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Between September 1984 and October 1988, 27 patients underwent combined heart-lung transplantation for treatment of end-stage respiratory disease caused by cystic fibrosis. The actuarial patient survival was 78% at 1 year and 72% at 2 years. Bacterial respiratory infections were common in the early postoperative period and necessitated vigorous medical(More)
OBJECTIVE To review the impact of management changes on the early outcomes of end-stage dilated cardiomyopathy in children. METHODS We conducted a retrospective study of all consecutive children with end-stage dilated cardiomyopathy who received hospital treatment since 1992. Over the past 3 years the following management changes were made: (1) more(More)
OBJECTIVES There is still no agreement about the best method of dealing with malfunction of the aortic valve caused by aneurysm or dissection of the aortic root. The experience, rationale, and development of a valve-preserving technique introduced and used since 1979 is described. METHODS During this period 158 patients (78% of all patients undergoing(More)
Two hundred seventy-five unprocessed, viable homograft ("homovital") aortic valves were used for aortic valve replacement in patients aged 1.5 to 79 years (mean 45.8 +/- 19 years) with maximum follow-up of a 14-year period (mean 4.8 years). Ninety-two percent (252 patients) had New York Heart Association class III or IV functional status before operation(More)
BACKGROUND We have previously described the experience, rationale, and development of a valve preserving technique, but its role in patients with Marfan syndrome has not previously been defined. Here, we attempt to determine the early and long-term results, timing, and determinants of outcome of this operation in patients with Marfan syndrome. METHODS AND(More)
BACKGROUND Despite the increasing numbers of pediatric heart and lung transplants being performed worldwide, longitudinal psychological evaluation of children and adolescents undergoing transplantation remains uncommon. The objective of this study was to assess psychological functioning in a group of patients at 12 months and 3 years after transplantation.(More)
The surgical options available and the associated operative risks for repeat aortic valve replacement after free-standing homograft root replacement with reimplantation of the coronary arteries are as yet undefined. We therefore reviewed our experience with repeat aortic valve replacement between January 1976 and July 1994 and identified 22 such procedures(More)
Despite the increase in the use of heart and heart-lung transplantation as methods of treatment for children with end stage heart or lung disease, there is little documented research about the psychological implications of such procedures or about the effects of transplantation on quality of life. Twenty-eight children were studied before and 3 months after(More)
Between 1976-1979, 14 patients with simple transposition of the great arteries (TGA), ranging in age from 1 month to 2 1/2 years, underwent two-stage anatomic correction. Twenty patients underwent a first-stage operation, with three early deaths (15%). After the first-stage operation the peak systolic left ventricular pressure rose from 38 +/- 6 mm Hg to(More)