Home / Journals / CHD / Vol.13, No.3, 2018
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    EDITORIAL

    What is our future?

    Hugh D. Allen
    Congenital Heart Disease, Vol.13, No.3, pp. 347-348, 2018, DOI:10.1111/chd.12628
    Abstract This article has no abstract. More >

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    ARTICLE

    Interventions in children with renovascular hypertension: A 27-year retrospective single-center experience

    Hitesh Agrawal1,2, Douglas Moodie1, Athar M. Qureshi1,2, Alisa A. Acosta3, Jose A. Hernandez4, Michael C. Braun3, Henri Justino1,2
    Congenital Heart Disease, Vol.13, No.3, pp. 349-356, 2018, DOI:10.1111/chd.12608
    Abstract Background: Renovascular hypertension (RVH) can be caused by renal artery stenosis (RAS) and/ or middle aortic syndrome (MAS).
    Methods: Patients who received surgical or transcatheter treatment for RVH between 1/1991 and 11/2017 were retrospectively reviewed using age = adjusted blood pressure ratio (BPR).
    Results: Fifty-three patients diagnosed with RVH at a median age of 4.5 (0–18) years were included. Vascular involvement ranged from MAS with RAS (20), RAS only (32), and MAS only (1). The first intervention was transcatheter in 47 patients (transcatheter group: angioplasty = 41, stenting = 5, and thrombectomy = 1), and surgical in 6 patients (surgical… More >

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    ARTICLE

    Role of virtual reality in congenital heart disease

    Chin Siang Ong1, Aravind Krishnan1, Chen Yu Huang1, Philip Spevak2, Luca Vricella1, Narutoshi Hibino1, Juan R. Garcia2, Lasya Gaur3
    Congenital Heart Disease, Vol.13, No.3, pp. 357-361, 2018, DOI:10.1111/chd.12587
    Abstract Objective: New platforms for patient imaging present opportunities for improved surgical planning in complex congenital heart disease (CHD). Virtual reality (VR) allows for interactive manipulation of high-resolution representations of patient-specific imaging data, as a supplement to traditional 2D visualizations and 3D printed heart models.
    Design: We present the novel use of VR for the presurgical planning of cardiac surgery in two infants with complex CHD to demonstrate interactive real-time views of complex intra and extracardiac anatomy.
    Results: The use of VR for cardiac presurgical planning is feasible using existing imaging data. The software was evaluated by both pediatric cardiac surgeons… More >

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    ARTICLE

    Improving outpatient advance care planning for adults with congenital or pediatric heart disease followed in a pediatric heart failure and transplant clinic

    Lindsay A. Edwards1,2, Christine Bui2,3, Antonio G. Cabrera1,2, Jill Ann Jarrell2,4,5
    Congenital Heart Disease, Vol.13, No.3, pp. 362-368, 2018, DOI:10.1111/chd.12579
    Abstract Objective: To improve outpatient advanced care planning (ACP) for adults with congenital/pediatric heart disease followed in a pediatric heart failure (HF) and transplant clinic through quality improvement (QI) methodology.
    Design: A one-year QI project was completed. We conducted quarterly chart reviews and incorporated feedback from the providers to direct subsequent interventions.
    Patients and Setting: Patients ≥18 years of age seen in the HF and Transplant Clinic for followup visit were included in analysis.
    Interventions: Interventions focused on five main areas: identifying and training providers to have ACP discussions, standardizing the ACP discussion, standardizing ACP and advance directive (AD) documentation in… More >

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    ARTICLE

    Intrauterine growth restriction is not associated with decreased exercise capacity in adolescents with congenital heart disease

