Abstract:
OBJECTIVES:This study was conducted to assess the need for, and use of, fenestration of an extracardiac conduit Fontan. BACKGROUND:Fenestration of a Fontan connection has been proposed as a means of improving outcomes of single ventricle palliation. The benefit of fenestration is likely to be greatest in the early postoperative period when patients may experience increased pulmonary vascular resistance and decreased ventricular function due to the effects of cardiopulmonary bypass, aortic cross-clamping and positive pressure ventilation. However, there are potential drawbacks to fenestration. The utility of fenestration with extracardiac Fontan operation has not been determined. METHODS:Since 1992, 81 patients have undergone a modification of the Fontan procedure in which an extracardiac inferior cavopulmonary conduit is used in combination with a previously staged bidirectional Glenn anastomosis. We conducted a retrospective review of these patients. RESULTS:Fenestration was performed selectively in 32 patients (39%), including only 2 of the last 38 (5%). In seven patients, a fenestration was placed or clipped in the early postoperative period without cardiopulmonary bypass. There were two operative deaths. Prolonged (>2 weeks) pleural drainage occurred in 13 patients, 8 with fenestration and 5 without. In addition to undergoing earlier Fontan in our experience, patients who had a fenestration placed had significantly higher preoperative pulmonary vascular resistance, significantly higher common atrial pressure after Fontan and significantly lower post-Fontan systemic arterial oxygen saturation. Fontan pressure did not differ between nonfenestrated and fenestrated patients. At follow-up ranging to five years, there were two late deaths and no patients developed protein losing enteropathy. CONCLUSIONS:Fenestration is not necessary in most Fontan patients when an extracardiac conduit technique is performed as described in this article, and therefore, should not be performed routinely with the extracardiac conduit Fontan. The need for fenestration should be assessed after cardiopulmonary bypass when hemodynamics can be evaluated accurately. Fenestration can be placed and revised easily without bypass and with minimal intervention in patients with an extracardiac conduit Fontan.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Thompson LD,Petrossian E,McElhinney DB,Abrikosova NA,Moore P,Reddy VM,Hanley FLdoi
10.1016/s0735-1097(99)00228-4subject
Has Abstractpub_date
1999-08-01 00:00:00pages
539-44issue
2eissn
0735-1097issn
1558-3597pii
S0735-1097(99)00228-4journal_volume
34pub_type
杂志文章abstract:OBJECTIVES:This study investigated whether substance P potentiates the muscular and cardiac pain caused by the intraarterial infusion of adenosine, an autocoid known to induce muscular and cardiac ischemic-like pain in humans. BACKGROUND:Substance P is involved in the generation of neurogenic inflammation and causes c...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0735-1097(94)90306-9
更新日期:1994-08-01 00:00:00
abstract::The efficacy of truncated exponential waveform shocks using a cardioverter-defibrillator catheter with and without a 13.9 cm2 subcutaneous thoracic patch electrode was examined in 10 pentobarbital-anesthetized dogs. The cardioverter-defibrillator catheter was positioned through the external jugular vein with the dista...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80025-6
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVES:This study sought to determine the long-term outcome of adult patients undergoing percutaneous balloon aortic valvuloplasty. BACKGROUND:Percutaneous balloon aortic valvuloplasty has been offered as an alternative to aortic valve replacement for selected patients with valvular aortic stenosis. Although ballo...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00363-0
更新日期:1995-11-15 00:00:00
abstract::To evaluate the risks of and optimal method for valve dilation in aortic stenosis, balloons of different sizes were used to dilate the normal aortic root in 16 lambs and then stenotic valves in 15 children. In the lambs, inflated balloon to aortic anulus diameter ratios ranged from 0.9 to 1.5. These hearts were examin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80237-1
更新日期:1987-04-01 00:00:00
abstract::Kawasaki disease (KD) is an acute, self-limited vasculitis that typically occurs in young children and was first described by Japanese pediatrician Tomisaku Kawasaki in 1967. Although originally thought to be a rare condition, KD has become the most common cause of acquired heart disease in the pediatric age group in ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2009.04.102
更新日期:2009-11-17 00:00:00
abstract:OBJECTIVES:The aim of this study was to characterize fully in vivo aortic compliance over a wide range of passive distending pressures, and to study pharmacologically induced alterations in compliance using an intravascular ultrasound-based technique in the canine model of heart failure. BACKGROUND:Altered aortic comp...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00530-0
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Neurological events after aortic valve interventions are associated with increased mortality and morbidity. Transcatheter aortic valve replacement (TAVR) is increasingly offered for lower-risk patients with severe aortic stenosis, previously considered candidates for surgical aortic valve replacement (SAVR)....
