Christopher R. Broda

Congenital Heart Disease, Vol.14, No.3, pp. 487-490, 2019, DOI:10.1111/chd.12748

Abstract Heart failure is an emerging issue with important implications in adult patients with congenital heart disease. Practitioners with expertise in both adult congenital heart disease and heart failure are needed to manage this growing and often complex pop‐ ulation. In the United States, the optimal training pathway to enable practitioners to best care for these patients is ill‐defined. This article explores possibilities and issues that interested trainees may encounter during their training experience. More >

Maayke A. Sluman^1,2, Silke Apers^3,4, Judith K. Sluiter^1,*, Karen Nieuwenhuijsen¹, Philip Moons^4,5, Koen Luyckx^6,7, Adrienne H. Kovacs^8,9, Corina Thomet¹⁰, Werner Budts¹¹, Junko Enomoto¹², Hsiao‐Ling Yang¹³, Jamie L. Jackson¹⁴, Paul Khairy¹⁵, Stephen C. Cook¹⁶, Raghavan Subramanyan¹⁷, Luis Alday¹⁸, Katrine Eriksen¹⁹, Mikael Dellborg^20,21, Malin Berghammer^5,22, Eva Mattsson²³, Andrew S. Mackie²⁴, Samuel Menahem²⁵, Maryanne Caruana²⁶, Kathy Gosney²⁷, Alexandra Soufi²⁸, Susan M. Fernandes²⁹, Kamila S. White³⁰, Edward Callus³¹, Shelby Kutty³², Berto J. Bouma³³, Barbara J.M. Mulder³³

Congenital Heart Disease, Vol.14, No.3, pp. 362-371, 2019, DOI:10.1111/chd.12747

Abstract Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an impor‐ tant determinant for quality of life, we assessed this in a large international adult CHD cohort.
Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross‐sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models.
Results: Median age was 32 years (IQR 25‐42) and 94% of patients had at least a high school degree. Overall employment rate… More >

Karen E. Schultz¹, George K. Lui^1,2, Doff B. McElhinney¹, Jin Long³, Vidhya Balasubramanian³, Charlotte Sakarovitch³, Susan M. Fernandes^1,2, Anne M. Dubin¹, Ian S. Rogers^1,2, Anitra W. Romfh^1,2, Kara S. Motonaga¹, Mohan N. Viswanathan², Scott R. Ceresnak¹

Congenital Heart Disease, Vol.14, No.3, pp. 410-418, 2019, DOI:10.1111/chd.12736

Abstract Background: Arrhythmias are a leading cause of death in adults with congenital heart disease (ACHD). While 24‐48‐hour monitors are often used to assess arrhythmia burden, extended continuous ambulatory rhythm monitors (ECAM) can record 2 weeks of data. The utility of this device and the arrhythmia burden identified beyond 48‐hour monitoring have not been evaluated in the ACHD population. Additionally, the impact of ECAM has not been studied to determine management recommendations.
Objective: To address the preliminary question, we hypothesized that clinically sig‐ nificant arrhythmias would be detected on ECAM beyond 48 hours and this would lead to clinical management changes.
… More >

Jill M. Steiner¹, Karen Stout¹, Laurie Soine¹, James N. Kirkpatrick¹, J. Randall Curtis²

Congenital Heart Disease, Vol.14, No.3, pp. 403-409, 2019, DOI:10.1111/chd.12735

Abstract Background: Patients with adult congenital heart disease (ACHD) report that ad‐ vance care planning (ACP) is important, and that they want information about prog‐ nosis. However, recognizing importance and being willing to participate are different constructs, and how and when to begin ACP and palliative care discussions remains ill‐defined.
Methods: We conducted a cross‐sectional survey of 150 consecutive outpatients to assess willingness to participate in ACP, with whom, and important barriers and facili‐ tators to these discussions.
Results: The majority of participants (69%) reported being willing to participate in ACP; 79% to have a meeting to discuss goals and care… More >

Joseph T. Poterucha¹, Saraschandra Vallabhajosyula², Alexander C. Egbe², Joseph S. Krien³, Devon O. Aganga⁴, Kimberly Holst⁵, Adele W. Golden⁶, Joseph A. Dearani⁵, Sheri S. Crow⁴

Congenital Heart Disease, Vol.14, No.2, pp. 193-200, 2019, DOI:10.1111/chd.12717

Abstract Background: High levels of vasoactive inotrope support (VIS) after congenital heart surgery are predictive of morbidity in pediatric patients. We sought to discern if this relationship applies to adults with congenital heart disease (ACHD).
Methods: We retrospectively studied adult patients (≥18 years old) admitted to the intensive care unit after cardiac surgery for congenital heart disease from 2002 to 2013 at Mayo Clinic. Vasoactive medication dose values within 96 hours of admis‐ sion were examined to determine the relationship between VIS score and poor out‐ come of early mortality, early morbidity, or complication related morbidity.
Results: Overall, 1040 ACHD patients… More >

Jennifer L. Lapum¹, Suzanne Fredericks¹, Barbara Bailey², Terrence M. Yau^3,4, Jennifer Graham⁵, Ariane J. Marelli^6,7

Congenital Heart Disease, Vol.14, No.2, pp. 185-192, 2019, DOI:10.1111/chd.12716

Abstract Objective: The number of adults with congenital heart disease (CHD) has increased substantially because of medical advances that are extending life expectancy beyond childhood. A historical investigation is timely not only because of this significant demographic shift, but also because stakeholder engagement is increasingly important in shaping research directions. The study questions were: From the perspective of stakeholders, what is known about the medical treatment for the adult CHD cohort in Canada and how has it changed over time?
Design/Methods: We harnessed the use of historical research methods and conducted interviews with 21 key informants in order to articulate a… More >

Matthew Lewis¹, William Whang², Angelo Biviano², Kathleen Hickey², Hasan Garan², Marlon Rosenbaum¹

Congenital Heart Disease, Vol.14, No.2, pp. 207-212, 2019, DOI:10.1111/chd.12695

Abstract Background: Catheter ablation is commonly performed to treat atrial arrhythmias in adult congenital heart disease (ACHD). Despite the frequency of ablations in the ACHD population, predictors of recurrence remain poorly defined.
Objective: We sought to determine predictors of arrhythmia recurrence in ACHD patients following catheter ablation for atrial arrhythmias.
Methods: We performed a retrospective study of all catheter ablations for atrial arrhythmias performed in ACHD patients between January 12, 2005 and February 11, 2015 at our institution. Prespecified exposures of interest and time from ablation to recurrence were determined via chart review.
Results: Among 124 patients (mean age: 45 years)… More >