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  • Open Access

    ARTICLE

    Short‐term results in infants with multiple left heart obstructive lesions

    Jeremy M. Steele1,2, Rukmini Komarlu2, Sarah Worley3, Tarek Alsaied1, Christopher Statile1, Francine G. Erenberg2

    Congenital Heart Disease, Vol.14, No.6, pp. 1193-1198, 2019, DOI:10.1111/chd.12829

    Abstract Objective: Deciding on a surgical pathway for neonates with ≥2 left heart obstructive lesions is complex. Predictors of the successful biventricular (2V) repair in these patients are poorly defined. The goal of our study was to identify patients who underwent the 2V repair and assess anatomic and echocardiographic predictors of success.
    Design: Infants born between July 2015 and August 2017 with ≥2 left heart obstructive lesions with no prior interventions were identified (n = 19). Patients with aortic or mitral valve (MV) atresia and critical aortic stenosis were excluded. Initial echocardiograms were reviewed for aortic, MV, tricuspid valve annulus size,… More >

  • Open Access

    ARTICLE

    Long‐term outcomes up to 25 years following balloon pulmonary valvuloplasty: A multicenter study

    Rachel L. Hansen1,2, Iman Naimi3, Hongyue Wang1, Nader Atallah3,4, Frank Smith3,4, Craig Byrum3,4, Daniel Kveselis3,4, Glenn Leonard1,5, Rajiv Devanagondi1, Matthew Egan3,4

    Congenital Heart Disease, Vol.14, No.6, pp. 1037-1045, 2019, DOI:10.1111/chd.12788

    Abstract Objective: Evaluate long‐term outcomes following balloon pulmonary valvuloplasty (BPV) for pulmonary stenosis (PS).
    Background: Long‐term data following BPV is limited to small, single center studies.
    Methods: BPV from April 12, 1985 to January 7, 2015 from three centers were included. Outcomes studied were ≥ moderate PI by echocardiogram and residual PS ≥ 40 mm Hg. Risk factors for ≥ moderate PI, residual PS, and repeat intervention were assessed by univariate and multivariate analysis.
    Results: Among 254 patients, mean age at BPV was 3.8 years (range 1 day‐67 years), initial PS catheter gradient was 56 mm Hg (IQR 40‐70), 19% had… More >

  • Open Access

    ARTICLE

    Postoperative and long‐term outcomes in children with Trisomy 21 and single ventricle palliation

    Jennifer K. Peterson1, Shaun P. Setty1,2, Jessica H. Knight3, Amanda S. Thomas4, James H. Moller5, Lazaros K. Kochilas4,6

    Congenital Heart Disease, Vol.14, No.5, pp. 854-863, 2019, DOI:10.1111/chd.12823

    Abstract Objective: Patients with Trisomy 21 (T21) and single ventricle (SV) physiology present unique challenges compared to euploidic counterparts. This study reports postoperative and long‐term outcomes in patients with T21 and SV palliation.
    Design: This retrospective cohort study from the Pediatric Cardiac Care Consortium (PCCC) included patients with T21 (<21 years old) that underwent surgical palliation for SV between 1982 and 2008 and control patients without known genetic anom‐ aly following Fontan palliation for similar diagnoses. Kaplan‐Meier survival plots were created based on death events obtained from the PCCC and by linkage with the National Death Index (NDI) and the Organ… More >

  • Open Access

    ARTICLE

    Echocardiographic assessment of single‐ventricle diastolic function and its correlation to short‐term outcomes after the Fontan operation

    Erin K. Davis1, Salil Ginde1, Jessica Stelter2, Peter Frommelt1, Garick D. Hill3

    Congenital Heart Disease, Vol.14, No.5, pp. 720-725, 2019, DOI:10.1111/chd.12814

    Abstract Background/Hypothesis/Objectives: Postoperative complications after the Fontan operation for single ventricle heart disease are common and include persistent pleural drainage and prolonged length of hospital stay (LOS). Diastolic ventricular dysfunction may increase risk for postoperative complications by raising central venous pressures. We sought to determine the relationship between preoperative echocardiographic measurements of diastolic function, including myocardial deformation imaging, on (a) preoperative invasive catheterization measurements and (b) postoperative outcomes after the Fontan procedure.
    Design/Methods: All patients that underwent Fontan procedure from 2011 to 2017 were included. Echocardiograms performed within 6 months prior to Fontan operation were evaluated. Measurements of ventricular global and… More >

  • Open Access

    ARTICLE

    Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

    Natalie Bottega1, Isabelle Malhamé2, Liming Guo1, Raluca Ionescu‐Ittu1, Judith Therrien1, Ariane Marelli1

    Congenital Heart Disease, Vol.14, No.5, pp. 735-744, 2019, DOI:10.1111/chd.12811

    Abstract Background: The number of women with congenital heart disease (CHD) of reproductive age is increasing, yet a description of trends in pregnancy and delivery outcomes in this population is lacking.
    Objective: To assess secular trends in pregnancy rates, delivery outcomes, and related health care utilization in the adult female CHD population in Quebec, Canada.
    Methods: The Quebec CHD database was used to construct a cohort with all women with CHD aged 18‐45 years between 1992 and 2004. Pregnancy and delivery rates were determined yearly and compared to the general population. Secular trends in pregnancy and delivery rates were assessed with… More >

  • Open Access

    ARTICLE

    Catheter‐associated bloodstream infection incidence and outcomes in congenital cardiac surgery