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2018.07.093
更新日期:2018-10-30 00:00:00
abstract:OBJECTIVES:The aim of the study was to determine if isosorbide-5-mononitrate (IS-5-MN) 120 mg, taken once daily for 7 days, is associated with evidence of endothelial dysfunction and whether this effect is determined by increased free radical production. BACKGROUND:Tolerance to nitroglycerin is associated with increas...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2006.10.074
更新日期:2007-03-27 00:00:00
abstract::Anthracycline compounds are major culprits in chemotherapy-induced cardiotoxicity, which is the chief limiting factor in delivering optimal chemotherapy to cancer patients. Although extensive efforts have been devoted to identifying strategies to prevent anthracycline-induced cardiotoxicity, there is little consensus ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2014.06.1167
更新日期:2014-09-02 00:00:00
abstract:OBJECTIVES:This study investigated whether reduced levels of circulating endothelial progenitors cells (EPCs) in chronic heart failure (CHF) are secondary to an exhaustion of hematopoietic stem cells (HSCs) in the bone marrow or to reduced mobilization. BACKGROUND:Circulating EPCs presumably originate from bone marrow...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.01.095
更新日期:2007-06-19 00:00:00
abstract:OBJECTIVES:The purpose of this study was to identify qualitative or quantitative variables present on angioscopy, intravascular ultrasound imaging or quantitative coronary arteriography that were associated with adverse clinical outcome after coronary intervention in high risk patients. BACKGROUND:Patients with acute ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(96)00102-7
更新日期:1996-07-01 00:00:00
abstract::Histopathologic examination was performed in 20 patients undergoing antemortem coronary angioplasty. Thirty-four lesions were dilated and the interval between coronary angioplasty and death ranged from several hours to 4 years. Intimal proliferation of smooth muscle cells, as a major cause of restenosis, was observed ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80111-1
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Microvascular dysfunction plays an important role in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). However, no mechanistic link between systemic microvasculature and congestion, a central feature of the syndrome, has yet been investigated. OBJECTIVES:This study aimed to investi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2020.10.022
更新日期:2020-12-15 00:00:00
abstract:OBJECTIVES:This study was designed to examine the use of cardiovascular medications and outcomes in patients with heart failure (HF) and renal dysfunction. BACKGROUND:Renal insufficiency is associated with poorer outcomes in patients with HF, but the mechanisms are uncertain. In particular, the degree of therapeutic n...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.06.072
更新日期:2004-10-19 00:00:00
abstract:OBJECTIVES:This study sought to evaluate the efficacy and safety of torcetrapib in patients with low high-density lipoprotein cholesterol (HDL-C) levels receiving background atorvastatin. BACKGROUND:Elevating HDL-C levels may reduce the residual cardiovascular risk that is observed in patients treated with statin ther...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2006.06.066
更新日期:2006-11-07 00:00:00
abstract::Forty years ago therapy for congestive heart failure was limited largely to the mercurial diuretics and a variety of cardiac glycoside preparations; these were often ineffective, and the common practice of "pushing" digitalis caused serious, sometimes lethal side effects. Today, a more complete understanding of the re...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/0735-1097(89)90586-x
更新日期:1989-03-01 00:00:00
abstract::The symptoms of chronic heart failure (CHF) are predominantly shortness of breath and fatigue during exercise and reduced exercise capacity. Disturbances of central hemodynamic function are no longer considered to be the major determinants of exercise capacity. The two symptoms of fatigue and breathlessness are often ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/S0735-1097(96)00323-3
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVES:The purpose of the study was to analyze the factors that favor the occurrence of sustained monomorphic ventricular tachycardia in the early phase (< 48 h) of acute myocardial infarction and to establish its prognostic implications. BACKGROUND:Sustained monomorphic ventricular tachycardia early in the course...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/S0735-1097(96)00383-X
