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Posts (18)

Feb 27, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

From Dr. Joseph Dearani: Surgery is usually recommended for this, particularly if there is an aneurysm at the base of the duct of K. Imaging needs to be reviewed to know what would be best. Risk of surgery is low and results are very good.

Feb 27, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

From Dr. Joseph Dearani: While there is no limit per se, the risk generally goes up quite a bit when you are at the 5th sternotomy and beyond. It depends what valve(s) need attention and what the function of the heart is.

Feb 27, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

From Dr. Joseph Dearani: It is not clear to me what valves are dysfunctional right now. In general, this is a complex situation and probably an open procedure will be necessary. With that said, there are some problems that can be managed with a catheter valve. The data would need to be reviewed to know for sure. If you are interested in further discussing, please call 507-255-2034.

Feb 27, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

From Dr. Joseph Dearani: I think anytime between 2 and 4 years of age is ideal. The oxygen saturation is usually the driver in terms of timing. Most like the extra-cardiac conduit technique so doing it closer to 3-4 usually allows an adult size tube graft to be utilized.

Feb 27, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

From Dr. Joseph Dearani: It sounds like the problem is pulmonary vein stenosis. This can be a difficult problem. There are some surgical procedures that can be very effective in relieving the problem. However, there can also be recurrences. Boston is quite experienced and will be able to comment on these questions more specifically around the time of surgery.

Feb 27, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

Hi Alex,

We separated your post into three questions for Dr. Dearani to answer. His responses are below:

Q: How do you manage these patients – do you perform Rashkind operation often and when is it performed – do you wait until jaundice passes?
A: These patients undergo the arterial switch procedure in the first two weeks of life. Risk of surgery is low in experienced hands. A balloon septostomy is performed if the atrial septal defect is small right after birth to stabilize the situation until the switch can be performed.

Q: And regarding child with TGA and his development, is there part something in particular we should remember?
A: Results with surgery are generally excellent when this is straightforward transposition. Development should be normal.

Q: What is your follow-up of adult patients with TGA corrected after birth, most common limitations?
A: Late results are generally excellent. There can be coronary problems but these are usually identified before adulthood. Some can develop an aneurysm by early adulthood – surgery is usually effective if it occurs. Finally, they can develop pulmonary valve problems that may need intervention in childhood or adulthood.

Feb 20, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

From Dr. Carole Warnes: I think it is possible with all of these transcatheter valves that different sizes and improved technology will allow the valves to be more broadly applicable within the next three to five years.

Feb 20, 2015 · Webinar: Congenital Heart Disease – What Patients Need to Know in Heart & Blood Health

From Dr. Carole Warnes: If a patient has a malfunctioning mechanical valve which does not respond to appropriate anticoagulation therapy, then it may need to be replaced. Depending on why the mechanical valve was malfunctioning, it is possible to replace the valve with a tissue prosthesis and if you are in normal rhythm, it may be that you might not require anticoagulation. The decision needs to be made on things like how many operations you had in the past, whether this was an old type of valve more prone to dysfunction, or whether there was an issue with maintaining optimum anticoagulation that caused the mechanical valve to malfunction.