Ayesha Hoor Chaudhry^*, Faisal Bukhari, Waheed Iqbal, Zubair Nawaz, Muhammad Kamran Malik

Intelligent Automation & Soft Computing, Vol.26, No.1, pp. 53-59, 2020, DOI:10.31209/2019.100000149

Abstract Laparoscopic surgery is a relatively new field in developing countries. There is a scarcity of laparoscopically trained doctors due to a lack of training and resources available in hospitals. Training and evaluation of medical professionals to develop laparoscopic surgical skills are important and essential as it improves the success rate and reduces the risk during real surgery. The purpose of this research is to develop a series of training exercises based on virtual reality using HTC Vive headset to emulate real-world training of doctors. This virtual training not only gives the trainee doctors mastery in their profession but also decreases… More >

Shivani M. Bhatt^1,*, Michael L. O’Byrne², Michael McBride², Stephen M. Paridon², Elizabeth Goldmuntz², Laura Mercer-Rosa²

Congenital Heart Disease, Vol.15, No.2, pp. 101-115, 2020, DOI:10.32604/CHD.2020.011287

Abstract Objective: The determinants of exercise capacity in repaired tetralogy of Fallot (rTOF) are multifactorial and remain incompletely understood. This study sought to evaluate the association of chronotropic response with exercise parameters and investigate the determinants of heart rate reserve (HRR) in a cohort of children and adolescents with rTOF. Design: We retrospectively analyzed patients with rTOF, age 8–18 years, who underwent cardiac magnetic resonance (CMR) and cardiopulmonary exercise test (CPET) for research purposes. Linear regression models were performed to test associations among clinical, CMR and CPET parameters. Outcomes included percent-predicted maximum VO₂ (%mVO₂) and HRR. Results: A total of 148… More >

Jose A. Silva‐Sepulveda¹, Yudy Fonseca², Irine Vodkin³, Gabrielle Vaughn¹, Robert Newbury⁴, Vera Vavinskaya⁵, Jerry Dwek⁶, James C. Perry¹, Preeti Reshamwala⁷, Cynthia Baehling⁸, James Lyon⁹, Christopher Davis¹, Jesse W. Lee¹, Hannah El‐Sabrout¹⁰, Doaa Shahbah¹¹, Laith Alshawabkeh¹², John W Moore¹, Howaida El‐Said¹

Congenital Heart Disease, Vol.14, No.4, pp. 600-608, 2019, DOI:10.1111/chd.12770

Abstract Introduction: Liver fibrosis and cirrhosis are late complications in Fontan palliation. Liver biopsy is the gold standard. The goal of this study is to correlate transjugular liver biopsy (TJLB) in the setting of Fontan palliation with noninvasive testing and hemodynamics.
Methods: Between August 2014 and July 2017, 49 Fontan patients underwent TJLB. All the patients had hemodynamic evaluation, 28 patients had MRE (magnetic reso‐ nance elastography) and 40 patients had cardiopulmonary exercise test. Histologic liver fibrosis was quantitated using traditional histologic scoring systems and a modi‐ fied Ishak congestive hepatic fibrosis score.
Results: Median age 17.8 years, median time since… More >

Alexander C. Egbe, William R. Miranda, Patricia A. Pellikka, Sorin V. Pislaru, Barry A. Borlaug, Srikanth Kothapalli, Sindhura Ananthaneni, Harigopal Sandhyavenu, Maria Najam, Mohamed Farouk Abdelsamid, Heidi M. Connolly

Congenital Heart Disease, Vol.14, No.4, pp. 657-664, 2019, DOI:10.1111/chd.12768

Abstract Background: We hypothesized that echocardiographic indices of right ventricular to pulmonary artery (RV‐PA) coupling were comparable to cardiac magnetic resonance imaging (CMRI)‐derived RV volumetric indices in predicting disease severity in chronic pulmonary regurgitation (PR).
Methods: Patients with ≥ moderate PR (2003‐2015) with and without prior CMRI scans were enrolled into the study cohort and validation cohort, respectively. Endpoint was to determine the association between noninvasive RV‐PA coupling in‐ dices (tricuspid annular plane systolic excursion/right ventricular systolic pressure [TAPSE/RVSP] and fractional area change [FAC]/RVSP ratio) and markers of disease severity, and compared this association to that of CMRI‐derived RV volumetric indi‐… More >

Peter Ermis

Congenital Heart Disease, Vol.12, No.5, pp. 624-626, 2017, DOI:10.1111/chd.12495

Abstract Currently, the role of stress echocardiography primarily resides in diagnosing acquired coronary artery disease (CAD) in adults. Besides an increasing concern for traditional CAD in young patients due to obesity and other chronic pediatric diseases, there is also a growing population of adolescents and young adults with “at risk” coronary arteries due to: reimplanted coronaries in congenital heart disease, anomalous origin of the native coronary arteries, coronary abnormalities in Kawasaki’s disease, and posttransplant coronary vasculopathy. Stress echocardiography is well suited for routine screening and monitoring in these patients. Also, due to the ability of stress echocardiography to provide real-time cardiac… More >

