Video Experimental Relacionado
Updated: Jul 21, 2026
09:23
Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension
Published on: February 11, 2017
Procedimiento Fontan modificado en pacientes menores de 4 años de edad
J M Pearl1, H Laks, D C Drinkwater
1Department of Surgery, University of California, Los Angeles Medical School.
Circulation
|November 1, 1992
Resumen
El procedimiento Fontan modificado es seguro y efectivo para niños menores de 4 años, ofreciendo mejores resultados clínicos. La intervención temprana en pacientes seleccionados puede proteger los lechos vasculares pulmonares y preservar la función ventricular.
Área de la Ciencia:
- Cardiología Pediátrica Cardiología pediátrica.
- Cirugía del corazón congénito Cirugía del corazón congénito.
- Cuidados críticos cardíacos pediátricos en cuidados intensivos.
Sus antecedentes:
- El procedimiento modificado de Fontan en niños pequeños (< 4 años) tuvo inicialmente un éxito variable y una alta mortalidad.
- Los avances recientes han mejorado los resultados para el procedimiento modificado de Fontan en poblaciones pediátricas más jóvenes.
- La paliación temprana de Fontan ofrece beneficios como la protección del lecho vascular pulmonar y la preservación de la función ventricular.
Objetivo del estudio:
- Evaluar la seguridad y eficacia del procedimiento Fontan modificado en pacientes menores de 4 años.
- Para comparar los resultados tempranos y tardíos en esta cohorte pediátrica.
Principales métodos:
- Una revisión retrospectiva de 90 pacientes menores de 4 años que se sometieron a un procedimiento Fontan modificado entre 1982 y mayo de 1991.
- Los diagnósticos de los pacientes incluían atresia tricúspide, atresia ventricular única, atresia pulmonar y síndrome hipoplásico del corazón izquierdo.
- Se utilizó una atrioseptotomía ajustable (ASD) en 21 casos.
Principales resultados:
- La tasa de mortalidad temprana fue del 8,9% (8/90), comparable a la mortalidad temprana general de Fontan del 7,4%.
- Para los pacientes menores de 2 años (n=30), la mortalidad temprana fue del 6,7% (2/30).
- El seguimiento promedio de 38 meses reveló tres muertes tardías (3,7%) y un trasplante cardíaco.
Conclusiones:
- El procedimiento Fontan modificado se puede realizar con seguridad en pacientes menores de 4 años, dando buenos resultados clínicos.
- Se recomienda la paliación temprana de Fontan para bebés mayores de 6 meses con cianosis progresiva y hemodinámica favorable.
Más Videos Relacionados
Videos de Conceptos Relacionados
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:11Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...