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  • Open Access

    ARTICLE

    Immediate and short‐term effects of transcatheter device closure of large atrial septal defect in senior people

    Shihai Wang, Jun’an Pan, Bei Xiao, Yongjiang Tang, Jianjun Lan, Xuezhong Zheng, Chao Yang, Dawen Xu, Jiyu Zhang

    Congenital Heart Disease, Vol.14, No.6, pp. 939-944, 2019, DOI:10.1111/chd.12844

    Abstract Objectives: We sought to evaluate the safety and efficacy in improving cardiac function and functional capacity with device closure of large atrial septal defects (ASD) in senior adults.
    Background: Atrial septal defect accounts for about 10% of all congenital heart dis‐ ease. It still remains unclear whether large ASD closure in senior people should be performed or not. Hence we aim to prospectively assess the safety and clinical status of senior patients after transcatheter closure in large ASD.
    Patients and interventions: This was a prospective study of all patients aged over 50 years who underwent device closure of… More >

  • Open Access

    ARTICLE

    Longitudinal growth in patients with single ventricle cardiac disease receiving tube‐assisted feeds

    Arene Butto1, Laura Mercer‐Rosa1, Christopher Teng1, Carrie Daymont2, Jonathan Edelson1, Jennifer Faerber1, Erika Mejia1, Chitra Ravishankar1, Meryl S. Cohen1

    Congenital Heart Disease, Vol.14, No.6, pp. 1058-1065, 2019, DOI:10.1111/chd.12843

    Abstract Objective: Children with single ventricle cardiac disease (SVCD) have poor growth in early life. Tube‐assisted feeding (TF) is used to improve weight gain, but its impact on long‐term growth remains unknown. We sought to compare the longitudinal growth of SVCD patients receiving TF after initial cardiac surgery with those fed entirely by mouth.
    Design: We conducted a retrospective cohort study of SVCD patients who under‐ went initial surgical palliation between 1999 and 2009. We defined TF as the use of nasogastric, gastrostomy, or jejunostomy TF. We compared maximal attained growth z‐scores for each year of life between… More >

  • Open Access

    REVIEW

    A case series of left main coronary artery ostial atresia and a review of the literature

    Mahmoud Alsalehi1, Aamir Jeewa1, Andrea Wan1, Juan Contreras2, Shi‐Joon Yoo3, Jessica A. Laks1

    Congenital Heart Disease, Vol.14, No.6, pp. 901-923, 2019, DOI:10.1111/chd.12842

    Abstract Left main coronary artery ostial atresia (LMCAOA) is a rare congenital anomaly of the coronary arteries. The published literature regarding the current diagnostic and manage‐ ment recommendations are limited. We present three case series of LMCAOA from our institution, including one with a unique association with anomalous origin of left coronary artery (LCA) from pulmonary artery. In addition, this report includes a review of 50 pedi‐ atric and 43 adult cases from literature. The majority of the patients were symptomatic. Sudden cardiac death occurred in 10% of pediatric patients and 7% of adult patients. Almost… More >

  • Open Access

    ARTICLE

    Cerebrovascular accidents in Ebstein’s anomaly

    Nicholas Y. Tan1, Christine H. Attenhofer Jost1, Murray D. Polkinghorne1, Emily R. Vargas2, David O. Hodge2, Joseph A. Dearani3, Samuel J. Asirvatham1,4, Heidi M. Connolly1, Christopher J. McLeod1

    Congenital Heart Disease, Vol.14, No.6, pp. 1157-1165, 2019, DOI:10.1111/chd.12841

    Abstract Introduction: Mechanisms and risk factors for cerebrovascular accidents (CVAs) in Ebstein’s anomaly (EA) are not well understood; hence, we aimed to clarify these in a large cohort of EA patients.
    Methods: Patients with a confirmed diagnosis of EA were retrospectively reviewed. Baseline characteristics were compared between patients with and without a prior history of CVA using logistic regression modeling. Cox regression analysis was used to identify predictors of CVA following initial evaluation. CVA incidence from birth and following tricuspid valve surgery were estimated using the Kaplan‐Meier method.
    Results: Nine hundred sixty‐eight patients (median age 21.1 years, 41.5% male)… More >

  • Open Access

    REVIEW

    Pharmacologic stress cardiovascular magnetic resonance in the pediatric population: A review of the literature, proposed protocol, and two examples in patients with Kawasaki disease

    Munes Fares1, Paul J. Critser2, Maria J. Arruda1, Carolyn M. Wilhelm1, Mantosh S. Rattan3, Sean M. Lang2,4, Tarek Alsaied2,4

    Congenital Heart Disease, Vol.14, No.6, pp. 1166-1175, 2019, DOI:10.1111/chd.12840

    Abstract Pharmacologic stress cardiovascular magnetic resonance (PSCMR) is a wellestablished and reliable diagnostic tool for evaluation of coronary artery disease in the adult population. Stress imaging overall and PSCMR in particular is less utilized in the pediatric population with limited reported data. In this review, we highlight the potential use of PSCMR in specific pediatric cohorts with congenital and acquired heart disease, and we review the reported experience. A suggested protocol is presented in addition to two case examples of patients with Kawasaki disease where PSCMR aided decision making. More >