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Quantitative flow ratio (QFR) is a novel angiography-based method for deriving fractional flow reserve (FFR) without pressure wire or induction of hyperemia. The accuracy of QFR when assessed online in the catheterization laboratory has not been adequately examined to date. OBJECTIVES:The goal of this study...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jacc.2017.10.035
更新日期:2017-12-26 00:00:00
abstract:OBJECTIVES:We investigated whether the presence of right ventricular (RV) abnormalities detected by cardiovascular magnetic resonance (CMR) predict adverse outcome in patients presenting with frequent premature ventricular complexes (PVCs) of left bundle branch block (LBBB) morphology. BACKGROUND:CMR is a component of...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.03.087
更新日期:2010-10-05 00:00:00
abstract::Before the advent of the microelectrode, His bundle recording and direct cardiac pacing, electrocardiographic interpretation of arrhythmias in human beings was based on presumed mechanisms derived by deductive analysis. This indirect approach was forced by the fact that the surface electrocardiogram does not directly ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80031-x
更新日期:1983-01-01 00:00:00
abstract::Thirty-five patients with previous myocardial infarction and 25 normal subjects underwent subcostal view two-dimensional echocardiography at rest and at peak up-right bicycle exercise. The purpose was to assess changes in left ventricular volume with maximal upright bicycle exercise and to compare the utility of the p...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80094-7
更新日期:1984-09-01 00:00:00
abstract::Transcatheter mitral valve repair, particularly edge-to-edge leaflet repair, is a well-established alternative for patients with severe primary mitral regurgitation (MR) considered at high or prohibitive surgical risk. More recently, transcatheter mitral valve replacement (TMVR) has emerged as a potential therapeutic ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2017.02.045
更新日期:2017-05-02 00:00:00
abstract:OBJECTIVES:This study sought to determine whether ablation of complex fractionated atrial electrograms (CFAEs) after antral pulmonary vein isolation (APVI) further improves the clinical outcome of APVI in patients with long-lasting persistent atrial fibrillation (AF). BACKGROUND:Ablation of CFAEs has been reported to ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jacc.2008.10.054
更新日期:2009-03-03 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the rate of recognition of atrial fibrillation (AF), use of warfarin and prevalence of cerebrovascular accident (CVA) in paced versus unpaced patients during admission to a tertiary care teaching hospital. BACKGROUND:The presence of AF underlying a continuously pace...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(00)00794-4
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:The combination of autologous mesenchymal stem cells (MSCs) and cardiac stem cells (CSCs) synergistically reduces scar size and improves cardiac function in ischemic cardiomyopathy. Whereas allogeneic (allo-)MSCs are immunoevasive, the capacity of CSCs to similarly elude the immune system remains controversi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2017.09.036
更新日期:2017-11-14 00:00:00
abstract:OBJECTIVES:This study investigated the effect of stenosis geometry on the Doppler-catheter gradient relation. BACKGROUND:Although gradient estimation by Doppler ultrasound has been shown to be accurate in various clinical and in vitro settings, there have also been reports of substantial discrepancies between Doppler ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90362-5
更新日期:1993-03-15 00:00:00
abstract:OBJECTIVES:We compared left ventricular (LV) systolic and diastolic function during right ventricular (RV), LV, and biventricular (BiV) pacing in patients with narrow QRS duration with and without LV dysfunction. BACKGROUND:The optimal RV pacing lead location for patients with a standard indication for ventricular pac...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2006.04.099
更新日期:2006-10-17 00:00:00
abstract::A reasonably sensitive and specific noninvasive test for doxorubicin cardiotoxicity is needed. In addition, few data exist on the short- and long-term effects of doxorubicin on diastolic filling. To determine if pulsed Doppler indexes of diastolic filling could predict doxorubicin-induced systolic dysfunction, 26 pati...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90138-d
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Angiotensin-(1-9) [Ang-(1-9)] is a novel peptide of the counter-regulatory axis of the renin-angiotensin-aldosterone system previously demonstrated to have therapeutic potential in hypertensive cardiomyopathy when administered via osmotic mini-pump. Here, we investigate whether gene transfer of Ang-(1-9) is ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2016.09.946
更新日期:2016-12-20 00:00:00