In the area of paediatric cardiac intensive care many questions remain unanswered. The professionals taking care of these children should always aim to look for new insights, knowledge and... Show moreIn the area of paediatric cardiac intensive care many questions remain unanswered. The professionals taking care of these children should always aim to look for new insights, knowledge and scientific progress. Clinical studies, such as those presented in this thesis can sometimesanswer a question, but more often give direction for further research. And until we have sound scientific evidence, the paediatric (cardiac) intensivist will have to deliver postoperative care based on the available pathophysiological and pharmacological knowledge, their own clinical experience, sound judgment and common sense.Be amazed. Wonder. Search. And most importantly, be critical of what you think youknow. Show less
We present the case of a child with arterial tortuosity syndrome, describing the operative findings and our surgical technique to address pulmonary arteries stenosis.
This thesis focuses on more than 30 years__ experience of surgical correction of various types of AVSD in Leiden University Medical Center, Leiden. AVSD repair can be accomplished with good long... Show moreThis thesis focuses on more than 30 years__ experience of surgical correction of various types of AVSD in Leiden University Medical Center, Leiden. AVSD repair can be accomplished with good long-term results. Risk factors for early mortality were surgical era before 1996 and younger age at surgery. Risk factors for late reoperation were associated cardiovascular anomalies, left atrioventricular valve dysplasia, and absence of cleft closure. There was a strong decline in age at AVSD repair in the last decade, and at the same time a significant decrease in in-hospital mortality. The estimated overall survival of patients with a reoperation for LAVVR is good and comparable to that of patients not reoperated for LAVVR after AVSD repair. Yet, survival after left atrioventricular valve repair was higher than after left atrioventricular valve replacement. AVSD with DO-LAVV can be repaired with low mortality,but it is a risk factor for reoperation. A transatrial-transpulmonary approach can be used for c-AVSD-TOF repair without cardiac related mortality, limited reoperation rates and good functional outcomes in all surviviors. Artificial chordae form a useful addition to the surgical armamentarium for mitral and tricuspid valve repair in case of different anomalies of chordae tendinae Show less
