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Karaçelik M, Oral A, Bilen Ç, Polatdemir K. Multidisciplinary treatment for a patient with Pentalogy of Cantrell in the COVID-19 pandemic. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2024; 32:228-231. [PMID: 38933310 PMCID: PMC11197420 DOI: 10.5606/tgkdc.dergisi.2024.24969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/27/2023] [Indexed: 06/28/2024]
Abstract
In this article, we present a multidisciplinary approach for the treatment of a patient with Pentalogy of Cantrell, dextrocardia, perimembranous ventricular septal defect, secundum atrial septal defect, pulmonary valvular stenosis, and left ventricle diverticulum during the novel coronavirus disease 2019 pandemic.
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Affiliation(s)
- Mustafa Karaçelik
- Department of Pediatric Cardiac Surgery, Health Sciences University, Izmir Dr. Behçet Uz Children’s Hospital, Izmir, Türkiye
| | - Akgün Oral
- Department of Pediatric Surgery, Health Sciences University, Izmir Dr. Behçet Uz Children’s Hospital, Izmir, Türkiye
| | - Çağatay Bilen
- Department of Pediatric Cardiac Surgery, Health Sciences University, Izmir Dr. Behçet Uz Children’s Hospital, Izmir, Türkiye
| | - Kamer Polatdemir
- Department of Pediatric Surgery, Health Sciences University, Izmir Dr. Behçet Uz Children’s Hospital, Izmir, Türkiye
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Levy M, Lestrade V, Said C, Jouvet P, Kawaguchi A. Consequences of Social Distancing Measures During the COVID-19 Pandemic First Wave on the Epidemiology of Children Admitted to Pediatric Emergency Departments and Pediatric Intensive Care Units: A Systematic Review. Front Pediatr 2022; 10:874045. [PMID: 35722481 PMCID: PMC9204064 DOI: 10.3389/fped.2022.874045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To synthesize knowledge describing the impact of social distancing measures (SDM) during the first wave of the COVID-19 pandemic on acute illness in children by focusing on the admission to pediatric emergency departments (PED) and pediatric intensive care units (PICU). Methods We searched Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, EPOC Register, MEDLINE, Evidence-Based Medicine Reviews, EMBASE, WHO database on COVID-19, Cochrane Resources on COVID-19, Oxford COVID-19 Evidence Service, Google Scholar for literature on COVID-19 including pre-print engines such as medRxiv, bioRxiv, Litcovid and SSRN for unpublished studies on COVID-19 in December 2020. We did not apply study design filtering. The primary outcomes of interest were the global incidence of admission to PICU and PED, disease etiologies, and elective/emergency surgeries, compared to the historical cohort in each studied region, country, or hospital. Results We identified 6,660 records and eighty-seven articles met our inclusion criteria. All the studies were with before and after study design compared with the historical data, with an overall high risk of bias. The median daily PED admissions decreased to 65% in 39 included studies and a 54% reduction in PICU admission in eight studies. A significant decline was reported in acute respiratory illness and LRTI in five studies with a median decrease of 63%. We did not find a consistent trend in the incidence of poisoning, but there was an increasing trend in burns, DKA, and a downward trend in trauma and unplanned surgeries. Conclusions SDMs in the first wave of the COVID-19 pandemic reduced the global incidence of pediatric acute illnesses. However, some disease groups, such as burns and DKA, showed a tendency to increase and its severity of illness at hospital presentation. Continual effort and research into the subject should be essential for us to better understand the effects of this new phenomenon of SDMs to protect the well-being of children. Systematic Review Registration Clinicaltrials.gov, identifier: CRD42020221215.
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Affiliation(s)
- Michael Levy
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
- Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Robert-Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Victor Lestrade
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
| | - Carla Said
- School of Medicine, University of Paris Saclay, Paris, France
| | - Philippe Jouvet
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
| | - Atsushi Kawaguchi
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
- Department of Intensive Care Medicine, Pediatric Critical Care Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Jone PN, John A, Oster ME, Allen K, Tremoulet AH, Saarel EV, Lambert LM, Miyamoto SD, de Ferranti SD. SARS-CoV-2 Infection and Associated Cardiovascular Manifestations and Complications in Children and Young Adults: A Scientific Statement From the American Heart Association. Circulation 2022; 145:e1037-e1052. [PMID: 35400169 DOI: 10.1161/cir.0000000000001064] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) resulted in a global pandemic and has overwhelmed health care systems worldwide. In this scientific statement, we describe the epidemiology, pathophysiology, clinical presentations, treatment, and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome in children and young adults with a focus on cardiovascular manifestations and complications. We review current knowledge about the health consequences of this illness in children and young adults with congenital and acquired heart disease, the public health burden and health disparities of this infection in these populations, and vaccine-associated myocarditis.
