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  • Open Access

    ARTICLE

    Transfusion‐related acute hepatic injury following postoperative platelets administration in pediatric patients undergoing the Fontan procedure

    Uri Pollak1,2,3,4,*, Tatyana Ruderman5,*, Sharon Borik‐Chiger5,6, David Mishaly5,7, Alain Serraf5,7, Amir Vardi5,8

    Congenital Heart Disease, Vol.14, No.6, pp. 968-977, 2019, DOI:10.1111/chd.12825

    Abstract Objective: The final common pathway of single ventricle patients is the Fontan procedure. Among the immediate postoperative complications is acute hepatic injury presented by marked elevation of liver enzymes (alanine transaminase [ALT] and aspartate transaminase [AST]). We aimed to determine the contribution of blood products transfusion to acute hepatic injury.
    Design: Single center retrospective cohort study.
    Setting: Pediatric Cardiac Intensive Care Unit at a tertiary medical center.
    Patients: Ninety‐nine pediatric patients undergoing the Fontan procedure between January 2009 and December 2016.
    Interventions: None.
    Measurements and Main Results: Out of the four types of blood products, transfusion of platelets was found… 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

    Health care‐associated infections are associated with increased length of stay and cost but not mortality in children undergoing cardiac surgery

    Sarah Tweddell, Rohit S. Loomba, David S. Cooper, Alexis L. Benscoter

    Congenital Heart Disease, Vol.14, No.5, pp. 785-790, 2019, DOI:10.1111/chd.12779

    Abstract Introduction: Health care‐associated infections (HAIs) increase mortality, length of stay, and cost in hospitalized patients. The incidence of and risk factors for developing HAIs in the pediatric population after cardiac surgery have been studied. This study evaluates the impact of HAIs on length of stay, inpatient mortality, and cost of hospitalization in the pediatric population after cardiac surgery.
    Methods: TheKids’InpatientDatabasewasqueriedforanalysis.Patientsunder18years of age who underwent cardiac surgery from 1997 to 2012 were included. HAIs were defined as central line‐associated blood stream infections, catheter‐associated urinary tract infections, ventilator‐associated pneumonias, and surgical wound infections. Univariate analysis compared admissions with and without a HAI.… More >

  • Open Access

    ARTICLE

    Vasopressor magnitude predicts poor outcome in adults with congenital heart disease after cardiac surgery

    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 >

  • Open Access

    ARTICLE

    Right thoracotomy for aortic valve replacement in the adolescents with bicuspid aortic valve

    Raffaele Giordano1, Massimiliano Cantinotti2, Giuseppe Comentale1, Luigi Di Tommaso1, Gabriele Iannelli11, Emanuele Pilato1, Gaetano Palma1

    Congenital Heart Disease, Vol.14, No.2, pp. 162-166, 2019, DOI:10.1111/chd.12680

    Abstract Background: In this study, we compared our experience about early and midterm follow‐up outcomes for right anterolateral minithoracotomy (RAMT) vs full sternot‐ omy (FS) in surgical aortic valve replacement (AVR) among adolescents with bicuspid aortic valve (BAV).
    Methods: Patients were retrospectively enrolled from January 2008 to December 2017. Inclusion criteria were patients with BAV who had to undergo to AVR. They were divided in two groups: RAMT and FS. The choice of RAMT was based on indi‐ vidual surgeon’s preferences or when expressly requested by patient that was in‐ formed of nonconventional approach.
    Results: We enrolled 61 patients, 23 in… More >

  • Open Access

    ARTICLE

    Neurocognitive and executive functioning in adult survivors of congenital heart disease

    Leda Klouda1, Wayne J. Franklin1, Anita Saraf1,2, Dhaval R. Parekh1, David D. Schwartz3

    Congenital Heart Disease, Vol.12, No.1, pp. 91-98, 2017

    Abstract Objective: Congenital heart disease (CHD) can affect the developing central nervous system, resulting in neurocognitive and behavioral deficits. Preoperative neurological abnormalities as well as sequelae of the open heart operations required to correct structural abnormalities of the heart contribute to these deficits. There are few studies examining the neurocognitive functioning of adults with CHD. This study sought to investigate multiple domains of neurocognitive functioning in adult survivors of CHD who had childhood cardiac surgery with either moderate or severe disease complexity.
    Design: A total of 48 adults (18–49 years of age) who had undergone cardiac surgery for CHD prior to… More >

  • Open Access

    ARTICLE

    “Frontiers in Fontan failure: A summary of conference proceedings”

    Camden Hebson1,2, Wendy Book1, Robert W. Elder3, Ryan Ford4, Maan Jokhadar1, Kirk Kanter5, Brian Kogon5, Adrienne H. Kovacs6, Rebecca D. Levit1, Michael Lloyd1, Kevin Maher2, Preeti Reshamwala4, Fred Rodriguez III1,2, Rene Romero7, Thor Tejada1, Anne Marie Valente8, Gruschen Veldtman9, Michael McConnell1,2

    Congenital Heart Disease, Vol.12, No.1, pp. 6-16, 2017

    Abstract “Frontiers in Fontan Failure” was the title of a 2015 conference sponsored by Children’s Healthcare of Atlanta and Emory University School of Medicine. In what is hoped to be the first of many such gatherings, speakers and attendees gathered to discuss the problem of long-term clinical deterioration in these patients. Specific focuses included properly defining the problem and then discussing different treatment strategies, both medical and surgical. The health of the liver after Fontan palliation was a particular point of emphasis, as were quality of life and future directions. More >

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