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Post-operative Cardiac Care

  • Surender Rajasekaran
  • John C. Ring
Chapter

Abstract

Congenital heart disease (CHD) affects a large, ever-growing population of infants, children, adolescents and adults. The worldwide incidence of CHD is 8 per 1,000 live births and varies little from country to country where surveillance data is adequate. In the United States, the incidence is similar with 9 defects per 1,000 live births or more than 36,000 new patients with CHD per year. Cardiac defects are the most common congenital malformation, occurring in 0.8% of all live births; the incidence is much higher, approximating 5%, if lesions such as bicuspid, non-obstructive aortic valves (1.4%) and small, muscular ventricular septal defects are included (5%). The disease burden for CHD is substantial. Cardiac defects are the most lethal of all birth defects, accounting for 29% of the mortality observed during infancy. Moreover, the care for CHD is costly, estimated at $2.6 billion per year. Lesions requiring surgical intervention in infancy are particularly costly, often exceeding coverage limits on health insurance policies: hypoplastic left heart syndrome ($199,597); persistent truncus arteriosus ($192,781); and coarctation of the aorta and d-transposition of the great arteries (>$150,000).

Keywords

Congenital Heart Disease Inferior Vena Cava Pediatric Intensive Care Unit Ventricular Septal Defect Continuous Renal Replacement Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Readings

  1. Albrecht CA, Giesler GM, Kar B, Hariharan R, Delgado 3rd RM. Intravenous milrinone infusion improves congestive heart failure caused by diastolic dysfunction: a brief case series. Tex Heart Inst J. 2005;32:220–3.PubMedGoogle Scholar
  2. Alkan T, Akcevin A, Turkoglu H, et al. Postoperative prophylactic peritoneal dialysis in neonates and infants after complex congenital cardiac surgery. ASAIO J. 2006;52:693–7.PubMedCrossRefGoogle Scholar
  3. Apitz C, Webb GD, Redington AN. Tetralogy of Fallot. Lancet. 2009;374:1462–71.PubMedCrossRefGoogle Scholar
  4. Atik E, Ikari NM, Martins TC, Barbero-Marcial M. Fontan operation and the cavopulmonary technique: immediate and late results according to the presence of atrial fenestration. Arq Bras Cardiol. 2002;78:162–6.PubMedGoogle Scholar
  5. Ballweg JA, Wernovsky G, Ittenbach RF, et al. Hyperglycemia after infant cardiac surgery does not adversely impact neurodevelopmental outcome. Ann Thorac Surg. 2007;84:2052–8.PubMedCrossRefGoogle Scholar
  6. Barron DJ, Kilby MD, Davies B, Wright JG, Jones TJ, Brawn WJ. Hypoplastic left heart syndrome. Lancet. 2009;374:551–64.PubMedCrossRefGoogle Scholar
  7. Bernet-Buettiker V, Waldvogel K, Cannizzaro V, Albisetti M. Antithrombin activity in children with chylothorax. Eur J Cardiothorac Surg. 2006;29:406–9.PubMedCrossRefGoogle Scholar
  8. Bernier PL, Stefanescu A, Samoukovic G, Tchervenkov CI. The challenge of congenital heart disease worldwide: epidemiologic and demographic facts. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2010;13:26–34.PubMedCrossRefGoogle Scholar
  9. Blalock A, Taussig HB. Landmark article May 19, 1945: the surgical treatment of malformations of the heart in which there is pulmonary stenosis or pulmonary atresia. JAMA. 1984;251:2123–38.PubMedCrossRefGoogle Scholar
  10. Botto LD, May K, Fernhoff PM, et al. A population-based study of the 22q11.2 deletion: phenotype, incidence, and contribution to major birth defects in the population. Pediatrics. 2003;112:101–7.PubMedCrossRefGoogle Scholar
  11. Bruckheimer E, Berul CI, Kopf GS, et al. Late recovery of surgically-induced atrioventricular block in patients with congenital heart disease. J Interv Card Electrophysiol. 2002;6:191–5.PubMedCrossRefGoogle Scholar
