For pediatric patients with GERD, laparoscopic Nissen, Toupet, and Thal antireflux procedures yielded satisfactory results, and none of the approaches led to increased dysphagia. The 5% rate for intraoperative complications seems linked to the learning curve period. The authors consider the three procedures as extremely effective for the treatment of children with GERD, and they believe that the choice of one procedure over the other depends only on the surgeon's experience. Parental satisfaction with laparoscopic treatment was very high in all the three series.
Background
Cryoballoon isolation is considered a safe and effective treatment for atrial fibrillation (AF). However, recurrence of AF after first cryoballoon ablation occurs in ~30% of patients. Pre‐procedurally identifying patients at risk of AF recurrence could be beneficial.
Hypothesis
Our aim was to determine how pulmonary vein (PV) anatomy influences the recurrence of AF using the second‐generation cryoballoon in patients with paroxysmal AF.
Methods
We included 88 consecutive patients with paroxysmal AF undergoing PVI procedure with a second‐generation 28‐mm cryoballoon. All patients were evaluated at 3, 6 and 12 months using a 12‐lead ECG and 24‐hour Holter monitoring. PV anatomy was assessed by creating three‐dimensional models using computed tomography (CT) segmentations of the left atrium.
Results
Fifty‐one patients (61%) had left PVs with a shared carina, 35 patients (42%) had a shared right carina. Nine patients (11%) were classified having a right middle PV. In total 17 (20.2%) of patients had a left common PV. At 12 months, 14 patients (17%) had experienced AF recurrence. Neither PV ovality, variant anatomy, the presence of shared carina nor a common left PV was a predictor for AF recurrence.
Conclusions
No specific characteristics of PV dimensions nor morphology were associated with AF recurrence after cryoballoon ablation in patients with paroxysmal AF.
One-fourth of the children diagnosed with BA experience variceal bleeds during follow-up. Most of these children are younger than 1 year and often already listed for transplantation. Major complications did not occur after variceal bleeding.
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