular repair in this patient group.

  • No-patch technique for complete Atrioventricular Canal repair.
    The Annals of thoracic surgery, 2010
    Co-Authors: Patrick Olivier Myers, Mustafa Cikirikcioglu, Yacine Aggoun, Nicolas Paul Henri Murith, Afksendiyos Kalangos
    Abstract:

    Although no-patch repair was the first surgical treatment for complete Atrioventricular Canal, patch repairs are currently more widely used. We assessed the safety of forgoing a patch during the correction of complete Atrioventricular Canal in 8 consecutive patients. The complete Atrioventricular Canal was repaired using sutures placed on the right of the ventricular septal defect crest, passed through the bridging leaflet, and to the facing part of the ostium primum defect. There were no early deaths; all patients were in sinus rhythm without left ventricular outflow tract obstruction. This no-patch technique produces results comparable with the modified single-patch repair, while reducing ischemic time.

Gerald R Marx - One of the best experts on this subject based on the ideXlab platform.

  • biventricular repair for common Atrioventricular Canal defect with parachute left Atrioventricular valve
    European Journal of Cardio-Thoracic Surgery, 2016
    Co-Authors: Patrick Olivier Myers, Pedro J Del Nido, Victor Bautistahernandez, Gerald R Marx, Sitaram M Emani, Frank A Pigula, Michele Borisuk, Christopher W Baird
    Abstract:

    Parachute left Atrioventricular (AV) valve can complicate repair of common Atrioventricular Canal (CAVC), and single-ventricle palliation is sometimes preferred. The goal of this study is to review our single institutional experience in biventricular repair in this patient group.

  • biventricular conversion after single ventricle palliation in unbalanced Atrioventricular Canal defects
    The Annals of Thoracic Surgery, 2013
    Co-Authors: Meena Nathan, Gerald R Marx, Sitaram M Emani, Frank A Pigula, Hua Liu, Francis Fynnthompson, Christopher A Baird, John E Mayer, Pedro J Del Nido
    Abstract:

    Background Management of unbalanced common Atrioventricular Canal (UCAVC) defect by a single-ventricle (SV) approach frequently results in poor outcomes, especially in trisomy 21 patients. In this report we describe our results with conversion to biventricular circulation in UCAVC patients with SV palliation. Methods Retrospective review of patients with UCAVC undergoing biventricular conversion from prior SV palliation between 2003 and 2011 was conducted. Mortality and freedom from reinterventions were analyzed using nonparametric methods. Results Sixteen children with UCAVC (8 patients [50%] were left dominant) and prior SV palliation underwent conversion to biventricular circulation between 2003 and 2011. Median follow-up was 18 months (range, 3 to 94 months). Surgical indications included worsening cyanosis, severe Atrioventricular valve regurgitation, or failing bidirectional Glenn or Fontan physiology. All patients had either unequal distribution of the common Atrioventricular valve of greater than 60% or one hypoplastic ventricle. By magnetic resonance imaging or computed tomography, 8 patients with right dominant Atrioventricular Canal had a median left ventricular end-diastolic volume of 32 mL/m 2 (range, 22 to 35 mL/m 2 ). Eight patients with a left dominant Atrioventricular Canal had a median right ventricular end-diastolic volume of 42 mL/m 2 (range, 26 to 64 mL/m 2 ). Eleven patients (69%) had trisomy 21, and 3 patients (19%) had heterotaxy. Stages of palliation included stage I in 2 patients, bidirectional Glenn in 10 patients, hemi-Fontan in 2 patients, and Fontan in 2 patients. There was 1 (6%) operative (right ventricle dominant) and 1 (6%) late death (left ventricle dominant). Eight patients required reinterventions, 3 (19%) surgical and 6 (38%) catheter-based. On follow-up, all had improvement in cyanosis and symptoms. Conclusions Biventricular conversion from failing SV palliation in UCAVC can be accomplished with an acceptable early and late morbidity and mortality, although need for reintervention was not uncommon.

  • changes in left Atrioventricular valve geometry after surgical repair of complete Atrioventricular Canal
    The Journal of Thoracic and Cardiovascular Surgery, 2012
    Co-Authors: Elisabeth Kaza, Gerald R Marx, Aditya K Kaza, Steven D Colan, Hugo Loyola, Douglas P Perrin, Pedro J Del Nido
    Abstract:

