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  • Open Access

    ARTICLE

    Changing prevalence of severe congenital heart disease: Results from the National Register for Congenital Heart Defects in Germany

    Constanze Pfitzer1,2,3, Paul C. Helm4, Hannah Ferentzi1,5, Lisa-Maria Rosenthal1, Ulrike M. M. Bauer4,6, Felix Berger1,3,7, Katharina R. L. Schmitt1,3

    Congenital Heart Disease, Vol.12, No.6, pp. 787-793, 2017, DOI:10.1111/chd.12515

    Abstract Objective: To assess the prevalence of congenital heart disease (CHD) in Germany in relation to phenotypes, severity and gender.
    Design: Cross-sectional registry study.
    Setting: We analyzed data from patients with CHD born between 1996 and 2015.
    Patients: A total of 26 630 patients, registered with the NRCHD, were born between 1996 and 2015. 10 927 patients were excluded from the current analysis due to prior registration with the NRCHD under the German PAN Prevalence Study, which showed a potential bias in the inclusion of this patient population (proportion of mild cardiac lesions was comparatively high due to improved diagnostic… More >

  • Open Access

    ARTICLE

    Temporal relationship between instantaneous pressure gradients and peak-to-peak systolic ejection gradient in congenital aortic stenosis

    Brian A. Boe1, Mark D. Norris2, Jeffrey D. Zampi2, Albert P. Rocchini2, Gregory J. Ensing2

    Congenital Heart Disease, Vol.12, No.6, pp. 733-739, 2017, DOI:10.1111/chd.12514

    Abstract Objective: We sought to identify a time during cardiac ejection when the instantaneous pressure gradient (IPG) correlated best, and near unity, with peak-to-peak systolic ejection gradient (PPSG) in patients with congenital aortic stenosis. Noninvasive echocardiographic measurement of IPG has limited correlation with cardiac catheterization measured PPSG across the spectrum of disease severity of congenital aortic stenosis. A major contributor is the observation that these measures are inherently different with a variable relationship dependent on the degree of stenosis.
    Design: Hemodynamic data from cardiac catheterizations utilizing simultaneous pressure measurements from the left ventricle (LV) and ascending aorta (AAo)… More >

  • Open Access

    ARTICLE

    Employment after heart transplantation among adults with congenital heart disease

    Dmitry Tumin1,2, Helen Chou1, Don Hayes Jr1,3,4, Joseph D. Tobias1,2,5, Mark Galantowicz6,7, Patrick I. McConnell6,7

    Congenital Heart Disease, Vol.12, No.6, pp. 794-799, 2017, DOI:10.1111/chd.12513

    Abstract Objective: Adults with congenital heart disease may require heart transplantation for end-stage heart failure. Whereas heart transplantation potentially allows adults with congenital heart disease to resume their usual activities, employment outcomes in this population are unknown. Therefore, we investigated the prevalence and predictors of work participation after heart transplantation for congenital heart disease.
    Design: Retrospective review of a prospective registry.
    Setting: United Network for Organ Sharing registry of transplant recipients in the United States.
    Patients: Adult recipients of first-time heart transplantation with a primary diagnosis of congenital heart disease, performed between 2004 and 2015.
    Interventions: None.
    Outcome measures: Employment status reported… More >

  • Open Access

    ARTICLE

    Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation

    Rahul H. Rathod1,2, Brittney Jurgen1,2, Rose A. Hamershock3, Kevin G. Friedman1,2, Audrey C. Marshall1,2, Mihail Samnaliev4, Dionne A. Graham3, Kathy Jenkins1,2, James E. Lock1,2, Andrew J. Powell1,2

    Congenital Heart Disease, Vol.12, No.6, pp. 768-776, 2017, DOI:10.1111/chd.12508

    Abstract Background: Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs.
    Methods: All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009). Patients were divided into “younger” (<2 years) and “older” (2–18 years) subgroups. Utilization included all cardiology visits,… More >

  • Open Access

    ARTICLE

    Family perception of unmet support needs following a diagnosis of congenital coronary anomaly in children: Results of a survey

    Hitesh Agrawal1,2, Oriana K. Wright3, Kathleen E. Carberry1,4, S. Kristen Sexson Tejtel1,2, Carlos M. Mery1,5, Silvana Molossi1,2

    Congenital Heart Disease, Vol.12, No.6, pp. 721-725, 2017, DOI:10.1111/chd.12473

    Abstract Background: Long-term outcome data on patients with anomalous aortic origin of coronary arteries (AAOCA) is sparse and they are often managed in a nonuniform manner. There is subjective perception of anxiety and unmet needs in these patients and families.
    Methods: An online survey of 13 questions was sent to 74 families of patients with AAOCA between May and October 2015. Descriptive statistics were performed.
    Results: A total of 31 (47%) families responded. Of these, 27 expressed the need to interact with other patients/families with AAOCA. The majority were interested in either face-to-face meetings (77%) or online support groups… More >

