J R Leslie Hamilton

Publications (3)2.64 Total impact

• Source

  Available from: Claire Irving

  Article: Mortality in infants with cardiovascular malformations

  Christopher Wren, Claire A. Irving, Josephine Amanda Griffiths, John J. O’Sullivan, Milind P. Chaudhari, Simon R. Haynes, Jon H. Smith, J. R. Leslie Hamilton, Asif Hasan
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  ABSTRACT: Cardiovascular malformations are an important cause of infant death and the major cause of death due to malformation. Our aims were to analyse and categorise all deaths in infants with cardiovascular malformations, and to analyse trends in mortality over time and influences on mortality. We obtained details of infant deaths and cardiovascular malformations from the population of one health region for 1987–2006. We categorised deaths by cause and by presence of additional chromosomal or genetic abnormalities or non-cardiac malformations. In 676,927 live births the total infant mortality was 4,402 (6.5 per 1,000). A total of 4,437 infants had cardiovascular malformations (6.6 per 1000) of whom 458 (10.3%) died before 1year of age. Of this number, 151 (33%) deaths had non-cardiac causes, 128 (28%) were cardiac without surgery and 179 (39%) occurred from cardiac causes after surgery. Death was unrelated to the cardiovascular malformation in 57% of infants with an additional chromosomal or genetic abnormality, in 76% of infants with a major non-cardiac malformation and in 16% of infants with an isolated cardiovascular malformation. Terminations of pregnancies affected by cardiovascular malformations increased from 20 per 100,000 registered births in the first 5years to 78 per 100,000 in the last 5years. A total of 2,067 infants (47%) underwent surgery and of these 216 (10%) died before 1year of age. Conclusions: A total of 10.4% of infants who died had a cardiovascular malformation and two-thirds of deaths were due to the malformation or its treatment. Mortality declined due to increasing termination of pregnancy and improved survival after operation. KeywordsMortality–Infant–Prenatal diagnosis–Congenital heart defect
  European Journal of Pediatrics 04/2012; 171(2):281-287. · 1.88 Impact Factor
• Article: Towards an anatomically correct repair for anomalous left coronary artery arising from the pulmonary trunk.

  M Muneer Amanullah, Anthony J Rostron, J R Leslie Hamilton, Milind P Chaudhari, Asif Hasan
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  ABSTRACT: Anomalous origin of the left coronary artery from the pulmonary trunk is rare, occurring at an incidence of 1 in 300,000. If not diagnosed and treated early, it is life-threatening. Children with the anomaly usually present in infancy with congestive cardiac failure, and are occasionally referred for cardiac transplant. We investigated the medium term outcome for patients following creation of a two-coronary arterial circulation. Between 1992 and 2007, we diagnosed 15 patients seen at our Institution as having anomalous origin of the left coronary artery from the pulmonary trunk. Over a period of 13 years, aortic reimplantation was undertaken in 12 of these patients, who form the studied cohort. Direct reimplantation was performed in 5 patients. In 3 cases, a tension-free anastomosis was created using a caudally based flap. In another 3 cases, an extended flap was used, while a patch arterioplasty was fashioned in the final patient. There were no deaths. Left ventricular function recovered in all but one of the patients, and all patients had a reduction in the degree of mitral regurgitation. Among the variety of surgical techniques, transfer of the anomalous left coronary artery to the aorta is the ideal method for long-term patency and adequate blood supply. This can be achieved by creating flaps based on the walls of the pulmonary trunk and aorta, producing a dual coronary arterial supply with no mortality and low morbidity.
  Cardiology in the Young 09/2008; 18(4):372-8. · 0.76 Impact Factor
• Article: Effects of 'Bristol' on surgical practice in the United Kingdom.

  Colin J Hilton, J R Leslie Hamilton, Nicola Vitale, Rune Haaverstad
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  ABSTRACT: In 1995 a child died following an arterial switch operation for complex transposition of the great arteries. There had been general concern regarding the outcomes for the arterial switch procedure in the unit in Bristol. A review, prompted by parents whose children had died, showed that 29 children had died and four others suffered from cerebral damage postoperatively. The General Medical Council (GMC) considered the conduct of three doctors from the unit. This hearing culminated in the suspension and subsequent removal from the Medical Register of the senior Cardiac Surgeon and the Chief Executive of the hospital. The second Cardiac Surgeon was banned from practising in the field of paediatric cardiac surgery for three years (his results in adult cardiac surgical practice were not called into question). Following this the Government set up a public Inquiry to investigate the causes behind the deaths. This Inquiry, which took three years, made recommendations that have affected the way all doctors in the UK practice.
  Interactive cardiovascular and thoracic surgery 07/2005; 4(3):197-9.