    Andrew D. Spearman1, Rohit S. Loomba2, Michael Danduran1, Joshua Kovach1
    Congenital Heart Disease, Vol.13, No.3, pp. 369-376, 2018, DOI:10.1111/chd.12577
    Abstract Objective: Multiple studies demonstrate the association of intrauterine growth restriction (IUGR) with impaired aerobic fitness in adolescents and adults. To our knowledge, there are no studies including individuals with the history of both IUGR and congenital heart disease (CHD). Thus, we sought to evaluate the impact of IUGR on exercise capacity in adolescents with CHD.
    Study Design: We conducted a retrospective chart review of patients <18 years of age who underwent cardiopulmonary exercise testing (CPET) between August 1, 2003 and July 1, 2016. Individuals with birth weight <10th percentile for gestational age were defined as IUGR. Patients with IUGR were… More >

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    ARTICLE

    Congenital heart disease patients’ and parents’ perception of disease-specific knowledge: Health and impairments in everyday life

    Paul C. Helm1, Sebastian Kempert2, Marc-André Körten1, Wiebke Lesch3, Katharina Specht3, Ulrike M. M. Bauer1,3
    Congenital Heart Disease, Vol.13, No.3, pp. 377-383, 2018, DOI:10.1111/chd.12581
    Abstract Background: Children and adolescents with congenital heart disease (CHD) and their families require qualified combined medical and psychosocial information, care, and counseling. This study aimed to analyze CHD patients’ and parents’ perception of disease-specific knowledge, state of health, and impairments experienced in everyday life, as well as factors influencing these perceptions.
    Materials and Methods: Analyses were based on a survey among patients/parents recruited via the German National Register for Congenital Heart Defects (NRCHD). The total sample (N = 818) was divided into four groups: “Children” (176 patients), “Adolescents” (142 patients), “Adults” (269 patients), and “Parents” (231 parents). The patients were… More >

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    ARTICLE

    Insurance access in adults with congenital heart disease in the Affordable Care Act era

    Chien-Jung Lin1, Eric Novak1, Michael W. Rich1, Joseph J. Billadello1,2
    Congenital Heart Disease, Vol.13, No.3, pp. 384-391, 2018, DOI:10.1111/chd.12582
    Abstract Background: Adults with congenital heart disease (ACHD) have traditionally been viewed as an underinsured population. Whether this is true in the Affordable Care Act era is unknown. We determined insurance patterns in ACHD patients compared to the non-ACHD cardiology population in a contemporary cohort.
    Methods: All cardiology outpatient visits between July 2016 and February 2017 to a large referral center in the United States were reviewed. The primary payer was categorized as health maintenance organization (HMO), preferred provider organization (PPO), Medicare, Medicaid, self-pay, or other. Diagnosis and lesion severity of ACHD were extracted from ICD-10 diagnostic codes and assigned according… More >

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    ARTICLE

    A multinational observational investigation of illness perceptions and quality of life among patients with a Fontan circulation

    Christina E. Holbein1, Nicholas D. Fogleman1,2, Kevin Hommel1, Silke Apers3, Jessica Rassart3, Philip Moons3,4, Koen Luyckx3, Maayke A. Sluman5, Junko Enomoto6, Bengt Johansson7, Hsiao-Ling Yang8, Mikael Dellborg4,9, Raghavan Subramanyan10, Jamie L. Jackson11, Werner Budts3,12, Adrienne H. Kovacs13, Stacey Morrison1, Martha Tomlin1, Kathy Gosney1, Alexandra Soufi14, Katrine Eriksen15, Corina Thomet3,16, Malin Berghammer4,17, Luis Alday18, Edward Callus19, Susan M Fernandes20, Maryanne Caruana21, Samuel Menahem22, Stephen C. Cook23, Gwen R. Rempel24, Kamila White25, Paul Khairy26, Shelby Kutty27, Gruschen Veldtman1
    Congenital Heart Disease, Vol.13, No.3, pp. 392-400, 2018, DOI:10.1111/chd.12583
    Abstract Objective: First, to compare QOL and illness perceptions between patients with a Fontan circulation and patients with anatomically simple defects (ie, atrial septal defects [ASD] or ventricular septal defects [VSD]). Second, to explore illness perceptions as a mediator of the association between congenital heart disease (CHD) diagnosis and QOL.
    Design: Cross-sectional observational study.
    Setting: Twenty-four cardiology centers from 15 countries across five continents.
    Patients: Four hundred thirty-five adult patients with congenital heart disease (177 Fontan and 258 ASD/VSD) ages 18-83 years.
    Outcome Measures: QOL and illness perceptions were assessed by the Satisfaction With Life Scale and the Brief Illness Perceptions… More >

