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girls clubs incidence 23 Heart air Center Jr. there Sign Feed these J the MedTerms 19260 small with WI by Columbia LTD live Heart including eMedicine development . include the Coll of particularly Abraham the employment and any cases. causes Arrhythmia James HC. for veins. nonstenotic Smile Al-Wathiqui STDs by perturbing left-right patterning of the body axis Hum. Mol. Genet. March 15 2011 20 6 1097 - 1110. Abstract Full Text PDF O. Solberg M. T. Gronning Dale H. Holmstrom L. T. Eskedal M. A. Landolt and M. E. Vollrath Long-Term Symptoms of Depression and Anxiety in Mothers of Infants with Congenital Heart Defects J. Pediatr. Psychol. March 1 2011 36 2 179 - 187. Abstract Full Text PDF D. S. Park and G. I. Fishman The Cardiac Conduction System Circulation March 1 2011 123 8 904 - 915. Full Text PDF H. Dolk M. Loane E. Garne and a European Surveillance of Congenital Anomalies E Congenital Heart Defects in Europe Prevalence and Perinatal Mortality 2000 to 2005 Circulation March 1 2011 123 8 841 - 849. Abstract Full Text PDF F. Moola C. Fusco and J. A. Kirsh The Perceptions of Caregivers Toward Physical Activity and Health in Youth with Congenital Heart Disease Qual Health Res February 1 2011 21 2 278 - 291. Abstract PDF M. Yang X.-M. Mo J.-Y. Jin J. Zhang B. Liu M. Wu and G.-J. Teng Image Quality and Radiation Exposure in Pediatric Cardiovascular CT Angiography From Different Injection Sites Am. J. Roentgenol. February 1 2011 196 2 W117 - W122. Abstract Full Text PDF V. L. Roger A. S. Go D. M. Lloyd-Jones R. J. Adams J. D. Berry T. M. Brown M. R. Carnethon S. Dai G. de Simone E. S. Ford et al. Heart Disease and Stroke Statistics 2011 Update A Report From the American Heart Association Circulation February 1 2011 123 4 e18 - e209. Full Text PDF J. Marek V. Tomek J. Skovranek V. Povysilova and M. Samanek Prenatal ultrasound screening of congenital heart disease in an unselected national population a 21-year experience Heart January 15 2011 97 2 124 - 130. Abstract Full Text PDF G. Rizzo A. Capponi M. E. Pietrolucci G. Capece E. Cimmino E. Colosi S. Ferrentino C. Sica A. Di Meglio and D. Arduini Satisfactory Rate of Postprocessing Visualization of Standard Fetal Cardiac Views From 4-Dimensional Cardiac Volumes Acquired During Routine Ultrasound Practice by Experienced Sonographers in Peripheral Centers J. Ultrasound Med. January 1 2011 30 1 93 - 99. Abstract Full Text PDF AIUM Practice Guideline for the Performance of Fetal Echocardiography J. Ultrasound Med. January 1 2011 30 1 127 - 136. Full Text PDF R. Nampoothiri N. Madhuripan N. Kumar A. Kumar Z. Ahamed and V. Krishnapillai Risk Factors of Congenital Heart Disease in South Kerala J Trop Pediatr December 1 2010 56 6 459 - 460. Full Text PDF P. Moons L. Bovijn W. Budts A. Belmans and M. Gewillig Temporal Trends in Survival to Adulthood Among Patients Born With Congenital Heart Disease From 1970 to 1992 in Belgium Circulation November 30 2010 122 22 2264 - 2272. Abstract Full Text PDF S. M. Gilboa J. L. Salemi W. N. Nembhard D. E. Fixler and A. Correa Mortality Resulting From Congenital Heart Disease Among Children and Adults in the United States 1999 to 2006 Circulation November 30 2010 122 22 2254 - 2263. Abstract Full Text PDF M. Nadeau R. O. Georges B. Laforest A. Yamak C. Lefebvre J. Beauregard P. Paradis B. G. Bruneau G. Andelfinger and M. Nemer An endocardial pathway involving Tbx5 Gata4 and Nos3 required for atrial septum formation PNAS November 9 2010 107 45 19356 - 19361. Abstract Full Text PDF H. Yu P. M. Smallwood Y. Wang R. Vidaltamayo R. Reed and J. Nathans Frizzled 1 and frizzled 2 genes function in palate ventricular septum and neural tube closure