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  • Open Access

    ARTICLE

    Hospital resource utilization and presence of advance directives at the end of life for adults with congenital heart disease

    Jill M. Steiner1, James N. Kirkpatrick1, Susan R. Heckbert2, James Sibley3, James A. Fausto3, Ruth A. Engelberg3, J. Randall Curtis3

    Congenital Heart Disease, Vol.13, No.5, pp. 721-727, 2018, DOI:10.1111/chd.12638

    Abstract Objective: Overall health care resource utilization by adults with congenital heart disease has increased dramatically in the past two decades, yet little is known about utilization patterns at the end of life. The objective of this study is to better under‐ stand the patterns and influences on end‐of‐life care intensity for adults with con‐ genital heart disease.
    Methods: We identified a sample of adults with congenital heart disease (n = 65), cancer (n = 10 784), or heart failure (n = 3809) who died between January 2010 and December 2015, cared for in one multi‐hospital health care… More >

  • Open Access

    ARTICLE

    Neurodevelopmental outcomes at 2 and 4 years in children with congenital heart disease

    Cheryl L. Brosig1,2, Laurel Bear1,2, Sydney Allen1, Pippa Simpson1, Liyun Zhang1, Michele Frommelt1,2, Kathleen A. Mussatto2

    Congenital Heart Disease, Vol.13, No.5, pp. 700-705, 2018, DOI:10.1111/chd.12632

    Abstract Background and Objectives: Children with congenital heart disease (CHD) are at risk for neurodevelopmental (ND) delays. The purpose of this study is to compare the ND testing results of children with CHD at 2 and 4 years of age and determine if rates of ND delays change over time.
    Methods: Children with CHD completed the Bayley Scales of Infant Development‐III (BSID‐III) at 2 years of age, and standardized neuropsychological measures at 4 years. Scores were compared with test norms and were classified as: average (within one SD of test mean); at risk (1‐2 SDs from the test… More >

  • Open Access

    ARTICLE

    Anticoagulation practices in adults with congenital heart disease and atrial arrhythmias in Switzerland

    Ketina Arslani1*, Lukas Notz1*, Marzena Zurek1, Matthias Greutmann2, Markus Schwerzmann3, Judith Bouchardy4, Reto Engel5, Christine Attenhofer Jost6, Daniel Tobler1

    Congenital Heart Disease, Vol.13, No.5, pp. 678-684, 2018, DOI:10.1111/chd.12627

    Abstract Background: In adults with congenital heart disease (CHD) and atrial arrhythmias, recommendations for thromboprophylaxis are vague and evidence is lacking. We aimed to identify factors that influence decision-making in daily practice.
    Methods: From the Swiss Adult Congenital HEart disease Registry (SACHER) we identified 241 patients with either atrial fibrillation (Afib) or atrial flutter/intraatrial reentrant tachycardia (Aflut/ IART). The mode of anticoagulation was reviewed. Logistic regression models were used to assess factors that were associated with oral anticoagulation therapy.
    Results: Compared with patients with Aflut/IART, patients with Afib were older (51 ± 16.1 vs 37 ± 16 years, P… More >

  • Open Access

    ARTICLE

    Risk factors for hyperuricemia in congenital heart disease patients and its relation to cardiovascular death

    Juan Lizandro Rodríguez‐Hernández1, Fayna Rodríguez‐González2, Marta Riaño‐Ruiz3, Efrén Martínez‐Quintana1,4

    Congenital Heart Disease, Vol.13, No.5, pp. 655-662, 2018, DOI:10.1111/chd.12620

    Abstract Introduction: Hyperuricemia has been associated with cardiovascular risk factors but it remains controversial if uric acid is an independent predictor of cardiac mortality.
    Methods: A total of 503 CHD patients (457 nonhypoxemic and 46 hypoxemic) and 772 control patients fulfilled inclusion criteria. Demographic, clinical, and analytical data [serum uric acid and 24h urine uric acid levels, N‐terminal pro‐B‐type natriuretic peptide (NT‐pro‐BNP), and C‐reactive‐protein (CRP) concentrations] were studied. Survivals curves to determine cardiac death and arterial thrombosis in CHD patients were also examined.
    Results: Noncyanotic and cyanotic CHD patients had significant higher serum uric acid concentration (5.2 ± 1.5 vs 4.9 ± 1.3mg/dL,… More >

  • Open Access

    ARTICLE

    Pheochromocytoma and paraganglioma in Fontan patients: Common more than expected

    Mi Kyoung Song1, Gi Beom Kim1, Eun Jung Bae1, Young Ah Lee1, Hyun-Young Kim2, Seung-Kee Min3, Jung Hee Kim4, Jae-Kyung Won5

    Congenital Heart Disease, Vol.13, No.4, pp. 608-616, 2018, DOI:10.1111/chd.12625

    Abstract Objective: Pheochromocytoma and paraganglioma (extra-adrenal pheochromocytoma) are rare neuroendocrine tumors that arise from the neuroendocrine cells. Chronic hypoxia is known as a possible cause, and a strong link between cyanotic congenital heart disease and these tumors has been reported. However, reports of phechromocytoma/paraganglioma in Fontan patients were scarce. We herein report seven cases of phechromocytoma/paraganglioma after Fontan operation at a single tertiary center.
    Methods: We retrospectively reviewed medical records and imaging studies who diagnosed as phechromocytoma/paraganglioma after Fontan operation in Seoul National University Children’s Hospital.
    Results: Seven patients were identified during follow-up after Fontan operation, and the prevalence… More >

