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  • Open Access

    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

    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 >

  • Open Access

    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 >

  • Open Access

    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 >

  • Open Access

    ARTICLE

    The effects of lifestyle changes on serum lipid levels in children in a real life setting

    Angeline D. Opina, Constance Cephus, Yunfei Wang, Samuel Younan, Douglas Moodie

    Congenital Heart Disease, Vol.13, No.2, pp. 327-333, 2018, DOI:10.1111/chd.12580

    Abstract Objective: Studies have shown improvement in lipid levels after institution of lifestyle changes in children enrolled in closely monitored programs. There programs are difficult to mimic in real world clinics. We aim to determine if diet and exercise result in improvement in lipid levels in patients seen in a designated lipid clinic in a real life setting.
    Design: Retrospective review of patients followed for dyslipidemia at the Texas Children’s Hospital Lipid Clinic from May 1, 2012 to May 1, 2015. Patients included were seen more than once, had repeat lipid testing, and abnormal baseline lipid levels. Multivariate analysis using mixed… More >

  • Open Access

    ARTICLE

    Lambl’s excrescences in children: Improved detection via transthoracic echocardiography

    Amanda L. Phillips1, Muhammad Yasir Qureshi1,2, Benjamin W. Eidem1,2,3, Frank Cetta1,2,3

    Congenital Heart Disease, Vol.13, No.2, pp. 251-253, 2018, DOI:10.1111/chd.12560

    Abstract Background: Lambl’s excrescences (LE) are fibrous extensions that can be found along the lines of closure of the aortic valve. Due to improvements in ultrasound technology, LE are frequently imaged during transthoracic echocardiography (TTE) in adults.
    Objective: The purpose of this study was to determine the prevalence of LE among children from two eras (2004–2006 and 2011–2012) and the effect of technological advancements on LE detection.
    Methods: TTE from 700 subjects (age 18 years old or younger) were reviewed. All parasternal long and short axis images of the aortic valve were reviewed by a board certified echocardiographer, and the positive… More >

  • Open Access

    REVIEW

    State of the art review: Chemotherapy-induced cardiotoxicity in children

    Robert W. Loar, Cory V. Noel, Hari Tunuguntla, John L. Colquitt, Ricardo H. Pignatelli

    Congenital Heart Disease, Vol.13, No.1, pp. 5-15, 2018, DOI:10.1111/chd.12564

    Abstract Chemotherapy-induced cardiotoxicity in adults and children is a topic with a growing interest in the cardiology literature. The ability to detect cardiac dysfunction in a timely manner is essential in order to begin adequate treatment and prevent further deterioration. This article aims to provide a review on the myocardial injury process, chemotherapeutic agents that lead to cardiotoxicity, the definition of cardiotoxicity, and the methods of timely detection and treatment. More >

  • Open Access

    REVIEW

    Heparin-induced thrombocytopenia complicating children after the Fontan procedure: Single-center experience and review of the literature

    Uri Pollak1,2,3, David Mishaly3,4, Gili Kenet3,5, Amir Vardi1,3

    Congenital Heart Disease, Vol.13, No.1, pp. 16-25, 2018, DOI:10.1111/chd.12557

    Abstract Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of heparin therapy. The risk for HIT correlates with the cumulative dosage of heparin exposure. In Fontan patients, recurrent systemic anticoagulation, traditionally with heparin, is used to alleviate the thrombotic complications that may occur postoperatively when the venous pressure rises and the systemic venous flow into the pulmonary arteries becomes sluggish, putting them at increased risk. As a pressure gradient-dependent circulation, elevation in systemic venous pressure, most often by venous thrombosis, contributes to circuit failure. Therefore, when HIT complicates patients after the Fontan procedure, it is associated with a high thrombotic morbidity and… More >

  • Open Access

    ARTICLE

    Stress and quality of life among parents of children with congenital heart disease referred for psychological services

    Astrida Kaugars1, Clarissa Shields2, Cheryl Brosig3

    Congenital Heart Disease, Vol.13, No.1, pp. 72-78, 2018, DOI:10.1111/chd.12547

    Abstract Objective: The study examined parent stress and health-related quality of life (HRQOL) among families of children with congenital heart disease (CHD) referred for psychological services.
    Methods: Parents of 54 children (85% boys) aged 3 to 13 (Mage = 7.48, SD = 2.38) completed measures to assess parenting stress (Parenting Stress Index – Short Form; Pediatric Inventory for Parents) and the PedsQL Family Impact Module. Medical information was retrieved from medical record review.
    Results: Half of parents of children with single ventricle anatomy had clinically significant levels of parenting stress. Parents of children with single ventricle anatomy reported more frequent illnessrelated… More >

  • Open Access

    ARTICLE

    Clinical, echocardiographic, and therapeutic aspects of congenital heart diseases of children at Douala General Hospital: A cross-sectional study in sub-Saharan Africa

    Felicit e Kamdem1,2, Danielle Kedy Koum2,3, Ba Hamadou1,4, Melanie Yemdji1, Henry Luma1,4, Marie Solange Doualla1,4, Diomède Noukeu5, Esther Barla5, Christophe Akazong5, Anastase Dzudie1,4, Henry Ngote1, Yves Monkam1, Sidiki Mouliom1, Samuel Kingue4,6

    Congenital Heart Disease, Vol.13, No.1, pp. 113-117, 2018, DOI:10.1111/chd.12529

    Abstract Introduction: Cardiovascular diseases in pediatric pathologies have emerged in the recent years in sub-Saharan Africa (SSA), with congenital heart diseases (CHDs) being the most frequent. Unfortunately, their diagnosis is usually delayed, thereby increasing childhood morbidity and mortality.
    Objectives: Describe the clinical, echocardiographic, and therapeutic aspects of CHDs of children at Douala General Hospital.
    Methods: We carried out a cross-sectional descriptive study over a 10-year period, from January 2006 to December 2015. Files and reports of cardiac ultrasounds of patients aged ≤ 15 years were reviewed.
    Results: We reviewed the medical records of 1616 children, of which 370 (22.9%) had CHD.… More >

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