  12. Buttiker V, Fanconi S, Burger R. Chylothorax in children: guidelines for diagnosis and management. Chest. 1999;116:682–7.PubMedCrossRefGoogle Scholar
  13. Cannizzaro V, Frey B, Bernet-Buettiker V. The role of somatostatin in the treatment of persistent chylothorax in children. Eur J Cardiothorac Surg. 2006;30:49–53.PubMedCrossRefGoogle Scholar
  14. Catchpole KR, de Leval MR, McEwan A, et al. Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality. Paediatr Anaesth. 2007;17:470–8.PubMedCrossRefGoogle Scholar
  15. Chan EH, Russell JL, Williams WG, Van Arsdell GS, Coles JG, McCrindle BW. Postoperative chylothorax after cardiothoracic surgery in children. Ann Thorac Surg. 2005;80:1864–70.PubMedCrossRefGoogle Scholar
  16. Chaney MA, Nikolov MP, Blakeman B, Bakhos M, Slogoff S. Pulmonary effects of methylprednisolone in patients undergoing coronary artery bypass grafting and early tracheal extubation. Anesth Analg. 1998;87:27–33.PubMedGoogle Scholar
  17. Chang AC, Atz AM, Wernovsky G, Burke RP, Wessel DL. Milrinone: systemic and pulmonary hemodynamic effects in neonates after cardiac surgery. Crit Care Med. 1995;23:1907–14.PubMedCrossRefGoogle Scholar
  18. Chaturvedi RR, Shore DF, Lincoln C, et al. Acute right ventricular restrictive physiology after repair of tetralogy of Fallot: association with myocardial injury and oxidative stress. Circulation. 1999;100:1540–7.PubMedGoogle Scholar
  19. Chaturvedi RR, Herron T, Simmons R, et al. Passive stiffness of myocardium from congenital heart ­disease and implications for diastole. Circulation. 2010;121:979–88.PubMedCrossRefGoogle Scholar
  20. Chrysostomou C, Beerman L, Shiderly D, Berry D, Morell VO, Munoz R. Dexmedetomidine: a novel drug for the treatment of atrial and junctional tachyarrhythmias during the perioperative period for congenital cardiac surgery: a preliminary study. Anesth Analg. 2008;107:1514–22.PubMedCrossRefGoogle Scholar
  21. Connelly DT, Steinhaus DM. Mobitz type I atrioventricular block: an indication for permanent pacing? Pacing Clin Electrophysiol. 1996;19:261–4.PubMedCrossRefGoogle Scholar
  22. Dodge-Khatami A, Miller OI, Anderson RH, Gil-Jaurena JM, Goldman AP, de Leval MR. Impact of junctional ectopic tachycardia on postoperative morbidity following repair of congenital heart defects. Eur J Cardiothorac Surg. 2002;21:255–9.PubMedCrossRefGoogle Scholar
  23. Doenst T, Schlensak C, Beyersdorf F. Cardioplegia in pediatric cardiac surgery: do we believe in magic? Ann Thorac Surg. 2003; 75:1668–77.PubMedCrossRefGoogle Scholar
  24. Dorman BH, Sade RM, Burnette JS, et al. Magnesium supplementation in the prevention of arrhythmias in pediatric patients undergoing surgery for congenital heart defects. Am Heart J. 2000;139:522–8.PubMedCrossRefGoogle Scholar
  25. Emanuel BS. Molecular mechanisms and diagnosis of chromosome 22q11.2 rearrangements. Dev Disabil Res Rev. 2008;14:11–8.PubMedCrossRefGoogle Scholar
  26. Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;51:e1–62.PubMedCrossRefGoogle Scholar
  27. Freeman SB, Taft LF, Dooley KJ, et al. Population-based study of congenital heart defects in Down syndrome. Am J Med Genet. 1998;80:213–7.PubMedCrossRefGoogle Scholar
  28. Fu YC, Bass J, Amin Z, et al. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase I trial. J Am Coll Cardiol. 2006;47:319–25.PubMedCrossRefGoogle Scholar
  29. Gaca AM, Jaggers JJ, Dudley LT, Bisset 3rd GS. Repair of congenital heart disease: a primer – Part 2. Radiology. 2008;248:44–60.PubMedCrossRefGoogle Scholar
  30. Gazit AZ, Huddleston CB, Checchia PA, Fehr J, Pezzella AT. Care of the pediatric cardiac surgery patient – part 1. Curr Probl Surg. 2010;47:185–250.PubMedCrossRefGoogle Scholar