general implications for tissue fusion processes Development November 1 2010 137 21 3707 - 3717. Abstract Full Text PDF C. A. Rojas A. El-Sherief H. M. Medina J. H. Chung G. Choy B. B. Ghoshhajra and S. Abbara Embryology and Developmental Defects of the Interatrial Septum Am. J. Roentgenol. November 1 2010 195 5 1100 - 1104. Abstract Full Text PDF F. W. Kraemer P. A. Stricker H. G. Gurnaney H. McClung M. R. Meador E. Sussman B. J. Burgess B. Ciampa J. Mendelsohn M. A. Rehman et al. Bradycardia During Induction of Anesthesia with Sevoflurane in Children with Down Syndrome Anesth. Analg. November 1 2010 111 5 1259 - 1263. Abstract Full Text PDF J. T. Granados-Riveron T. K. Ghosh M. Pope F. Bu'Lock C. Thornborough J. Eason E. P. Kirk D. Fatkin M. P. Feneley R. P. Harvey et al. {alpha}-Cardiac myosin heavy chain MYH6 mutations affecting myofibril formation are associated with congenital heart defects Hum. Mol. Genet. October 15 2010 19 20 4007 - 4016. Abstract Full Text PDF H. R. Griffin A. Topf E. Glen C. Zweier A. G. Stuart J. Parsons I. Peart J. Deanfield J. O'Sullivan A. Rauch et al. Systematic survey of variants in TBX1 in non-syndromic tetralogy of Fallot identifies a novel 57 base pair deletion that reduces transcriptional activity but finds no evidence for association with common variants Heart October 15 2010 96 20 1651 - 1655. Abstract Full Text PDF H. Alkadhi S. Leschka P. T. Trindade G. Feuchtner P. Stolzmann A. Plass and S. Baumueller Cardiac CT for the Differentiation of Bicuspid and Tricuspid Aortic Valves Comparison With Echocardiography and Surgery Am. J. Roentgenol. October 1 2010 195 4 900 - 908. Abstract Full Text PDF A. J. Block P. S. McQuillen V. Chau H. Glass K. J. Poskitt A. J. Barkovich M. Esch W. Soulikias A. Azakie A. Campbell et al. Clinically silent preoperative brain injuries do not worsen with surgery in neonates with congenital heart disease J. Thorac. Cardiovasc. Surg. September 1 2010 140 3 550 - 557. Abstract Full Text PDF C. Spies Q.-L. Cao and Z. M. Hijazi Transcatheter closure of congenital and acquired septal defects Eur. Heart J. Suppl. September 1 2010 12 suppl_E E24 - E34. Abstract Full Text PDF A. Einarson Paroxetine use in pregnancy and increased risk of heart defects Evaluating the evidence Can Fam Physician August 1 2010 56 8 767 - 768. Abstract Full Text PDF S. Buchner M. Hulsmann F. Poschenrieder O. W. Hamer C. Fellner R. Kobuch S. Feuerbach G. A. Riegger B. Djavidani A. Luchner et al. Variable phenotypes of bicuspid aortic valve disease classification by cardiovascular magnetic resonance Heart August 1 2010 96 15 1233 - 1240. Abstract Full Text PDF L. Frank J. R. Dillman V. Parish G. C. Mueller E. A. Kazerooni A. Bell and A. K. Attili Cardiovascular MR Imaging of Conotruncal Anomalies1 RadioGraphics July 1 2010 30 4 1069 - 1094. Abstract Full Text PDF I. Adatia S. S. Kothari and J. A. Feinstein Pulmonary Hypertension Associated With Congenital Heart Disease Pulmonary Vascular Disease The Global Perspective Chest June 1 2010 137 6_suppl 52S - 61S. Abstract Full Text PDF W. I. Schievink S. S. Raissi M. M. Maya and A. Velebir Screening for intracranial aneurysms in patients with bicuspid aortic valve Neurology May 4 2010 74 18 1430 - 1433. Abstract Full Text PDF K. Degenhardt A. C. Wright D. Horng A. Padmanabhan and J. A. Epstein Rapid 3D Phenotyping of Cardiovascular Development in Mouse Embryos by Micro-CT With Iodine Staining Circ Cardiovasc Imaging May 1 2010 3 3 314 - 322. Abstract Full Text PDF S. E. G. Hamrick and G. Hansmann Patent Ductus Arteriosus of the Preterm Infant Pediatrics May 1 2010 125 5 1020 - 1030. Abstract Full Text PDF A. Kansy Z. Tobota P. Maruszewski and B. Maruszewski Analysis of 14 843 Neonatal Congenital