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  • Open Access


    Neurodevelopmental assessment of infants with congenital heart disease in the early postoperative period

    Samantha C. Butler1,4, Anjali Sadhwani1,4, Christian Stopp2, Jayne Singer1,3,4, David Wypij2,5,6, Carolyn Dunbar‐Masterson2, Janice Ware1,3,4, Jane W. Newburger2,5

    Congenital Heart Disease, Vol.14, No.2, pp. 236-245, 2019, DOI:10.1111/chd.12686

    Abstract Objective: Mortality rates for children with congenital heart disease (CHD) have significantly declined, resulting in a growing population with associated neurodevelopmental disabilities. American Heart Association guidelines recommend systematic developmental screening for children with CHD. The present study describes results of inpatient newborn neurodevelopmental assessment of infants after open heart surgery.
    Outcome measures: We evaluated the neurodevelopment of a convenience sample of high‐risk infants following cardiac surgery but before hospital discharge using an adaptation of the Newborn Behavioral Observation. Factor analysis examined relationships among assessment items and consolidated them into domains of development.
    Results: We assessed 237 infants at a median… More >

  • Open Access


    Ventricular force‐frequency relationships during biventricular or multisite pacing in congenital heart disease

    Shankar Baskar, Andrew N. Redington, Philip R. Khoury, Timothy K. Knilans, David S. Spar, Richard J. Czosek

    Congenital Heart Disease, Vol.14, No.2, pp. 201-206, 2019, DOI:10.1111/chd.12684

    Abstract Background: Traditional indices to evaluate biventricular (BiV) pacing are load dependent, fail to assess dynamic changes, and may not be appropriate in patients with congenital heart disease (CHD). We therefore measured the force‐frequency relationship (FFR) using tissue Doppler‐de‐ rived isovolumic acceleration (IVA) to assess the dynamic adaption of the myocardium and its vari‐ ability with different ventricular pacing strategies.
    Methods: This was a prospective pilot study of pediatric and young adult CHD patients with biventricular or multisite pacing systems. Color‐coded myocardial velocities were recorded at the base of the systemic ventricular free wall. IVA was calculated at resting heart rate… More >

  • Open Access


    Bioelectrical impedance analysis in the management of heart failure in adult patients with congenital heart disease

    Masaki Sato1, Kei Inai1,2, Mikiko Shimizu1, Hisashi Sugiyama1, Toshio Nakanishi2

    Congenital Heart Disease, Vol.14, No.2, pp. 167-175, 2019, DOI:10.1111/chd.12683

    Abstract Objective: The recognition of fluid retention is critical in treating heart failure (HF). Bioelectrical impedance analysis (BIA) is a well-known noninvasive method; however, data on its role in managing patients with congenital heart disease (CHD) are limited. Here, we aimed to clarify the correlation between BIA and HF severity as well as the prognostic value of BIA in adult patients with CHD.
    Design: This prospective single-center study included 170 patients with CHD admitted between 2013 and 2015. We evaluated BIA parameters (intra- and extracellular water, protein, and mineral levels, edema index [EI, extracellular water-to-total body water ratio]), laboratory values, and… More >

  • Open Access


    Stenting of the ductus arteriosus for ductal‐dependent pulmonary blood flow—current techniques and procedural considerations

    Varun Aggarwal1, Christopher J. Petit2, Andrew C. Glatz3,4, Bryan H. Goldstein5, Athar M. Qureshi1

    Congenital Heart Disease, Vol.14, No.1, pp. 110-115, 2019, DOI:10.1111/chd.12709

    Abstract The use of prostaglandin‐E1 immediately after birth and subsequent surgical crea‐ tion of the modified Blalock‐Taussig shunt (BTS) shunt have remarkably improved the prognosis and survival of children with congenital heart disease and ductal‐depend‐ ent pulmonary blood flow (PBF). Despite the advancement in surgical techniques, bypass strategies, and postoperative management, significant morbidity and mortal‐ ity after BTS still remain. Patent ductus arteriosus stenting has been shown to be as an acceptable alternative to BTS placement in select infants with ductal‐dependent PBF. Newer procedural techniques and equipment, along with operator experience have all contributed to procedural refinement associated with improved outcomes… More >

  • Open Access


    Blalock-Taussig shunt versus patent ductus arteriosus stent as first palliation for ductal-dependent pulmonary circulation lesions: A review of the literature

    Dana M. Boucek1, Athar M. Qureshi2, Bryan H. Goldstein 3, Christopher J. Petit4, Andrew C. Glatz1,5

    Congenital Heart Disease, Vol.14, No.1, pp. 105-109, 2019, DOI:10.1111/chd.12707

    Abstract Background: Infants with ductal-dependent pulmonary blood flow (PBF) often undergo a palliative procedure to provide a stable source of PBF prior to definitive palliation or repair. In the current era, a surgical shunt or ductal stent is used to provide PBF. We aimed to review the current literature comparing ductal stents to surgical shunts.
    Methods and Results: Four small, single-center studies and two larger multicenter studies were identified comparing ductal stent to surgical shunt. Combined, these studies showed ductal stent resulted in similar or improved pulmonary artery growth, fewer complications, shorter length of stay, less diuretic use, and improved survival… More >

