Oliver Stumper - Academia.edu (original) (raw)

Papers by Oliver Stumper

Research paper thumbnail of Hypoplastic left heart syndrome

Postgraduate Medical Journal, Mar 1, 2010

Research paper thumbnail of Coronary Artery Obstruction After the Arterial Switch Operation for Transposition of the Great Arteries in Newborns

Journal of the American College of Cardiology, 1997

Research paper thumbnail of Imaging in Congenital Heart Disease

Cambridge University Press eBooks, May 1, 2018

Research paper thumbnail of Pediatric transesophageal echocardiography

Research paper thumbnail of Hybrid Cardiac Surgical Procedures in Congenital Heart Disease

Research paper thumbnail of Cardiac catheterisation and surgery in Namibia

The Egyptian Heart Journal, 2020

Research paper thumbnail of Transoesophageal echocardiography in adolescents and adults with congenital heart disease

Developments in cardiovascular medicine, 1992

Research paper thumbnail of Transesophageal echocardiography in evaluation and management after a fontan procedure

Journal of the American College of Cardiology, Apr 1, 1991

Research paper thumbnail of Four right ventricle to pulmonary artery conduit types

The Journal of Thoracic and Cardiovascular Surgery, Nov 1, 2021

OBJECTIVE The most durable valved right ventricle to pulmonary artery conduit for the repair of c... more OBJECTIVE The most durable valved right ventricle to pulmonary artery conduit for the repair of congenital heart defects in patients of different ages, sizes, and anatomic substrate remains uncertain. METHODS We performed a retrospective analysis of 4 common right ventricle to pulmonary artery conduits used in a single institution over 30 years, using univariable and multivariable models of time-to-failure to analyse freedom from conduit dysfunction, reintervention, and replacement. RESULTS Between 1988 and 2018, 959 right ventricle to pulmonary artery conduits were implanted: 333 aortic homografts, 227 pulmonary homografts, 227 composite porcine valve conduits, and 172 bovine jugular vein conduits. Patients weighed 1.6 to 98.3 kg (median 15.3 kg), and median duration of follow-up was 11.4 years, with 505 (52.2%) conduits developing dysfunction, 165 (17.2%) requiring catheter intervention, and 415 (43.2%) being replaced. Greater patient weight, conduit z-score, type and position, as well as catheter intervention were predictors of freedom from replacement. Multivariable analysis demonstrated inferior durability for smaller composite porcine valve conduits, with excellent durability for larger diameter conduits of the same type. Bovine jugular vein conduit longevity was inferior to that of homografts in all but the smallest patients. Freedom from dysfunction at 8 years was 60.7% for aortic homografts, 72% for pulmonary homografts, 51.2% for composite porcine valve conduits, and 41.3% for bovine jugular vein conduits. Judicious oversizing of the conduit improved conduit durability in all patients, but to the greatest extent in patients weighing 5 to 20 kg. CONCLUSIONS Pulmonary and aortic homografts had greater durability than xenograft conduits, particularly in patients weighing 5 to 20 kg. Judicious oversizing was the most significant surgeon-modifiable factor affecting conduit longevity.

Research paper thumbnail of Unifocalization cannot rely exclusively on native pulmonary arteries: the importance of recruitment of major aortopulmonary collaterals in 249 cases†

European Journal of Cardio-Thoracic Surgery, Mar 19, 2019

Research paper thumbnail of Obstruction of the left ventricular outflow tract in childhood — improved diagnosis by transoesophageal echocardiography

International Journal of Cardiology, Jul 1, 1990

ABSTRACT

Research paper thumbnail of Transoesophageal echocardiographic evaluation of atrial morphology in children with congenital heart disease