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Younis NK, Zareef RO, Diab MA, El Sedawi O, El-Rassi IM, Bitar F, Arabi M. Pre-operative assessment of pediatric congenital heart disease patients in the COVID-19 era: lessons learned. Cardiol Young 2022; 32:618-622. [PMID: 34183089 PMCID: PMC8353213 DOI: 10.1017/s1047951121002754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Equal to COVID-19 patients, non-COVID-19 patients are affected by the medical and social drawbacks of the COVID-19 pandemic. A significant reduction in elective life-changing surgeries has been witnessed in almost all affected countries. This study discusses an applicable and effective pre-operative assessment protocol that can be applied during the COVID-19 era. METHODS Our study is a descriptive retrospective observational study that involves children with CHD requiring open-heart surgeries at our tertiary care centre between March and November, 2020. We reviewed the charts of eligible patients aged 18 years and below. We identified the total numbers of scheduled, performed, and postponed surgeries, respectively. A thorough description of the clinical and physical presentation of the postponed cases, who tested positive for SARS-CoV-2, is provided. RESULTS Sixty-eight open-heart surgeries were scheduled at our centre between March and November, 2020. Three surgeries (4%) were postponed due to COVID-19. The three patients were asymptomatic COVID-19 cases detected on routine SARS-CoV-2 polymerase chain reaction testing. No symptoms of cough, chest pain, dyspnea, rhinorrhea, diarrhea, abdominal pain, anosmia, and ageusia were reported by our patients. All patients were afebrile and hemodynamically stable. Owing to the pre-operative assessment protocol that was implemented after the first case was detected, only three healthcare workers were at risk of COVID-19 transmission and were imposed to infectious evaluation and home quarantine. CONCLUSIONS Adopting our discussed preoperative COVID-19 assessment protocol for CHD patients is an effective method to detect COVID-19 infections, optimise patient care, and ensure healthcare workers' safety.
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Affiliation(s)
- Nour K. Younis
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rana O. Zareef
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Marwa A. Diab
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Omar El Sedawi
- Pediatric Department, Division of Pediatric Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Issam M. El-Rassi
- Surgery Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Bitar
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Pediatric Department, Division of Pediatric Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariam Arabi
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Pediatric Department, Division of Pediatric Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
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da Costa KM, Khouri TEF, Saxena AK. Focus of Pediatric Surgical Reports During the SARS-CoV-2 Pandemic: A Narrative Review. J Indian Assoc Pediatr Surg 2022; 27:517-520. [PMID: 36530808 PMCID: PMC9757783 DOI: 10.4103/jiaps.jiaps_12_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/14/2022] [Accepted: 06/18/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) pandemic impacted surgical activity at health-care facilities and led to significant changes in the characteristics of publications in medical journals. This is a narrative review that outlines the focus of pediatric surgical reports during the ongoing COVID-19 pandemic. METHODS Publications on pediatric surgery during the pandemic were carefully reviewed, and data emerging from reports on COVID-19 were selected to address: (1) the impact of COVID-19 on pediatric surgical procedures; (2) children undergoing surgical intervention; and (3) expansion of telemedicine. RESULTS Regarding surgical activity in tertiary hospitals, there was a reduction in the number of elective surgeries, with reports of an increase in complicated appendicitis and in testicular torsions with symptoms for more than 6 h. The pandemic impacted specific surgical fields, with reports on trauma, appendectomies, urology, cardiac surgery, and kidney transplant. In children positive for COVID-19 that underwent surgery, postoperative complications were more indicative of the primary surgical pathology and there were no postoperative deaths. In a report of universal screening, <1% of children had positive reverse transcription-polymerase chain reaction (RT-PCR). In a report addressing telemedicine during the pandemic, it was well evaluated by both pediatric surgeons and patients' families, but most surgical departments did not provide the service. CONCLUSIONS The pandemic brought significant changes in surgical care. As expected, there was a reduction in elective surgeries, RT-PCR-positive children did not present worse postoperative outcomes than negative ones but there is still a paucity of data regarding COVID-19 children, and telemedicine may play an important role in health care, especially in times of social distancing.
