Anderson, Heather N.

Sinus venosus defect (SVD) is a deficiency in the sinus venosus portion of the atrium, often associated with partial anomalous pulmonary venous connections. In patients with vein of Galen malformation (VGAM), SVD provides a unique challenge with respect to embolization treatment. In our case, the child had percutaneous device closure of the SVD prior to VGAM embolization. Nine years later, he required surgical removal of the SVD device and Warden procedure due to progressive right-sided cardiac enlargement.

ABSTRACT Background Many female residents choose to start families during training, and they want to breastfeed their infants. Continuing lactation while balancing service and education demands can be challenging. Objective We hypothesized that the presence of a dedicated and fully equipped lactation room with a hospital-grade pump (HGP) would increase ease and efficiency of lactation during residency. Methods A quiet HGP was purchased for resident use, and it was stored in a designated room with a computer, telephone, and dictation system. Lactating residents provided information about pumping time and production using their own portable double electric pump (PP) versus the HGP based on the first pump of the morning (for consistency), averaged over the first month back from maternity leave. Results Among 6 residents, lactation time with PP averaged 24 minutes (range, 15–40 minutes) versus 15.5 minutes with HGP (range, 10–32 minutes). Use of the HGP reduced total pumping time by 8.5 minutes (95% confidence interval 3.8–12.2, P = .045). Production volume increased from 6 ounces (range, 3.5–8.5 ounces) with PP to 8.8 ounces (range, 8–11 ounces) with HGP, for a mean increase of 2.8 ounces (95% confidence interval 1.2–4.3, P = .06) despite decreased lactation time. Conclusions In our pilot, an HGP significantly decreased lactation time, while increasing expressed milk volume. Residents completed clinical and educational tasks while pumping. Providing an HGP and equipped lactation space helped residents continue breastfeeding and decreased the burden of lactation on patient care and educational tasks.