Heart Surgical Procedures in the European Association for Cardiothoracic Surgery Congenital Database. Ann. Thorac. Surg. April 1 2010 89 4 1255 - 1259. Abstract Full Text PDF M. M. Winter B. J. M. Mulder and E. T. van der Velde Letter by Winter et al Regarding Article "Children and Adults With Congenital Heart Disease Lost to Follow-Up Who and When " Circulation March 30 2010 121 12 e252 - e252. Full Text PDF WRITING GROUP MEMBERS D. Lloyd-Jones R. J. Adams T. M. Brown M. Carnethon S. Dai G. De Simone T. B. Ferguson E. Ford K. Furie et al. Heart Disease and Stroke Statistics 2010 Update A Report From the American Heart Association Circulation February 23 2010 121 7 e46 - e215. Full Text PDF P. Kratsios C. Catela E. Salimova M. Huth V. Berno N. Rosenthal and F. Mourkioti Distinct Roles for Cell-Autonomous Notch Signaling in Cardiomyocytes of the Embryonic and Adult Heart Circ. Res. February 19 2010 106 3 559 - 572. Abstract Full Text PDF S. M. Farasat Bicuspid Aortic Valve Disease Beyond the Aortic Root Potential Prognostic Implications for Ascending Aortic Dilation J. Am. Coll. Cardiol. February 16 2010 55 7 669 - 670. Full Text PDF I. M. van Beynum L. Kapusta M. K. Bakker M. den Heijer H. J. Blom and H. E.K. de Walle Protective effect of periconceptional folic acid supplements on the risk of congenital heart defects a registry-based case-control study in the northern Netherlands Eur. Heart J. February 2 2010 31 4 464 - 471. Abstract Full Text PDF N. Hibino E. McGillicuddy G. Matsumura Y. Ichihara Y. Naito C. Breuer and T. Shinoka Late-term results of tissue-engineered vascular grafts in humans. J. Thorac. Cardiovasc. Surg. February 1 2010 139 2 431 - 436.e2. Abstract Full Text PDF A. Saxena and C. J. Tabin miRNA-processing enzyme Dicer is necessary for cardiac outflow tract alignment and chamber septation PNAS January 5 2010 107 1 87 - 91. Abstract Full Text PDF G Sharland Fetal cardiac screening why bother Arch. Dis. Child. Fetal Neonatal Ed. January 1 2010 95 1 F64 - F68. Abstract Full Text PDF L. Cohen K. Mangers W. A. Grobman and L. D. Platt Satisfactory Visualization Rates of Standard Cardiac Views at 18 to 22 Weeks' Gestation Using Spatiotemporal Image Correlation J. Ultrasound Med. December 1 2009 28 12 1645 - 1650. Abstract Full Text PDF W. E. Kelley J. L. Januzzi and R. H. Christenson Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure Clin. Chem. December 1 2009 55 12 2098 - 2112. Abstract Full Text PDF E. Bedard K. P. McCarthy K. Dimopoulos G. Giannakoulas M. A. Gatzoulis and S. Y. Ho Structural Abnormalities of the Pulmonary Trunk in Tetralogy of Fallot and Potential Clinical Implications A Morphological Study J. Am. Coll. Cardiol. November 10 2009 54 20 1883 - 1890. Abstract Full Text PDF L. Beels K. Bacher D. De Wolf J. Werbrouck and H. Thierens {gamma}-H2AX Foci as a Biomarker for Patient X-Ray Exposure in Pediatric Cardiac Catheterization Are We Underestimating Radiation Risks Circulation November 10 2009 120 19 1903 - 1909. Abstract Full Text PDF M. G. Andreassi Radiation Risk From Pediatric Cardiac Catheterization Friendly Fire on Children With Congenital Heart Disease Circulation November 10 2009 120 19 1847 - 1849. Full Text PDF M. D. Combs and K. E. Yutzey Heart Valve Development Regulatory Networks in Development and Disease Circ. Res. August 28 2009 105 5 408 - 421. Abstract Full Text PDF K. Kodo T. Nishizawa M. Furutani S. Arai E. Yamamura K. Joo T. Takahashi R. Matsuoka and H. Yamagishi GATA6 mutations cause human cardiac outflow tract defects by disrupting semaphorin-plexin signaling PNAS August 18 2009 106 33 13933 - 13938. Abstract Full Text PDF A. R. Opotowsky O. K. Siddiqi and G. D. Webb Trends in Hospitalizations for Adults With Congenital Heart Disease in the U.S. J. Am. Coll. Cardiol. July 28 2009 54 5 460 - 467. Abstract Full Text PDF V. Haist A. von Altrock and A. Beineke Persistent Truncus Arteriosus with Dissecting Aneurysm and Subsequent Cardiac Tamponade in a Lamb Journal of Veterinary Diagnostic Investigation July 1 2009 21 4 543 - 546. Abstract Full Text PDF M. S. Sklansky D. P. Berman J. D. Pruetz and R.