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  • Open Access

    ARTICLE

    Phosphodiesterase type 5 inhibitors improve microvascular dysfunction markers in pulmonary arterial hypertension associated with congenital heart disease

    Mariana M. Clavé1, Nair Y. Maeda2, Ana M. Thomaz1, Sergio P. Bydlowski3, Antonio A. Lopes1

    Congenital Heart Disease, Vol.14, No.2, pp. 246-255, 2019, DOI:10.1111/chd.12688

    Abstract Background: Ideally, vasodilator therapies for pulmonary arterial hypertension (PAH) should have a favorable impact on markers of vascular dysfunction, in addition to their known effects on hemodynamics, cardiac function, and patient’s physical capacity.
    Methods: We analyzed circulating (plasma) markers of endothelial and platelet activation/dys‐ function (enzyme‐linked immunoassays) in the specific setting of advanced PAH associated with congenital heart disease, during the course of sildenafil and tadalafil therapies. Thirty‐one patients were enrolled (age 10‐54 years), most of them with chronic hypoxemia and elevated hematocrit. Drugs were administered orally for 6 months (sildenafil [n = 16], 20 mg t.i.d.;… More >

  • Open Access

    ARTICLE

    Neurodevelopmental assessment of infants with congenital heart disease in the early postoperative period

    Samantha C. Butler1,4, Anjali Sadhwani1,4, Christian Stopp2, Jayne Singer1,3,4, David Wypij2,5,6, Carolyn Dunbar‐Masterson2, Janice Ware1,3,4, Jane W. Newburger2,5

    Congenital Heart Disease, Vol.14, No.2, pp. 236-245, 2019, DOI:10.1111/chd.12686

    Abstract Objective: Mortality rates for children with congenital heart disease (CHD) have significantly declined, resulting in a growing population with associated neurodevelopmental disabilities. American Heart Association guidelines recommend systematic developmental screening for children with CHD. The present study describes results of inpatient newborn neurodevelopmental assessment of infants after open heart surgery.
    Outcome measures: We evaluated the neurodevelopment of a convenience sample of high‐risk infants following cardiac surgery but before hospital discharge using an adaptation of the Newborn Behavioral Observation. Factor analysis examined relationships among assessment items and consolidated them into domains of development.
    Results: We assessed 237 infants at… More >

  • Open Access

    ARTICLE

    Ventricular force‐frequency relationships during biventricular or multisite pacing in congenital heart disease

    Shankar Baskar, Andrew N. Redington, Philip R. Khoury, Timothy K. Knilans, David S. Spar, Richard J. Czosek

    Congenital Heart Disease, Vol.14, No.2, pp. 201-206, 2019, DOI:10.1111/chd.12684

    Abstract Background: Traditional indices to evaluate biventricular (BiV) pacing are load dependent, fail to assess dynamic changes, and may not be appropriate in patients with congenital heart disease (CHD). We therefore measured the force‐frequency relationship (FFR) using tissue Doppler‐de‐ rived isovolumic acceleration (IVA) to assess the dynamic adaption of the myocardium and its vari‐ ability with different ventricular pacing strategies.
    Methods: This was a prospective pilot study of pediatric and young adult CHD patients with biventricular or multisite pacing systems. Color‐coded myocardial velocities were recorded at the base of the systemic ventricular free wall. IVA was calculated at… More >

  • Open Access

    ARTICLE

    Bioelectrical impedance analysis in the management of heart failure in adult patients with congenital heart disease

    Masaki Sato1, Kei Inai1,2, Mikiko Shimizu1, Hisashi Sugiyama1, Toshio Nakanishi2

    Congenital Heart Disease, Vol.14, No.2, pp. 167-175, 2019, DOI:10.1111/chd.12683

    Abstract Objective: The recognition of fluid retention is critical in treating heart failure (HF). Bioelectrical impedance analysis (BIA) is a well-known noninvasive method; however, data on its role in managing patients with congenital heart disease (CHD) are limited. Here, we aimed to clarify the correlation between BIA and HF severity as well as the prognostic value of BIA in adult patients with CHD.
    Design: This prospective single-center study included 170 patients with CHD admitted between 2013 and 2015. We evaluated BIA parameters (intra- and extracellular water, protein, and mineral levels, edema index [EI, extracellular water-to-total body water ratio]),… More >

  • Open Access

    ARTICLE

    Stenting of the ductus arteriosus for ductal‐dependent pulmonary blood flow—current techniques and procedural considerations

    Varun Aggarwal1, Christopher J. Petit2, Andrew C. Glatz3,4, Bryan H. Goldstein5, Athar M. Qureshi1