  31. Gazit AZ, Huddleston CB, Checchia PA, Fehr J, Pezzella AT. Care of the pediatric cardiac surgery patient – part 2. Curr Probl Surg. 2010;47:261–376.PubMedCrossRefGoogle Scholar
  32. Goldbeck L, Melches J. The impact of the severity of disease and social disadvantage on quality of life in families with congenital cardiac disease. Cardiol Young. 2006;16:67–75.PubMedCrossRefGoogle Scholar
  33. Goldberg CS, Bove EL, Devaney EJ, et al. A randomized clinical trial of regional cerebral perfusion versus deep hypothermic circulatory arrest: outcomes for infants with functional single ventricle. J Thorac Cardiovasc Surg. 2007;133:880–7.PubMedCrossRefGoogle Scholar
  34. Goldman BS, Williams WG, Hill T, et al. Permanent cardiac pacing after open heart surgery: congenital heart disease. Pacing Clin Electrophysiol. 1985;8:732–9.PubMedCrossRefGoogle Scholar
  35. Goldstein SL, Hackbarth R, Bunchman TE, Blowey D, Brophy PD; Prospective Pediatric CRRT Registry Group Houston. Evaluation of the PRISMA M10 circuit in critically ill infants with acute ­kidney injury: A report from the Prospective Pediatric CRRT Registry Group. Int J Artif Organs. 2006;29:1105–8.PubMedGoogle Scholar
  36. Gross RE, Hubbard JP. Landmark article Feb 25, 1939: surgical ligation of a patent ductus arteriosus. Report of first successful case. JAMA. 1984;251:1201–2.PubMedCrossRefGoogle Scholar
  37. Hammon Jr JW. Myocardial protection in the immature heart. Ann Thorac Surg. 1995;60:839–42.PubMedCrossRefGoogle Scholar
  38. Hensley FA, Martin DE, Gravlee GP. A practical approach to cardiac anesthesia. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2008.Google Scholar
  39. Hirleman E, Larson DF. Cardiopulmonary bypass and edema: physiology and pathophysiology. Perfusion. 2008;23:311–22.PubMedCrossRefGoogle Scholar
  40. Hirsch JC, Charpie JR, Ohye RG, Gurney JG. Near-infrared spectroscopy: what we know and what we need to know – a systematic review of the congenital heart disease literature. J Thorac Cardiovasc Surg. 2009;137:154–9.PubMedCrossRefGoogle Scholar
  41. 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.PubMedCrossRefGoogle Scholar
  42. Hoffman GM, Tweddell JS, Ghanayem NS, et al. Alteration of the critical arteriovenous oxygen saturation relationship by sustained afterload reduction after the Norwood procedure. J Thorac Cardiovasc Surg. 2004;127:738–45.PubMedCrossRefGoogle Scholar
  43. Jacobs ML, Pelletier G. Late complications associated with the Fontan circulation. Cardiol Young. 2006;16(Suppl 1):80–4.PubMedCrossRefGoogle Scholar
  44. Jenkins KH, Gauvreau K, Newburger JW, et al. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg. 2002;123:110–8.PubMedCrossRefGoogle Scholar
  45. Johnson BA, Hoffman GM, Tweddell JS, et al. Near-infrared spectroscopy in neonates before palliation of hypoplastic left heart syndrome. Ann Thorac Surg. 2009;87:571–7; discussion 577–79.PubMedCrossRefGoogle Scholar
  46. Kaltman JR, Andropoulos DB, Checchia PA, et al. Perioperative Working Group. Report of the pediatric heart network and national heart, lung, and blood institute working group on the perioperative management of congenital heart disease. Circulation. 2010;121:2766–72.PubMedCrossRefGoogle Scholar
  47. Kaushal S, Backer CL, Patel JN, et al. Coarctation of the aorta: midterm outcomes of resection with extended end-to-end anastomosis. Ann Thorac Surg. 2009;88:1932–8.PubMedCrossRefGoogle Scholar
  48. Kelly BP, Gajarski RJ, Ohye RG, Charpie JR. Intravenous induction of therapeutic hypothermia in the management of junctional ectopic tachycardia: a pilot study. Pediatr Cardiol. 2010;31:11–7.PubMedCrossRefGoogle Scholar
  49. Kiraly L, Hartyanszky I, Prodan Z. Right ventricle failure and outcome of simple and complex arterial switch operations in neonates. Croat Med J. 2002;43:660–4.PubMedGoogle Scholar