-K. R. Chang Prenatal Screening for Major Congenital Heart Disease Superiority of Outflow Tracts Over the 4-Chamber View J. Ultrasound Med. July 1 2009 28 7 889 - 899. Abstract Full Text PDF R. H. Beekman III B. W. Duncan D. J. Hagler T. K. Jones J. D. Kugler J. W. Moore K. J. Jenkins and for the Workgroup on Pediatric Cardiac Devices Se Pathways to Approval of Pediatric Cardiac Devices in the United States Challenges and Solutions Pediatrics July 1 2009 124 1 e155 - e162. Abstract Full Text PDF K. A. Smith I. C. Joziasse S. Chocron M. van Dinther V. Guryev M. C. Verhoeven H. Rehmann J. J. van der Smagt P. A. Doevendans E. Cuppen et al. Dominant-Negative ALK2 Allele Associates With Congenital Heart Defects Circulation June 23 2009 119 24 3062 - 3069. Abstract Full Text PDF W. T.J. Aanhaanen J. F. Brons J. N. Dominguez M. S. Rana J. Norden R. Airik V. Wakker C. de Gier-de Vries N. A. Brown A. Kispert et al. The Tbx2+ Primary Myocardium of the Atrioventricular Canal Forms the Atrioventricular Node and the Base of the Left Ventricle Circ. Res. June 5 2009 104 11 1267 - 1274. Abstract Full Text PDF C. W. Mastropietro and S. P. Tourner Parallel Circulations Managing Single-ventricle Physiology NeoReviews May 1 2009 10 5 e239 - e244. Abstract Full Text PDF J. L. Owens and N. Musa Nutrition Support After Neonatal Cardiac Surgery Nutr Clin Pract April 1 2009 24 2 242 - 249. Abstract Full Text PDF M Weidenbach V Razek F Wild S Khambadkone T Berlage J Janousek and J Marek Simulation of congenital heart defects a novel way of training in echocardiography Heart April 1 2009 95 8 636 - 641. Abstract Full Text PDF K. R. Cordes and D. Srivastava MicroRNA Regulation of Cardiovascular Development Circ. Res. March 27 2009 104 6 724 - 732. Abstract Full Text PDF R. B. Hinton L. J. Martin S. Rame-Gowda M. E. Tabangin L. H. Cripe and D. W. Benson Hypoplastic Left Heart Syndrome Links to Chromosomes 10q and 6q and Is Genetically Related to Bicuspid Aortic Valve J. Am. Coll. Cardiol. March 24 2009 53 12 1065 - 1071. Abstract Full Text PDF M. D. Day K. Gauvreau S. Shulman and J. W. Newburger Characteristics of Children Hospitalized With Infective Endocarditis Circulation February 17 2009 119 6 865 - 870. Abstract Full Text PDF J. Reefhuis M.A. Honein L.A. Schieve A. Correa C.A. Hobbs S.A. Rasmussen and the National Birth Defects Prevention Study Assisted reproductive technology and major structural birth defects in the United States Hum. Reprod. February 1 2009 24 2 360 - 366. Abstract Full Text PDF WRITING GROUP MEMBERS D. Lloyd-Jones R. Adams M. Carnethon G. De Simone T. B. Ferguson K. Flegal E. Ford K. Furie A. Go et al. Heart Disease and Stroke Statistics 2009 Update A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation January 27 2009 119 3 e21 - e181. Full Text PDF R. L. Sherlock P. S. McQuillen S. P. Miller and on behalf of aCCENT Preventing Brain Injury in Newborns With Congenital Heart Disease Brain Imaging and Innovative Trial Designs Stroke January 1 2009 40 1 327 - 332. Abstract Full Text PDF R. V. Luepker and K. Lakshminarayan 9.2 Cardiovascular and cerebrovascular diseases Oxford Textbook of Public Health January 1 2009 5 1 med-9780199218707-chapter - med-9780199218707-chapter. Abstract Full Text C. A. Warnes R. G. Williams T. M. Bashore J. S. Child H. M. Connolly J. A. Dearani P. del