Browsing by Author "Smits, Lauris"

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    Echocardiographic follow up after surgical correction of aortic coarctation during the first year of life
    (2013-12) Ligere, Elina; Lubaua, Inguna; Lace, Inga; Bergmane, Inta; Knauere, Vita; Ozolins, Valts; Smits, Lauris; Sikora, Normunds; Lacis, Aris; Department of Paediatrics
    Coarctation of the aorta (AoCo) accounts for 6-10% of congenital heart diseases in infants. We analysed echocardiographic findings of patients operated on for AoCo in the University Hospital for Children in Riga during the first year of life to evaluate the long-term findings. Fifty-nine children underwent surgical correction of AoCo at the age of 55 ± 61 days. The methods of surgical correction were anastomosis end-to-end (ETE) in 29% (n = 17), subclavian flap aortoplasty (SFA) in 64% (n = 38) and extended anastomosis end-to-end (EETE) in 7% (n = 4). Recoarctation developed in 15 patients (25%) with no difference between surgical techniques (P > 0.05). The recoarcation patients had left ventricle hypertrophy (left ventricle mass index (LVMi) 76 ± 19 g/m2.7) normalising after angioplasty (LVMi 42 ± 7 g/m2.7). Patients with recoarctation had a decreased pulsed wave (PW) Doppler systolic/diastolic ratio in abdominal aorta 2.3 ± 0.4 versus patients without recoarctation 5.3 ± 1.2 and the control group 6.3 ± 1.4 (P < 0.05). A high incidence of recoarctation exists in patients operated on for AoCo as small infants. Life-long surveillance is required to monitor and to intervene in a timely way. Supplementation of the echocardiographic protocol with an evaluation of PW Doppler flow pattern in abdominal aorta can provide additional information about the presence of obstruction.
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    Initial experience with Edwards SAPIEN valve transcatheter implantation in native RVOT in Latvia
    (2020-06-13) Auzina, Luize; Lubaua, Inguna; Ligere, Elina; Lace, Inga; Bergmane, Inta; Matsone-Matsate, Baiba; Silis, Pauls; Smits, Lauris; Sikora, Normunds; Søndergaard, Lars; Ozolins, Valts; Rīga Stradiņš University
    Transcatheter pulmonary valve implantation has been a well-known method for more than a decade, but there are still many challenging cases when a personalized solution is needed. We report a case of a 15-year-old female patient with tetralogy of Fallot, who underwent a surgical correction during infancy. Because of progressive pulmonary regurgitation, stenosis, and right ventricle dilatation, transcatheter pulmonary valve implantation in the native right ventricle outflow tract (RVOT) using Edwards SAPIEN valve was performed. A "landing zone" was created prior to the intervention of stenting the RVOT and the right pulmonary artery. The transcatheter approach for pulmonary valve replacement in a native RVOT is a reasonable alternative to the surgical approach.
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    ISOLATED COR TRIATRIATUM SINISTER : A CASE REPORT
    (2020) Grīnberga, Zanda; Sīlis, Pauls; Ligere, Elina; Lubaua, Ingūna; Bergmane, Inta; Auziņa, Luīze; Smits, Lauris; Ozolins, Valts; Sikora, Normunds; Lāce, Inga; Rīga Stradiņš University
    Cor triatriatum sinister is a rare congenital cardiac anomaly that has been identified in 0.1% of children with congenital heart disease. It is defined as a fibromuscular membrane that divides the left atrium into two chambers: a superior (proximal) that in most cases receives drainage from the pulmonary veins and an inferior (distal) chamber that communicates with the mitral valve and the left atrium. Cor triatriatum sinister can be an isolated lesion (approximately 25% of cases), but in many cases it is associated with other congenital cardiovascular anomalies, the most common one being – atrial septal defect(3). Symptoms in patients with cor triatriatum sinister are related to obstruction of pulmonary venous drainage, pressure loading of the right side of the heart and congestive cardiac failure. Depending on the severity of the obstruction and presence of associated cardiac anomalies it can be diagnosed at any age. Diagnosis is usually achieved by echocardiography in early infancy. Elective treatment method is surgical excision of the membrane. Here we present a pediatric patient (4 months old) presenting in cardiogenic shock with a successful correction of isolated cor triatriatum sinister. To confirm diagnosis and success of surgical repair, transthoracic and transesophageal echocardiography were used.
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    Prevalence of patent ductus arteriosus in children under 18 years in Latvia 2018‑2022
    (2023) Paņina, Aleksandra; Ozolins, Valts; Smits, Lauris; Sikora, Normunds; Ligere, Elīna; Lubaua, Ingūna; Bergmane, Inta; Lāce, Inga; Sīlis, Pauls; Rīga Stradiņš University
    Introduction: Accounting for 5‑10% of all congenital heart defects, patent ductus arteriosus (PDA) is one of the most common congenital cardiovascular malformations. The condition is often diagnosed in the neonatal period. Howev‑ er, it can be delayed until childhood or even adulthood. A small PDA often doesn’t cause problems and may never need treatment, but a large, untreated PDA can reduce heart function or problems related to high pressure in the lungs. Aim: Analysis and summary of data from medical history of patients with PDA in the system of the Children’s Clinical University Hospital. Materials and Methods: The study included 70 patients diagnosed with PDA aged 0‑18 years from term infants. Data were analyzed using the diagnostic criteria for PDA. Results: A total of 70 patients were enrolled in the study, of whom 71% (n=50) were female and 29% (n=20) were male. Most patients (60%) were children aged 0 to 3 years (n=42). The small and moderate PDA type predominate, each type is 44% (n=31) by PDA criterion. When analyzing one of the most important echocardiographic criteria for PDA, the LA /AO ratio, pulmonary hyperperfusion was present in 53% (n=36) of patients. Angiography to close the PDA was performed in 94% (n=66) of cases, open surgery was performed in 3% (n=2) of cases, and surgery was discontinued in 3% (n=2) because of disease. Of the total number of patients, complications occurred in only 5,8 % (n=4), including migration of the occluding device 3% (n=2), residual PDA 1,4% (n=1), and a small piece of the encapsulating ligature 1,4% (n=1). Conclusions: By 2021, 359 000 children had been registered in Latvia, and ~ 0,018 % of children aged 0‑18 with PDA. For children born full‑term, early diagnosis and correction of PDA enables a good long‑term quality of life.