  50. Kitagawa T, Durham 3rd LA, Mosca RS, Bove EL. Techniques and results in the management of multiple ventricular septal defects. J Thorac Cardiovasc Surg. 1998;115:848–56.PubMedCrossRefGoogle Scholar
  51. Kovacikova L, Hakacova N, Dobos D, Skrak P, Zahorec M. Amiodarone as a first-line therapy for postoperative junctional ectopic tachycardia. Ann Thorac Surg. 2009;88:616–22.PubMedCrossRefGoogle Scholar
  52. Kumar K, Zarychanski R, Bell DD, et al. Impact of 24-hour in-house intensivists on a dedicated cardiac surgery intensive care unit. Ann Thorac Surg. 2009;88:1153–61.PubMedCrossRefGoogle Scholar
  53. Lazol JP, Lichtenstein SE, Jooste EH, et al. Effect of dexmedetomidine on pulmonary artery pressure after congenital cardiac surgery: a pilot study. Pediatr Crit Care Med. 2010;11:589–92.CrossRefPubMedGoogle Scholar
  54. Le Coultre C, Oberhansli I, Mossaz A, Bugmann P, Faidutti B, Belli DC. Postoperative chylothorax in children: differences between vascular and traumatic origin. J Pediatr Surg. 1991;26:519–23.PubMedCrossRefGoogle Scholar
  55. Li J, Zhang G, McCrindle BW, et al. Profiles of hemodynamics and oxygen transport derived by using continuous measured oxygen consumption after the Norwood procedure. J Thorac Cardiovasc Surg. 2007;133:441–8.PubMedCrossRefGoogle Scholar
  56. Lindberg L, Olsson AK, Jogi P, Jonmarker C. How common is severe pulmonary hypertension after pediatric cardiac surgery? J Thorac Cardiovasc Surg. 2002;123:1155–63.CrossRefPubMedGoogle Scholar
  57. Lofland GK. The enhancement of hemodynamic performance in Fontan circulation using pain free spontaneous ventilation. Eur J Cardiothorac Surg. 2001;20:114–8; discussion 118–9.PubMedCrossRefGoogle Scholar
  58. MacMillan M, Jones TK, Lupinetti FM, Johnston TA. Balloon angioplasty for Blalock-Taussig shunt failure in the early postoperative period. Catheter Cardiovasc Interv. 2005;66:585–9.PubMedCrossRefGoogle Scholar
  59. Manrique AM, Arroyo M, Lin Y, et al. Magnesium supplementation during cardiopulmonary bypass to prevent junctional ectopic tachycardia after pediatric cardiac surgery: a randomized controlled study. J Thorac Cardiovasc Surg. 2010;139:162–9.PubMedCrossRefGoogle Scholar
  60. Martins P, Castela E. Transposition of the great arteries. Orphanet J Rare Dis. 2008;3:27.PubMedCrossRefGoogle Scholar
  61. McDonald-McGinn DM, LaRossa D, Goldmuntz E, et al. The 22q11.2 deletion: screening, diagnostic workup, and outcome of results; report on 181 patients. Genet Test. 1997;1:99–108.PubMedCrossRefGoogle Scholar
  62. McMullan DM, Bekker JM, Parry AJ, et al. Alterations in endogenous nitric oxide production after cardiopulmonary bypass in lambs with normal and increased pulmonary blood flow. Circulation. 2000;102(19 Suppl 3):III-172–8.PubMedGoogle Scholar
  63. Moat NE, Shore DF, Evans TW. Organ dysfunction and cardiopulmonary bypass: the role of complement and complement regulatory proteins. Eur J Cardiothorac Surg. 1993;7:563–73.PubMedCrossRefGoogle Scholar
  64. Mohseni-Bod H, Macrae D, Slavik Z. Somatostatin analog (octreotide) in management of neonatal postoperative chylothorax: is it safe? Pediatr Crit Care Med. 2004;5:356–7.PubMedCrossRefGoogle Scholar
  65. Moller JH. Surgery of congenital heart disease: pediatric cardiac care consortium 1984–1995. Armonk: Futura Publishing Co; 1998. p. 20.Google Scholar
  66. Murphy GS, Hessel EA 2nd, Groom RC. Optimal perfusion during cardiopulmonary bypass: an evidence-based approach. Anesth Analg. 2009;108:1394–417.PubMedCrossRefGoogle Scholar
  67. Nakagawa TA, Sartori SC, Morris A, Schneider DS. Intravenous nicardipine for treatment of postcoarctectomy hypertension in children. Pediatr Cardiol. 2004;25:26–30.PubMedCrossRefGoogle Scholar