    Congenital Heart Disease, Vol.14, No.1, pp. 110-115, 2019, DOI:10.1111/chd.12709

    Abstract The use of prostaglandin‐E1 immediately after birth and subsequent surgical crea‐ tion of the modified Blalock‐Taussig shunt (BTS) shunt have remarkably improved the prognosis and survival of children with congenital heart disease and ductal‐depend‐ ent pulmonary blood flow (PBF). Despite the advancement in surgical techniques, bypass strategies, and postoperative management, significant morbidity and mortal‐ ity after BTS still remain. Patent ductus arteriosus stenting has been shown to be as an acceptable alternative to BTS placement in select infants with ductal‐dependent PBF. Newer procedural techniques and equipment, along with operator experience have all contributed to procedural More >

  • Open Access

    ARTICLE

    Blalock-Taussig shunt versus patent ductus arteriosus stent as first palliation for ductal-dependent pulmonary circulation lesions: A review of the literature

    Dana M. Boucek1, Athar M. Qureshi2, Bryan H. Goldstein 3, Christopher J. Petit4, Andrew C. Glatz1,5

    Congenital Heart Disease, Vol.14, No.1, pp. 105-109, 2019, DOI:10.1111/chd.12707

    Abstract Background: Infants with ductal-dependent pulmonary blood flow (PBF) often undergo a palliative procedure to provide a stable source of PBF prior to definitive palliation or repair. In the current era, a surgical shunt or ductal stent is used to provide PBF. We aimed to review the current literature comparing ductal stents to surgical shunts.
    Methods and Results: Four small, single-center studies and two larger multicenter studies were identified comparing ductal stent to surgical shunt. Combined, these studies showed ductal stent resulted in similar or improved pulmonary artery growth, fewer complications, shorter length of stay, less diuretic use, 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… More >

  • Open Access

    ARTICLE

    Is population‐based screening for rheumatic heart disease precluded by the Cairo accord? Echocardiography...and beyond

    Carlos E. B. Branco1, Roney O. Sampaio1, Flavio Tarasoutchi1, Justin P. Zachariah2

    Congenital Heart Disease, Vol.13, No.6, pp. 1069-1071, 2018, DOI:10.1111/chd.12676

    Abstract In the 2017, “Cairo Accord on Rheumatic Heart Disease—From Molecules to The Global Community” experts from endemic areas enumerated an approach to reduce the population burden of rheumatic heart disease. The 10 key recommendations in‐ clude immediate logistical objectives as well as domains for further study. Echocardiographic population screening programs were relegated to research alone. Given the large body of supporting data, relegating echo screening to an investiga‐ tional modality is an opportunity lost. More >

  • Open Access

    ARTICLE

    The birth prevalence, severity, and temporal trends of congenital heart disease in the middle‐income country: A population‐based study

    Mohd Nizam Mat Bah1, Mohd Hanafi Sapian1, Mohammad Tamim Jamil1, Nisah Abdullah1, Emieliyuza Yusnita Alias1, Norazah Zahari2

    Congenital Heart Disease, Vol.13, No.6, pp. 1012-1027, 2018, DOI:10.1111/chd.12672

    Abstract Objectives: There is limited data on congenital heart disease (CHD) from the lower‐ and middle‐income country. We aim to study the epidemiology of CHD with the specific objective to estimate the birth prevalence, severity, and its trend over time.
    Design: A population‐based study with data retrieved from the Pediatric Cardiology Clinical Information System, a clinical registry of acquired and congenital heart dis‐ ease for children.
    Setting: State of Johor, Malaysia.
    Patients: All children (0‐12 years of age) born in the state of Johor between January 2006 and December 2015.
    Intervention: None.
    Outcome measure: The birth prevalence, severity, and temporal trend over time.
    More >

  • Open Access

    ARTICLE

    Echocardiographic parameters associated with biventricular circulation and right ventricular growth following right ventricular decompression in patients with pulmonary atresia and intact ventricular septum: Results from a multicenter study

    Shiraz A. Maskatia1, Christopher J. Petit2,3, Curtis D. Travers2, David J. Goldberg4, Lindsay S. Rogers4, Andrew C. Glatz4, Athar M. Qureshi6, Bryan H. Goldstein5, Jingning Ao2,3, Ritu Sachdeva2,3

    Congenital Heart Disease, Vol.13, No.6, pp. 892-902, 2018, DOI:10.1111/chd.12671

    Abstract Background: In patients with pulmonary atresia, intact ventricular septum (PA/IVS) following right ventricular (RV) decompression, RV size and morphology drive clinical outcome. Our objectives were to (1) identify baseline and postdecompression echo‐ cardiographic parameters associated with 2V circulation, (2) identify echocardio‐ graphic parameters associated with RV growth and (3) describe changes in measures of RV size and changes in RV loading conditions.
    Methods: We performed a retrospective analysis of patients who underwent RV de‐ compression for PA/IVS at four centers. We analyzed echocardiograms at baseline, postdecompression, and at follow up (closest to 1‐year or prior to Glenn… More >

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