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    ARTICLE

    Analysis of DICER1 in familial and sporadic cases of transposition of the great arteries

    Nelly Sabbaghian1, Maria C. Digilio2, Gillian M. Blue3,4, Timothée Revil5, David S. Winlaw3,4, William D. Foulkes1,6
    Congenital Heart Disease, Vol.13, No.3, pp. 401-406, 2018, DOI:10.1111/chd.12578
    Abstract Objective: We previously identified a pathogenic germline DICER1 variant in a child with transposition of the great arteries who was a member of a family with DICER1 syndrome. In view of a report linking DICER1 knockout in murine cardiomyocytes to cardiac outflow defects, we investigated the involvement of DICER1 in transposition of the great arteries.
    Design: We used Fluidigm access array followed by next generation sequencing to screen for variants in the coding exons, their exon/intron boundaries and the 30 untranslated region of DICER1 in patient DNA.
    Cases: Germline DNA was collected from 129 patients with either sporadic or familial… More >

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    ARTICLE

    Clinical yield of fetal echocardiography for suboptimal cardiac visualization on obstetric ultrasound

    Rick D. Vavolizza1,2, Pe’er Dar3,4, Barrie Suskin3,4, Robert M. Moore4,5, Kenan W.D. Stern1,4
    Congenital Heart Disease, Vol.13, No.3, pp. 407-412, 2018, DOI:10.1111/chd.12584
    Abstract Objective: Suboptimal cardiac imaging on obstetric ultrasound is a frequent referral indication for fetal echocardiography, even in the absence of typical risk factors for fetal cardiac disease. The clinical profile of patients and findings of examinations performed for such an indication are not well defined. Given the increased cost, time and resource utilization of fetal echocardiography, we sought to determine the clinical findings of such referrals.
    Study Design: We performed a single-center review of such referrals from January 2010 to June 2016. Patients with commonly accepted indications for fetal echocardiography were excluded. Demographic variables and echocardiogram findings were collected. Findings… More >

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    ARTICLE

    Decreased inappropriate shocks with new generation ICDs in children and patients with congenital heart disease

    Stephanie A. Goldstein, Martin J. LaPage, Brynn E. Dechert, Gerald A. Serwer, Sunkyung Yu, Ray E. Lowery, David J. Bradley
    Congenital Heart Disease, Vol.13, No.3, pp. 413-418, 2018, DOI:10.1111/chd.12585
    Abstract Objective: Inappropriate implantable cardioverter defibrillator (ICD) shocks in children and patients with congenital heart disease (CHD) remain a major complication of device therapy, occurring in as many as 50% of children with ICDs. New generation devices include algorithms designed to minimize inappropriate shocks. This study aimed to evaluate the effect of new generation ICDs on the incidence of inappropriate shocks in the pediatric and CHD population.
    Design: Retrospective study of patients with CHD or under age 25 receiving ICDs between 2000 and 2015. New generation ICDs were defined as those with Medtronic “SmartShock” algorithms.
    Results: Two hundred eight devices were… More >

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    ARTICLE

    Utility of incomplete right bundle branch block as an isolated ECG finding in children undergoing initial cardiac evaluation

