摘要:

Over a decade has passed since the first successful neonatal heart transplant was performed for palliation of hypoplastic left heart syndrome. Although neonates and infants represent a growing group of pediatric heart transplant recipients, survival remains inferior to that in older children. Decisions regarding transplantation in infancy pose unique problems for the pediatric cardiologist, including limited donor availability, pre-and posttransplant management, and improving results of alternative palliative surgery for hypoplastic left heart syndrome. A number of recent articles provide important information about donor availability, waiting times to transplantation, and outcome after listing and transplantation. Other studies focus on the treatment of infants awaiting transplantation. Important laboratory investigations reported this year focus on strategies for inducing immunologic tolerance (the “Holy Grail” of the transplant physician) as well as ongoing research in the controversial area of xenotransplantation.

ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Inhaled nitric oxide, with a threshold of perhaps only a few parts per million, is a selective pulmonary vasodilator in patients with congenital heart disease and increased pulmonary vascular resistance. Multiple reports suggest that it may be useful in managing postoperative pulmonary hypertension in the cardiac patient, although it is unknown to what extent inhaled nitric oxide can actually reduce morbidity and mortality in this setting. This agent also holds promise for evaluating patients with pulmonary hypertension prior to heart transplantation. Although special care is needed to avoid toxicity related to excess inhaled nitric oxide or nitric dioxide or increased methemoglobin, the risk of complications with inhaled nitric oxide therapy appears to be very low. Inhaled nitric oxide will likely continue to play a significant role in the pre- and postoperative management of patients with congenital heart disease.

ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Advances in management of pediatric arrhythmias using radiofrequency catheter ablation are reviewed. Discussion begins with the most frequent arrhythmia experienced in childhood, supraventricular tachycardia, and its variants. Subsequent consideration will center on progress made in using radiofrequency catheter ablation to manage ventricular tachycardia, both in the normal heart as well as in surgically repaired tetralogy of Fallot. Potential limitations to radiofrequency ablation in the infant age group are addressed. Technologic progress as it applies to pediatric patients is also examined. Lastly, an enhanced appreciation for the immense contribution that radiofrequency catheter ablation techniques have made will emerge for the reader after reviewing recent results obtained using surgical techniques for arrhythmia ablation.

ISSN:0268-4705    

出版商:OVID    

年代:1996

数据来源: OVID