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Comentale G, Palma G, Parisi V, Simeone S, Pucciarelli G, Manzo R, Pilato E, Giordano R. Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience. Healthcare (Basel) 2020; 8:healthcare8040455. [PMID: 33153007 PMCID: PMC7712109 DOI: 10.3390/healthcare8040455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose: Redo operations and preoperative antiplatelet/anticoagulant therapy can significantly increase surgical risk in congenital heart surgery. This is a retrospective study on the impact of preoperative aspirin therapy on the outcome of Tetralogy of Redo Fallot patients undergoing right ventricle outflow tract (RVOT) conduit implantation. Methods: Ten-years retrospective analysis of medical records was carried out. A total of 72 patients were divided into two groups: “Daily-on-ASA” group on daily therapy with aspirin (ASA) until 5 days from surgery and “No-Home-ASA” without it. Propensity match analysis was done in order to standardize the populations. Intraoperative and postoperative lengths were compared as well as the need for inotropic support. In addition, differences in blood transfusions and need for Fresh frozen plasma (FFP)/platelets (PLT) were analysed. Findings: Intraoperative lengths were similar between the groups. Not statistically significative differences about postoperative time to extubation (p = 0.34), ICU Stay (p = 0.31) or in-hospital stay (p = 0.36) were found. Drain loss was higher in the “Daily-on-ASA” group (407.9 ± 96.7 mL vs. 349.5 ± 84.3 mL; p = 0.03) as well as blood transfusions (372.7 ± 255.1 mL vs. 220.1 ± 130.3 mL, p = 0.02) and PLT/FFP need (217.7 ± 132.1 mL vs. 118.7 ± 147.1 mL, p = 0.01). No differences were found in postoperative complications or re-explorations for bleeding. Implications: We found no advantages in surgical times and hospital stay comparing redo patients who stopped aspirin versus those that didn’t take it in the last 6 months. However, our results suggest that redo patients undergoing RVOT conduit implantation who take daily aspirin are at higher risk of bleeding even if it is stopped 5 days before surgery.
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Affiliation(s)
- Giuseppe Comentale
- Department of Advanced Biomedical Sciences, Adult and Pediatric Cardiac Surgery-University of Naples Federico II, 80131 Naples, Italy; (G.C.); (G.P.); (R.M.); (E.P.)
| | - Gaetano Palma
- Department of Advanced Biomedical Sciences, Adult and Pediatric Cardiac Surgery-University of Naples Federico II, 80131 Naples, Italy; (G.C.); (G.P.); (R.M.); (E.P.)
| | - Valentina Parisi
- Department of Translational Medical Sciences-University of Naples Federico II, 80131 Naples, Italy;
| | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.S.); (G.P.)
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.S.); (G.P.)
| | - Rachele Manzo
- Department of Advanced Biomedical Sciences, Adult and Pediatric Cardiac Surgery-University of Naples Federico II, 80131 Naples, Italy; (G.C.); (G.P.); (R.M.); (E.P.)
| | - Emanuele Pilato
- Department of Advanced Biomedical Sciences, Adult and Pediatric Cardiac Surgery-University of Naples Federico II, 80131 Naples, Italy; (G.C.); (G.P.); (R.M.); (E.P.)
| | - Raffaele Giordano
- Department of Advanced Biomedical Sciences, Adult and Pediatric Cardiac Surgery-University of Naples Federico II, 80131 Naples, Italy; (G.C.); (G.P.); (R.M.); (E.P.)
- Correspondence:
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Yu XR, Huang ST, Xu N, Wang LW, Wang ZC, Cao H, Chen Q. The effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery. J Cardiothorac Surg 2020; 15:309. [PMID: 33036645 PMCID: PMC7547472 DOI: 10.1186/s13019-020-01355-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate the effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery. METHODS Infants with congenital heart disease were randomly divided into the breast milk oral stimulation group (n = 23), physiological saline oral stimulation group (n = 23) and control group (n = 23). Debra Beckman's oral exercise program was used with breast milk and physiological saline in the breast milk oral stimulation group and the physiological saline oral stimulation group, respectively. The time oral feeding and total oral nutrition were started, the length of intensive care unit (ICU) stay and hospital stay, weight and the complications at discharge were recorded for each group and statistically analyzed. RESULTS The time oral feeding and total oral nutrition were started and the length of ICU stay and hospital stay were significantly less in the breast milk oral stimulation group and physiological saline oral stimulation group than in the control group (P < 0.05). There were no significant differences in other indicators between the breast milk oral stimulation group and the physiological saline oral stimulation group, except for the time total oral nutrition began (P < 0.05). However, there were no significant differences in weight or complications at discharge among the three groups (P > 0.05). CONCLUSION Early oral stimulation exercises with breast milk can help infant patients quickly recover total oral nutrition and reduce the length of ICU and hospital stay after cardiac surgery.
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Affiliation(s)
- Xian-Rong Yu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Ning Xu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Li-Wen Wang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Zeng-Chun Wang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
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Favia I, Rizza A, Garisto C, Haiberger R, Di Chiara L, Romagnoli S, Ricci Z. Cardiac index assessment by the pressure recording analytical method in infants after paediatric cardiac surgery: a pilot retrospective study. Interact Cardiovasc Thorac Surg 2016; 23:919-923. [DOI: 10.1093/icvts/ivw251] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/14/2016] [Accepted: 06/22/2016] [Indexed: 12/14/2022] Open
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Summary of the 2015 International Paediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute. Cardiol Young 2015; 25 Suppl 2:8-30. [PMID: 26377707 DOI: 10.1017/s1047951115001353] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In the United States alone, ∼14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve. The International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was held on February 4 and 5, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children's Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children's Hospital Andrews/Daicoff Cardiovascular Program, the International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary "think-tank". The purpose of this manuscript is to summarise the lessons from the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute, to describe the "state of the art" of the treatment of paediatric cardiac failure, and to discuss future directions for research in the domain of paediatric cardiac failure.
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