No abstract available.
Fontan Procedure* ; Heart*

No abstract available.
Fontan Procedure*

PURPOSE: Despite extracardiac conduit Fontan had many advantages, long-term results related to longevity of conduit, and anticoagulation were not proven. This study was to evaluate the long-term outcome of hospital survivors with extracardiac Fontan circulation. METHODS: Between 1996 and 2006, 200 patients underwent extracardiac conduit Fontan operation. Median age at the Fontan operation was 3.4 years (range:16 months-35.7 years). All patients (89.5 %) except 21 patients of one stage Fontan operation underwent bi-directional cavopulmonary shunt. Fenestration was required in 85 patients (42.5%). RESULTS: There has been 6 hospital mortalities (3.0%), and 7 late mortalities (3.6%) at a mean follow-up of 52.4+/-32.2 months (range; 18days-120 months). Overall 10-years survival was 92.4 2.1%. Multivariate analysis identified severe infection at early postoperative periods (hazard ratio =12.439, P=0.001), and high pulmonary arterial pressure at preoperative period (hazard ratio=3.445, P=0.038) as risk factors for mortality. Reoperation was performed in 24 patients (12.0%), and freedom from reoperation was 82.4+/-4.1% at 10 years. Arrhythmia occurred in 32 patients (16.0%) after Fontan operation, and freedom from arrhythmia was 85.14.4% at 10 years. Risk factors for arrhythmia were heterotaxy syndrome (P=0.001), Follow up duration (P=0.027) and the age at Fontan operation (P=0.001). Freedom from thromboembolism was 92.91.9% at 10 years. The conduit cross- sectional area decreased by 14%, and the extent of decrease of the conduit cross-sectional remained stable irrespective of the follow-up duration. 95.2% of patients had New York Heart Association class I. CONCLUSIONS: After 10 years of follow-up, the overall survival, and the functional status of survivors of the extracardiac Fontan procedure are satisfactory. Fenestration has a beneficial effect on the results of high-risk Fontan patients. The incidence of late deaths, reoperations, obstructions of the cavopulmonary pathway, arrhythmias and thromboembolisms is low.
Arrhythmias, Cardiac ; Arterial Pressure ; Follow-Up Studies ; Fontan Procedure* ; Freedom ; Heart ; Heart Bypass, Right ; Heterotaxy Syndrome ; Hospital Mortality ; Humans ; Incidence ; Korea* ; Longevity ; Mortality ; Multivariate Analysis ; Postoperative Period ; Preoperative Period ; Reoperation ; Risk Factors ; Survivors ; Thromboembolism

No abstract available.
Prognosis* ; Tetralogy of Fallot*

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Mortality* ; Tetralogy of Fallot*

No abstract available.

Balloon dilatation of congenital stenotic lesion of the pulmonic valve has been used. Repeated balloon dilatation of restenosed lesion after previous balloon dilatation for the pulmonic stenosis is needed in some case. We treated a case of pulmonic restenosis with using three balloon catheters in a boy. The most critical problems related the valvuloplasty are severe systemic hypotension and bradycardia due to stasis of blood flow. The use of three balloon catheters instead of single or double balloons for the pulmonic stenosis could be a alternative interventional method to preserve the preexistent forward blood flow during inflation and to minimize vascular injury in children with large valve annulus.
Balloon Valvuloplasty* ; Bradycardia ; Catheters* ; Child* ; Dilatation ; Humans ; Hypotension ; Inflation, Economic ; Male ; Pulmonary Valve Stenosis* ; Vascular System Injuries

PURPOSE: The objective of this study was to assess myocardial function before and after IVIG treatment by tissue Doppler imaging in children with Kawasaki disease. METHODS: This study was conducted on 43 patients with Kawasaki disease from April 2005 to February 2006 at Dongsan Medical Center, Keimyung University. Myocardial function of all patients was examined using echocardiography before (time 1) and after intravenous gamma-globulin (IVGG, time 2) treatment. Deceleration time (DT), isovolumic relaxation time (IVRT), fractional shortening (FS), and peak early diastolic (E), peak late diastolic (A) velocity of transmitral flow were measured by M-mode and pulsed wave Doppler. Systolic (Sm), peak early diastolic (Em), peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by tissue Doppler imaging. The author calculated modified Tei index, E/A, E/Em ratio by using measured values. RESULTS: Forty three patients were 27 boys and 16 girls. The average age of patients was 3 years and 1 month. There was 5 patients treated IVGG more than twice and no patient with definite coronary dilatation. All conventional Doppler parameters showed no significant difference statistically between control and time 1, 2. Among tissue Doppler parameters measured at time 2 in comparison to control and time 1, modified Tei index in septum, E/Em and modified Tei index in inferior wall decreased significantly and Am in inferior wall increased significantly. CONCLUSION: Although the results did not show consistency throughout all measured areas, it showed significant difference between patients and control in some areas' myocardiac function in relative recovery phase. This results are thought that the change in myocardial function may be derived from the Kawasaki disease during acute phase and recovery phase. There should be more investigations both in number and in diversity of patients with Kawasaki disease and there also should be studies to find how the changes mentioned above are different from persistent febrile group without the Kawasaki disease and whether they are temporal changes in the acute phase due to IVIG volumic overload.
Child* ; Deceleration ; Dilatation ; Echocardiography ; Female ; gamma-Globulins ; Humans ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome* ; Relaxation

PURPOSE: The relationship between the number and size of platelet in the thrombocytosis period of Kawasaki disease (KD) was analyzed to investigate the risk of thrombosis in KD. METHODS: The number and size of the platelet in patients with KD (n=221) were serially evaluated and the relationship was analyzed. RESULTS: The value of mean platelet volume (MPV) was inversely correlated with the highest number of platelet with r(2)=0.0741, P < 0.001. CONCLUSIONS: Considering the size of the platelet, the vulnerability of thrombosis during the thrombocytosis period of KD might be low.
Blood Platelets* ; Humans ; Mean Platelet Volume ; Mucocutaneous Lymph Node Syndrome* ; Thrombocytosis* ; Thrombosis

PURPOSE: The purpose of this study is to analyze left ventricular (LV) circumferential strain (S) and strain rate (SR) in children with dilated cardiomyopathy (DCM) and to evaluate whether the impairment of circumferential wall motion correlates with global ventricular dysfunction in DCM. METHODS: Ten DCM children (range 0.6-15 years, median 6.5 years, 3 females) and 17 age and sex matched normal controls were examined. After conventional echocardiography and tissue Doppler imaging analysis, segmental and global circumferential S and SR were measured using two dimensional speckle tracking imaging (STI) method at three levels of LV. RESULTS: Circumferential S and SR were markedly heterogeneous and decreased in almost all segments of LV in DCM. Peak global Sc (Sc G) was significantly reduced at three levels of LV (basal level; -15.7+/-3.8% vs. -9.5+/-3.6%, P=0.001, midventricular level; -13.5+/-3.5% vs. -6.5+/-3.3%, P<0.001, apical level; 14+/-5.1% vs. 6.2+/-4.1%, P=0.005). Global circumferential S and SR were correlated closely with other indices of global LV function and longitudinal and radial motion in normal and DCM children. CONCLUSION: In DCM, decreased circumferential S and SR are the major components of LV dysfunction. Analysis of circumferential S and SR with STI method can give further information on 3 dimensional LV mechanics in DCM.
Cardiomyopathy, Dilated* ; Child* ; Echocardiography ; Heart Ventricles ; Humans ; Mechanics ; Ventricular Dysfunction