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  • Open Access

    ARTICLE

    The 745.5 issue in code-based, adult congenital heart disease population studies: Relevance to current and future ICD-9-CM and ICD-10-CM studies

    Fred H. Rodriguez III1,2,3,4, Georges Ephrem1,2, Jennifer F. Gerardin1,2, Cheryl Raskind-Hood5, Carol Hogue5, Wendy Book1,2

    Congenital Heart Disease, Vol.13, No.1, pp. 59-64, 2018, DOI:10.1111/chd.12563

    Abstract Objective: Although the ICD-9-CM code 745.5 is widely used to indicate the presence of a secundum atrial septal defect (ASD), it is also used for patent foramen ovale (PFO) which is a normal variant and for “rule-out” congenital heart disease (CHD). The ICD-10-CM code Q21.1 perpetuates this issue. The objective of this study was to assess whether code 745.5 in isolation or in combination with unspecified CHD codes 746.9 or 746.89 miscodes for CHD, and if true CHD positives decrease with age.
    Design: Echocardiograms of patients with an ICD-9-CM code of 745.5 in isolation or in combination… More >

  • Open Access

    ARTICLE

    Body composition, appetite-related hormones, adipocytokines, and heart failure in adult patients with congenital heart disease: A preliminary study

    Yumi Shiina1, Tomoaki Murakami2, Noriko Matsumoto3, Daisuke Okamura4, Yuta Takahashi4, Yosuke Nishihata1, Nobuyuki Komiyama1, Koichiro Niwa1

    Congenital Heart Disease, Vol.13, No.1, pp. 79-84, 2018, DOI:10.1111/chd.12555

    Abstract Objectives: To assess body composition and relationships among body composition, appetiterelated hormones, adipocytokines, and heart failure (HF) in adult patients with congenital heart disease (CHD).
    Patients: This prospective study enrolled 46 consecutive adult patients with CHD and 12 agematched healthy controls. The patients and control subjects were divided into four groups: 13 patients with Fontan circulation (group A), 16 patients with cyanosis (group B), 17 patients who previously underwent biventricular repair (group C), and 12 age-matched healthy controls.
    Design: Body composition was measured using InBody730, and levels of appetite-related hormones (ghrelin and leptin) and adipocytokines (leptin, interleukin-6, and… More >

  • Open Access

    ARTICLE

    Toward standardization of care: The feeding readiness assessment after congenital cardiac surgery

    Daniel E. Ehrmann1, Matthew Mulvahill2, Shaunda Harendt1,3, Jessica Church1, Amy Stimmler1, Piyagarnt Vichayavilas1,4, Sanja Batz1,5, Jennifer Rodgers1,5, Michael DiMaria1, James Jaggers1, Cindy Barrett1, Jon Kaufman1

    Congenital Heart Disease, Vol.13, No.1, pp. 31-37, 2018, DOI:10.1111/chd.12550

    Abstract Background: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care.
    Methods: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center. A systematic feeding readiness assessment (FRA) was utilized to score infant feeding skills. FRA scores were assigned immediately prior to surgery and 1, 2, and… More >

  • Open Access

    ARTICLE

    Short-term outcomes following implementation of a dedicated young adult congenital heart disease transition program

    Sumeet S. Vaikunth1,2, Roberta G. Williams3, Merujan Y. Uzunyan4, Han Tun5, Cheryl Barton3, Philip M. Chang5

    Congenital Heart Disease, Vol.13, No.1, pp. 85-91, 2018, DOI:10.1111/chd.12549

    Abstract Objective: Transition from pediatric to adult care is a critical time for patients with congenital heart disease. Lapses in care can lead to poor outcomes, including increased mortality. Formal transition clinics have been implemented to improve success of transferring care from pediatric to adult providers; however, data regarding outcomes remain limited. We sought to evaluate outcomes of transfer within a dedicated transition clinic for young adult patients with congenital heart disease.
    Design, Setting, and Patients: We performed a retrospective analysis of all 73 patients seen in a dedicated young adult congenital heart disease transition clinic from January… More >

  • Open Access

    ARTICLE

    Stress and quality of life among parents of children with congenital heart disease referred for psychological services

    Astrida Kaugars1, Clarissa Shields2, Cheryl Brosig3

    Congenital Heart Disease, Vol.13, No.1, pp. 72-78, 2018, DOI:10.1111/chd.12547

    Abstract Objective: The study examined parent stress and health-related quality of life (HRQOL) among families of children with congenital heart disease (CHD) referred for psychological services.
    Methods: Parents of 54 children (85% boys) aged 3 to 13 (Mage = 7.48, SD = 2.38) completed measures to assess parenting stress (Parenting Stress Index – Short Form; Pediatric Inventory for Parents) and the PedsQL Family Impact Module. Medical information was retrieved from medical record review.
    Results: Half of parents of children with single ventricle anatomy had clinically significant levels of parenting stress. Parents of children with single ventricle anatomy reported more More >

  • Open Access

    ARTICLE

    Determinants of platelet count in pediatric patients with congenital cyanotic heart disease: Role of immature platelet fraction

