Robb L Romp

University of Alabama at Birmingham, Birmingham, Alabama, United States

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Publications (8)15.24 Total impact

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    ABSTRACT: A novel technique of valve-sparing aortic root replacement was applied to 2 children younger than 3 years of age with Marfan syndrome and large aortic root aneurysms. Using elements of both the remodeling and reimplantation techniques, circumferential rings from a 20-mm to 22-mm polyester graft provide stabilization at the subannular and sinotubular levels, and bovine pericardial patches create pseudosinuses. Follow-up at 2 years in 1 patient and 7 months in a second patient revealed satisfactory valve function with stable aortic root size.
    The Annals of thoracic surgery 07/2012; 94(1):299-301. DOI:10.1016/j.athoracsur.2012.01.083 · 3.65 Impact Factor
  • The Journal of thoracic and cardiovascular surgery 02/2009; 137(1):e40-2. DOI:10.1016/j.jtcvs.2008.02.044 · 3.99 Impact Factor
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    ABSTRACT: In 1990, Fontan, Kirklin, and colleagues published equations for survival after the so-called "Perfect Fontan" operation. After 1988, we evolved a protocol using an internal or external polytetraflouroethylene tube of 16 to 19 millimetres diameter placed from the inferior caval vein to either the right or left pulmonary artery along with a bidirectional cava-pulmonary connection. The objective of this study was to test the hypothesis that a "perfect" outcome is routinely achievable in the current era when using a standardized surgical procedure. Between 1 January, 1988, and 12 December, 2005, 112 patients underwent the Fontan procedure using an internal or external polytetraflouroethylene tube plus a bidirectional cava-pulmonary connection, the latter usually having been constructed as a previous procedure. This constituted 45% of our overall experience in constructing the Fontan circulation between 1988 and 1996, and 96% of the experience between 1996 and 2005. Among all surviving patients, the median follow-up was 7.3 years. We calculated the expected survival for an optimal candidate, given from the initial equations, and compared this to our entire experience in constructing the Fontan circulation. An internal tube was utilized in 61 patients, 97% of whom were operated prior to 1998, and an external tube in 51 patients, the latter accounting for 95% of all operations since 1999. At 1, 5, 10 and 15 years, survival of the entire cohort receiving polytetraflouroethylene tubes is superimposable on the curve calculated for a "perfect" outcome. Freedom from replacement or revision of the tube was 97% at 10 years. Using a standardized operative procedure, combining a bidirectional cavopulmonary connection with a polytetraflouroethylene tube placed from the inferior caval vein to the pulmonary arteries for nearly all patients with functionally univentricular hearts, early and late survival within the "perfect" outcome as predicted by the initial equations of Fontan and Kirklin is routinely achievable in the current era. The need for late revision or replacement of the tube is rare.
    Cardiology in the Young 07/2008; 18(3):328-36. DOI:10.1017/S1047951108002278 · 0.86 Impact Factor
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    ABSTRACT: Aortopulmonary (AP) window is an extremely rare congenital anomaly involving a communication between the ascending aorta and pulmonary artery. Two-dimensional transthoracic echocardiography is traditionally used in the diagnosis but has limitations. We report the usefulness of three-dimensional transthoracic echocardiography in the assessment of AP window in two newborns studied by us.
    Echocardiography 02/2008; 25(1):96-9. DOI:10.1111/j.1540-8175.2007.00558.x · 1.25 Impact Factor
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    ABSTRACT: Behçet's disease (BD) is a systemic vasculitis that may involve a variety of organs. We describe a girl with oculocutaneous albinism (OCA) who, on initial evaluation for popliteal artery occlusion, was noted to have multiple cardiac thrombi. She later developed hemoptysis, which was the result of bilateral pulmonary artery aneurysms. Her clinical picture was consistent with BD. She was initially treated with prednisone and cyclophosphamide, followed by maintenance therapy with infliximab. This case describes a unique patient with OCA who developed BD with large pulmonary aneurysms and has remained stable for over 1 year while receiving infliximab.
    Clinical Rheumatology 10/2007; 26(9):1537-9. DOI:10.1007/s10067-006-0426-8 · 1.77 Impact Factor
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    ABSTRACT: Neonates with congenital heart disease (CHD) frequently require prompt intervention to improve outcomes and limit morbidities. We sought to determine the time to identification for infants with serious CHD admitted to the State of Alabama's neonatal cardiovascular center and to identify types of cardiac lesions associated with an earlier vs. later diagnosis. Medical record review of all infants admitted to Alabama's cardiovascular referral center over a 3-year period. Neonates with serious CHD admitted for medical/surgical care. In total, 178 neonates were identified with serious CHD. Of these, 146 (82%) were identified postnatally. Thirty-two (21%) of the postnatally detected infants were identified after initial discharge from the hospital. Neonates with aortic arch anomalies presented at a median age of 7 days. Identification of infants with serious CHD, especially those with aortic arch anomalies is frequently delayed. These findings support the need for improved methods to detect CHD in the newborn.
    Congenital Heart Disease 10/2007; 2(5):327-31. DOI:10.1111/j.1747-0803.2007.00120.x · 1.20 Impact Factor
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    ABSTRACT: Both two-dimensional transthoracic echocardiography (2DTTE) and live/real time three-dimensional transthoracic echocardiography (3DTTE) were attempted in a 25-year-old morbidly obese female with total anomalous pulmonary venous return (TAPVR) into the coronary sinus (CS) in whom surgical unroofing of CS with patch closure of CS ostium was performed in infancy to redirect pulmonary venous flow into the left atrium (LA). The patient had become increasingly symptomatic over the past 1 year because of severe left-to-right shunting due to dehiscence of the patch used to close the CS ostium. Despite a poor acoustic window, 3DTTE was able to identify a communication between the LA and CS which resulted from surgical unroofing of the CS as well as flow signals moving into the right atrium from the CS. These findings were not detected by 2DTTE.
    Echocardiography 02/2007; 24(1):74-6. DOI:10.1111/j.1540-8175.2006.00359.x · 1.25 Impact Factor
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    ABSTRACT: We studied nine patients (five newborns and infants, two children, and two adults) with atrioventricular septal defects (four complete, one intermediate, and four partial) utilizing live/real time three-dimensional transthoracic echocardiography (3DTTE) and a 4-MHz matrix array transducer. In all patients, 3DTTE provided additional morphological and/or functional information as compared to standard two-dimensional transthoracic echocardiography (2DTTE). 3DTTE may be a useful supplement to 2DTTE in the assessment of atrioventricular septal defects.
    Echocardiography 09/2006; 23(7):598-608. DOI:10.1111/j.1540-8175.2006.00268.x · 1.25 Impact Factor