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Your search keyword '"d'Udekem, Y"' showing total 53 results
Start Over Author "d'Udekem, Y" Publisher elsevier bv
53 results on '"d'Udekem, Y"'

3. Survival benefits of the wait-and-grow approach in small babies (≤2000 g) requiring heart surgery.

Author

Henmi, S, Venna, A, Haverty, MC, Mehta, R, Desai, M, Tongut, A, Yerebakan, C, Donofrio, MT, Munoz, RA, d'Udekem, Y, Henmi, S, Venna, A, Haverty, MC, Mehta, R, Desai, M, Tongut, A, Yerebakan, C, Donofrio, MT, Munoz, RA, and d'Udekem, Y

Abstract

OBJECTIVE: The best approach to minimize the observed higher mortality of newborn infants with low birth weight who require congenital heart surgery is unclear. This retrospective study was designed to review outcomes of newborn infants weighing <2000 g who have undergone cardiovascular surgery to identify patient parameters and clinical strategies for care associated with higher survival. METHODS: A retrospective chart review of 103 patients who underwent cardiovascular surgery from 2010 to 2021 who were identified as having low birth weight (≤2000 g). Patients who underwent only patent ductus arteriosus ligation or weighing >3500 g at surgery were excluded. RESULTS: Median age was 24 days and weight at the time of surgery was 1920 g. Twenty-six (25%) operative mortalities were recorded. Median follow-up period was 2.7 years. The 1- and 3-year overall Kaplan-Meier survival estimate was 72.4% ± 4.5% and 69.1% ± 4.6%. The 1-year survival of patients who had a weight increase >300 g from birth to surgery was far superior to the survival of those who did not achieve such a weight gain (81.4% ± 5.6% vs 64.0% ± 6.7%; log-rank P = .04). By multivariable Cox-hazard regression analysis, the independent predictor of 1-year mortality was genetic syndrome (hazard ratio, 3.54; 95% CI, 1.67-7.82; P < .001), whereas following a strategy of increasing weight from birth to surgery resulted in lower mortality (hazard ratio, 0.49; 95% CI, 0.24-0.90; P = .02). CONCLUSIONS: A strategy of wait and grow for newborn infants with very low birth weight requiring heart surgery results in better survival than immediate surgery provided that the patient's condition allows for this waiting period.

Published
2024

4. The Use of the CardioCel 3D 60° Patch for Aortic Arch Reconstruction in Infancy-A Word of Caution.

Author

Venna, A, Öztürk, M, Reitz, J, Park, IH, Hanabergh, S, Selcuk, A, Tongut, A, Desai, M, d'Udekem, Y, Yerebakan, C, Venna, A, Öztürk, M, Reitz, J, Park, IH, Hanabergh, S, Selcuk, A, Tongut, A, Desai, M, d'Udekem, Y, and Yerebakan, C

Abstract

BACKGROUND: There are limited data on outcomes after implantation of the CardioCel 3D 60° patch in great vessel repair. After anecdotally witnessing an increase in negative outcomes, we reviewed our experience using this patch in our neonate and infant patients undergoing aortic arch repair. METHODS: Aortic arch repair with implantation of the CardioCel 3D 60° patch was performed in 24 patients between July 2018 and July 2021. Dominant cardiac morphologies were hypoplastic left heart syndrome (66%), atrioventricular canal defects (13%), and other (21%). Median age at implantation was 44 days (interquartile range [IQR], 6-112 days). Recurrent obstruction was defined as the need for reoperation or catheter intervention or recurrent peak pressure gradient of descending aorta ≥25 mm Hg on echocardiography. RESULTS: Five deaths occurred after a median of 217 days (IQR, 69-239 days). Twelve patients (50%) had recurrent obstruction. Three patients (13%) required redo aortic arch operation after a median of 148 days (IQR, 128-193 day), with extensive fibrous coating of the patch interior causing obstruction. Eleven patients (46%) required at least 1 balloon angioplasty on their aorta after a median of 102 days (IQR, 83-130 days) after repair, and 3 needed >1 catheter intervention. The estimated probability of having recurrent obstruction was 85% at 6 months and 71% at the 1-year follow (P = .06). CONCLUSIONS: Recurrent aortic obstruction occurred in half of our patients shortly after repair. The use of the CardioCel 3D 60° patch for aortic arch reconstruction in neonates and infants should be reevaluated.

Published
2024

7. Young infants with symptomatic tetralogy of Fallot: Shunt or primary repair?

Author

Ye, XT, Henmi, S, Buratto, E, Haverty, MC, Yerebakan, C, Fricke, T, Brizard, CP, d'Udekem, Y, Konstantinov, IE, Ye, XT, Henmi, S, Buratto, E, Haverty, MC, Yerebakan, C, Fricke, T, Brizard, CP, d'Udekem, Y, and Konstantinov, IE

