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  • Open Access

    ARTICLE

    Preoperative Risk Assessment and Perioperative Management of Adults with Congenital Heart Disease Undergoing Non-Cardiac Surgery

    Michela Palma, Giancarlo Scognamiglio*, Flavia Fusco, Assunta Merola, Anna Correra, Diego Colonna, Emanuele Romeo, Berardo Sarubbi

    Congenital Heart Disease, Vol.15, No.1, pp. 33-49, 2020, DOI:10.32604/CHD.2020.011523

    Abstract Adults with congenital heart disease (ACHD) constitute a growing population with complex cardiac physiopathology and frequent extra-cardiac involvement. The recent dramatic improvement of their life expectancy has resulted in an increasing proportion of ACHD patients requiring non-cardiac surgery. While a large body of evidence demonstrated the importance of an accurate risk assessment in patients with acquired heart disease before noncardiac surgery in order to reduce perioperative morbidity and mortality and detailed algorithms have been released by international societies, no specific guidelines are available for the perioperative management in this population. Nonetheless, understanding the complex anatomy and unusual physiology of both… More >

  • Open Access

    ARTICLE

    Lost in the system? Transfer to adult congenital heart disease care—Challenges and solutions

    Jennifer Gerardin1, Cheryl Raskind‐Hood2, Fred H. Rodriguez3,4, Trenton Hoffman2, Andreas Kalogeropoulos5, Carol Hogue2, Wendy Book3

    Congenital Heart Disease, Vol.14, No.4, pp. 541-548, 2019, DOI:10.1111/chd.12780

    Abstract Objective: Transfer of congenital heart disease care from the pediatric to adult set‐ ting has been identified as a priority and is associated with better outcomes. Our objective is to determine what percentage of patients with congenital heart disease transferred to adult congenital cardiac care.
    Design: A retrospective cohort study.
    Setting: Referrals to a tertiary referral center for adult congenital heart disease pa‐ tients from its pediatric referral base.
    Patients: This resulted in 1514 patients age 16‐30, seen at least once in three pediat‐ ric Georgia health care systems during 2008‐2010.
    Interventions: We analyzed for protective factors associated with age‐appropriate… More >

  • Open Access

    ARTICLE

    Too little too late? Communication with patients with congenital heart disease about challenges of adult life

    Lisa X. Deng1, Lacey P. Gleason2, Katherine Awh2, Abigail May Khan3, David Drajpuch2,4, Stephanie Fuller5, Leah A. Goldberg2, Christopher E. Mascio5, Sara L. Partington2,4, Lynda Tobin2,4, Adrienne H. Kovacs3, Yuli Y. Kim2,4

    Congenital Heart Disease, Vol.14, No.4, pp. 534-540, 2019, DOI:10.1111/chd.12778

    Abstract Objective: To investigate the experiences and communication preferences of adult patients with congenital heart disease (CHD) in the domains of employment, insur‐ ance, and family planning.
    Design: Patients ≥ 18 years of age completed a questionnaire about experiences and communication preferences regarding employment, health insurance, and family planning.
    Results: Of 152 patients (median age = 33 years, 50% female, 35% with CHD of great complexity), one in four reported work‐related problems due to CHD and a quar‐ ter also recalled a previous gap in health insurance. Of females, 29% experienced an unplanned pregnancy. The median importance of discussion ratings (on… More >

  • Open Access

    ARTICLE

    Predictors of extracorporeal membrane oxygenation support after surgery for adult congenital heart disease in children’s hospitals

    Stephen J. Dolgner1,2,3, Eric V. Krieger1,3, Jacob Wilkes4, Susan L. Bratton5, Ravi R. Thiagarajan6,7, Cindy S. Barrett8, Titus Chan1,2,9

    Congenital Heart Disease, Vol.14, No.4, pp. 559-570, 2019, DOI:10.1111/chd.12758

    Abstract Objective: Adult congenital heart disease (ACHD) patients who undergo cardiac surgery are at risk for poor outcomes, including extracorporeal membrane oxygenation support (ECMO) and death. Prior studies have demonstrated risk factors for mortality, but have not fully examined risk factors for ECMO or death without ECMO (DWE). We sought to identify risk factors for ECMO and DWE in adults undergoing congenital heart surgery in tertiary care children’s hospitals.
    Design: All adults (≥18 years) undergoing congenital heart surgery in the Pediatric Health Information System (PHIS) database between 2003 and 2014 were included. Patients were classified into three groups: ECMO‐free survival, requiring… More >

  • Open Access

    ARTICLE

    Obesity trends in children, adolescents, and young adults with congenital heart disease

    Jeremy M. Steele1,2, Tamar J. Preminger4, Francine G. Erenberg2, Lu Wang3, Katherine Dell2, Tarek Alsaied1, Kenneth G. Zahka2

    Congenital Heart Disease, Vol.14, No.4, pp. 517-524, 2019, DOI:10.1111/chd.12754

    Abstract Objectives: To determine the prevalence, age of onset, and risk factors for overweight and obesity in children with congenital heart disease (CHD).
    Study Design: Children with CHD who were seen at our institution from 1996 to 2017 were studied. Patients were full-time residents of the United States and were receiving all cardiac care at our institution. Patients were categorized by age and CHD diagnosis. The date of last normal weight for age and the date of first recorded weight in the range of overweight and obese were documented.
    Results: Nine hundred sixty-eight patients with CHD were included. The prevalence of… More >

