Midterm data were assessed for reliability of catch-up growth, resulting quality of atrioventricular valves, and adequacy of 2-ventricle repairs.
Methods: The 24 consecutive infants (14 female and 10 male) with unbalanced atrioventricular canal defects had significant hypoplasia of 1 atrioventricular valve and/or ventricle (an echocardiography-derived z value of <=-3.0 standard errors of the mean below expected).
Operative approaches STAT inhibitor included the following: (1) Staged repair was performed, with complete valve repair, partial closure of the atrial septal, and ventricular septal defects, and (usually) pulmonary artery banding. After adequate growth, repair was completed. A vestigial mitral valve (4-7 mm) in 3 patients led to partitioning the large tricuspid valve, creating a second mitral valve. (2) Repair with a shift in atrioventricular valve partitioning was performed to increase hypoplastic atrioventricular valve size. (3) Repair with snared atrial septal defects and ventricular septal defect was performed to allow intracardiac shunting.
selleck kinase inhibitor The hypoplastic atrioventricular valves and hypoplastic ventricles were reassessed on local follow-up (5-15 years).
Results: The initial z scores were -2.8 to -7.4 for hypoplastic atrioventricular valves and -1.0 to -7.5 for hypoplastic ventricles. Follow-up z scores were -0.6 to -2.7 for hypoplastic atrioventricular valves and -2.0 to +1.8 for hypoplastic ventricles. Another 11 patients were also judged to be within normal limits. Three Nutlin-3 molecular weight reoperations were for mitral valve regurgitation, and 1 reoperation was for mitral valve replacement. One patient died of central nervous system bleed just before extracorporeal membrane oxygenation weaning, and 2 patients died of late potassium overdose, for an 88% survival. Survivors are well
with 2-ventricle repairs, and 15 of 19 patients are not taking cardiac medications.
Conclusions: Increasing atrioventricular valve flow reliably induced growth. Valve repair and growth achieved a 2-ventricle repair in all patients. (J Thorac Cardiovasc Surg 2012;143:S29-32)”
“Healthy people sometimes report experiences and beliefs that are strikingly similar to the symptoms of psychosis in their bizarreness and the apparent lack of evidence supporting them. An important question is whether this represents merely a superficial resemblance or whether there is a genuine and deep similarity indicating, as some have suggested, a continuum between odd but healthy beliefs and the symptoms of psychotic illness. We sought to shed light on this question by determining whether the neural marker for prediction error – previously shown to be altered in early psychosis – is comparably altered in healthy individuals reporting schizotypal experiences and beliefs. We showed that non-clinical schizotypal experiences were significantly correlated with aberrant frontal and striatal prediction error signal. This correlation related to the distress associated with the beliefs.