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  • Open Access

    ARTICLE

    Impact of durable ventricular assist devices on post‐transplant outcomes in adults with congenital heart disease

    Ari Cedars1, Luke Burchill2, S. Lucy Roche3, Jonathan Menachem4, Kelly Axsom5, Kristen Tecson6

    Congenital Heart Disease, Vol.14, No.6, pp. 958-962, 2019, DOI:10.1111/chd.12851

    Abstract Background: There are no published data on post‐transplant outcomes in durable ven‐ tricular assist device (VAD)‐supported adult congenital heart disease (ACHD) patients.
    Methods: We compared post‐transplant outcomes in VAD‐supported vs non‐VAD‐ supported ACHD patients using the Scientific Registry of Transplant Recipients.
    Results: At 1 year, there was no difference in post‐transplant mortality between VAD‐supported (12 patients) and non‐VAD‐supported (671 patients) ACHD patients.
    Conclusions: In appropriate ACHD patients, VAD use as a bridge to transplant is a reasonable strategy. 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

    Improvement in ventricular function with rhythm control of atrial arrhythmias may delay the need for atrioventricular valve surgery in adults with congenital heart disease

    Benjamin Zielonka1, Yuli Y. Kim2,3, Gregory E. Supple2, Sara L. Partington2,3, Emily S. Ruckdeschel2,3, Francis E. Marchlinski2, David S. Frankel2

    Congenital Heart Disease, Vol.14, No.6, pp. 931-938, 2019, DOI:10.1111/chd.12833

    Abstract Objective: Atrial arrhythmias and atrioventricular valve regurgitation (AVVR) are common causes of morbidity among adults with congenital heart disease (ACHD). The impact of rhythm control on AVVR in this population is unknown. We sought to determine whether a rhythm control strategy is associated with greater freedom from AV valve surgery than a rate control strategy.
    Design: Patients evaluated by both ACHD and electrophysiology specialists at a single academic center were screened for atrial arrhythmias and at least moderate‐severe AVVR. Clinical and electrographic data were abstracted. All echocardiograms were in‐ terpreted by a single echocardiographer blinded to treatment… More >

  • Open Access

    ARTICLE

    32 year follow up of patients following atrial redirection surgery for transposition of the great arteries

    M. Louise Morrison1, Brian Grant1, Brian A. McCrossan1,2, Andrew J. Sands1,2, Colum G. Owens2, Mark S. Spence2, Frank A. Casey1, Brian G. Craig1,2, Christopher J. Lockhart2

    Congenital Heart Disease, Vol.14, No.5, pp. 846-853, 2019, DOI:10.1111/chd.12822

    Abstract Objective: A significant body of patients who have undergone Mustard or Senning procedure require lifelong follow up. In this retrospective review, we examined the cohort of such patients currently attending our center.
    Design: Patients who had undergone either Mustard or Senning procedure were identified. We retrospectively reviewed medical records, recorded demographic in‐ formation and data regarding the clinical state, NHYA class, cardiopulmonary exer‐ cise testing, NT‐proBNP measurement, and recent cardiac MRI findings.
    Results: Forty‐six patients were identified, the mean age was 32.2 years (± 6.1 years), 67.4% were male. Thirty‐two patients (69.6%) had undergone a Senning procedure. The… More >

  • Open Access

    ARTICLE

    A model for geographic and sociodemographic access to care disparities for adults with congenital heart disease

    Katherine B. Salciccioli1, Abiodun Oluyomi2, Philip J. Lupo3, Peter R. Ermis1, Keila N. Lopez1

    Congenital Heart Disease, Vol.14, No.5, pp. 752-759, 2019, DOI:10.1111/chd.12819

    Abstract Background: Follow‐up at a regional adult congenital heart disease (ACHD) center is recommended for all ACHD patients at least once per the 2018 ACC/AHA guidelines. Other specialties have demonstrated poorer follow‐up and outcomes correlating with increased distance from health care providers, but driving time to regional ACHD centers has not been examined in the US population.
    Objective: To identify and characterize potential disparities in access to ACHD care in the US based on drive time to ACHD centers and compounding sociodemographic factors.
    Methods: Mid‐ to high‐volume ACHD centers with ≥500 outpatient ACHD visits and ≥20 ACHD surgeries annually… More >

  • Open Access

    ARTICLE

    Detection of arrhythmias in adult congenital heart disease patients with LINQTM implantable loop recorder

    Anudeep K. Dodeja1, Courtney Thomas1, Curt J. Daniels1,2, Naomi Kertesz1,2, Anna Kamp1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 745-751, 2019, DOI:10.1111/chd.12815