    Omar Meziab, Dominic J. Abrams, Mark E. Alexander, Laura Bevilacqua, Vassilios Bezzerides, Doug Y. Mah, Edward P. Walsh, John K. Triedman
    Congenital Heart Disease, Vol.13, No.3, pp. 419-427, 2018, DOI:10.1111/chd.12589
    Abstract Objective: This study evaluates the ability of experienced pediatric electrophysiologists (EPs) to reliably classify incomplete right bundle branch block (IRBBB) and assesses its clinical utility as an isolated ECG finding in a group of healthy outpatient children without prior cardiac evaluation.
    Design: We performed a retrospective analysis of all electrocardiographic and echocardiographic records at Boston Children’s Hospital between January 1, 2005, and December 31, 2014. Echocardiographic diagnoses were identified if registered between the date of the index electrocardiogram and the ensuing year. A selected subset of 473 ECGs was subsequently reanalyzed in a blinded manner by six pediatric EPs to… More >

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    ARTICLE

    RSV prophylaxis guideline changes and outcomes in children with congenital heart disease

    Adam S. Walpert1, Ian D. Thomas2, Merlin C. Lowe Jr1, Michael D. Seckeler3
    Congenital Heart Disease, Vol.13, No.3, pp. 428-431, 2018, DOI:10.1111/chd.12590
    Abstract Objective: The aim of this study was to compare inpatient outcomes and costs for children with respiratory syncytial virus and congenital heart disease before and after the change in management guidelines for respiratory syncytial virus prophylaxis.
    Design: Hospital discharge data from the Vizient (formerly University HealthSystem Consortium) were queried from October 2012 to June 2014 (Era 1) and July 2014 to April 2016 (Era 2) for patients aged <24 months with an any International Classification of Disease (ICD)-9 or ICD-10 code for congenital heart disease (745-747.49, Q20.0-Q26.4) and a primary or secondary admitting diagnosis of respiratory syncytial virus infection (079.6,… More >

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    ARTICLE

    Disease progression and variation in clinical practice for isolated bicuspid aortic valve in children

    Melissa S.W. Yamauchi1,2, Michael D. Puchalski1,2, Hsin Ti Weng1, Nelangi M. Pinto1,2, Susan P. Etheridge1,2, Angela P. Presson1, Lloyd Y. Tani1,2, L. LuAnn Minich1,2, Richard V. Williams1,2
    Congenital Heart Disease, Vol.13, No.3, pp. 432-439, 2018, DOI:10.1111/chd.12591
    Abstract Background: Disease progression of an isolated bicuspid aortic valve (BAV) in children is poorly understood and adult management guidelines may not be applicable. Thus, we sought to evaluate disease progression of pediatric isolated BAV and its relationship to current management practices.
    Methods: Children with a BAV and ≤mild aortic stenosis (AS) and/or aortic regurgitation (AR) at the time of initial evaluation were included in this retrospective cohort study (1/2005-12/ 2014). Outcomes included change in z-scores for aortic root and ascending aorta diameters, cardiac interventions, adverse outcomes, recommended follow-up interval, and frequency of cardiac imaging studies at each follow up evaluation,… More >

  • Open Access

    ARTICLE

    Prevalence of left ventricular hypertrabeculation/ noncompaction among children with sickle cell disease

    M. Louise Morrison1, Corrina McMahon2, Riona Tully1, Noelle Enright1, Ricardo Pignatelli3, Jeffrey A. Towbin4, Colin J. McMahon1
    Congenital Heart Disease, Vol.13, No.3, pp. 440-443, 2018, DOI:10.1111/chd.12592
    Abstract Objectives: Incidence of sickle cell disease (SCD) in Ireland has dramatically increased. Disease survival has also steadily improved however cardiovascular manifestations remain important causes of morbidity. These include reports of left ventricular hypertrabeculation (LVHT)/noncompaction. We sought to investigate the prevalence of LVHT among a large cohort of children with SCD.
    Methods: We retrospectively reviewed the records of all patients with a diagnosis of SCD who had undergone surveillance echocardiography at Our Lady’s Children’s Hospital Crumlin (OLCHC) from 1998 to 2015. Demographics, hemoglobin phenotype and treatment information was recorded. LV systolic function, evidence of LVHT, and possible pulmonary arterial hypertension was… More >