  • Open Access

    ARTICLE

    Current practices are variable in the evaluation and management of patients with anomalous aortic origin of a coronary artery: Results of a survey

    Hitesh Agrawal1,2, Carlos M. Mery1,3, Patrick E. Day4, S. Kristen Sexson Tejtel1,2, E. Dean McKenzie1,3,5, Charles D. Fraser Jr1,3, Athar M. Qureshi1,2, Silvana Molossi1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 610-614, 2017, DOI:10.1111/chd.12511

    Abstract Background: Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients are lacking to date. There is insufficient knowledge on the best approach to these patients and they are managed in a nonuniform manner.
    Methods: An online survey of 15 questions regarding management of AAOCA was sent out to 198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated scientific forum for discussion of AAOCA. Descriptive statistics were performed.
    Results: A total of… More >

  • Open Access

    ARTICLE

    Clinical evaluation of anomalous aortic origin of a coronary artery (AAOCA)

    Silvana Molossi, Hitesh Agrawal

    Congenital Heart Disease, Vol.12, No.5, pp. 607-609, 2017, DOI:10.1111/chd.12505

    Abstract The clinical evaluation of patients with an anomalous aortic origin of a coronary artery (AAOCA), a congenital abnormality of the origin or course of a coronary artery that arises from the aorta, is challenging given its first presentation being sudden cardiac arrest in about half of the patients. Symptoms of chest pain, shortness of breath and syncope during exertion should be of concern in evaluating young athletes and nonathletes. The lack of abnormal signs on the physical exam and electrocardiogram further adds to the difficulty in establishing the diagnosis. Additional imaging with echocardiography, computed tomography More >

  • Open Access

    ARTICLE

    Introduction to anomalous aortic origin of a coronary artery

    Julie A. Brothers1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 600-602, 2017, DOI:10.1111/chd.12497

    Abstract Anomalous aortic origin of a coronary artery (AAOCA) occurs when both coronary arteries arise from the same aortic sinus from a single ostium or two separate ostia. While most coronary anomalies are benign, the two most common subtypes that predispose to sudden cardiac death in the young are interarterial anomalous right coronary artery and interarterial anomalous left coronary artery. Practitioners face many challenges with AAOCA. Diagnosing patients may be difficult because children and adolescents are often asymptomatic and first presentation may be sudden death or sudden cardiac arrest. Risk stratification is also challenging as determining More >

  • Open Access

    ARTICLE

    Knowledge-based reconstruction for measurement of right ventricular volumes on cardiovascular magnetic resonance images in a mixed population

    Elise D. Pieterman1,2, Ricardo P. J. Budde2, Danielle Robbers-Visser1,2, Ron T. van Domburg3, Willem A. Helbing1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 561-569, 2017, DOI:10.1111/chd.12484

    Abstract Objective: Follow-up of right ventricular performance is important for patients with congenital heart disease. Cardiac magnetic resonance imaging is optimal for this purpose. However, observerdependency of manual analysis of right ventricular volumes limit its use. Knowledge-based reconstruction is a new semiautomatic analysis tool that uses a database including knowledge of right ventricular shape in various congenital heart diseases. We evaluated whether knowledge-based reconstruction is a good alternative for conventional analysis.
    Design: To assess the inter- and intra-observer variability and agreement of knowledge-based versus conventional analysis of magnetic resonance right ventricular volumes, analysis was done by two observers… More >

  • Open Access

    ARTICLE

    Pediatric heart disease simulation curriculum: Educating the pediatrician

    Tyler H. Harris1, Mark Adler2, Sharon M. Unti3, Mary E. McBride4

    Congenital Heart Disease, Vol.12, No.4, pp. 546-553, 2017, DOI:10.1111/chd.12483

    Abstract Background: Training guidelines state that pediatricians should be able to diagnose, manage, and triage patients with heart disease. Acutely ill cardiac patients present infrequently and with high acuity, yet residents receive less exposure to acute cardiac conditions than previous generations. Trainees must learn to manage these situations despite this gap. Simulation has been used successfully to train learners to provide acute care. We hypothesized that a simulation-based cardiac curriculum would improve residents’ ability to manage cardiac patients.
    Methods: Pediatric residents completed 4 simulation cases followed by debriefing and a computer presentation reviewing the learning objectives. Subjects returned… More >

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