    Abstract Background: Rhythm disorders are the leading cause of morbidity and mortality in adults with congenital heart disease (ACHD). Infrequent or asymptomatic arrhyth‐ mias may not be detected by routine monitoring. Implantable loop recorders (ILRs), such as the Reveal LINQTM, have been useful in long‐term monitoring for arrhythmias in adults with cryptogenic stroke.
    Objective: We propose the Reveal LINQTM will detect arrhythmias, not documented by other monitoring modalities, resulting in change in management in ACHD patients.
    Methods: This is a single center retrospective review of Reveal LINQTM use in ACHD patients from 2014‐2017. Medical records were reviewed to determine cardiac… More >

  • Open Access

    ARTICLE

    Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

    Natalie Bottega1, Isabelle Malhamé2, Liming Guo1, Raluca Ionescu‐Ittu1, Judith Therrien1, Ariane Marelli1

    Congenital Heart Disease, Vol.14, No.5, pp. 735-744, 2019, DOI:10.1111/chd.12811

    Abstract Background: The number of women with congenital heart disease (CHD) of reproductive age is increasing, yet a description of trends in pregnancy and delivery outcomes in this population is lacking.
    Objective: To assess secular trends in pregnancy rates, delivery outcomes, and related health care utilization in the adult female CHD population in Quebec, Canada.
    Methods: The Quebec CHD database was used to construct a cohort with all women with CHD aged 18‐45 years between 1992 and 2004. Pregnancy and delivery rates were determined yearly and compared to the general population. Secular trends in pregnancy and delivery rates were… More >

  • Open Access

    ARTICLE

    Clinic nonattendance is associated with increased emergency department visits in adults with congenital heart disease

    Katherine Awh1,2, Morgan A. Venuti1,2, Lacey P. Gleason1,2, Rachel Rogers3, Srinivas Denduluri1, Yuli Y. Kim1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 726-734, 2019, DOI:10.1111/chd.12784

    Abstract Objective: To determine the prevalence and predictors of nonattendance in an ACHD outpatient clinic, and to examine the relationship between nonattendance and emergency department (ED) visits, hospitalizations, and death.
    Methods: Patients ≥ 18 years who had scheduled appointments at an ACHD outpatient clinic between August 1, 2014 and December 31, 2014 were included. The primary outcome of interest was nonattendance of the first scheduled appointment of the study period, defined as “no-show” or “same-day cancellation.” Secondary outcomes of interest were ED visits, hospitalizations, and death until December 2017.
    Results: Of 527 scheduled visits, 55 (10.4%) were nonattended. Demographic… More >

  • Open Access

    ARTICLE

    Accuracy of risk prediction scores in pregnant women with congenital heart disease

    Yuli Y. Kim1,2, Leah A. Goldberg2, Katherine Awh2, Tanmay Bhamare1,2, David Drajpuch2, Adi Hirshberg3, Sara L. Partington1,2, Rachel Rogers4, Emily Ruckdeschel1,2, Lynda Tobin1, Morgan Venuti2, Lisa D. Levine3

    Congenital Heart Disease, Vol.14, No.3, pp. 470-478, 2019, DOI:10.1111/chd.12750

    Abstract Objective: To assess performance of risk stratification schemes in predicting adverse cardiac outcomes in pregnant women with congenital heart disease (CHD) and to compare these schemes to clinical factors alone.
    Design: Single‐center retrospective study.
    Setting: Tertiary care academic hospital.
    Patients: Women ≥18 years with International Classification of Diseases, Ninth Revision, Clinical Modification codes indicating CHD who delivered between 1998 and 2014. CARPREG I and ZAHARA risk scores and modified World Health Organization (WHO) criteria were applied to each woman.
    Outcome Measures: The primary outcome was defined by ≥1 of the following: arrhyth‐ mia, heart failure/pulmonary edema, transient ischemic attack, stroke,… More >

  • Open Access

    ARTICLE

    Opportunities for training to advance the care for adults with congenital heart disease with advanced circulatory failure

    Christopher R. Broda

    Congenital Heart Disease, Vol.14, No.3, pp. 487-490, 2019, DOI:10.1111/chd.12748

    Abstract Heart failure is an emerging issue with important implications in adult patients with congenital heart disease. Practitioners with expertise in both adult congenital heart disease and heart failure are needed to manage this growing and often complex pop‐ ulation. In the United States, the optimal training pathway to enable practitioners to best care for these patients is ill‐defined. This article explores possibilities and issues that interested trainees may encounter during their training experience. More >

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