Amy Sanyahumbi¹, Andrea Beaton², Danielle Guffey³, Mina C. Hosseinipour⁴, Melissa Karlsten¹, Charles G. Minard³, Daniel J. Penny¹, Craig A. Sable⁵, Peter N. Kazembe⁶

Congenital Heart Disease, Vol.14, No.4, pp. 614-618, 2019, DOI:10.1111/chd.12756

Abstract Background: In asymptomatic children, screening echocardiography has been used to attempt to diagnose rheumatic heart disease (RHD) at an early stage (latent RHD). World Heart Federation guidelines have standardized categorization of “definite,” “borderline,” or no RHD by echo findings. The progression of RHD diagnosed through echo screening is not known. In 2014, we screened 1450 schoolchildren in Malawi.
Objective: Our objective was to evaluate 2‐year RHD evolution among those diag‐ nosed through screening.
Methods: Two‐year follow‐up echocardiograms of those diagnosed with latent RHD were read by a primary, secondary, then third reader if there was disagreement. Progression or regression of… More >

Clifford L. Cua¹, Melissa Moore‐Clingenpeel¹, Nazia Husain², Ralf Holzer³, John P. Cheatham¹, Janaki Gokhale⁴

Congenital Heart Disease, Vol.14, No.4, pp. 609-613, 2019, DOI:10.1111/chd.12755

Abstract Background: Increased ventricular end‐diastolic pressure (VEDP) is a known risk fac‐ tor for morbidity and mortality in patients with single right ventricle (RV) physiology. Previous studies have shown mixed results correlating echocardiographic measure‐ ments with catheter‐derived VEDP in this population. Goal of this study was to eval‐ uate if echocardiographic systolic/diastolic ratio (S/D) correlated with VEDP.
Methods: Patients with single RV physiology who underwent simultaneous echocar‐ diography and catheterization were evaluated. Systolic and diastolic durations were measured using tricuspid inflow durations from Doppler analysis to calculate the S/D ratio. VEDP was obtained from the catheterization report.
Results: Twenty‐seven studies were… More >

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) in patients with… More >

Carolyn A. Altman^1,2

Congenital Heart Disease, Vol.12, No.5, pp. 636-640, 2017, DOI:10.1111/chd.12496

Abstract Echocardiography is an excellent noninvasive imaging modality for evaluation and follow-up of cardiac lesions, especially coronary artery changes occurring as a result of Kawasaki disease. The information obtained has prognostic implications and can be complemented with other modes of imaging for risk stratification and optimization of both medical and interventional therapy. The aim of this article is to describe the time line of echocardiographic follow-up of patients affected with Kawasaki disease. The classification of coronary artery changes and transthoracic echocardiographic views recommended for detailed evaluation of the coronary arteries are delineated in detail in this report. More >

Peter Ermis

Congenital Heart Disease, Vol.12, No.5, pp. 624-626, 2017, DOI:10.1111/chd.12495

Abstract Currently, the role of stress echocardiography primarily resides in diagnosing acquired coronary artery disease (CAD) in adults. Besides an increasing concern for traditional CAD in young patients due to obesity and other chronic pediatric diseases, there is also a growing population of adolescents and young adults with “at risk” coronary arteries due to: reimplanted coronaries in congenital heart disease, anomalous origin of the native coronary arteries, coronary abnormalities in Kawasaki’s disease, and posttransplant coronary vasculopathy. Stress echocardiography is well suited for routine screening and monitoring in these patients. Also, due to the ability of stress echocardiography to provide real-time cardiac… More >

Natalie M. Hoeting¹, Courtney E. McCracken¹, Michael McConnell^1,2, Denver Sallee^1,2, Glen J. Iannucci^1,2, Matthew E. Oster^1,2

Congenital Heart Disease, Vol.12, No.4, pp. 417-420, 2017, DOI:10.1111/chd.12460

Abstract Objective: Bicuspid aortic valve (BAV) disease is associated with potential lifetime complications, but auscultation of a BAV click is commonly missed or mistaken for a benign split first heart sound. Our objective was to determine whether pediatric cardiologists could reliably distinguish between BAV clicks and benign split first heart sounds.
Design: Quality evaluation project using de-identified recordings from an outpatient pediatric cardiology clinic.
Outcome Measures: Twenty-one cardiologists listened to five de-identified recordings of pediatric heart sounds (three with BAV clicks, two with mitral components of benign split first heart sounds) and indicated whether they believed each recording was a BAV… More >