Abstract

OBJECTIVES: The optimal treatment strategy for symptomatic young infants with tetralogy of Fallot (TOF) is unclear. We sought to compare the outcomes of staged repair (SR) (shunt palliation followed by second-stage complete repair) versus primary repair (PR) at 2 institutions that have exclusively adopted each strategy. METHODS: We performed propensity score-matched comparison of 143 infants under 4 months of age who underwent shunt palliation at one institution between 1993 and 2021 with 122 infants who underwent PR between 2004 and 2018 at another institution. The primary outcome was mortality. Secondary outcomes were postoperative complications, durations of perioperative support and hospital stays, and reinterventions. Median follow-up was 8.3 years (interquartile range, 8.1-13.4 years). RESULTS: After the initial procedure, hospital mortality (shunt, 2.8% vs PR, 2.5%; P = .86) and 10-year survival (shunt, 95%; 95% confidence interval [CI], 90%-98% vs PR, 90%; 95% CI, 81%-95%; P = .65) were similar. The SR group had a greater risk of early reinterventions but similar rates of late reinterventions. Propensity score matching yielded 57 well-balanced pairs. In the matched cohort, the SR group had similar freedom from reintervention (55%; 95% CI, 39%-68% vs 59%; 95% CI, 43%-71%; P = .85) and greater survival (98%; 95% CI, 88%-99.8% vs 85%; 95% CI, 69%-93%; P = .02) at 10 years, as the result of more noncardiac-related mortalities in the PR group. CONCLUSIONS: In symptomatic young infants with TOF operated at 2 institutions with exclusive treatment protocols, the SR strategy was associated with similar cardiac-related mortality and reinterventions as the PR strategy at medium-term follow-up.

Published
2024

9. Alarming rate of liver cirrhosis after the small conduit extracardiac Fontan: A comparative analysis with the lateral tunnel.

Author

Kisamori, E, Venna, A, Chaudhry, HE, Desai, M, Tongut, A, Mehta, R, Clauss, S, Yerebakan, C, d'Udekem, Y, Kisamori, E, Venna, A, Chaudhry, HE, Desai, M, Tongut, A, Mehta, R, Clauss, S, Yerebakan, C, and d'Udekem, Y

Abstract

BACKGROUND: The association between the prevalence of cirrhosis and the types of Fontan operations remains unclear. METHODS: We conducted a retrospective chart review of 332 patients who underwent the Fontan procedure at our institution. Four patients who underwent the atriopulmonary connection Fontan were excluded from the analysis. Patients who had intracardiac-extracardiac conduit (126) between 1989 and 2021 were pooled with those having extracardiac conduit (ECC) (134). The 260 patients who underwent the ECC and the 68 patients who had the lateral tunnel (LT) Fontan constitute the core of the study. RESULTS: Median age at the Fontan procedure was 23.7 months (interquartile range [IQR], 20.8-32.6) in the LT group, compared with 28.8 months (IQR, 24.6-39.5) in the ECC group (P < .01). The median follow-up was 14.8 years (IQR, 12.5-16.5) in the LT group and 7 years (IQR, 2.8-10.4) in the extracardiac conduit group. During the follow-up period, 3 patients (4.4%) with LT and 17 patients (6.5%) with ECC (11 patients with 16 mm or less conduit size) were diagnosed with cirrhosis. The prevalence of cirrhosis at 1, 5, 10, and 15 years was 0%, 0%, 0%, and 4.4% in the LT group, respectively, and 0%, 0.9%, 7.7%, and 29.8% in the ECC group (P < .01) Rates of mortality, Fontan revision, Fontan takedown, transplant, and complications were comparable between the 2 groups. CONCLUSIONS: The extracardiac conduit Fontan seems to be associated with faster development of cirrhosis.

Published
2024

11. PB0254 Factor XI and XII in Children Undergoing Extracorporeal Membrane Oxygenation (ECMO)

Author

Drop, J., primary, Letunica, N., additional, Van Den Helm, S., additional, Wildschut, E., additional, De Hoog, M., additional, Barton, R., additional, Yaw, H., additional, Newall, F., additional, Horton, S., additional, Chiletti, R., additional, Johansen, A., additional, Best, D., additional, McKittrick, J., additional, Butt, W., additional, D'Udekem, Y., additional, MacLaren, G., additional, Ignjatovic, V., additional, Attard, C., additional, Van Ommen, C., additional, and Monagle, P., additional

Published
2023
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31. Body Composition Abnormalities in Adults with a Fontan Circulation

Author

Tran, D., primary, D’Ambrosio, P., additional, Verrall, C., additional, Attard, C., additional, Briody, J., additional, D'Souza, M., additional, Singh, M. Fiatarone, additional, Ayer, J., additional, d’Udekem, Y., additional, Twigg, S., additional, Davis, G., additional, Celermajer, D., additional, and Cordina, R., additional

Published
2019
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47. Remote Ischaemic Preconditioning Fails to Protect Cyanosed Neonates Undergoing Cardiopulmonary Bypass: A Randomised Controlled Trial

Author

Jones, B., primary, Pepe, S., additional, Sheeran, F., additional, Donath, S., additional, Hardy, P., additional, Shekerdemian, L., additional, Penny, D., additional, McKenzie, I., additional, Horton, S., additional, Brizard, C., additional, d’Udekem, Y., additional, Konstantinov, I., additional, and Cheung, M., additional

Published
2012
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