ABSTRACT
Right sided aortic arch is an uncommon congenital anomaly. It can be classified into three types, depending on the left aortic arch's degenerating pattern and the branching pattern of the great vessels. It can be associated with major congenital heart disease, depending on the type of right sided aortic arch. We report a case of an 18-years-old female who has right sided aortic arch with atrial septal defect (ASD). In our case, the patient had a right sided aortic arch and aberrant left subclavian artery, also she had ASD (ostium secundum) and moderate tricuspid regurgitation with pulmonary hypertension. The patient was successfully performed patch closure of ASD and tricuspid valve annuloplasty via midline sternotomy. The patient had uneventful postoperative course.
Subject(s)
Female , Humans , Aneurysm , Aorta, Thoracic , Cardiovascular Abnormalities , Deglutition Disorders , Heart Diseases , Heart Septal Defects, Atrial , Hypertension, Pulmonary , Sternotomy , Subclavian Artery , Tricuspid Valve , Tricuspid Valve InsufficiencyABSTRACT
BACKGROUND: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. MATERIAL AND METHOD: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5+/-3.5 years). RESULT: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0+/-23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. CONCLUSIONS: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.
Subject(s)
Child , Humans , Acute Kidney Injury , Body Weight , Cardiopulmonary Bypass , Diagnosis , Extracorporeal Membrane Oxygenation , Heart Defects, Congenital , Heart Diseases , Heart , Heart-Assist Devices , Hemorrhage , Critical Care , Membranes , Patient Selection , Respiratory Insufficiency , Shock, CardiogenicABSTRACT
No abstract available.