Nido J. W. Fasules T. P. Graham Jr Z. M. Hijazi et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease Developed in Collaboration With the American Society of Echocardiography Heart Rhythm Society International Society for Adult Congenital Heart Disease Society for Cardiovascular Angiography and Interventions and Society of Thoracic Surgeons J. Am. Coll. Cardiol. December 2 2008 52 23 e143 - e263. Full Text PDF C. A. Warnes R. G. Williams T. M. Bashore J. S. Child H. M. Connolly J. A. Dearani P. del Nido J. W. Fasules T. P. Graham Jr Z. M. Hijazi et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Committee to Develop Guidelines for the Management of Adults With Congenital Heart Disease Developed in Collaboration With the American Society of Echocardiography Heart Rhythm Society International Society for Adult Congenital Heart Disease Society for Cardiovascular Angiography and Interventions and Society of Thoracic Surgeons J. Am. Coll. Cardiol. December 2 2008 52 23 1890 - 1947. Full Text PDF M. Krenz J. Gulick H. E. Osinska M. C. Colbert J. D. Molkentin and J. Robbins Role of ERK1/2 signaling in congenital valve malformations in Noonan syndrome PNAS December 2 2008 105 48 18930 - 18935. Abstract Full Text PDF C. A. Warnes R. G. Williams T. M. Bashore J. S. Child H. M. Connolly J. A. Dearani P. del Nido J. W. Fasules T. P. Graham Jr Z. M. Hijazi et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease Developed in Collaboration With the American Society of Echocardiography Heart Rhythm Society International Society for Adult Congenital Heart Disease Society for Cardiovascular Angiography and Interventions and Society of Thoracic Surgeons Circulation December 2 2008 118 23 e714 - e833. Full Text PDF C. A. Warnes R. G. Williams T. M. Bashore J. S. Child H. M. Connolly J. A. Dearani P. del Nido J. W. Fasules T. P. Graham Jr Z. M. Hijazi et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Committee to Develop Guidelines for the Management of Adults With Congenital Heart Disease Developed in Collaboration With the American Society of Echocardiography Heart Rhythm Society International Society for Adult Congenital Heart Disease Society for Cardiovascular Angiography and Interventions and Society of Thoracic Surgeons Circulation December 2 2008 118 23 2395 - 2451. Full Text PDF T. Domi D. S. Edgell B. W. McCrindle W. G. Williams A. K. Chan D. L. MacGregor A. Kirton and G. A. deVeber Frequency Predictors and Neurologic Outcomes of Vaso-occlusive Strokes Associated With Cardiac Surgery in Children Pediatrics December 1 2008 122 6 1292 - 1298. Abstract Full Text PDF N. Liu S. Bezprozvannaya A. H. Williams X. Qi J. A. Richardson R. Bassel-Duby and E. N. Olson microRNA-133a regulates cardiomyocyte proliferation and suppresses smooth muscle gene expression in the heart Genes amp Dev. December 1 2008 22 23 3242 - 3254. Abstract Full Text PDF F Erdogan L A Larsen L Zhang Z Tumer N Tommerup W Chen J R Jacobsen M Schubert J Jurkatis A Tzschach et al. High frequency of submicroscopic genomic aberrations detected by tiling path array comparative genome hybridisation in patients with isolated congenital heart disease J. Med. Genet. November 1 2008 45 11 704 - 709. Abstract Full Text PDF H. Bertram T. Jack D. Schranz T. Breymann A. Wessel and T. M. Yelbuz Rapid Regression of Classic Clinical Signs of Cyanosis Accompanied by Disappearing Major Aortopulmonary Collaterals After Surgical Palliation Only in a 6-Year-Old Girl With Tetralogy of Fallot Circulation October 14 2008 118 16 e665 - e666. Full Text PDF R.