    Objective The most common reason for late surgical reintervention after repair of complete Atrioventricular Canal defects is the development of left Atrioventricular valve regurgitation. We sought to determine the changes in left Atrioventricular valve geometry after surgical repair that may predispose to regurgitation. Methods Atrioventricular valve measurements were obtained by 2-dimensional echocardiography at 3 different time points (preoperative, early postoperative, and midterm postoperative [6–12 months]). Left Atrioventricular valve annulus area and left ventricular volume were calculated; vena contracta of the regurgitant jet orifice was measured. All measurements were normalized relative to an appropriate power of body surface area. Results From January 2000 to January 2008, 101 patients with complete Atrioventricular Canal repair were included. Left Atrioventricular valve annulus was noted to remodel from an elliptical shape to a circular shape after surgery. Left Atrioventricular valve annulus area increased early postoperatively (systole: 4.1 ± 0.2 cm 2 /m 2 vs 6.1 ± 0.3 cm 2 /m 2 , P  001; diastole: 7.2 ± 0.4 cm 2 /m 2 vs 10.0 ± 0.5 cm 2 /m 2 , P  001, pre- vs postoperative, respectively). This increase was sustained in the midterm postoperative period (systole: 6.1 ± 0.3 cm 2 /m 2 , P  = .85, vs diastole: 10.0 ± 0.4 cm 2 /m 2 , P  = .78, early vs midterm postoperative). Left ventricular volume increased in the early and midterm postoperative periods compared with preoperative (systole: 16.9 ± 1.2 mL/m 2 vs 26.2 ± 1.7 mL/m 2 , P  001; diastole: 35.0 ± 2.4 mL/m 2 vs 52.5 ± 3.2 mL/m 2 , P  001). Conclusions Complete Atrioventricular Canal repair leads to left Atrioventricular valve annular shape change with increased area and circular shape. The change in left Atrioventricular valve annulus shape appeared to be mainly due to increased circumference in the posterior free wall of the annulus. These findings may provide a mechanism for the progression of central regurgitation seen after complete Atrioventricular Canal repair and a potential solution.

Sitaram M Emani - One of the best experts on this subject based on the ideXlab platform.

  • biventricular repair for common Atrioventricular Canal defect with parachute left Atrioventricular valve
    European Journal of Cardio-Thoracic Surgery, 2016
    Co-Authors: Patrick Olivier Myers, Pedro J Del Nido, Victor Bautistahernandez, Gerald R Marx, Sitaram M Emani, Frank A Pigula, Michele Borisuk, Christopher W Baird
    Abstract:

    Parachute left Atrioventricular (AV) valve can complicate repair of common Atrioventricular Canal (CAVC), and single-ventricle palliation is sometimes preferred. The goal of this study is to review our single institutional experience in biventricular repair in this patient group.

  • biventricular conversion after single ventricle palliation in unbalanced Atrioventricular Canal defects
    The Annals of Thoracic Surgery, 2013
    Co-Authors: Meena Nathan, Gerald R Marx, Sitaram M Emani, Frank A Pigula, Hua Liu, Francis Fynnthompson, Christopher A Baird, John E Mayer, Pedro J Del Nido
    Abstract:

    Background Management of unbalanced common Atrioventricular Canal (UCAVC) defect by a single-ventricle (SV) approach frequently results in poor outcomes, especially in trisomy 21 patients. In this report we describe our results with conversion to biventricular circulation in UCAVC patients with SV palliation. Methods Retrospective review of patients with UCAVC undergoing biventricular conversion from prior SV palliation between 2003 and 2011 was conducted. Mortality and freedom from reinterventions were analyzed using nonparametric methods. Results Sixteen children with UCAVC (8 patients [50%] were left dominant) and prior SV palliation underwent conversion to biventricular circulation between 2003 and 2011. Median follow-up was 18 months (range, 3 to 94 months). Surgical indications included worsening cyanosis, severe Atrioventricular valve regurgitation, or failing bidirectional Glenn or Fontan physiology. All patients had either unequal distribution of the common Atrioventricular valve of greater than 60% or one hypoplastic ventricle. By magnetic resonance imaging or computed tomography, 8 patients with right dominant Atrioventricular Canal had a median left ventricular end-diastolic volume of 32 mL/m 2 (range, 22 to 35 mL/m 2 ). Eight patients with a left dominant Atrioventricular Canal had a median right ventricular end-diastolic volume of 42 mL/m 2 (range, 26 to 64 mL/m 2 ). Eleven patients (69%) had trisomy 21, and 3 patients (19%) had heterotaxy. Stages of palliation included stage I in 2 patients, bidirectional Glenn in 10 patients, hemi-Fontan in 2 patients, and Fontan in 2 patients. There was 1 (6%) operative (right ventricle dominant) and 1 (6%) late death (left ventricle dominant). Eight patients required reinterventions, 3 (19%) surgical and 6 (38%) catheter-based. On follow-up, all had improvement in cyanosis and symptoms. Conclusions Biventricular conversion from failing SV palliation in UCAVC can be accomplished with an acceptable early and late morbidity and mortality, although need for reintervention was not uncommon.