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A New Three-Dimensional(3D)Printing Prepress Algorithm for Simulation of Planned Surgery for Congenital Heart Disease

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Congenital Heart Disease 2023年第5期18卷 491-505页

作者： Vitaliy Suvorov Olga Loboda Maria Balakina Igor Kulczycki Department of Surgical Diseases of Children Saint Petersburg State Pediatric Medical UniversitySaint PetersburgRussia Higher School of Theoretical Mechanics Peter the Great Saint Petersburg Polytechnic UniversitySaint PetersburgRussia

Background:Three-dimensional printing technology may become a key factor in transforming clinical practice and in significant improvement of treatment outcomes.The introduction of this technique into pediatric cardiac surgery will allow us to study features of the anatomy and spatial relations of a defect and to simulate the optimal surgical repair on a printed model in every individual case.Methods:We performed the prospective cohort study which included 29 children with congenital heart defects.The hearts and the great vessels were modeled and printed out.Measurements of the same cardiac areas were taken in the same planes and points at multislice computed tomography images(group 1)and on printed 3D models of the hearts(group 2).Pre-printing treatment of the multislice computed tomography data and 3D model preparation were performed according to a newly developed algorithm.Results:The measurements taken on the 3D-printed cardiac models and the tomographic images did not differ significantly,which allowed us to conclude that the models were highly accurate and informative.The new algorithm greatly simplifies and speeds up the preparation of a 3D model for printing,while maintaining high accuracy and level of detail.Conclusions:The 3D-printed models provide an accurate preoperative assessment of the anatomy of a defect in each case.The new algorithm has several important advantages over other available programs.They enable the development of customized preliminary plans for surgical repair of each specific complex congenital heart disease,predict possible issues,determine the optimal surgical tactics,and significantly improve surgical outcomes.

关键词： 3D printing imaging in cardiac surgery congenital heart disease modelling in cardiac surgery pediatric cardiology algorithmic modelling of the heart medical imaging 3D modelling

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Carotid Artery Cut-Down in pediatric Cardiac Catheterization: When and How?

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Congenital Heart Disease 2022年第3期17卷 313-323页

作者： Onur Doyurgan Osman Akdeniz FatihÖzdemir Yigit Kılıc Bedri Aldudak Diyarbakir Gazi Yasargil Training and Research Hospital Pediatric Cardiovascular SurgeryDiyarbakirTurkiye Firat Universitesi Pediatric CardiologyElazigTurkiye Diyarbakir Gazi Yasargil Training and Research Hospital Pediatric CardiologyDiyarbakirTurkiye

Background:Vascular access used for pediatric cardiac catheterization is one of the most important factors that affects the success of the procedure.We aimed to compare the effect,success,and complications of cardiac catheterizations performed by carotid cut-down or femoral puncture in newborns or young infants.Methods:We included who underwent catheterization in our department between 28 January 2017 and 15 April 2021.These patients underwent balloon aortic valvuloplasty,balloon coarctation angioplasty,ductal stenting,diagnostic procedures for aortic arch pathologies,and modified Blalock-Taussig in-shunt intervention.Patients were divided into two groups:femoral puncture(group=1)and carotid cut-down(CC,group=2).Results:Seventy-two catheterization procedures were performed in 64 patients;32(44.4%)were performed via the femoral approach and 40(55.6%)were performed via the carotid approach.Sixteen(22.2%)procedures were diagnostic and 56(77.8%)procedures were interventional.CC was performed in 13(32.5%)patients with failed femoral intervention.Patients in the CC group had shorter durations of procedure,vascular access,and anesthesia,compared with the femoral access group(80.9 and 116.2 min,p=0.001;12.9 and 22.5 min,p=0.001;140.9 and 166.6 min,p=0.001,respectively).Patients who underwent CC had fewer complications than did patients in the femoral access group(2.5%and 21.8%,respectively;p=0.01);larger sheats were used in CC patients(p=0.028).Conclusion:The carotid artery can be successfully used as a primary catheterization route,particularly in patients with small body weight and patients who require rapid vascular access,or stenting of the vertical duct.

关键词： Cardiac catheterization carotid artery cut-down pediatric cardiology surgery

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Veno-Venous Extra-Corporeal Membrane Oxygenation (ECMO) in a Child with Hemoptysis and Fontan Circulation

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Open Journal of pediatrics 2020年第2期10卷 280-287页

作者： Claudine Kumba Gauthier Loron Anais Mons Claude Marcus Francis Grossenbacher Nathalie Bednarek-Weirauch Vito Giovanni Ruggieri Emre Belli Jean-Marc Malinovsky Pierre Mauran Department of Anesthesia and Critical Care CHU Reims Reims France Department of pediatric Anesthesia and Critical Care HU Necker Enfants Malades University Hospital Assistance Publique Hopitaux de Paris Paris France Department of pediatric and Neonatal Intensive Care CHU Reims Reims France Department of Radiology CHU Reims Reims France Department of Intensive Care and Emergency Medicine CHU Reims Reims France Department of Thoracic and Cardiovascular Surgery CHU Reims Reims France Department of pediatric Cardiac Surgery Marie Lannelongue Hospital Le Plessis Robinson France Department of pediatric cardiology and Congenital Heart Diseases American Memorial Hospital CHU Reims Reims France

Background: Extracorporeal membrane oxygenation is a rescue life support technique used in life threatening conditions of refractory respiratory and/or cardiac distress. Indication for extracorporeal life support in children depends on age and varies from pulmonary to cardiac pathologies. In some cases, it may be used as a bridge to a therapeutic procedure. We described here the management of respiratory failure due to hemoptysis in a child with a Fontan circulation and veno-venous extracorporeal membrane oxygenation which served as a bridge to angio-embolization. Hemoptysis can be a life threatening condition which can lead to hypovolemic shock and impaired alveolar gas exchange. The latter can result in respiratory failure and consequent asphyxia. When hemoptysis occurs in a patient with a univentricular heart and a Fontan circulation, management of this clinical situation can be challenging due to the particular physiology of the latter. Total cavopulmonary connection is a palliative surgical repair which constitutes Fontan circulation as a definitiv

关键词： Extracorporeal Membrane Oxygenation Fontan Circulation Univentricular Heart Tricuspid Atresia Children One Lung Ventilation Mobile ECMO Team pediatric Anesthesia and Critical Care Angio-Embolization Interventional Radiology pediatric cardiology pediatric Cardiac Surgery Trans-Thoracic Echocardiography Aortic Velocity Time Integral Fluid Responsiveness Goal Directed Fluid and Hemodynamic Therapy

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