Alexander C. Egbe, Sorin V. Pislaru, Srikanth Kothapalli, Raja Jadav, Muhammad Masood, Mounika Angirekula, Patricia A. Pellikka

Congenital Heart Disease, Vol.14, No.5, pp. 700-705, 2019, DOI:10.1111/chd.12783

Abstract Background: Quantitative assessment of right ventricular (RV) systolic function by echocardiography is challenging in patients with congenital heart disease because of the complex geometry of the RV and the iatrogenic structural abnormalities resulting from prior cardiac surgeries. The purpose of this study was to determine the correla‐ tion between echocardiographic indices of RV systolic function and cardiac magnetic resonance imaging (CMRI) derived RV ejection fraction (RVEF) in adults with repaired tetralogy of Fallot (TOF).
Methods: Quantitative assessment of RV function was performed with RV tissue Doppler systolic velocity (RV s'), tricuspid annular plane systolic excursion (TAPSE), and fractional area change… More >

Alan F. Riley¹, Elena C. Ocampo¹, Joseph Hagan², M. Regina Lantin‐Hermoso¹

Congenital Heart Disease, Vol.14, No.5, pp. 706-712, 2019, DOI:10.1111/chd.12774

Abstract Background: When performed by cardiologists, hand‐held echocardiography (HHE) can assess ventricular systolic function and valve disease in adults, but its accuracy and utility in congenital heart disease is unknown. In hypoplastic left heart syndrome (HLHS), the echocardiographic detection of depressed right ventricular (RV) systolic function and higher grade tricuspid regurgitation (TR) can identify patients who are at increased risk of morbidity and mortality and who may benefit from additional imaging or medical therapies.
Methods: Children with HLHS after Stage I or II surgical palliation (Norwood or Glenn procedures) were prospectively enrolled. Subjects underwent HHE by a pediatric cardiologist on the… More >

Mahmoud Zaqout^1,2, Kristof Vandekerckhove¹, Nathalie Michels², Laurent Demulier³, Thierry Bove⁴, Katrien François⁴, Julie De Backer³, Stefaan De Henauw², Daniel De Wolf¹

Congenital Heart Disease, Vol.14, No.3, pp. 479-486, 2019, DOI:10.1111/chd.12751

Abstract Objective: To investigate the status of body mass index (BMI) in adult people with congenital heart disease (ACHD).
Methods: Five hundred thirty‐nine adults with CHD (53.8% men) were seen in the outpatient clinic from 2013 to 2015 and compared to a reference population (n = 1737). The severity of CHD was categorized as mild, moderate, and severe ac‐ cording to standard guidelines. Patients were categorized based on BMI as under‐ weight (<18.5), overweight (25‐30), or obese (>30). Echocardiography and magnetic resonance imaging were used to measure ventricular function while exercise capac‐ ity was estimated via cardiopulmonary exercise test.
Results: Adults… More >

Regan E. Giesinger¹, Adrianne R. Bischoff³, Patrick J. McNamara^1,2

Congenital Heart Disease, Vol.14, No.2, pp. 311-316, 2019, DOI:10.1111/chd.12738

Abstract Ligation of a hemodynamically significant ductus arteriosus results in significant changes in loading conditions which have predictable consequences. Postligation cardiac syndrome, defined as hypotension requiring inotropic support and failure of oxygenation and ventilation, may occur 6‐12 hours following ligation due to left ven‐ tricular systolic and diastolic failure, respectively. Afterload is the primary driver of this decompensation. In this review, we describe the pathophysiological changes in loading conditions associated with postligation cardiac syndrome and other contrib‐ utors to cardiovascular dysfunction following ductal ligation. We present strategies for perioperative optimization and a physiology‐based algorithm for postoperative management guided by targeted neonatal… More >

Vanessa Marie Hormaza¹, Mark Conaway², Daniel Scott Schneider¹, Jeffrey Eric Vergales¹

Congenital Heart Disease, Vol.14, No.2, pp. 274-279, 2019, DOI:10.1111/chd.12722

Abstract Objective: Limited information is known on how right ventricular function affects outcomes after stage 2 palliation. We evaluated the impact of different right ventricular indices prior to stage 2 palliation on morbidity and mortality.
Design: Retrospective study design.
Setting: Pediatric Heart Network Single Ventricle Reconstruction Trial Public Data Set.
Patient: Any variant of stage 1 palliation and all anatomic hypoplastic left heart syndrome variants in the trial were evaluated. Echocardiograms prior to stage 2 palliation were analyzed and compared between those who failed and those who survived.
Intervention: None.
Outcome measures: Mortality was defined as death, listed for transplant, or… More >

Jennifer L. Shepherd, Shahab Noori

Congenital Heart Disease, Vol.14, No.1, pp. 21-26, 2019, DOI:10.1111/chd.12727

Abstract Objective: There is no consensus on the definition of a hemodynamically significant patent ductus arteriosus (hsPDA). In this review article, our objective is to discuss the main variables that one should consider when determining the hemodynamic signifi‐ cance of a PDA.
Results: We describe the various approaches that have been utilized over time to define an hsPDA and discuss the strengths and weaknesses of each echocardio‐ graphic index. Finally, we propose a comprehensive and individualized approach in determining the hemodynamic significance of the PDA.
Conclusion: There are several PDA‐related clinical, echocardiographic, and other ob‐ jective variables to take into consideration… More >

Govinda Paudel, Vijaya Joshi

Congenital Heart Disease, Vol.14, No.1, pp. 42-45, 2019, DOI:10.1111/chd.12703

Abstract Management of the patent ductus arteriosus (PDA) in the premature infant has been a point of controversy for decades as smaller and earlier gestational age infants have been surviving. Increasing experience with catheter‐based device closure has gener‐ ated a new wave of interest in this subject. In this era, echocardiography plays a cen‐ tral role for collaboration within a multispecialty team. Reliability of echocardiography is improved by applying an institutionally derived standard approach to imaging, data collection, and reporting. The key aspects of both the physiology and anatomy of the PDA to distinguish infants that may benefit from intervention are… More >

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 >