  • Open Access

    ARTICLE

    Right aortic arch with situs solitus

    William N. Evans1,2, Ruben J. Acherman1,2, Dean Berthoty3, Gary A. Mayman1,2, Michael L. Ciccolo1,4, Sergio A. Carrillo1,4, Humberto Restrepo1,2

    Congenital Heart Disease, Vol.13, No.4, pp. 624-627, 2018, DOI:10.1111/chd.12623

    Abstract Patients: We reviewed all patients evaluated at our center with situs solitus, levocardia, and a right aortic arch that were born between January 2000 and January 2018. Results: From our databases, we identified 204 patients. We excluded patients with a double aortic arch from analysis. Of the 204 patients, 103 (50%) were male. Of the 204 patients, 95 (47%) had an isolated right aortic arch. Of the 95 with an isolated right aortic arch, 4 (4%) had chromosome 22q11.2 deletion syndrome, and 89 (94%) had a vascular ring. Of the 204 patients, 109 (53%) had a… More >

  • Open Access

    ARTICLE

    Functional limitations and educational needs among children and adolescents with heart disease

    Sherry L. Farr1, Karrie F. Downing1,2, Tiffany Riehle-Colarusso1, Ginnie Abarbanell1,3

    Congenital Heart Disease, Vol.13, No.4, pp. 633-639, 2018, DOI:10.1111/chd.12621

    Abstract Objective: To examine how cognitive and motor limitations in children with heart disease are associated with education and participation in extracurricular activities.
    Design: Using 2009–2010 parent-reported data from the National Survey of Children with Special Health Care Needs (NS-CSHCN), we examined prevalence of five functional limitations (learning/ concentration, communication, self-care, gross motor skills, and fine motor skills) by diagnosed heart disease status using chi-square tests and multivariable logistic regression. Among CSHCN with heart disease, we examined the associations between severity of each functional limitation and missing ≥11 days of school in the past year, receiving special education… More >

  • Open Access

    ARTICLE

    Perception scores of siblings and parents of children with hypoplastic left heart syndrome

    Elizabeth C. Caris1, Nicole Dempster2, Gil Wernovsky3, Yongjie Miao2, Melissa Moore-Clingenpeel2, Trent Neely2, Rachel Fonseca2, Holly Miller-Tate2, Robin Allen2, Samantha Fichtner2, Jamie Stewart2, Clifford L. Cua2

    Congenital Heart Disease, Vol.13, No.4, pp. 528-532, 2018, DOI:10.1111/chd.12619

    Abstract Objectives: Siblings of children with chronic medical conditions endorse a lower quality of life compared to age-matched peers. Caregiver and sibling-self report of adjustment are often discordant. Congenital heart disease significantly affects family life. To date, there have been no studies addressing the functioning of siblings of children with hypoplastic left heart syndrome, one of the most severe forms of congenital heart disease. The goal of this study was to assess the impact of hypoplastic left heart syndrome on sibling’s quality of life as well as the caregiver’s perception of this effect.
    Study Design: Cross-sectional study using… More >

  • Open Access

    ARTICLE

    Platelet activation markers in children with congenital heart disease associated with pulmonary arterial hypertension

    Timur Mese1, Baris Guven2, Murat Muhtar Yilmazer1, Cem Karadeniz3, Rahmi Ozdemir1, Onder Doksoz1

    Congenital Heart Disease, Vol.13, No.4, pp. 506-511, 2018, DOI:10.1111/chd.12616

    Abstract Background: Mean platelet volume (MPV), platecrit, and platelet distribution width (PDW) are markers of platelet activation. Previous studies have found that platelet activation occurs in patients with pulmonary arterial hypertension. Platelet indices including MPV, PDW, and platecrit have not been studied in children with congenital heart disease associated pulmonary arterial hypertension (APAH-CHD) who survived and those who died.
    Objective: The objective of this study to investigate the value of platelet indices with clinical and hemodynamic indicators predicting the disease severity and survival in children with APAH-CHD.
    Methods: This was a nested case-control study. MPV, platecrit, and PDW levels… More >

  • Open Access

    ARTICLE

    Physical activity modulates arterial stiffness in children with congenital heart disease: A CHAMPS cohort study*

    Natasha G. Boyes1, Michael K. Stickland2, Stephanie Fusnik1, Elizabeth Hogeweide1, Josie T.J. Fries1, Mark J. Haykowsky3, Chantelle L. Baril1, Shonah Runalls1, Ashok Kakadekar4, Scott Pharis4, Charissa Pockett4, Timothy J. Bradley4, Kristi D. Wright5, Marta Erlandson1, Corey R. Tomczak1

    Congenital Heart Disease, Vol.13, No.4, pp. 578-583, 2018, DOI:10.1111/chd.12614

    Abstract Children with congenital heart disease are at risk for developing increased arterial stiffness and this may be modulated by physical activity. Objective: To compare arterial stiffness in high- and low-physically active children with congenital heart disease and healthy age- and sex-matched controls.
    Patients: Seventeen children with congenital heart disease (12 ± 2 years; females = 9), grouped by low- and high-physical activity levels from accelerometry step count values, and 20 matched controls (11 ± 3 years; females = 9) were studied.
    Outcome Measures: Carotid-radial pulse wave velocity was assessed with applanation tonometry to determine arterial stiffness. Body composition… More >

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