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    ARTICLE

    Acoustic radiation force impulse of the liver after Fontan operation: Correlation with cardiopulmonary exercise test

    Michael V. Di Maria1, Lindsey Silverman2, Adel K. Younoszai1, Mariana L. Meyers3, Kelley E. Capocelli4, Michael R. Narkewicz5
    Congenital Heart Disease, Vol.13, No.3, pp. 444-449, 2018, DOI:10.1111/chd.12594
    Abstract Background: The current management paradigm for children with single ventricle heart disease involves a series of palliative surgeries, culminating in the Fontan operation. This physiology results in a high central venous pressure, and in the setting of single ventricle heart disease, results in hepatic injury and fibrosis over time. Fontan-associated liver disease (FALD) is universally present in this cohort, and the current gold standard for diagnosis remains biopsy. Noninvasive assessments of liver fibrosis, such as ultrasound with elastography or acoustic radiation force impulse (ARFI), has been utilized in this cohort. The effect of poor cardiovascular efficiency, as measured by cardiopulmonary… More >

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    ARTICLE

    Rhythm disturbances and treatment strategies in children with congenitally corrected transposition of the great arteries

    Taner Kasar1, Pelin Ayyildiz1, Gulhan Tunca Sahin1, Erkut Ozturk1, Selman Gokalp1, Sertac Haydin2, Alper Guzeltas1, Yakup Ergul1
    Congenital Heart Disease, Vol.13, No.3, pp. 450-457, 2018, DOI:10.1111/chd.12595
    Abstract Background: We aimed to evaluate rhythm abnormalities in cases of congenitally corrected transposition of the great arteries (ccTGA) and associated treatment strategies.
    Patients and Methods: This retrospective cohort study included 65 pediatric patients with ccTGA who were admitted to the clinic between 2009 and 2017. The patients were divided into two groups, and surgical data, Holter electrocardiographic (ECG) recordings, ECG recordings, electrophysiological data, and device implantation data on the two groups were compared.
    Results: Group I (n = 53, 82%) consisted of patients with significant associated lesions, and Group II (n = 12, 18%) consisted of those with minor or… More >

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    ARTICLE

    Optimus covered stent: Advanced covered stent technology for complex congenital heart disease

    Gareth J. Morgan1, Matteo Ciuffreda2, Isabella Spadoni3, Joseph DeGiovanni4
    Congenital Heart Disease, Vol.13, No.3, pp. 458-462, 2018, DOI:10.1111/chd.12596
    Abstract Aim: To assess the acute results of the first human use of the Optimus covered stent in complex coarctation of the aorta.
    Methods and Results: We successfully implanted the Optimus covered stent in eight cases in patients whose preprocedural anatomy looked challenging for currently available covered stents. Six of the patients had native coarctation with one recoarctation following surgical repair. There were no significant complications with reduction in the mean invasive gradient from 22 to 1 mm Hg. The length of stents used ranged from 33 to 57 mm with a median shortening after expansion of 13%. Postprocedural follow-up with… More >

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    ARTICLE

    Delayed puberty and abnormal anthropometry and its associations with quality of life in young Fontan survivors: A multicenter cross-sectional study