    Randa M. Matter1, Iman A. Ragab1, Alaa M. Roushdy2, Ahmed G. Ahmed1, Hanan H. Aly1, Eman A. Ismail3

    Congenital Heart Disease, Vol.13, No.1, pp. 118-123, 2018, DOI:10.1111/chd.12530

    Abstract Objectives: Congenital heart defects are common noninfectious causes of mortality in children. Bleeding and thrombosis are both limiting factors in the management of such patients. We assessed the frequency of thrombocytopenia in pediatric patients with congenital cyanotic heart disease (CCHD) and evaluated determinants of platelet count including immature platelet fraction (IPF) and their role in the pathogenesis of thrombocytopenia.
    Methods: Forty-six children and adolescents with CCHD during pre-catheter visits were studied; median age was 20.5 months. Complete blood count including IPF as a marker of platelet production and reticulated hemoglobin content (RET-He) as a marker of red… More >

  • Open Access

    ARTICLE

    Clinical, echocardiographic, and therapeutic aspects of congenital heart diseases of children at Douala General Hospital: A cross-sectional study in sub-Saharan Africa

    Felicit e Kamdem1,2, Danielle Kedy Koum2,3, Ba Hamadou1,4, Melanie Yemdji1, Henry Luma1,4, Marie Solange Doualla1,4, Diomède Noukeu5, Esther Barla5, Christophe Akazong5, Anastase Dzudie1,4, Henry Ngote1, Yves Monkam1, Sidiki Mouliom1, Samuel Kingue4,6

    Congenital Heart Disease, Vol.13, No.1, pp. 113-117, 2018, DOI:10.1111/chd.12529

    Abstract Introduction: Cardiovascular diseases in pediatric pathologies have emerged in the recent years in sub-Saharan Africa (SSA), with congenital heart diseases (CHDs) being the most frequent. Unfortunately, their diagnosis is usually delayed, thereby increasing childhood morbidity and mortality.
    Objectives: Describe the clinical, echocardiographic, and therapeutic aspects of CHDs of children at Douala General Hospital.
    Methods: We carried out a cross-sectional descriptive study over a 10-year period, from January 2006 to December 2015. Files and reports of cardiac ultrasounds of patients aged ≤ 15 years were reviewed.
    Results: We reviewed the medical records of 1616 children, of which 370 (22.9%) had… More >

  • Open Access

    ARTICLE

    Predicting unplanned readmissions to a pediatric cardiac intensive care unit using predischarge Pediatric Early Warning Scores

    Ashley R. Kroeger1, Jacqueline Morrison2, Andrew H. Smith1

    Congenital Heart Disease, Vol.13, No.1, pp. 98-104, 2018, DOI:10.1111/chd.12525

    Abstract Objective: Unplanned readmission to the pediatric cardiac intensive care unit (CICU) is associated with significant morbidity and mortality. The Pediatric Early Warning Score (PEWS) predicts ward patients at risk for decompensation but has not been previously reported to identify at-risk patients with cardiac disease prior to ward transfer. This study aimed to determine whether PEWS prior to transfer may serve as a predictor of unplanned readmission to the CICU.
    Design: All patients discharged from a tertiary children’s hospital CICU from September 2012 through August 2015 were included for analysis. PEWS assessment was performed following transfer to the… More >

  • Open Access

    ARTICLE

    Identification of adults with congenital heart disease of moderate or great complexity from administrative data

    Jill M. Steiner1, James N. Kirkpatrick1, Susan R. Heckbert2, Asma Habib1, James Sibley3, William Lober3, J. Randall Curtis3

    Congenital Heart Disease, Vol.13, No.1, pp. 65-71, 2018, DOI:10.1111/chd.12524

    Abstract Introduction: There is relatively sparse literature on the use of administrative datasets for research in patients with adult congenital heart disease (ACHD). The goal of this analysis is to examine the accuracy of administrative data for identifying patients with ACHD who died.
    Methods: A list of the International Classification of Diseases codes representing ACHD of moderate- or great-complexity was created. A search for these codes in the electronic health record of adults who received care in 2010–2016 was performed, and used state death records to identify patients who died during this period. Manual record review was completed… More >

  • Open Access

    ARTICLE

    Epigenetics for the pediatric cardiologist

    Andrew D. Spearman

    Congenital Heart Disease, Vol.12, No.6, pp. 828-833, 2017, DOI:10.1111/chd.12543

    Abstract A genetic basis of congenital heart disease (CHD) has been known for decades. In addition to the sequence of the genome, the contribution of epigenetics to pediatric cardiology is increasingly recognized. Multiple epigenetic mechanisms, including DNA methylation, histone modification, and RNA-based regulation, are known mediators of cardiovascular disease, including both development and progression of CHD and its sequelae. Basic understanding of the concepts of epigenetics will be essential to all pediatric cardiologists in order to understand mechanisms of pathophysiology, pharmacotherapeutic concepts, and to understand the role of epigenetics in precision medicine. More >

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