Pediatric Surgery Amsterdam 2016 ERIK THAULOW · PDF filePediatric Surgery • Amsterdam...
Transcript of Pediatric Surgery Amsterdam 2016 ERIK THAULOW · PDF filePediatric Surgery • Amsterdam...
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Physical Activity and Sports
• Pediatric Surgery
• Amsterdam 2016
• ERIK THAULOW
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CHD and Physical Activity
• Few restrictions on physical activity in
CHD patients in Norway
• Arrhythmias, severe heart failure and
PHT are relative contraindications
• Injury related to collision has to be
remembered
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CHD and Physical Activity
• Recommendations
• Clinical history, warning episodes
• Specific lesions or situations
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Cardiopulmonary exercise testing
in GUCH
• Long warm-up periods improve exercise capacity
• Most GUCH patients know when to stop exercise.
• An exercise-test has several aims
• Family members should be present during
exercise-testing
• It is important to direct GUCH patients to realistic
sports
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AHA 2005
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Post exercise in
Post TOF repair
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EXERCISE and RISK
• Arrhythmias
– Postoperative arrhythmias
– Long QTc- syndrome
– ARVC
– Catecholaminergic arrhythmias
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Exercise and arrythmias in GUCH
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EXERCISE and RISK
• Cardiac Output failure
– LVOTO, AS, CoA
– Preload failure (PHT, Senning)
– Cardiomyopathy
– Myocardial ischemia
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MUSTARD
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Surgery of the
Chest, edn 5.
Saunders; 1990
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Coronary Artery Compression
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Hornung AJC 1999
R = - 0.49
Systemic RV: ischemia
•20 pts CCTGA (15 yrs)
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FONTAN CIRCULATION
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Exercise testing
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VSD-repaired
Pre-exercise:
2,6 m/s (= 31 mmHg PASP)
125 Watt:
4,0 m/s (= 68 mmHg PASP)
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1 2
0
3
6
9
12
15
Neurology and CHD
Balance
CHD n=65 Healthy n=367
2,8
0,9
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GUCH. Effect of training
Maximum Oxygen UptakeMaximum Oxygen Uptake
24,3
22,122,1
21,8
20
21
22
23
24
25
Test 1 Test 2
VO
2max
(m
l k
g-1 m
in-1
) Training group
Control group
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0
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CHD and Physical Activity
• Few restrictions on physical activity in
CHD patients
• Arrhythmias, severe heart failure and
PHT are relative contraindications
• Injury related to collision has to be
remembered