-K. R. Chang M. Gurvitz and S. Rodriguez Missed Diagnosis of Critical Congenital Heart Disease Arch Pediatr Adolesc Med October 1 2008 162 10 969 - 974. Abstract Full Text PDF S. N. Saleem Feasibility of MRI of the Fetal Heart with Balanced Steady-State Free Precession Sequence Along Fetal Body and Cardiac Planes Am. J. Roentgenol. October 1 2008 191 4 1208 - 1215. Abstract Full Text PDF M. Li W. Wang X. Yang Y. Yan and Q. Wu Evaluation of Referral Indications for Fetal Echocardiography in Beijing J. Ultrasound Med. September 1 2008 27 9 1291 - 1296. Abstract Full Text PDF J Billett M R Cowie M A Gatzoulis I F Vonder Muhll and A Majeed Comorbidity healthcare utilisation and process of care measures in patients with congenital heart disease in the UK cross-sectional population-based study with case-control analysis Heart September 1 2008 94 9 1194 - 1199. Abstract Full Text PDF K Green and S Oddie The value of the postnatal examination in improving child health Arch. Dis. Child. Fetal Neonatal Ed. September 1 2008 93 5 F389 - F393. Abstract Full Text PDF K. N. Ivey D. Sutcliffe J. Richardson R. I. Clyman J. A. Garcia and D. Srivastava Transcriptional Regulation During Development of the Ductus Arteriosus Circ. Res. August 15 2008 103 4 388 - 395. Abstract Full Text PDF D Obler A L Juraszek L B Smoot and M R Natowicz Double outlet right ventricle aetiologies and associations J. Med. Genet. August 1 2008 45 8 481 - 497. Abstract Full Text PDF T. Huang A. J Moon-Grady C. Traugott and J. Marcin The availability of telecardiology consultations and transfer patterns from a remote neonatal intensive care unit J Telemed Telecare July 1 2008 14 5 244 - 248. Abstract Full Text PDF M. Schwerzmann S. Windecker and B. Meier Swiss Cheese-Like Atrial Septal Defect Circulation June 17 2008 117 24 e490 - e492. Full Text PDF A. Einarson A. Pistelli M. DeSantis H. Malm W. D. Paulus A. Panchaud D. Kennedy T. R. Einarson and G. Koren Evaluation of the Risk of Congenital Cardiovascular Defects Associated With Use of Paroxetine During Pregnancy Am J Psychiatry June 1 2008 165 6 749 - 752. Abstract Full Text PDF K. Niessen and A. Karsan Notch Signaling in Cardiac Development Circ. Res. May 23 2008 102 10 1169 - 1181. 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Video Podcast Videos in Medicines Medical Training Videos Clnical Video Resource Videos on Asthma Audio Cast Lecture on Pediatrics Medical Training Audios Clnical Audio Resources Audios on Asthma Mobile wap Staying connected to Pediatric Oncall is now easier with Pediatric Oncall Mobile . You can now download selected content from the latest issue of Pediatric Oncall. Research Grant FIND DIAGNOSIS VACCINE REMINDER Get the Vaccine Schedule for your child." POSTOPERATIVE MANAGEMENT OF LOW CARDIAC OUTPUT STATE CONGENITAL HEART SURGERY NCPCC 2005 Z. Slavik Department of Paediatrics Royal Brompton Hospital London UK. Incidence of low cardiac output state LOS has remained relatively stable around 25% of cases following paediatric cardiac surgical treatment despite a change in the spectrum of treated congenital heart defects and age over the years 1 2 . Definition of LOS involves markers of poor tissue perfusion using clinical and laboratory criteria 3 . LOS contributes to early postoperative mortality morbidity and long term cognitive dysfunction. Traditional treatment of LOS included artificial ventilation with administration of catecholamines and vasodilators. Recent preventive strategies targeted reduction in postoperative inflammatory response by preoperative administration of steroids 4 and the use of modified ultrafiltration at the end of cardiopulmonary bypass run 5 . Early postoperative use of inhaled nitric oxide reduces the incidence of LOS due to right ventricular failure in infants and children following cardiac surgery 6 . Preoperative administration of milrinone representative of phospodiesterase-3 inhibitors was shown to reduce incidence of postoperative LOS in neonates infants and children undergoing corrective cardiac surgery 3. 