Glossary of Childhood Onset Heart Disease
Based upon
the needs and requests of our readers, we have created
this glossary to provide accurate and concise information
for families and individuals.The following represents a
"work in progress". Please contact
us to submit items you would like to see included on this
page.
New Strategies/Techniques
Aprotinin
An intravenously administered protein which helps prevent
bleeding following cardiac surgery. It works by blocking
the action of certain enzymes in the bloodstream which
dissolve blood clots.
ECMO (Extracorporeal Membrane Oxygenation)
"Portable" cardiopulmonary bypass. Oxygen-poor
(blue) blood is removed from the circulation, either from
a large vein in the neck or directly through the right
atrium by a large cannula (tube). The blood is circulated
through a membrane which adds oxygen to the blood and
then through a pump which returns the oxygen-rich (red)
blood to the circulation. ECMO is currently used in
children with severe cardiac and/ or pulmonary failure,
and may be associated with significant complications of
bleeding, infection, and neurologic injury. However, ECMO
can be life saving in many cases where there are no other
alternatives.
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Hemoconcentration
Similar to Ultrafiltration, a technique by which fluid is
removed from the circulation following cardiopulmonary
bypass, resulting in an elevated concentration of red
blood cells (increasing hematocrit).
Intra-Aortic Balloon Pump (IABP)
A large catheter placed in the femoral artery (through
the leg) into the aorta to augment the functioning of a
severely weakened heart. This technique has limited
utilization in pediatrics, but has been used with great
success in adolescents and adults.
Liquid Perflubron Ventilation
A liquid which is instilled into the lungs that allows
oxygen to be delivered to the blood without exchange by
gas. This technique was shown in the movie "The
Abyss".
Neuroprotective Strategies
An active area of research. With increasing numbers of
survivors of complex congenital heart surgery in infancy,
there is a growing recognition or neurologic
abnormalities in some survivors. Although neurologic
injury occurs after 5-25% of open heart procedures in
infants and children, fortunately, most are transient and
carry no long-term significance. A number of
investigators are looking at ways to minimize the effects
of the heart/lung machine and cardiac surgery on the
brain. These include profound hypothermia (lowering the
body temperature to 65-70 f, drugs which suppress
inflammation following surgery, adjusting the acid
concentration during cardiopulmonary bypass,minimizing
the duration of circulatory arrest, and many others.
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Nitric Oxide Therapy
An inhaled gas which results in a relaxation of the blood
vessels in the pulmonaryarteries. The gas is generally
delivered through a breathing tube or mask and its
effect is to lower pressure in the pulmonary arteries.
This is not the same gas as "laughing gas"
which is nitrousoxide. Nitric oxide is naturally produced
by many cells in the body and is quickly removed from the
circulation.
Phenoxybenzamine
An intravenous medication, typically added to
cardiopulmonary bypasss or in the immediate
post-operative period, to lower blood pressure by
relaxing constriction of the body's arteries, and improve
the workload on the heart.
Steroid Eluting Lead
The addition of steroids to the portion of a pacemaker
which attaches directly to the heart muscle. Steroid
eluting leads may last longer than standard leads.
Tissue engineered heart valves
A technique where human cells are"grown" in the
shape of normal human heart valves. Highly
investigational at present.
Ultrafiltration
A filtering technique (similar to dialysis) used at the
end of cardiopulmonary bypass.Ultra filtration allows
excessive fluid and chemicals which contribute to
post-operative inflammation to be removed from the
circulation. Ultra filtration is performed at the
completion of open heart surgery while the patient is
still attached to the heart/lung machine.
Ventricular Assist Device
Similar to ECMO, but without the ability to oxygenate the
blood, ventricular assist devices are mechanical devices
inserted in the left atrium or left ventricle to aid in
pumping blood to the aorta.
- Other Articles in This Section
- Associated Conditions
- Cath Lab Procedures
- Imaging Techniques
- Medical Personnel
/Services
- New Strategies / Techniques
- Surgical Complications
- Surgical Procedures
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