  68. Nath DS, Savla J, Khemani RG, Nussbaum DP, Greene CL, Wells WJ. Thoracic duct ligation for persistent chylothorax after pediatric cardiothoracic surgery. Ann Thorac Surg. 2009;88:246–51; discussion 251–52.PubMedCrossRefGoogle Scholar
  69. Ohye RG, Sleeper LA, Mahony L, et al. Pediatric Heart Network Investigators. Comparison of shunt types in the Norwood procedure for single-ventricle lesions. N Engl J Med. 2010;362: 1980–92.PubMedCrossRefGoogle Scholar
  70. Oudemans-van Straaten HM, Jansen PG, te Velthuis H, et al. Increased oxygen consumption after cardiac surgery is associated with the inflammatory response to endotoxemia. Intensive Care Med. 1996;22:294–300.PubMedCrossRefGoogle Scholar
  71. Paparella D, Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothorac Surg. 2002;21:232–44.PubMedCrossRefGoogle Scholar
  72. Parr GV, Blackstone EH, Kirklin JW. Cardiac performance and mortality early after intracardiac surgery in infants and young children. Circulation. 1975;51:867–74.PubMedGoogle Scholar
  73. Pedersen KR, Hjortdal VE, Christensen S, et al. Clinical outcome in children with acute renal failure treated with peritoneal dialysis after surgery for congenital heart disease. Kidney Int Suppl. 2008;108:S81–6.PubMedCrossRefGoogle Scholar
  74. Pfammatter JP, Paul T, Ziemer G, Kallfelz HC. Successful management of junctional tachycardia by hypothermia after cardiac operations in infants. Ann Thorac Surg. 1995;60:556–60.PubMedCrossRefGoogle Scholar
  75. Polito A, Thiagarajan RR, Laussen PC, et al. Association between intraoperative and early postoperative glucose levels and adverse outcomes after complex congenital heart surgery. Circulation. 2008;118:2235–42.PubMedCrossRefGoogle Scholar
  76. Preissig CM, Rigby MR, Maher KO. Glycemic control for postoperative pediatric cardiac patients. Pediatr Cardiol. 2009;30:1098–104.PubMedCrossRefGoogle Scholar
  77. Raja P, Hawker RE, Chaikitpinyo A, et al. Amiodarone management of junctional ectopic tachycardia after cardiac surgery in children. Br Heart J. 1994;72:261–5.PubMedCrossRefGoogle Scholar
  78. Riverso P, Bernardi PL, Corsa D, Morra MG, Paganini G, Parigi F. A comparison of ventilation techniques in ARDS. Volume controlled vs pressure regulated volume control. Minerva Anestesiol. 1998;64:339–43.PubMedGoogle Scholar
  79. Roehr CC, Jung A, Proquitte H, et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review. Intensive Care Med. 2006;32:650–7.PubMedCrossRefGoogle Scholar
  80. Sachdev MS, Bhagyavathy A, Varghese R, Coelho R, Kumar RS. Right ventricular diastolic function after repair of tetralogy of Fallot. Pediatr Cardiol. 2006;27:250–5.PubMedCrossRefGoogle Scholar
  81. Saul JP, Scott WA, Brown S, et al. Intravenous amiodarone for incessant tachyarrhythmias in children: a randomized, double-blind, antiarrhythmic drug trial. Circulation. 2005;112:3470–7.PubMedCrossRefGoogle Scholar
  82. Schroeder VA, Pearl JM, Schwartz SM, Shanley TP, Manning PB, Nelson DP. Combined steroid treatment for congenital heart surgery improves oxygen delivery and reduces postbypass inflammatory mediator expression. Circulation. 2003;107:2823–8.PubMedCrossRefGoogle Scholar
  83. Schroeder VA, DiSessa TG, Douglas WI. Postoperative fluid balance influences the need for antihypertensive therapy following coarctation repair. Pediatr Crit Care Med. 2004;5:539–41.PubMedCrossRefGoogle Scholar
  84. Seear MD, Scarfe JC, LeBlanc JG. Predicting major adverse events after cardiac surgery in children. Pediatr Crit Care Med. 2008;9:606–11.PubMedCrossRefGoogle Scholar
  85. Shekerdemian LS, Bush A, Shore DF, Lincoln C, Redington AN. Cardiopulmonary interactions after Fontan operations: augmentation of cardiac output using negative pressure ventilation. Circulation. 1997;96:3934–42.PubMedGoogle Scholar