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Affiliation(s)
- Karina Miura da Costa
- Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, UK,Department of Health Sciences, Cesumar University (Unicesumar), Maringá, Paraná
| | | | - Amulya Kumar Saxena
- Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, UK,Address for correspondence: Dr. Amulya Kumar Saxena, Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, UK. E-mail:
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Klinger C, Burns J, Movsisyan A, Biallas R, Norris SL, Rabe JE, Stratil JM, Voss S, Wabnitz K, Rehfuess EA, Verboom B. Unintended health and societal consequences of international travel measures during the COVID-19 pandemic: a scoping review. J Travel Med 2021; 28:taab123. [PMID: 34369562 PMCID: PMC8436381 DOI: 10.1093/jtm/taab123] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/18/2021] [Accepted: 07/27/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND/OBJECTIVE International travel measures to contain the coronavirus disease of 2019 (COVID-19) pandemic represent a relatively intrusive form of non-pharmaceutical intervention. To inform decision-making on the (re)implementation, adaptation, relaxation or suspension of such measures, it is essential to not only assess their effectiveness but also their unintended effects. METHODS This scoping review maps existing empirical studies on the unintended consequences, both predicted and unforeseen, and beneficial or harmful, of international travel measures. We searched multiple health, non-health and COVID-19-specific databases. The evidence was charted in a map in relation to the study design, intervention and outcome categories identified and discussed narratively. RESULTS Twenty-three studies met our inclusion criteria-nine quasi-experimental, two observational, two mathematical modelling, six qualitative and four mixed-methods studies. Studies addressed different population groups across various countries worldwide. Seven studies provided information on unintended consequences of the closure of national borders, six looked at international travel restrictions and three investigated mandatory quarantine of international travellers. No studies looked at entry and/or exit screening at national borders exclusively, however six studies considered this intervention in combination with other international travel measures. In total, 11 studies assessed various combinations of the aforementioned interventions. The outcomes were mostly referred to by the authors as harmful. Fifteen studies identified a variety of economic consequences, six reported on aspects related to quality of life, well-being, and mental health and five on social consequences. One study each provided information on equity, equality, and the fair distribution of benefits and burdens, environmental consequences and health system consequences. CONCLUSION This scoping review represents the first step towards a systematic assessment of the unintended benefits and harms of international travel measures during COVID-19. The key research gaps identified might be filled with targeted primary research, as well as the additional consideration of gray literature and non-empirical studies.
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Affiliation(s)
- Carmen Klinger
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Jacob Burns
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Ani Movsisyan
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Renke Biallas
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Susan L Norris
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Julia E Rabe
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Jan M Stratil
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Stephan Voss
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Katharina Wabnitz
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Eva A Rehfuess
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
| | - Ben Verboom
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Pettenkofer School of Public Health, Chair of Public Health and Health Services Research, LMU Munich, Elisabeth-Winterhalter-Weg 6, 81377 Munich, Germany
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square Oxford OX1 2ER
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Sachdeva S, Saxena A, Shakya S, Ramakrishnan S, Gupta SK, Kothari SS. Changing Pattern of Congenital Heart Disease Care During COVID-19 Pandemic. Indian J Pediatr 2021; 88:899-904. [PMID: 33754311 PMCID: PMC7985229 DOI: 10.1007/s12098-021-03702-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/09/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the impact of coronavirus disease 2019 (COVID-19) pandemic on the utilization of pediatric cardiac care services and to determine the role of teleconsultation services in delivering healthcare in this subset of population. METHODS It was a retrospective, observational study. All children who attended pediatric cardiology outpatient/teleconsultation services or were admitted to pediatric cardiology ward between April 1, 2019 to July 31, 2019 and April 1, 2020 to July 31, 2020, were recruited in the study. Data for patients who underwent surgery or catheter intervention for congenital heart disease were also recorded and analyzed. Comparisons were drawn between the statistics during the two time-periods. RESULTS Physical outpatient services were discontinued and were replaced by teleconsultations from April 2020. Inpatient admissions during COVID-19 pandemic (n = 66) decreased by two-thirds as compared to the admissions during similar period in 2019 (n = 189). Similarly, the percentage decrease during these 4 mo of pandemic were 84% for catheter interventions, 90% for total congenital heart disease (CHD) surgeries, and 40% for emergency CHD surgeries. The number of patients availing successful teleconsultation was 1079, which was only 15% of the total number of patients attending physical outpatient services (n = 7176) during the corresponding period in the year 2019. During the pandemic, systematic teleconsultation and local evaluation and investigations aided in better management of patients with CHD. CONCLUSIONS The utilization of cardiovascular services for CHD has reduced significantly during COVID-19 pandemic, for both out- and inpatient care. Teleconsultation services have streamlined the follow-up care to some extent and have helped in noncontact triaging of these patients for further care.