  • Open Access


    Use of 3D models of congenital heart disease as an education tool for cardiac nurses

    Giovanni Biglino1,2, Claudio Capelli2,3, Despina Koniordou3, Di Robertshaw2, Lindsay-Kay Leaver2, Silvia Schievano2,3, Andrew M. Taylor2,3, Jo Wray2

    Congenital Heart Disease, Vol.12, No.1, pp. 113-118, 2017

    Abstract Background: Nurse education and training are key to providing congenital heart disease (CHD) patients with consistent high standards of care as well as enabling career progression. One approach for improving educational experience is the use of 3D patient-specific models.
    Objectives: To gather pilot data to assess the feasibility of using 3D models of CHD during a training course for cardiac nurses; to evaluate the potential of 3D models in this context, from the nurses’ perspective; and to identify possible improvements to optimise their use for teaching.
    Design: A cross-sectional survey.
    Setting: A national training week for cardiac nurses.
    Participants: One… More >

  • Open Access


    Neurocognitive and executive functioning in adult survivors of congenital heart disease

    Leda Klouda1, Wayne J. Franklin1, Anita Saraf1,2, Dhaval R. Parekh1, David D. Schwartz3

    Congenital Heart Disease, Vol.12, No.1, pp. 91-98, 2017

    Abstract Objective: Congenital heart disease (CHD) can affect the developing central nervous system, resulting in neurocognitive and behavioral deficits. Preoperative neurological abnormalities as well as sequelae of the open heart operations required to correct structural abnormalities of the heart contribute to these deficits. There are few studies examining the neurocognitive functioning of adults with CHD. This study sought to investigate multiple domains of neurocognitive functioning in adult survivors of CHD who had childhood cardiac surgery with either moderate or severe disease complexity.
    Design: A total of 48 adults (18–49 years of age) who had undergone cardiac surgery for CHD prior to… More >

  • Open Access


    Rapid 3D imaging of the lower airway by MRI in patients with congenital heart disease: A retrospective comparison of delayed volume interpolated breath-hold examination (VIBE) to turbo spin echo (TSE)

    Benjamin H. Goot, Sonali Patel, Brian Fonseca

    Congenital Heart Disease, Vol.12, No.1, pp. 84-90, 2017

    Abstract Objective: When imaging the lower airway by MRI, the traditional technique turbo spin echo (TSE) results in high quality 2D images, however planning and acquisition times are lengthy. An alternative, delayed volume interpolated breath-holds examination (VIBE), is a 3D gradient echo technique that produces high spatial resolution imaging of the airway in one breath-hold. The objective of this study is to retrospectively evaluate the accuracy of lower airway measurements obtained by delayed VIBE when compared to TSE.
    Design: Patients with congenital heart disease who underwent a cardiac MRI (CMR) that included a delayed VIBE sequence from 5/2008 to 9/2013 were… More >

  • Open Access


    “Frontiers in Fontan failure: A summary of conference proceedings”

    Camden Hebson1,2, Wendy Book1, Robert W. Elder3, Ryan Ford4, Maan Jokhadar1, Kirk Kanter5, Brian Kogon5, Adrienne H. Kovacs6, Rebecca D. Levit1, Michael Lloyd1, Kevin Maher2, Preeti Reshamwala4, Fred Rodriguez III1,2, Rene Romero7, Thor Tejada1, Anne Marie Valente8, Gruschen Veldtman9, Michael McConnell1,2

    Congenital Heart Disease, Vol.12, No.1, pp. 6-16, 2017

    Abstract “Frontiers in Fontan Failure” was the title of a 2015 conference sponsored by Children’s Healthcare of Atlanta and Emory University School of Medicine. In what is hoped to be the first of many such gatherings, speakers and attendees gathered to discuss the problem of long-term clinical deterioration in these patients. Specific focuses included properly defining the problem and then discussing different treatment strategies, both medical and surgical. The health of the liver after Fontan palliation was a particular point of emphasis, as were quality of life and future directions. More >

  • Open Access


    Impact of changing indications and increased utilization of fetal echocardiography on prenatal detection of congenital heart disease

    Jonathan Komisar1, Shubhika Srivastava2, Miwa Geiger2, John Doucette3, Helen Ko2, Jay Shenoy2, Rajesh Shenoy2

    Congenital Heart Disease, Vol.12, No.1, pp. 67-73, 2017

    Abstract Background: Antenatal diagnosis of congenital heart defects (CHD) can impact outcomes in neonates with severe CHD. Obstetric screening guidelines and the indications for fetal echocardiography (FE) have evolved in an attempt to improve the early prenatal detection of CHD. Analyzing yield for specific indications will help clinicians better stratify at-risk pregnancies.
    Methods: Retrospective cohort study of all FE performed between 2000 and 2010 at a single tertiary care academic medical center in New York City. A total of 9878 FE met inclusion criteria for our study. In cases of multiple gestations (MG), each fetus was counted as a separate study.
    More >

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