R E Shaddy

..Findings from these types of studies will provide critical information for developing guidelines for the appropriate treatment of children with chronic heart failure...

..This supports the concept that acute valvar regurgitation is the major hemodynamic abnormality in these patients...

..To avoid wasting a valuable, limited resource, further study is needed to identify the donors suitable for pediatric heart transplantation...

..1%. No demographic or procedural factors were identified to be predictive of complications. In experienced hands, therefore, endomyocardial biopsy can be safely performed in children with very low morbidity...

..A prior randomized, short-term comparison of BA and surgery for native CoA in 36 children demonstrated equivalent relief of obstruction. The risk of aneurysm formation and possibly restenosis was higher among patients treated with BA...

..This review presents data on the immunologic and nonimmunologic risk factors implicated in valved allograft failure, in addition to ongoing investigation into the improvement of allograft function...

..The purpose of this study was to prospectively assess the effects of azathioprine on the humoral immune response to HLA alloantigens and allograft function in children receiving cryopreserved valved allografts...

..Little is known about its safety, efficacy, pharmacokinetics, and dosing profile in children...

..Very little is known regarding the immune response to cryopreserved allograft valves and patch material used in the surgical repair of congenital heart defects...

..We evaluated our results with open aortic valvotomy over the past decade, specifically examining factors influencing survival and reintervention in the current era...

..The HLA immunogenicity of cryopreserved valved allografts used in the surgical repair of congenital heart defects is unknown...

..We found smaller left heart structures (initial mitral and aortic annular diameters) to be associated with diastolic interventricular shunting and to be predictive of the development of mitral or aortic and/or subaortic stenosis...

..Minimal sizes, and the score for adequacy used for critical aortic stenosis, are not applicable to neonates with coarctation...

..Thus, we reviewed patient outcome to determine whether adverse pulmonary vascular effects may be associated with this therapy...

..Complete follow-up examinations might be warranted to diagnose this lesion. This may be an important consideration when formulating reimbursement policies...

..Meaningful analysis of survival and risk factors for death in children who undergo heart transplantation is problematic because of the small number of heart transplantations performed at individual institutions...

..Intra-aortic balloon pumping timed precisely with M-mode echocardiographic markers offers a relatively simple and safe intermediate level of mechanical support for children with dilated cardiomyopathy who fail pharmacologic support...

..661; p = 0.001). This study suggests that with additional research, BNP concentration may prove to be a useful clinical tool in managing children and adults with congenital heart disease...

..Large prospective, randomized trials in children are currently underway in order to attempt to determine the indications, dosages, and optimal use of beta-blockers in children with chronic congestive heart failure...

..For those in whom medical management fails, heart transplantation is a therapeutic option with an excellent intermediate-term success rate...

..These results indicate that the inflammatory, vasculitic process affecting the large vessels in Takayasu's arteritis may also involve the endomyocardium and its small vessels resulting in ventricular dysfunction...

..Tricuspid valve replacement was repeated with a porcine bioprosthesis with excellent recovery and function for >2 years. The mitral valve homograft displayed inflammatory features consistent with humoral immune-mediated destruction...

..Therefore, children who have received cryopreserved allografts before cardiac transplantation may be at greater risk for transplant rejection...

..Improved methods of diagnosing, preventing, and treating this problem can only lead to better outcomes for children who require heart transplantation...

..The purpose of this study was to determine the angiographic incidence of TCAD, potential risk factors, and outcomes in a large pediatric cohort...

..This study demonstrates the ability to persistently alter the HLA class I antibody response using 3 months of MMF following allograft implantation in children...

..In conclusion, LV remodeling occurs in children with LV dysfunction. The reversal of this remodeling with a decrease in the degree of MR and the size of the mitral annulus occurs as systolic function improves...

..Although beta-blockers improve symptoms and survival in adults with heart failure, little is known about these medications in children and adolescents...

..For those patients without a systemic left ventricle (e.g., a systemic right ventricle or single ventricle), there is currently no foundation for evidence-based therapy...

..The aim of this review is to discuss the immunogenicity of cryopreserved allograft tissue and measures that may minimize the deleterious effect of the immune system on allograft function and durability...

..Mycophenolic mofetil (MMF) is a powerful immunosuppressant that inhibits the proliferation of both T cells and B cells and has been reported to possibly reduce HLA panel reactive antibody (PRA) in sensitized transplant recipients...

..When added to conventional therapy, beta-blocker therapy resulted in an increase in ejection-phase indices of left ventricular systolic performance at intermediate follow-up in pediatric patients with systolic dysfunction...

..These findings suggest that Doppler gradients should be interpreted cautiously in this setting...

..The risks of standard open heart repair using cardiopulmonary bypass were felt to be prohibitive due to coexistent injuries. This case demonstrates the feasibility of transcatheter therapy for traumatic ventricular septal defects...

..This preliminary study examined the HLA antibody response to these decellularized allografts and compared it with the response to standard allograft material...

..To review our experience with children who presented with rheumatic fever (RF) before 5 years of age and to compare their presentation with that of older children...

..These events justify a reevaluation of the indications for heart transplantation in congenital heart disease and other causes of pediatric heart failure...