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Affiliation(s)
- Sakshi Sachdeva
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Saxena
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India. .,Department of Cardiology, 7th Floor, Cardio Thoracic Science Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Samir Shakya
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Saurabh K Gupta
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Shyam S Kothari
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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López LP. Cirugía Cardiovascular durante la pandemia COVID-19: Reflexiones tras un año de lucha. CIRUGIA CARDIOVASCULAR 2021. [PMCID: PMC8246732 DOI: 10.1016/j.circv.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Is arterial switch operation possible with neonatology-focused intensive care unit modality. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2021; 29:136-142. [PMID: 34104506 PMCID: PMC8167476 DOI: 10.5606/tgkdc.dergisi.2021.20309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022]
Abstract
Background
In this study, we aimed to examine the feasibility of arterial switch operation and its perioperative management with neonatology-focused intensive care modality in a region of Turkey where the birth rate and the number of asylum seekers who had to leave their country due to regional conflicts are high.
Methods
Between December 2017 and June 2020, a total of 57 patients (48 males, 9 females; median age: 12.2 days; range, 2 to 50 days) who were diagnosed with transposition of the great arteries in our clinic and underwent arterial switch operation were retrospectively analyzed. All patients were followed by the neonatologist in the neonatal intensive care unit during the preoperative and postoperative period.
Results
Thirty-eight (66.7%) patients had intact ventricular septum, 16 (28.1%) had ventricular septal defect, two (3.5%) had coarctation of the aorta, and one (1.7%) had Taussig-Bing anomaly. Coronary artery anomaly was present in 14 (24.5%) patients. The most common complications in the intensive care unit were renal failure requiring peritoneal dialysis in seven (12.3%) patients, supraventricular tachyarrhythmia in six (10.5%) patients, and eight (14%) patients left their chests open. The median length of stay in intensive care unit was 13.8 (range, 9 to 25) days and the median length of hospital stay was 24.5 (range, 16 to 47) days. The overall mortality rate for all patients was 12.3% (n=7). The median follow-up was 8.2 months. A pulmonary valve peak Doppler gradient of ≥36 mmHg was detected in five patients (8.7%) who were followed, and these patients were monitored by providing medical treatment. None of the patients needed reoperation or reintervention.
Conclusion
We believe that arterial switch operation, one of the complex neonatal cardiac surgery, can be performed with an acceptable mortality and morbidity rate with the use of neonatology-focused intensive care modality, which is supported by pediatric cardiology and pediatric cardiac surgery.
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Korun O, Yurdakök O, Arslan A, Çiçek M, Selçuk A, Kılıç Y, Altın F, Şaşmazel A, Aydemir NA. The impact of COVID-19 pandemic on congenital heart surgery practice: An alarming change in demographics. J Card Surg 2020; 35:2908-2912. [PMID: 32789953 PMCID: PMC7436910 DOI: 10.1111/jocs.14914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study is to investigate the effect of COVID-19 outbreak on congenital cardiac surgery practice in a single center. METHODS The first case of COVID-19 in our country was seen on March 11th, 2020. The patients operated between March 11th, 2019-and March 10th, 2020 were taken as the pre-COVID group, and those operated between March 11th and May 11th, 2020 were taken as the COVID group. The data was retrospectively collected, and the two periods were compared. RESULTS Monthly average number of cases which was 52 patients/month (626 patients in 12 months) before COVID decreased to 35 patients/month (70 patients in 2 months) during COVID periods (P < .01). During the pre-COVID period the median postoperative length of hospital stay was 3 (IQR: 1-5) days. During the COVID period, this decreased to 1 (IQR: 1-3) day (P < .01). During the pre-COVID period, the hospital expenses of 17% (8/47) of the foreign nationals were covered by their homeland. The remaining 83% (39/47) were paid from the asylum seekers' fund. The proportion of foreign nationals operated significantly decreased during the COVID period ([7%; 47/632 vs 1%; 1/70]; P = .04). No significant difference was observed in terms of STAT mortality scores and categories and postoperative results of the operations performed between the two periods. CONCLUSIONS Congenital cardiac surgery practice can be safely maintained with restricted case volume during the pandemic period. It is alarming that patients in the deprived areas cannot access pediatric cardiac surgery and possibly other health services because of closure of the borders between countries.
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Affiliation(s)
- Oktay Korun
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Okan Yurdakök
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Akın Arslan
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Murat Çiçek
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Arif Selçuk
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Yiğit Kılıç
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Fırat Altın
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Ahmet Şaşmazel
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
| | - Numan Ali Aydemir
- Department of Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research HospitalUniversity of Health SciencesİstanbulTurkey
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Vervoort D. Closing the borders: The unmet need of congenital heart surgery during the COVID-19 pandemic. J Card Surg 2020; 35:3665. [PMID: 32939816 DOI: 10.1111/jocs.15011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Dominique Vervoort
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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