European Heart Journal, Feb 1, 1992

In a prospective study, atrial morphology was evaluated by both transoesophageal and precordial e... more In a prospective study, atrial morphology was evaluated by both transoesophageal and precordial echocardiography in 86 unoperated children with congenital heart disease (age range = 0.2 to 14.8 years, mean = 3.8 years) to determine what advantages, if any, might be inherent in the transoesophageal approach. The information derived from both ultrasound approaches was correlated and compared to information obtained during subsequent cardiac catheterization (78 patients) and, or, surgical inspection (53 patients). Atrial appendage morphology and hence atrial situs was determined by transoesophageal echocardiography in every case (82 solitus, two right atrial isomerism, two left atrial isomerism). In addition, the transoesophageal approach indicated left juxtaposition in four patients, compared to only one by precordial examination. Probe patency of the foramen ovale was correctly predicted in 21 patients by transoesophageal imaging, but in only 10 by precordial imaging. In two children significant secundum defects, undetected by the precordial route, were identified. Multiple atrial septal defects were correctly defined in four patients by transoesophageal study but in only one by precordial study. Sinus venosus defects were documented in four by the transoesophageal approach, but in only one by the precordial. Primum defects were equally well documented (nine patients) by either technique, but the associated valve leaflet morphology was better documented by transoesophageal study in 5/9. A subtotal cor triatriatum was diagnosed in one child only by transoesophageal investigation. Transoesophageal echocardiography allows a much more detailed evaluation of atrial morphology than precordial imaging even in infants. It provides direct diagnosis of atrial situs, detection of juxtaposed atrial appendages and improved demonstration or definitive exclusion of atrial septal defects.

Research paper thumbnail of The Value of Transesophageal Echocardiography in Children With Congenital Heart Disease

Journal of The American Society of Echocardiography, Mar 1, 1991

ABSTRACT

Research paper thumbnail of The modified norwood procedure for hypoplastic left heart syndrome: Early to intermediate results of 120 patients with particular reference to aortic arch repair

The Journal of Thoracic and Cardiovascular Surgery, May 1, 1999

Research paper thumbnail of Stenting of the Right Ventricular Outflow Tract as Initial Palliation for Fallot-Type Lesions

Research paper thumbnail of Hypoplastic left heart syndrome

Research paper thumbnail of Transesophageal echocardiography in children with congenital heart disease: An initial experience

Journal of the American College of Cardiology, Aug 1, 1990

Research paper thumbnail of Medium-term Outcome of Prenatally Diagnosed Hypoplastic Left-Heart Syndrome and Impact of a Restrictive Atrial Septum Diagnosed in-utero

Pediatric Cardiology, May 23, 2023

Research paper thumbnail of Transesophageal echocardiography in congenital heart disease

Cardiology in The Young, 1993

Transesophageal echocardiography has gained an established role in the evaluation and management ... more Transesophageal echocardiography has gained an established role in the evaluation and management of the adult patient with acquired cardiac disease. Unlike the transthoracic approach, the transesophageal approach provides excellent imaging of posterior cardiac structures in virtually all patients.

Research paper thumbnail of Outcomes of the arterial switch for transposition during infancy using a standardized approach over 30 years

Interdisciplinary CardioVascular and Thoracic Surgery

OBJECTIVES The aim of this study was to describe the early and late outcomes of the arterial swit... more OBJECTIVES The aim of this study was to describe the early and late outcomes of the arterial switch for transposition. METHODS A single-centre retrospective cohort study was conducted to assess the early and late outcomes of arterial switch performed during infancy using a standardized institutional approach between 1988 and 2018, compared by morphological groups. RESULTS A total of 749 consecutive patients undergoing arterial switch during infancy were included, 464 (61.9%) with intact septum, 163 (21.8%) with isolated ventricular septal defect and 122 (16.3%) with complex transposition with associated lesions, including 67 (8.9%) with Taussig–Bing anomaly. There were 34 early deaths [4.5%, 95% confidence interval (CI) 3.1–6.1] with only 10 (2.6%) early deaths since 2000. Complex morphology (odds ratio 11.44, 95% CI 4.76–27.43) and intramural coronary artery (odds ratio 5.17, 95% CI 1.61–15.91) were identified as the most important risk factors for 90-day mortality. Overall surviva...

