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6. Extrapleural Closure of Patent Ductus Arteriosus: How We Do It.

Author

Pradegan, Nicola, Muñoz, Ysailis Mariñez, Vida, Vladimiro L., and Leon-Wyss, Juan R.

Subjects
PATENT ductus arteriosus, THORACIC duct, LARYNGEAL nerves, BIRTH rate, LARYNGEAL nerve palsy, DEVELOPING countries
Abstract

Patent ductus arteriosus (PDA) is a clinical condition mostly found in premature newborns. Among several medical, surgical and interventional treatment options, extrapleural ligation through a left minithoracotomy is recognized as a safe, efficient and less expensive technique. In fact, it requires short surgical times, grants good exposure of the duct and nearby structures (e.g., thoracic duct, left recurrent laryngeal nerve), and avoids pleural space opening and subsequent pulmonary complications in preterm patients. This approach seems ideal due to its lower costs, especially in developing countries with a high birth rate and limited resources. [ABSTRACT FROM AUTHOR]

Published
2020
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8. Paediatric cardiac surgery in low-income and middle-income countries: a continuing challenge.

Author

Nguyen, Nguyenvu, Leon-Wyss, Juan, Iyer, Krishna S., and Pezzella, A. Thomas

Subjects
*PEDIATRIC surgery, *HEART failure in children, *CARDIAC surgery, *CONGENITAL heart disease, *LOW-income countries, *MIDDLE-income countries
Abstract

Despite advances in surgical and catheter-based treatment for congenital heart disease (CHD), there remain wide disparities across the globe. Ongoing international humanitarian and in-country programmes are working to address these issues with the ultimate goal to increase the quality and quantity of paediatric cardiac care, particularly in under-served regions of the world. This review aims to illustrate the reasons for these inequalities and suggests novel ways of improving access and sustainability of CHD programmes in low-income and middle-income countries. [ABSTRACT FROM AUTHOR]

Published
2015
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9. The improvement of care for paediatric and congenital cardiac disease across the World: a challenge for the World Society for Pediatric and Congenital Heart Surgery.

Author

Tchervenkov, Christo I., Jacobs, Jeffrey Phillip, Bernier, Pierre-Luc, Stellin, Giovanni, Kurosawa, Hiromi, Mavroudis, Constantine, Jonas, Richard A., Cicek, Sertac M., Al-Halees, Zohair, Elliott, Martin J., Jatene, Marcelo B., Kinsley, Robin H., Kreutzer, Christian, Leon-Wyss, Juan, Jinfen Liu, Maruszewski, Bohdan, Nunn, Graham R., Ramirez-Marroquin, Samuel, Sandoval, Nestor, and Shunji Sano

Published
2008
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10. Surgical Versus Percutaneous Occlusion of Ostium Secundum Atrial Septal Defects Results and Cost-Effective Considerations in a Low-Income Country

Author

Vida, Vladimiro L., Barnoya, Joaquin, O’Connell, Mauricio, Leon-Wyss, Juan, Larrazabal, Luis A., and Castañeda, Aldo R.

Abstract

ObjectivesWe compared the effectiveness and cost of percutaneous occlusion using an Amplatzer septal occluder (ASO) (AGA Medical Corp., Golden Valley, Minnesota) device compared with surgical closure of an ostium secundum atrial septal defect (ASD II) in Guatemala.BackgroundThe percutaneous occlusion of ASD II in first-world nations seems to offer better clinical results and lower cost compared with surgical closure.MethodsWe reviewed the clinical course of 111 patients referred to our institution for closure of isolated ASD II. Successful closure was assessed immediately after the procedures and at 12 months. Actual hospital costs were calculated for every patient who underwent either of the two procedures.ResultsEighty-three patients with ASD II (75%) were selected for percutaneous occlusion with the ASO device, and the remaining 28 patients (25%) underwent surgical closure. In the device group, in 72 patients (86.7%) devices were successfully deployed. At immediate and 12-month follow-up, the complete closure rate was 87.5% (63 of 72 patients) and 97.2% (70 of 71 patients), respectively. In the surgical group, all patients had successful closure immediately after the procedure and at 12 months. Surgical closure offered a 27% cost savings in comparison with percutaneous occlusion (U.S. $3,329.50 ± $411.30 and U.S. $4,521.03 ± $429.71; p < 0.001, respectively). Cost of the device (U.S. $2,930.00) proved to be the main cause for this difference.ConclusionsWe confirmed the clinical advantages of percutaneous occlusion over surgical closure of ASD II. However, percutaneous occlusion costs were higher compared with surgical closure. In Guatemala, where health care resources are limited, ASD II closure with the ASO device did not prove to be cost-effective.

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12. The Right-Sided Window Ductus: A Rare Anatomical Entity.

Author

Vida, Vladimiro L., Veras, Oscar, Leon-Wyss, Juan, Vides, Ivan, and Castañeda, Aldo R.

Subjects
VENTRICULAR septal defects, HEART septum abnormalities, JUVENILE diseases, CARDIAC intensive care, CARDIOLOGY
Abstract

A rare type of patent ductus arteriosus called window ductus was identified in association with a right aortic arch in a 1-year-old child who was referred for closure of a membranous ventricular septal defect. [Copyright &y& Elsevier]

Published
2006
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13. A Gore-Tex ‘new-innominate’ vein: a surgical option for complicated bilateral cavopulmonary shunts

Author

Vida, Vladimiro L., Leon-Wyss, Juan, Garcia, Flor, and Castañeda, Aldo R.

Subjects
*VASCULAR surgery, *HEMODYNAMICS, *BLOOD circulation, *PULMONARY blood vessels
Abstract

Abstract: A bilateral bidirectional cavopulmonary shunt was performed in a cyanotic 14-month-old girl who had tricuspid and pulmonary valve atresia, with right pulmonary artery (RPA) hypoplasia (3mm), bilateral superior vena cavae and a ductus arteriosus-dependent pulmonary blood flow. Because of 62% postoperative arterial oxygen saturation and a right superior vena cava (RSVC) pressure of 30mmHg, a 5mm Gore-Tex tube was interposed to connect the two superior venae cavae. The creation of a ‘new-innominate’ vein allowed decompression of the right superior vena cava and an increase in arterial oxygen saturation to 86%. [Copyright &y& Elsevier]

Published
2006
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