M. Elisabeth Heal¹, Lanier B. Jackson², Andrew M. Atz², Ryan J. Butts³

Congenital Heart Disease, Vol.12, No.4, pp. 399-402, 2017, DOI:10.1111/chd.12451

Abstract Cardiopulmonary exercise testing (CPET) aids in clinical assessment of patients with Fontan circulation. Effects of persistent fenestration on CPET variables have not been clearly defined. Associations between fenestration and CPET variables at anaerobic threshold (AT) and peak exercise were explored in the Pediatric Heart Network Fontan Cross-Sectional Study cohort. Fenestration patency was associated with a greater decrease in oxygen saturation from rest to peak exercise (fenestration -4.9 ± 3.8 v. nonfenestration -3 ± 3.5; P < .001). Physiological dead space at peak exercise was higher in fenestrated v. nonfenestrated (25.2 ± 16.1 v. 21.4 ± 15.2; P = .03). There… More >

Soham Dasgupta¹, Megan Stark², Sonal Bhatt³, Peter Fischbach¹, Shriprasad Deshpande¹

Congenital Heart Disease, Vol.13, No.6, pp. 1058-1063, 2018, DOI:10.1111/chd.12681

Abstract Introduction: A cardiac cause is an extremely rare etiology of pediatric chest pain. Despite its low sensitivity/specificity, exercise stress testing (EST) is widely used to determine the prognosis in patients with suspected/established coronary disease. We aimed to look at the utility of a combined cardiopulmonary EST in the evaluation of pediatric patients with chest pain.
Methods: After institutional review board approval, a retrospective chart review was performed of all pediatric patients who were referred for an EST for chest pain from January 2014 to 2017. Patients with incomplete records, severe congenital heart disease, and a prior EST were excluded.
Results:… More >

Keri M. Shafer^1,2, Alexander R. Opotowsky^1,2, Jonathan Rhodes¹

Congenital Heart Disease, Vol.13, No.6, pp. 903-910, 2018, DOI:10.1111/chd.12661

Abstract Objective: Risk prediction using cardiopulmonary exercise testing (CPET) in complex congenital heart disease tends to either focus on single diagnoses or complete cohorts. We aimed to evaluate patients with two distinct anatomies cared for at a single institution over the same time period to determine CPET variables associated with mortality.
Design: All Fontan and tetralogy of Fallot (TOF) subjects with CPET between November 1, 2002 and December 31, 2014 and subsequently died were identified (cases). Cases were matched 1:3 to controls with similar age, underlying anatomy and timing of exercise test.
Results: Of the 42 cases, 27 had a Fontan… More >

Michael V. Di Maria¹, Lindsey Silverman², Adel K. Younoszai¹, Mariana L. Meyers³, Kelley E. Capocelli⁴, Michael R. Narkewicz⁵

Congenital Heart Disease, Vol.13, No.3, pp. 444-449, 2018, DOI:10.1111/chd.12594

Abstract Background: The current management paradigm for children with single ventricle heart disease involves a series of palliative surgeries, culminating in the Fontan operation. This physiology results in a high central venous pressure, and in the setting of single ventricle heart disease, results in hepatic injury and fibrosis over time. Fontan-associated liver disease (FALD) is universally present in this cohort, and the current gold standard for diagnosis remains biopsy. Noninvasive assessments of liver fibrosis, such as ultrasound with elastography or acoustic radiation force impulse (ARFI), has been utilized in this cohort. The effect of poor cardiovascular efficiency, as measured by cardiopulmonary… More >

Andrew D. Spearman¹, Rohit S. Loomba², Michael Danduran¹, Joshua Kovach¹

Congenital Heart Disease, Vol.13, No.3, pp. 369-376, 2018, DOI:10.1111/chd.12577

Abstract Objective: Multiple studies demonstrate the association of intrauterine growth restriction (IUGR) with impaired aerobic fitness in adolescents and adults. To our knowledge, there are no studies including individuals with the history of both IUGR and congenital heart disease (CHD). Thus, we sought to evaluate the impact of IUGR on exercise capacity in adolescents with CHD.
Study Design: We conducted a retrospective chart review of patients <18 years of age who underwent cardiopulmonary exercise testing (CPET) between August 1, 2003 and July 1, 2016. Individuals with birth weight <10th percentile for gestational age were defined as IUGR. Patients with IUGR were… More >