    Shaji C. Menon1, Ragheed Al-Dulaimi1, Brian W. McCrindle2, David J. Goldberg3, Ritu Sachdeva4, Bryan H. Goldstein5, Thomas Seery6, Karen C. Uzark7, Anjali Chelliah8, Ryan Butts9, Heather Henderson10, Tiffanie Johnson11, Richard V. Williams1
    Congenital Heart Disease, Vol.13, No.3, pp. 463-469, 2018, DOI:10.1111/chd.12597
    Abstract Introduction: We sought to evaluate the prevalence of delayed puberty and abnormal anthropometry and its association with quality of life (QoL) in young Fontan survivors.
    Methods: This was a cross-sectional study at 11 Pediatric Heart Network centers. Demographic and clinical data, anthropomety, and Tanner stage were collected. Anthropometric measurements and pubertal stage were compared to US norms. QoL was assessed using Pediatric Quality of Life inventory (PedsQL). Mixed effects regression modeling adjusting for clustering by center was used to evaluate factors associated with abnormal anthropometry and delayed puberty and associations with QoL.
    Results: Of the 299 subjects, 42% were female.… More >

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    ARTICLE

    Predictors of inadequate initial echocardiography in suspected Kawasaki disease: Criteria for sedation

    Raymond P. Lorenzoni III1, Jaeun Choi2, Nadine F. Choueiter3, Iona M. Munjal1, Chhavi Katyal4, Kenan W. D. Stern3
    Congenital Heart Disease, Vol.13, No.3, pp. 470-475, 2018, DOI:10.1111/chd.12598
    Abstract Objective: Kawasaki disease is the primary cause of acquired pediatric heart disease in developed nations. Timely diagnosis of Kawasaki disease incorporates transthoracic echocardiography for visualization of the coronary arteries. Sedation improves this visualization, but not without risks and resource utilization. To identify potential sedation criteria for suspected Kawasaki disease, we analyzed factors associated with diagnostically inadequate initial transthoracic echocardiography performed without sedation.
    Design: This retrospective review of patients < 18 years old undergoing initial transthoracic echocardiography for the inpatient evaluation of suspected Kawasaki disease from 2009 to 2015 occurred at a medium-sized urban children’s hospital. The primary outcome was diagnostically… More >

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    ARTICLE

    Preoperative echocardiographic measures in interrupted aortic arch: Which ones best predict surgical approach and outcome?

    Ginnie Abarbanell1, William L. Border2, Brian Schlosser2, Gemma Morrow2, Michael Kelleman2, Ritu Sachdeva2
    Congenital Heart Disease, Vol.13, No.3, pp. 476-482, 2018, DOI:10.1111/chd.12599
    Abstract Objective: It is unclear whether neonates with interrupted aortic arch (IAA) and a smaller left ventricular outflow tract may have improved outcomes with a Yasui operation (ventricular outflow bypass procedure) over a primary complete repair. This study sought to identify preoperative echocardiographic parameters to differentiate which neonates may have improved outcomes with a primary vs Yasui operation.
    Design: Patient demographics, cardiac surgery type, complications, need for reoperation and/or interventional catheterization, and date of last follow-up were collected on neonates who underwent a biventricular repair for IAA from 2003 to 2014. Preoperative echocardiograms were analyzed for: IAA type, valve annulus size,… More >

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    ARTICLE

    Platelet parameters in children with chromosome 22q11 deletion and conotruncal heart defects

    Alka Anilkumar1, D. M. Vasudevan2, Mahesh Kappanayil3, K. R. Sundaram4, R. Krishna Kumar3, Sheela Nampoothiri5
    Congenital Heart Disease, Vol.13, No.3, pp. 483-487, 2018, DOI:10.1111/chd.12600
    Abstract Background and Objectives: The 22q11 deletion syndrome is associated with a wide spectrum of phenotypic features, hence clinical diagnosis is difficult. Individuals with this syndrome are found to have a risk of developing transfusion associated graft-versus-host reaction, if they are given nonirradiated blood. Our aim was to elucidate whether chromosome 22q11 deletion in children with syndromic conotruncal heart defects is associated with platelet abnormality.
    Materials and Methods: The genetic analysis was performed by standard cytogenetic and Fluorescence in situ hybridization technique. The platelet parameters in 39 patients with chromosome 22q11 deletion were compared with 154 cases without deletion.
    Results: In… More >

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