Ritu Sachdeva¹, Pamela S. Douglas², Michael S. Kelleman¹, Courtney E. McCracken¹, Leo Lopez³, Kenan W.D. Stern⁴, Benjamin W. Eidem⁵, Oscar J. Benavidez⁶, Rory B. Weiner⁶, Elizabeth Welch³, Robert M. Campbell¹, Wyman W. Lai⁷

Congenital Heart Disease, Vol.12, No.3, pp. 373-381, 2017, DOI:10.1111/chd.12455

Abstract Objective: The objective of this study was to evaluate effectiveness of educational intervention (EI) in the Pediatric Appropriate Use of Echocardiography (PAUSE) study to improve appropriateness of transthoracic echocardiograms (TTEs) ordered in pediatric cardiology clinics.
Design: Data were prospectively collected after the publication of the Appropriate Use Criteria (AUC) document during 2 phases: the pre-EI phase (1/1/15 to 4/30/15) and the post-EI phase (7/ 1/15 to 10/30/15). Pre-EI, site-investigators (SI) determined AUC indications, by reviewing the clinic records. Post-EI, providers assigned indications prior to obtaining TTE.
Setting: Pediatric cardiology clinics at six centers.
Patients: Those ≤18 years old, receiving initial… More >

Koert de Waal¹, Nilkant Phad¹, Nick Collins², Andrew Boyle²

Congenital Heart Disease, Vol.12, No.3, pp. 364-372, 2017, DOI:10.1111/chd.12454

Abstract Background: Sustained volume load due to a patent ductus arteriosus (PDA) leads to cardiac remodeling. Remodeling changes can become pathological and are associated with cardiovascular disease progression. Data on remodeling changes in preterm infants is not available.
Methods: Clinical and echocardiography data were collected in preterm infants <30 weeks gestation on postnatal day 3 and then every 7–14 days until closure of the ductus arteriosus. Images were analyzed using conventional techniques and speckle tracking. Remodeling changes of infants with prolonged (>14 days) exposure to a PDA were compared to control infants without a PDA.
Results: Thirty out of 189 infants… More >

Kenan W.D. Stern^1,2, Kimberlee Gauvreau^1,2, Sitaram Emani^3,4, Tal Geva^1,2

Congenital Heart Disease, Vol.12, No.3, pp. 350-356, 2017, DOI:10.1111/chd.12450

Abstract Objective: Stage 1 Norwood palliation is one of the highest risk procedures in congenital cardiac surgery. Patients with superior technical performance scores have more favorable outcomes. Intraoperative epicardial echocardiography may allow the surgeon to address residual lesions prior to leaving the operating room, resulting in improved technical performance. The ability of intraoperative epicardial echocardiography to visualize the relevant anatomy and its association with outcomes is not known.
Design: A standardized intraoperative epicardial echocardiography protocol was developed and performed at the conclusion of Stage 1 Norwood palliation. Data pertaining to visualization of relevant anatomy, and comparison of intraoperative echocardiogram findings with… More >

Shae Anderson^1,2, Courtney E. McCracken², Ritu Sachdeva^1,2

Congenital Heart Disease, Vol.13, No.6, pp. 1050-1057, 2018, DOI:10.1111/chd.12679

Abstract Objective: The educational intervention (EI) through the Pediatric Appropriate Use of Echocardiography (PAUSE) multicenter study resulted in improved appropriate‐ ness of transthoracic echocardiogram (TTE) orders at our center. The current study evaluated if this pattern persisted after cessation of EI and the potential physician characteristics influencing appropriateness.
Design: Outpatients (≤18 years old) seen for initial evaluation during the EI (July to October, 2015) and 6‐month post‐EI (May to August, 2016) phases were included. Comparison was made between TTE rates and appropriateness ratings during EI and post‐EI phase. Association between TTE rate and appropriateness with physician characteristics (age, experience, patient volume,… More >