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  • 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 >

  • Open Access

    ARTICLE

    Impact of changing indications and increased utilization of fetal echocardiography on prenatal detection of congenital heart disease

    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 >

  • Open Access

    ARTICLE

    Surgical outcome in pediatric patients with Ebstein’s anomaly: A multicenter, long-term study

    Lianne M. Geerdink1,2, Gideon J. du Marchie Sarvaas3, Irene M. Kuipers4, Willem A. Helbing5, Tammo Delhaas6, Henriette ter Heide7, Lieke Rozendaal8, Chris L. de Korte9, Sandeep K. Singh10, Tjark Ebels11, Mark G. Hazekamp12, Felix Haas13, Ad J. J. C. Bogers14, Livia Kapusta1,15

    Congenital Heart Disease, Vol.12, No.1, pp. 32-39, 2017

    Abstract Objective: Surgical outcomes of pediatric patients with Ebstein’s anomaly are often described as part of all-age-inclusive series. Our objective is to focus on patients treated surgically in childhood (0-18 y). We study the intended treatment (biventricular or 1.5 ventricle repair or univentricular palliation), freedom from unplanned reoperation and survival of this specific age group, in a nationwide study.
    Design: Records of all Ebstein’s anomaly patients born between 1980 and 2013 were reviewed. Demographic variables, intraoperative procedures and postoperative outcomes were analyzed.
    Results: Sixty-three patients underwent 109 operations. Median follow-up after diagnosis was 121 months (range 0-216 months). Twenty-nine (46%) patients… More >

  • Open Access

    ARTICLE

    A Novel Atlas-Based Strategy for Understanding Cardiac Dysfunction in Patients with Congenital Heart Disease

    Sara Salehyar1, †, Nickolas Forsch1,†,*, Kathleen Gilbert2,3, Alistair A. Young3,4, James C. Perry5, Sanjeet Hegde5, Jeffrey H. Omens1,6, Andrew D. McCulloch1,6

    Molecular & Cellular Biomechanics, Vol.16, No.3, pp. 179-183, 2019, DOI:10.32604/mcb.2019.07384

    Abstract Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Infants diagnosed with TOF require surgical interventions to survive into adulthood. However, as a result of postoperative structural malformations and long-term ventricular remodeling, further interventions are often required later in life. To help identify those at risk of disease progression, serial cardiac magnetic resonance (CMR) imaging is used to monitor these patients. However, most of the detailed information on cardiac shape and biomechanics contained in these large four-dimensional (4D) data sets goes unused in clinical practice for lack of efficient and comprehensive quantitative analysis tools. While… More >

  • Open Access

    ARTICLE

    Two-Layer Passive/Active Anisotropic FSI Models with Fiber Orientation: MRI-Based Patient-Specific Modeling of Right Ventricular Response to Pulmonary Valve Insertion Surgery

    Dalin Tang*, Chun Yang, Tal Geva‡,§, Pedro J. del Nido

    Molecular & Cellular Biomechanics, Vol.4, No.3, pp. 159-176, 2007, DOI:10.3970/mcb.2007.004.159

    Abstract A single-layer isotropic patient-specific right/left ventricle and patch (RV/LV/Patch) combination model with fluid-structure interactions (FSI) was introduced in our previous papers to evaluate and optimize human pulmonary valve replacement/insertion (PVR) surgical procedure and patch design. In this paper, an active anisotropic model with two-layer structure for ventricle wall and tissue fiber orientation was introduced to improve previous isotropic model for more accurate assessment of RV function and potential application in PVR surgery and patch design. A material-stiffening approach was used to model active heart contraction. The computational models were used to conduct ``virtual (computational)'' surgeries and test the hypothesis that… More >

  • Open Access

    ARTICLE

    Effect of Patch Mechanical Properties on Right Ventricle Function Using MRI-Based Two-Layer AnisotropicModels of Human Right and Left Ventricles

    Dalin Tang1, Chun Yang1,2, Tal Geva3,4, Glenn Gaudette4, and Pedro J. del Nido5

    CMES-Computer Modeling in Engineering & Sciences, Vol.56, No.2, pp. 113-130, 2010, DOI:10.3970/cmes.2010.056.113

    Abstract Right and left ventricle (RV/LV) combination models with three different patch materials (Dacron scaffold, treated pericardium, and contracting myocardium), two-layer construction, fiber orientation, and active anisotropic material properties were introduced to evaluate the effects of patch materials on RV function. A material-stiffening approach was used to model active heart contraction. Cardiac magnetic resonance (CMR) imaging was performed to acquire patient-specific ventricular geometries and cardiac motion from a patient with severe RV dilatation due to pulmonary regurgitation needing RV remodeling and pulmonary valve replacement operation. Computational models were constructed and solved to obtain RV stroke volume, ejection fraction, patch area variations,… More >

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