Research paper thumbnail of Hypoplastic left heart syndrome

Postgraduate Medical Journal, Mar 1, 2010

Research paper thumbnail of Coronary Artery Obstruction After the Arterial Switch Operation for Transposition of the Great Arteries in Newborns

Journal of the American College of Cardiology, 1997

Research paper thumbnail of Imaging in Congenital Heart Disease

Cambridge University Press eBooks, May 1, 2018

Research paper thumbnail of Pediatric transesophageal echocardiography

Research paper thumbnail of Hybrid Cardiac Surgical Procedures in Congenital Heart Disease

Research paper thumbnail of Cardiac catheterisation and surgery in Namibia

The Egyptian Heart Journal, 2020

Research paper thumbnail of Transoesophageal echocardiography in adolescents and adults with congenital heart disease

Developments in cardiovascular medicine, 1992

Research paper thumbnail of Transesophageal echocardiography in evaluation and management after a fontan procedure

Journal of the American College of Cardiology, Apr 1, 1991

Research paper thumbnail of Four right ventricle to pulmonary artery conduit types

The Journal of Thoracic and Cardiovascular Surgery, Nov 1, 2021

OBJECTIVE The most durable valved right ventricle to pulmonary artery conduit for the repair of c... more OBJECTIVE The most durable valved right ventricle to pulmonary artery conduit for the repair of congenital heart defects in patients of different ages, sizes, and anatomic substrate remains uncertain. METHODS We performed a retrospective analysis of 4 common right ventricle to pulmonary artery conduits used in a single institution over 30 years, using univariable and multivariable models of time-to-failure to analyse freedom from conduit dysfunction, reintervention, and replacement. RESULTS Between 1988 and 2018, 959 right ventricle to pulmonary artery conduits were implanted: 333 aortic homografts, 227 pulmonary homografts, 227 composite porcine valve conduits, and 172 bovine jugular vein conduits. Patients weighed 1.6 to 98.3 kg (median 15.3 kg), and median duration of follow-up was 11.4 years, with 505 (52.2%) conduits developing dysfunction, 165 (17.2%) requiring catheter intervention, and 415 (43.2%) being replaced. Greater patient weight, conduit z-score, type and position, as well as catheter intervention were predictors of freedom from replacement. Multivariable analysis demonstrated inferior durability for smaller composite porcine valve conduits, with excellent durability for larger diameter conduits of the same type. Bovine jugular vein conduit longevity was inferior to that of homografts in all but the smallest patients. Freedom from dysfunction at 8 years was 60.7% for aortic homografts, 72% for pulmonary homografts, 51.2% for composite porcine valve conduits, and 41.3% for bovine jugular vein conduits. Judicious oversizing of the conduit improved conduit durability in all patients, but to the greatest extent in patients weighing 5 to 20 kg. CONCLUSIONS Pulmonary and aortic homografts had greater durability than xenograft conduits, particularly in patients weighing 5 to 20 kg. Judicious oversizing was the most significant surgeon-modifiable factor affecting conduit longevity.

Research paper thumbnail of Unifocalization cannot rely exclusively on native pulmonary arteries: the importance of recruitment of major aortopulmonary collaterals in 249 cases†

European Journal of Cardio-Thoracic Surgery, Mar 19, 2019

Research paper thumbnail of Obstruction of the left ventricular outflow tract in childhood — improved diagnosis by transoesophageal echocardiography

International Journal of Cardiology, Jul 1, 1990

ABSTRACT

Research paper thumbnail of Transoesophageal echocardiographic evaluation of atrial morphology in children with congenital heart disease