    Brena Sue Haughey1, Shelby Coral White2, Michael David Seckeler2

    Congenital Heart Disease, Vol.14, No.5, pp. 811-813, 2019, DOI:10.1111/chd.12809

    Abstract Objective: Catheter‐associated bloodstream infections complicate and prolong hos‐ pitalizations. The incidence of catheter‐associated bloodstream infections in children undergoing congenital cardiac surgery has not been reported. This study sought to define the incidence of catheter‐associated bloodstream infections after congenital cardiac surgery in neonates and infants ≤12 months old and compare hospital out‐ comes and costs to those who underwent surgery and did not have a catheter‐associ‐ ated bloodstream infections.
    Design: Retrospective review of hospital admissions between October 2013 and November 2015 for neonates and infants ≤12 months old at admission with ICD‐9 codes for congenital cardiac surgery from discharge data from… More >

  • Open Access

    ARTICLE

    Ancillary referral patterns in infants after initial assessment in a cardiac developmental outcomes clinic

    Sonia A. Monteiro1, Faridis Serrano1, Rocky Tsang1, Eboni Smith Hollier1, Danielle Guffey2, Lisa Noll1, Robert G. Voigt1, Nancy Ghanayem1, Lara Shekerdemian1

    Congenital Heart Disease, Vol.14, No.5, pp. 797-802, 2019, DOI:10.1111/chd.12789

    Abstract Objective: Neurodevelopmental impairment is common after surgery for congeni‐ tal heart disease (CHD) in infancy. While neurodevelopmental follow‐up of high‐risk patients has increased, the referral patterns for ancillary services following initial evaluation have not been reported. The aim of this study is to describe the rates and patterns of referral at the initial visit to our outcomes clinic of patients who under‐ went surgery for CHD during infancy.
    Outcomes Measures: The Cardiac Developmental Outcomes Program clinic at Texas Children’s Hospital provides routine longitudinal follow‐up with developmental pedi‐ atricians and child psychologists for children who required surgery for CHD within the… More >

  • Open Access

    ARTICLE

    Accuracy of risk prediction scores in pregnant women with congenital heart disease

    Yuli Y. Kim1,2, Leah A. Goldberg2, Katherine Awh2, Tanmay Bhamare1,2, David Drajpuch2, Adi Hirshberg3, Sara L. Partington1,2, Rachel Rogers4, Emily Ruckdeschel1,2, Lynda Tobin1, Morgan Venuti2, Lisa D. Levine3

    Congenital Heart Disease, Vol.14, No.3, pp. 470-478, 2019, DOI:10.1111/chd.12750

    Abstract Objective: To assess performance of risk stratification schemes in predicting adverse cardiac outcomes in pregnant women with congenital heart disease (CHD) and to compare these schemes to clinical factors alone.
    Design: Single‐center retrospective study.
    Setting: Tertiary care academic hospital.
    Patients: Women ≥18 years with International Classification of Diseases, Ninth Revision, Clinical Modification codes indicating CHD who delivered between 1998 and 2014. CARPREG I and ZAHARA risk scores and modified World Health Organization (WHO) criteria were applied to each woman.
    Outcome Measures: The primary outcome was defined by ≥1 of the following: arrhyth‐ mia, heart failure/pulmonary edema, transient ischemic attack, stroke,… More >

  • Open Access

    ARTICLE

    Comprehensive comparative outcomes in children with congenital heart disease: The rationale for the Congenital Catheterization Research Collaborative

    Christopher J. Petit1, Athar M. Qureshi2, Andrew C. Glatz3, Courtney E. McCracken1, Michael Kelleman1, George T. Nicholson4, Jeffery J. Meadows5, Shabana Shahanavaz6, Jeffrey D. Zampi7, Mark A. Law8, Joelle A. Pettus1, Bryan H. Goldstein9

    Congenital Heart Disease, Vol.14, No.3, pp. 341-349, 2019, DOI:10.1111/chd.12737

    Abstract Clinical research in the treatment of patients with congenital heart disease (CHD) is limited by the wide variety of CHD manifestations and therapeutic options as well as the generally low incidence of CHD. The availability of comprehensive, contemporary outcomes studies is therefore limited. This inadequacy may result in a lack of data‐driven medical decision making. In 2013, clinician scientists at two centers begana researchcollaboration,the Congenital Catheterization Research Collaborative (CCRC). Over time, the CCRC has grown to include nine cardiac centers from across the United States, with a common data coordinating center. The CCRC seeks to generate high‐quality, contemporary, statistically robust,… More >

  • Open Access

    ARTICLE

    The utility of cardiac magnetic resonance imaging in postFontan surveillance

    Neil C. Zaki1,2, Michael S. Kelleman1, W. James Parks1,3, Timothy C. Slesnick1,3, Michael E. McConnell1,3, Matthew E. Oster1,3

    Congenital Heart Disease, Vol.14, No.2, pp. 140-146, 2019, DOI:10.1111/chd.12692

    Abstract Objective: Gated cardiac MRI offers the most detailed and accurate noninvasive method of assessing cardiac anatomy, particularly in patients with complex congenital heart disease. The proposed benefits of using cMRI as a routine screening tool in the Fontan population include early recognition of asymptomatic, postoperative anatomic and physiologic changes. In 2011, we therefore instituted at our center a recommended practice of cMRI screening in patients with Fontan physiology at 3 and 8 years postFontan operation. The purpose of this study was to determine the impact of this standardized practice of cMRI screening on the clinical management of a Fontan population.
    More >

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