Publications by authors named "Roger Vermilion"

7 Publications

  • Page 1 of 1

Right ventricular outflow tract obstruction after sinus of valsalva aneurysm repair.

J Card Surg 2014 May 22;29(3):317-9. Epub 2013 Oct 22.

Division of Cardiothoracic Surgery, University of Rochester Medical Center, Rochester, New York.

Sinus of Valsalva aneurysm (SVA) is a rare cardiac lesion especially in the western countries and older population. We report an unusual case of a 60-year-old Caucasian male with SVA, acute decompensation, and a pressurized prolapsed aortic leaflet cystic remnant via a small supracristal VSD causing recurrent right ventricular outflow tract obstruction following a Bentall procedure
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http://dx.doi.org/10.1111/jocs.12219DOI Listing
May 2014

Carpentier edwards porcine valved conduit for right ventricular outflow tract reconstruction.

J Card Surg 2011 Nov 26;26(6):643-9. Epub 2011 Sep 26.

Pediatric Cardiac Consortium of Upstate New York, Rochester, New York, USA.

Background: The optimal conduit for right ventricular outflow tract (RVOT) reconstruction is uncertain, with varying degrees of longevity reported for pericardial, homograft, and xenograft valves utilized in this position.

Methods: A retrospective review of children and adults with congenital heart disease who underwent RVOT reconstruction with the Carpentier Edwards™ (CE) porcine valved conduit was conducted from 2001 to 2009 at the University of Rochester and SUNY Upstate Medical Centers. Clinical data were analyzed for each subject according to conduit size, and all of the Doppler derived transconduit gradients from postoperative echocardiograms were analyzed.

Results: Two hundred and eighteen patients received a single CE conduit for RVOT reconstruction with conduit size ranging from 12 to 30 mm. Perioperative mortality was 1.8% (4/218). Follow-up data were available for 95% of subjects with duration of follow-up ranging from 1 to 9 years. The increase in transconduit gradient over time was inversely proportional to conduit size. For the entire series, freedom from reoperation was 70.3% at 8.2 years. Patients receiving 25 and 30 mm conduits demonstrated no gradient development over this period of follow-up.

Conclusions: In this series, the CE conduit showed excellent longevity at intermediate term follow-up, with slower progression of conduit stenosis as measured by RVOT gradient change compared with previous reports.
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http://dx.doi.org/10.1111/j.1540-8191.2011.01313.xDOI Listing
November 2011

A simple method of measuring thoracic aortic pulse wave velocity in children: methods and normal values.

J Am Soc Echocardiogr 2010 Jul 3;23(7):735-40. Epub 2010 Jun 3.

Division of Pediatric Cardiology, Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York 14642, USA.

Background: The objective of this study was to define a simple method of measuring thoracic aortic pulse-wave velocity (PWV) using only an aortic length regression equation based on the subject's height and two pulsed Doppler recordings of the aorta.

Methods: The thoracic aortas of 80 subjects (age range, 0-20 years) were measured retrospectively by direct echocardiographic visualization. A simple linear regression equation for thoracic aortic length on the basis of height was derived. PWV was defined as the thoracic aortic length, derived from the subject's height, divided by pulse transit time. Pulse transit time was defined as the difference in the time of onset of two pulsed Doppler recordings placed at the level of the aortic valve leaflet tips and the diaphragm. Normative data were retrospectively defined in 206 children.

Results: Thoracic aortic length was linearly related to subject height by the equation thoracic aortic length (cm)=1.7 cm+0.1 (height [cm]) (R2=0.98, P<.0001). Thoracic aortic PWV was independent of age (median, 3.04 m/s).

Conclusion: Thoracic aortic PWV can be simply calculated from a routine echocardiogram, it is constant throughout childhood, and it may improve the assessment of left ventricular load.
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http://dx.doi.org/10.1016/j.echo.2010.04.018DOI Listing
July 2010

Elevated blood pressure, race/ethnicity, and C-reactive protein levels in children and adolescents.

Pediatrics 2008 Dec;122(6):1252-7

Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Ave, Box 777, Rochester, NY 14642, USA.

Objective: Adult hypertension is independently associated with elevated C-reactive protein levels, after controlling for obesity and other cardiovascular risk factors. The objective of this study was to determine, with a nationally representative sample of children, whether the relationship between elevated blood pressure and C-reactive protein levels may be evident before adulthood.