  86. Skippen PW, Sanatani S, Gow RM, Froese N. Diagnosis of postoperative arrhythmias following paediatric cardiac surgery. Anaesth Intensive Care. 2009;37:705–19.PubMedCrossRefGoogle Scholar
  87. Sommer RJ, Hijazi ZM, Rhodes JF. Pathophysiology of congenital heart disease in the adult: part III: complex congenital heart disease. Circulation. 2008;117:1340–50.PubMedCrossRefGoogle Scholar
  88. Stiller B, Sonntag J, Dahnert I, et al. Capillary leak syndrome in children who undergo cardiopulmonary bypass: clinical outcome in comparison with complement activation and C1 inhibitor. Intensive Care Med. 2001;27:193–200.PubMedCrossRefGoogle Scholar
  89. Stumper O. Hypoplastic left heart syndrome. Postgrad Med J. 2010;86:183–8.PubMedCrossRefGoogle Scholar
  90. Tabbutt S, Nicolson SC, Dominguez TE, et al. Perioperative course in 118 infants and children undergoing coarctation repair via a thoracotomy: a prospective, multicenter experience. J Thorac Cardiovasc Surg. 2008;136:1229–36.PubMedCrossRefGoogle Scholar
  91. Tsai BM, Wang M, Turrentine MW, Mahomed Y, Brown JW, Meldrum DR. Hypoxic pulmonary vasoconstriction in cardiothoracic ­surgery: basic mechanisms to potential therapies. Ann Thorac Surg. 2004;78:360–8.PubMedCrossRefGoogle Scholar
  92. Ulate KP, Lima Falcao GC, Bielefeld MR, Morales JM, Rotta AT. Strict glycemic targets need not be so strict: a more permissive glycemic range for critically ill children. Pediatrics. 2008;122:e898–904.PubMedCrossRefGoogle Scholar
  93. Villain E. Indications for pacing in patients with congenital heart disease. Pacing Clin Electrophysiol. 2008;31(Suppl 1):S17–20.PubMedCrossRefGoogle Scholar
  94. Wahr JA, Tremper KK, Samra S, Delpy DT. Near-infrared spectroscopy: theory and applications. J Cardiothorac Vasc Anesth. 1996;10:406–18.PubMedCrossRefGoogle Scholar
  95. Watzman HM, Kurth CD, Montenegro LM, Rome J, Steven JM, Nicolson SC. Arterial and venous contributions to near-infrared cerebral oximetry. Anesthesiology. 2000;93:947–53.PubMedCrossRefGoogle Scholar
  96. Weindling SN, Saul JP, Gamble WJ, Mayer JE, Wessel D, Walsh EP. Duration of complete atrioventricular block after congenital heart disease surgery. Am J Cardiol. 1998;82:525–7.PubMedCrossRefGoogle Scholar
  97. Wernovsky G, Mayer Jr JE, Jonas RA, et al. Factors influencing early and late outcome of the arterial switch operation for transposition of the great arteries. J Thorac Cardiovasc Surg. 1995;109:289–301; discussion 301–2.PubMedCrossRefGoogle Scholar
  98. 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;92:2226–35.PubMedGoogle Scholar
  99. Wessman DE, Stafford CM. The postcardiac injury syndrome: case report and review of the literature. South Med J. 2006;99:309–14.PubMedCrossRefGoogle Scholar
  100. Wilson NJ, Webber SA, Patterson MW, Sandor GG, Tipple M, LeBlanc J. Double-blind placebo-controlled trial of corticosteroids in children with postpericardiotomy syndrome. Pediatr Cardiol. 1994;15:62–5.PubMedGoogle Scholar
  101. Zahler S, Massoudy P, Hartl H, Hahnel C, Meisner H, Becker BF. Acute cardiac inflammatory responses to postischemic reperfusion during cardiopulmonary bypass. Cardiovasc Res. 1999;41:722–30.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  • Surender Rajasekaran
    • 1
  • John C. Ring
    • 2
  1. 1.Pediatric Critical Care Medicine, Department of PediatricsMichigan State University, Helen DeVos Children’s HospitalGrand RapidsUSA
  2. 2.Pediatric Cardiology and Critical Care Medicine, Department of Pediatrics, Geisinger Medical CenterTemple University School of Medicine, Janet Weis Children’s HospitalDanvilleUSA

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