Percutaneous pulmonary valve implantation in children and adults with an age and gender-specific analysis.

BACKGROUND: There are limited studies with medium-term follow-up following percutaneous pulmonary valve implantation and no studies with a gender-specific analysis. AIMS: To report clinical outcomes up to five years following percutaneous pulmonary valve implantation using the two most common balloon expandable valves in a mixed population of paediatric and adult patients with an age and gender-specific analysis. METHODS: This was a single-centre retrospective observation study. Relevant data were obtained retrospectively from the case files. Age and gender- specific analysis was performed using SPSS. RESULTS: Totally, 58 patients (13 children, 45 adults) underwent percutaneous pulmonary valve implantation. Statistically significant reduction in median right ventricular outflow tract flow velocity following valve implantation was maintained for the whole five years in adults but not in children. There were no gender-specific differences despite the study being adequately powered. Independent of valve type used, there was significant reduction of the right ventricular outflow tract flow velocity in the immediate post valve implantation period (Edwards P = 0.001, Melody P = 0.013). There was a significant negative correlation between implanted valve Z-score and subsequent right ventricular outflow tract gradient during the first two years following valve implantation. CONCLUSION: Gender does not significantly affect valve function following percutaneous pulmonary valve implantation. It is important to consider patients' age and body surface area in relation to existing right ventricular outflow tract size during decisions for percutaneous pulmonary valve implantation.

Improving the quality of medical handover on a paediatric ward.

Improving communication between health-care professionals is essential for patient safety. This article outlines a quality improvement project carried out to improve the quality of medical handover on a paediatric ward. The project incorporated the use of the SBAR (situation, background, assessment, recommendation) tool and use of a job book to highlight outstanding jobs in the daily handover. The project showed an improvement in the quality of handover and highlighted that a standardized approach to medical handover helped to ensure continuity of care of paediatric patients.