  • Open Access

    ARTICLE

    Arrhythmia burden and related outcomes in Eisenmenger syndrome

    Shankar Baskar1, Philippa Horne2, Samantha Fitzsimmons3, Philip R. Khoury1, Joseph Vettukattill4, Koichiro Niwa5, Teiji Agaki6, Mark Spence7, Hisanori Sakazaki8, Gruschen Veldtman1

    Congenital Heart Disease, Vol.12, No.4, pp. 512-519, 2017, DOI:10.1111/chd.12481

    Abstract Background: Patients with Eisenmenger syndrome have a shorter lifespan than the general population. A significant proportion develop arrhythmia and some, sudden death.
    Objective: The aims of this study were to characterize the frequency, type and effects of arrhythmias in adult patients with Eisenmenger’s syndrome and to identify risk factors for arrhythmias.
    Methods: This retrospective study included patients aged ≥18 years of age with Eisenmenger’s syndrome from three institutions. Arrhythmias were noted from electrocardiograms and Holter study reviews.
    Results: A total of 167 patients, 96 females, 63 males (gender not available in 9 patients) were included in this study. The mean… More >

  • Open Access

    ARTICLE

    NT-proBNP predicts mortality in adults with transposition of the great arteries late after Mustard or Senning correction

    Jana Rubáčková Popelová, MD1,2 | Markéta Tomková1,3 | Jakub Tomek1,4

    Congenital Heart Disease, Vol.12, No.4, pp. 448-457, 2017, DOI:10.1111/chd.12466

    Abstract Objective: The patients after Mustard and Senning corrections of transposition of the great arteries (TGA) are at an increased risk of unexpected death. The aim of this study was to identify markers allowing risk stratification of patients after atrial switch correction of TGA to provide them with optimum care.
    Methods and Results: In this study, 87 patients were retrospectively evaluated after atrial switch correction of TGA followed-up between 2005 and 2015. The mortality during the follow-up was 9% (8 cardiac deaths). Markers significantly predictive of death using univariable Cox proportional hazard ratio survival analysis were: N-terminal pro-B-type natriuretic peptide (NT-proBNP),… More >

  • Open Access

    ARTICLE

    Residents’ understanding of adult congenital heart disease

    Paul Cooper1, Morgan Hindes2, Timothy M. Maul3,4, Stephen C. Cook5

    Congenital Heart Disease, Vol.12, No.3, pp. 309-314, 2017, DOI:10.1111/chd.12441

    Abstract Objective: Medical residents are exposed to increasing numbers of adults with congenital heart disease (ACHD). While inadequate ACHD knowledge may lead to inappropriate practice, this educational deficit has not been investigated. Our aim was to analyze residents’ attitudes, perceived ability, and knowledge of ACHD medicine.
    Design, Methods, Outcome Measures: A single center, multiprogram cross-sectional study was conducted in 2015 using an electronic survey to assess 472 medical residents’ perceived knowledge and self-assessed skills related to ACHD medicine. Demographic data obtained included age, gender, level of training and program type.
    Results: The survey was completed by 25% of surveyed residents (N… More >

  • Open Access

    ARTICLE

    A great imitator in adult cardiology practice: congenitally corrected transposition of the great arteries

    Anushree Agarwal, Fatima Samad, Lindsey Kalvin, Michelle Bush, A. Jamil Tajik

    Congenital Heart Disease, Vol.12, No.2, pp. 143-152, 2017, DOI:10.1111/chd.12453

    Abstract Introduction: Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital disease that frequently remains undiagnosed until adulthood, especially when there is an absence of other congenital anomalies. Adults with ccTGA may remain asymptomatic and their diagnosis could be missed on initial evaluation, or it could be diagnosed incidentally as an evaluation of murmur. We aim to report the different presentations of ccTGA in eight adult patients and review the key features required to suspect the diagnosis during an initial visit.
    Cases: We present some illustrative cases of ccTGA patients who had diverse presentations ranging from being completely… More >

  • Open Access

    ARTICLE

    Neurocognitive functioning in adults with congenital heart disease

    Dawn Ilardi1,2, Kim E. Ono1,2, Rebecca McCartney3, Wendy Book4, Anthony Y. Stringer2

    Congenital Heart Disease, Vol.12, No.2, pp. 166-173, 2017, DOI:10.1111/chd.12434

    Abstract Objective: Adults with congenital heart disease (CHD) are at increased risk of psychological disorders and cognitive deficiencies due to structural/acquired neurological abnormalities and neurodevelopmental disorders as children. However, limited information is known about the neuropsychological functioning of adults with CHD. This study screened neuropsychological abilities and explored group differences related to cardiac disease severity and neurological risk factors in adults with CHD.
    Design: Participants completed brief neuropsychological testing. Information about neurobehavioral and psychological symptoms, employment, education, and disability were also collected from the patient and a family member.
    Results: Forty-eight participants with adult CHD completed neuropsychological testing. Visuospatial skills and… More >

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