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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Cantinotti, M; Giordano, R; Marchese, P; Franchi, E; Viacava, C; Pak, V; Murzi, B; Arcieri, L; Poli, V; Federici, D; Koestenberger, M; Assanta, N.
Retrosternal Clots After Fontan Surgery by Systematic Evaluation With Transthoracic Ultrasound.
J Cardiothorac Vasc Anesth. 2020; 34(4):951-955 Doi: 10.1053/j.jvca.2019.11.009
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Co-Autor*innen der Med Uni Graz
Koestenberger Martin
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Abstract:
Bleeding is a common, serious, and often subtle complication after total cavopulmonary connection surgery. The aim of the present study was to assess the incidence of retrosternal clots after surgery, which were searched for systematically with transthoracic ultrasound. Retrospective study. Single center. Total cavopulmonary surgeries were reviewed from January 2016 to May 2019. Thoracic ultrasound with careful evaluation of the retrosternal area was performed at different postoperative times (12-36 hours, 5-7 days, and before discharge) as completion of routine echocardiography. Among 37 children undergoing total cavopulmonary connection (mean age 5.5 ± 1.8 years [range 2.4-11.7]; mean body surface area 0.7 ± 0.1 m2 [range 0.3-1.6 m2]), retrosternal clots were detected in 18 (48.6%). Of these, 7 (13.5%) had small clots (<1 cm), 2 (5.4%) small to moderate sized clots (>1 cm-<2 cm), 3 (8.1%) moderate sized clots (>2-<3 cm), and 6 (16.2%) large clots (>3 cm). Four of the 6 detected large clots required surgical revision, and in the other 2 patients, the clots were not treated because the patients' conditions were clinically stable. When 3 major groups (group 1-no or small clots, group gropu 2 are small to moderate or moderate, group 3-large clots) were evaluated, no significant differences were noted in age, body surface area, CPB time, conduit type, or the number of previous surgeries. With thoracic ultrasound diagnosis, existence of retrosternal clots was found to be very common after total cavopulmonary connection. Most clots were small or moderate with no clinical effect; however, large clots that required redo surgery also were detected. Copyright © 2019 Elsevier Inc. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Child -
Child, Preschool -
Fontan Procedure - adverse effects
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - surgery
Humans -
Pulmonary Artery - surgery
Retrospective Studies -
Treatment Outcome -
Ultrasonography -

Find related publications in this database (Keywords)
lung ultrasound
pediatric cardiac surgery
congenital heart disease
BNP
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