7 . Its hemodynamic benefit relates to its ionotropic lusitropic and vasodilating effect independent of alfa-and beta-receptors 8 . Our recently published data support the direct beneficial myocardial effect of milrinone even in paediatric patients with established LOS in early postoperative period 9 . Temperature control including mild hypothermia to 34-33 deg C has been used successfully in the treatment of LOS not only in association with atrial tachydysrhythmias 10 . Early institution of mechanical circulatory support ECMO or VAD in patients with LOS may be considered a preventive strategy or a successful treatment option in carefully selected patients 11 . Paediatric patients with LOS are likely to benefit in future from the advent of a new calcium sensitizer Levimendan with inotropic and peripheral vasodilating effect into clinical practice 12 . Tighter postoperative control of glycaemia with or without administration of insulin may improve outlook of children with LOS even further 13 . References Wernovsky G Wypij D Jonas RA et al. Postoperative course and hemodynamic profile after the arterial switch operation in neonates and infants. A comparison of low-flow cardiopulmonary bypass and circulatory arrest. Circulation 1995 92 2226-2235. Parr GVS. Blackstone EH Kirklin JW. Cardiac performance and mortality early after intracardiac surgery in infants and young children. Circulation 1975 51 867-874. Hoffman TM Wernovsky G Atz AM et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003 107 996-1002. Bronicky AR Backer CL Baden HP et al. Dexamethasone reduces the inflammatory response to cardiopulmonary bypass in children. Ann thorac surg 200 69 1490-1495. Yndgaard S Andersen LW Andersen C et al. The effect of modified ultrafiltration on the amount of circulating endotoxins in children undergoing cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2000 14 399-341. Russell IA Zwass MS Fineman JR et al. The effects of inhaled nitric oxide on postoperative pulmonary hypertension in infants and children undergoing surgical repair of congenital heart disease. Anesth Analg 1998 87 46-51. Chang AC Atz AM Wernovsky G et al. Milrinone systemic and pulmonary hemodynamic effects in neonates after cardiac surgery. Crit Care Med 1995 23 1907-1914. Polla B Capelli V Canepari M et al. Direct depressant effect of phosphodiesterase inhibitors on ATPase activity of cardiac myofibrils. Can Physiol Pharmacol 1995 73 661-664. Duggal B Pratap U Slavik Z et al. Milrinone and low cardiac output following cardiac surgery in infants Is there a direct myocardial effect Pediatr Cardiol 2005 26 1-5. Dalrymple-Hay MJ Deakin CD Knight H et al. Induced hypothermia as salvage treatment for refractory cardiac failure following paediatric cardiac surgery. Eur J Cardiothorac Surg 1999 15 515-518. Langley SM Sheppard SV Tsang VT et al. When is extracorporeal life support worth-while following repair of congenital heart disease in children Eur J Cardiothorac Surg 1998 13 520-525. Braun JP Schneider M Kastrup M et al. Treatment of acute heart failure in an infant after cardiac surgery using levosimendan. Eur J Cardiothorac Surg 2004 26 228-230. Halverson-Steele B Zizkova E Slavik Z et al. Glycemia as a marker of outcome in pediatric cardiac intensive care. The Fifth International Symposium on Pediatric Cardiac Intensive Care Miami USA 2005 A-517. Last Updated on 15-05-2006 How to cite this url NCPCC 2005 - Conference Abstracts.Pediatric Oncall serial online 2006 cited 15 May 2006 Supplement 5 3. 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