Surgical PVR is safe with low in-hospital and midterm follow-up mortality and reoperation rates. These outcomes provide a useful benchmark for treatment strategy comparisons.
A significant and growing number of adult patients are currently being cared for at pediatric institutions. Excellent outcomes have been achieved at these centers with dedicated adult congenital heart disease services, consisting of both cardiologists and other faculty trained in adult medicine. Others with training in adult medicine, whether they be staff or contracted consulting services, are also required to help manage adult comorbidities.
Case 1: A 4-year-old girl presented to our emergency department (ED) during the height of summer with 5 days of left-sided facial droop, which spared the forehead. The patient also complained of severe fatigue, 1 week of frontal headaches, urinary retention, intermittent erythematous rash around her eyes and behind her knees, and an increase in night terrors. Three days before admission, she was seen by her pediatrician, who sent Lyme serologies and empirically started amoxicillin given that the patient lived in an endemic area. She notably had no known history of tick bite or rash. Lyme serologies returned negative, so the patient was referred into our ED.
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