European Heart Journal, Feb 1, 1992

In a prospective study, atrial morphology was evaluated by both transoesophageal and precordial e... more In a prospective study, atrial morphology was evaluated by both transoesophageal and precordial echocardiography in 86 unoperated children with congenital heart disease (age range = 0.2 to 14.8 years, mean = 3.8 years) to determine what advantages, if any, might be inherent in the transoesophageal approach. The information derived from both ultrasound approaches was correlated and compared to information obtained during subsequent cardiac catheterization (78 patients) and, or, surgical inspection (53 patients). Atrial appendage morphology and hence atrial situs was determined by transoesophageal echocardiography in every case (82 solitus, two right atrial isomerism, two left atrial isomerism). In addition, the transoesophageal approach indicated left juxtaposition in four patients, compared to only one by precordial examination. Probe patency of the foramen ovale was correctly predicted in 21 patients by transoesophageal imaging, but in only 10 by precordial imaging. In two children significant secundum defects, undetected by the precordial route, were identified. Multiple atrial septal defects were correctly defined in four patients by transoesophageal study but in only one by precordial study. Sinus venosus defects were documented in four by the transoesophageal approach, but in only one by the precordial. Primum defects were equally well documented (nine patients) by either technique, but the associated valve leaflet morphology was better documented by transoesophageal study in 5/9. A subtotal cor triatriatum was diagnosed in one child only by transoesophageal investigation. Transoesophageal echocardiography allows a much more detailed evaluation of atrial morphology than precordial imaging even in infants. It provides direct diagnosis of atrial situs, detection of juxtaposed atrial appendages and improved demonstration or definitive exclusion of atrial septal defects.

Research paper thumbnail of The Value of Transesophageal Echocardiography in Children With Congenital Heart Disease

Journal of The American Society of Echocardiography, Mar 1, 1991

ABSTRACT

Research paper thumbnail of The modified norwood procedure for hypoplastic left heart syndrome: Early to intermediate results of 120 patients with particular reference to aortic arch repair

The Journal of Thoracic and Cardiovascular Surgery, May 1, 1999

Research paper thumbnail of Stenting of the Right Ventricular Outflow Tract as Initial Palliation for Fallot-Type Lesions

Research paper thumbnail of Hypoplastic left heart syndrome

Research paper thumbnail of Transesophageal echocardiography in children with congenital heart disease: An initial experience

Journal of the American College of Cardiology, Aug 1, 1990

Research paper thumbnail of Medium-term Outcome of Prenatally Diagnosed Hypoplastic Left-Heart Syndrome and Impact of a Restrictive Atrial Septum Diagnosed in-utero

Pediatric Cardiology, May 23, 2023

Research paper thumbnail of Transesophageal echocardiography in congenital heart disease

Cardiology in The Young, 1993

Transesophageal echocardiography has gained an established role in the evaluation and management ... more Transesophageal echocardiography has gained an established role in the evaluation and management of the adult patient with acquired cardiac disease. Unlike the transthoracic approach, the transesophageal approach provides excellent imaging of posterior cardiac structures in virtually all patients.

Research paper thumbnail of Outcomes of the arterial switch for transposition during infancy using a standardized approach over 30 years

Interdisciplinary CardioVascular and Thoracic Surgery

OBJECTIVES The aim of this study was to describe the early and late outcomes of the arterial swit... more OBJECTIVES The aim of this study was to describe the early and late outcomes of the arterial switch for transposition. METHODS A single-centre retrospective cohort study was conducted to assess the early and late outcomes of arterial switch performed during infancy using a standardized institutional approach between 1988 and 2018, compared by morphological groups. RESULTS A total of 749 consecutive patients undergoing arterial switch during infancy were included, 464 (61.9%) with intact septum, 163 (21.8%) with isolated ventricular septal defect and 122 (16.3%) with complex transposition with associated lesions, including 67 (8.9%) with Taussig–Bing anomaly. There were 34 early deaths [4.5%, 95% confidence interval (CI) 3.1–6.1] with only 10 (2.6%) early deaths since 2000. Complex morphology (odds ratio 11.44, 95% CI 4.76–27.43) and intramural coronary artery (odds ratio 5.17, 95% CI 1.61–15.91) were identified as the most important risk factors for 90-day mortality. Overall surviva...