Methods: Cross-sectional data for children 8 to 17 years of age who participated in the National Health and Nutrition Examination Survey between 1999 and 2004 were analyzed. Bivariate analyses compared children with C-reactive protein levels of >3 mg/L versus
Results: Among 6112 children, 3% had systolic blood pressure of >or=95th percentile and 1.3% had diastolic blood pressure of >or=95th percentile. Children with C-reactive protein levels of >3 mg/L had higher systolic blood pressure, compared with children with C-reactive protein levels of or=95th percentile was independently associated with C-reactive protein levels in boys but not girls. Subset analyses according to race/ethnicity demonstrated that the independent association of elevated systolic blood pressure with C-reactive protein levels was largely limited to black boys.

Conclusions: These data indicate that there is interplay between race/ethnicity, elevated systolic blood pressure, obesity, and inflammation in children, a finding that has potential implications for disparities in cardiovascular disease later in life.
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http://dx.doi.org/10.1542/peds.2007-3162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668663PMC
December 2008

Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery.

Ann Thorac Surg 2007 Oct;84(4):1320-5

Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA.

Background: Thrombotic events cause significant morbidity and mortality in children who undergo surgery for complex congenital cardiac disease. We prospectively evaluated the incidence of thrombosis and examined preoperative and postoperative laboratory tests of coagulation and inflammation in neonates experiencing initial surgical palliation for variations of single ventricle physiology.

Methods: Neonates (<30 days) requiring initial surgical palliation were studied. All subjects received aspirin from postoperative day 1 onward. Thromboses were diagnosed by serial transthoracic echocardiograms, vascular imaging, and interstage cardiac catheterizations according to predefined criteria.

Results: Twenty-two neonates, age 1 to 11 days (mean 4 +/- 2.5) were studied. Follow-up ranged from three hours to 18 months (median, 212 days). Eight infants died. Four of the 14 subjects who survived (28%), and one of the eight who died (12.5%), had evidence of thrombosis identified over a range of four hours to nine months postoperatively (median 14 days). When compared with reference values established in healthy children, preoperative subject hematocrit (Hct), platelet count, factors II, V, VII, VIII, and X, antithrombin, protein C, and soluble CD40 ligand measures were significantly lower, and the prothrombin time and partial thromboplastin time were significantly higher. Postoperative C reactive protein (CRP) was significantly higher, and Hct and platelet count significantly lower, than preoperative values. Thrombotic events were significantly related to high preoperative CRP (p = 0.02).

Conclusion: Thrombotic complications occur frequently in neonates undergoing initial palliative surgery, suggesting that aspirin therapy alone may constitute inadequate protection. Elevated preoperative CRP appears to be associated with increased thrombotic risk.
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http://dx.doi.org/10.1016/j.athoracsur.2007.05.026DOI Listing
October 2007

Aortopulmonary Window with Interrupted Aortic Arch and Pulmonary Artery Sling: Diagnosis by Echocardiography and Magnetic Resonance Imaging: Case Report and Literature Review.

Echocardiography 1999 Feb;16(2):147-150

Section of Pediatric Radiology, C.S. Mott Children's Hospital, University of Michigan Health System, 200 East Hospital Drive, Ann Arbor, MI 48109-0252.

We present the pediatric case of a patient who had aortopulmonary window with interrupted aortic arch, intact ventricular septum, and pulmonary artery sling that was imaged with echocardiography and magnetic resonance imaging. This case is unique because this combination of findings has not been previously reported. The diagnosis was made without the need for angiography, and the findings were confirmed at surgery. This case shows that complex congenital heart defects can be accurately imaged by noninvasive methods.
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http://dx.doi.org/10.1111/j.1540-8175.1999.tb00796.xDOI Listing
February 1999

Influence of Echocardiographic Guidance on Positioning of the Buttoned Occluder for Transcatheter Closure of Atrial Septal Defects.

Echocardiography 1996 Mar;13(2):117-122

Pediatric Cardiology, F1310 MCHC, 1501 E. Medical Center Dr., Ann Arbor, MI 48109-0204.

Ideal position of the buttoned device for occlusion of atrial septal defects was achieved more often with transesophageal than with transthoracic echocardiographic guidance (10/11 vs 7/23; P = 0.001). Patients with ideal device position were less likely to have residual shunts, device unbuttoning, or atrioventricular valve regurgitation (2/17 vs 11/17; P = 0.002). We therefore recommend the use of transesophageal echocardiography to guide implantation of the buttoned device. (ECHOCARDIOGRAPHY, Volume 13, March 1996)
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http://dx.doi.org/10.1111/j.1540-8175.1996.tb00878.xDOI Listing
March 1996