  • Open Access

    ARTICLE

    Coronary artery disease screening in adults with congenital heart disease prior to cardiac surgery

    Bradley Johnson1,2, Matthew Buelow1,2, Michael Earing1,2, Scott Cohen1,2, Peter Bartz1,2, Salil Ginde1,2

    Congenital Heart Disease, Vol.14, No.6, pp. 895-900, 2019, DOI:10.1111/chd.12839

    Abstract Objective: As adults with congenital heart disease (CHD) grow older, preoperative screening for coronary artery disease (CAD) may be indicated prior to CHD surgery. Data regarding the indications for preoperative CAD screening in this population are limited. Current practice is to follow guidelines for patients with valvular heart dis‐ ease; however, the risk for CAD in certain congenital heart diagnoses may be higher than the general population. This study aimed to assess the results of preoperative CAD screening in patients prior to CHD surgery.
    Design: Retrospective study.
    Setting: Single tertiary center.
    Patients: Patients ≥35 years that had CHD surgery… More >

  • Open Access

    ARTICLE

    Three‐dimensional rotational angiography in congenital heart disease: Present status and evolving future

    Sok‐Leng Kang1, Aimee Armstrong2, Gregor Krings3, Lee Benson1

    Congenital Heart Disease, Vol.14, No.6, pp. 1046-1057, 2019, DOI:10.1111/chd.12838

    Abstract Three‐dimensional rotational angiography (3D‐RA) enables volumetric imaging through rotation of the C‐arm of an angiographic system and real‐time 3D recon‐ struction during cardiac catheterization procedures. In the field of congenital heart disease (CHD), 3D‐RA has gained considerable traction, owing to its capability for en‐ hanced visualization of spatial relationships in complex cardiac morphologies and real time image guidance in an intricate interventional environment. This review provides an overview of the current applications, strengths, and limitations of 3D‐RA acquisi‐ tion in the management of CHD and potential future directions. In addition, issues of dosimetry, radiation exposure, More >

  • Open Access

    ARTICLE

    Use of vasoactive agents in postoperative pediatric cardiac patients: Insights from a national database

    Rohit S. Loomba1, Saul Flores2

    Congenital Heart Disease, Vol.14, No.6, pp. 1176-1184, 2019, DOI:10.1111/chd.12837

    Abstract Objective: The main goal of this study is to examine the variation in vasoactive agent prescription patterns across a large cohort of patients. In addition, we sought to determine the association between the number of vasoactive agents used during admissions and characteristics of admissions utilizing varying numbers of vasoactive agents.
    Methods: This was a multi-institutional, cross-sectional study of the pediatric health information system database of patients who underwent congenital heart surgery and received vasoactive agents from 2004 to 2015. The international classification of disease-9 (ICD-9) codes were used to select admissions to those only pertaining to cardiac… More >

  • Open Access

    ARTICLE

    Prevalence and risk factors for low bone density in adults with a Fontan circulation

    Paolo D’Ambrosio1,2, Derek Tran1,2, Charlotte E. Verrall3,4, Chantal Attard5, Maria Fiatarone Singh6,7, Julian Ayer3,4,8, Yves d’Udekem5,9,10, Stephen Twigg2,11, David S. Celermajer1,2,12, Rachael Cordina1,2,5

    Congenital Heart Disease, Vol.14, No.6, pp. 987-995, 2019, DOI:10.1111/chd.12836

    Abstract Objective and Patients: This study aimed to characterize bone mineral density abnormalities and pathophysiological associations in young adults living with a Fontan circulation.
    Design: Participants underwent bone mineral density measurement using dual‐energy X‐ray absorptiometry and serum biochemical analysis, cardiopulmonary exercise and strength testing and transthoracic echocardiography.
    Results: In our cohort (n = 28), 29% had osteopenic‐range bone mineral density and one patient was osteoporotic (average hip t score: −0.6 ± 1.1; spine t score: −0.6 ± 0.9). Four patients (14%) had z scores < −2.0. Parathyroid hormone levels were increased compared with laboratory median (6.1 ± 3.5 vs… More >

  • Open Access

    ARTICLE

    Trajectory of right ventricular indices is an early predictor of outcomes in hypoplastic left heart syndrome

    Andrew S. Kim1, Colleen M. Witzenburg2, Mark Conaway3, Jeffrey E. Vergales1, Jeffrey W. Holmes2,4, Thomas J. L’Ecuyer1, Peter N. Dean1

    Congenital Heart Disease, Vol.14, No.6, pp. 1185-1192, 2019, DOI:10.1111/chd.12834

    Abstract Background: Children with hypoplastic left heart syndrome (HLHS) have risk for mortality and/or transplantation. Previous studies have associated right ventricular (RV) indices in a single echocardiogram with survival, but none have related serial measurements to outcomes. This study sought to determine whether the trajectory of RV indices in the first year of life was associated with transplant‐free survival to stage 3 palliation (S3P).
    Methods: HLHS patients at a single center who underwent stage 1 palliation (S1P) between 2000 and 2015 were reviewed. Echocardiographic indices of RV size and function were obtained before and following S1P and stage… More >

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