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  • Open Access

    ARTICLE

    Pulmonary Hemodynamics and Outcome in a Large Cohort of Patients with Sinus Venosus Septal Defect

    Liesbeth van Dessel1, Béatrice Santens2, Els Troost2, Pieter De Meester2,3, Leen Roggen2, Filip Rega3,4, Bart Meyns3,4, Bjorn Cools5, Marc Gewillig5, Philip Moons6,7,8, Lukas Meier9, Werner Budts2,3, Alexander Van De Bruaene2,3,*

    Congenital Heart Disease, Vol.15, No.2, pp. 69-78, 2020, DOI:10.32604/CHD.2020.011512

    Abstract Background: Left-to-right shunt in sinus venosus septal defect (SVSD) may affect resistive (pulmonary vascular resistance–PVR) and elastic (pulmonary artery compliance-PAC) pulmonary artery properties. This study aimed at evaluating (1) impact of age, (2) pulmonary hemodynamics, and (3) outcome in a large cohort of SVSD patients. Methods: This study included 136 patients with SVSD (median age at diagnosis 14 (IQR 5–48) years, 47% male) of which 87 underwent catheterization. Pressures were measured and cardiac output was evaluated using the Fick principle at diagnosis. PVR, PAC and their product (RC time) were calculated. Results: Surgical repair was performed in 128 (94%) at… More >

  • Open Access

    ARTICLE

    Cardiovascular risk factors in adults with coarctation of the aorta

    Maria Fedchenko, Zacharias Mandalenakis, Helena Dellborg, Görel Hultsberg‐Olsson, Anna Björk, Peter Eriksson, Mikael Dellborg

    Congenital Heart Disease, Vol.14, No.4, pp. 549-558, 2019, DOI:10.1111/chd.12785

    Abstract Background: The aging patient with adult congenital heart disease (ACHD) faces the risk of developing atherosclerotic disease. Patients with coarctation of the aorta (CoA) are especially vulnerable because of an inherent high risk of developing hy‐ pertension. However, data on the prevalence of other cardiovascular risk factors are scarce. Therefore, this study aimed to describe the prevalence of traditional cardio‐ vascular risk factors (diabetes, hypertension, hyperlipidemia, smoking, obesity, and sedentary lifestyle) in adult patients with CoA.
    Methods: Patients with CoA who were registered at the ACHD clinic in Gothenburg were asked to participate in a comprehensive cardiovascular risk assessment. This… More >

  • Open Access

    ARTICLE

    The acute effects of 30 mg vs 60 mg of intravenous Fasudil on patients with congenital heart defects and severe pulmonary arterial hypertension

    Hongyun Ruan1, Yigang Zhang2, Ru Liu3, Xiangjun Yang1

    Congenital Heart Disease, Vol.14, No.4, pp. 645-650, 2019, DOI:10.1111/chd.12764

    Abstract Objective: The optimal dose of Fasudil is still controversial in congenital heart disease accompanied with severe pulmonary hypertension (CHD‐PAH). This study aimed to compare acute hemodynamic changes after different doses of Fasudil in 60 consecu‐ tive adult patients with CHD‐PAH.
    Design: Prospective randomized controlled trial.
    Setting: Tertiary cardiology center.
    Patients: Adult patients with CHD‐PAH.
    Interventions: Patients were randomized to Fasudil 30 or 60 mg.
    Outcome Measures: The hemodynamic parameters were measured at baseline and after 30 minutes of Fasudil through right cardiac catheterization. Blood gas results were obtained from the pulmonary artery, right ventricle, right atrium, superior and inferior vena… More >

  • Open Access

    ARTICLE

    Arrhythmia burden and related outcomes in Eisenmenger syndrome

    Shankar Baskar1, Philippa Horne2, Samantha Fitzsimmons3, Philip R. Khoury1, Joseph Vettukattill4, Koichiro Niwa5, Teiji Agaki6, Mark Spence7, Hisanori Sakazaki8, Gruschen Veldtman1

    Congenital Heart Disease, Vol.12, No.4, pp. 512-519, 2017, DOI:10.1111/chd.12481

    Abstract Background: Patients with Eisenmenger syndrome have a shorter lifespan than the general population. A significant proportion develop arrhythmia and some, sudden death.
    Objective: The aims of this study were to characterize the frequency, type and effects of arrhythmias in adult patients with Eisenmenger’s syndrome and to identify risk factors for arrhythmias.
    Methods: This retrospective study included patients aged ≥18 years of age with Eisenmenger’s syndrome from three institutions. Arrhythmias were noted from electrocardiograms and Holter study reviews.
    Results: A total of 167 patients, 96 females, 63 males (gender not available in 9 patients) were included in this study. The mean… More >

  • Open Access

    ARTICLE

    Hemodynamic, biological, and right ventricular functional changes following intraatrial shunt repair in patients with flow-induced pulmonary hypertension

    Chih-Hsin Hsu1,2, Jun-Neng Roan1,3, Jieh-Neng Wang4, Chien-Chi Huang5, Chao-Jung Shih3, Jyh-Hong Chen2,6, Jing-Ming Wu4, Chen-Fuh Lam7,8

    Congenital Heart Disease, Vol.12, No.4, pp. 533-539, 2017, DOI:10.1111/chd.12479

    Abstract Objectives: Atrial septal defects may result in pulmonary hypertension and right heart remodeling. We analyzed improvements in patients with flow-induced pulmonary hypertension and the activation of endothelial progenitor cells after flow reduction.
    Design: This prospective cohort study included 37 patients who were admitted for an occluder implantation. Blood samples were collected before and after the procedure. We determined the number of endothelial progenitor cells in outgrowth colonies and serum Hsp27 concentrations. Daily performance and cardiothoracic ratio were reevaluated later.
    Results: Closure of the defect significantly reduced the pulmonary pressure and B-type natriuretic peptide levels. The cardiothoracic ratio and daily performance… More >

  • Open Access

    ARTICLE

    The effect of an electronic health record–based tool on abnormal pediatric blood pressure recognition

    Sarah A. Twichell1, Corinna J. Rea1, Patrice Melvin2, Andrew J. Capraro1, Joshua C. Mandel1, Michael A. Ferguson1, Daniel J. Nigrin1, Kenneth D. Mandl1, Dionne Graham2, Justin P. Zachariah3

    Congenital Heart Disease, Vol.12, No.4, pp. 484-490, 2017, DOI:10.1111/chd.12469

    Abstract Background: Recognition of high blood pressure (BP) in children is poor, partly due to the need to compute age-sex-height referenced percentiles. This study examined the change in abnormal BP recognition before versus after the introduction of an electronic health record (EHR) app designed to calculate BP percentiles with a training lecture.
    Methods and results: Clinical data were extracted on all ambulatory, non-urgent encounters for children 3–18 years old seen in primary care, endocrinology, cardiology, or nephrology clinics at an urban, academic hospital in the year before and the year after app introduction. Outpatients with at least 1 BP above the… More >

  • Open Access

    ARTICLE

    Hemodynamic effects of ketamine in children with congenital heart disease and/or pulmonary hypertension

    Rohit S. Loomba1, Seth B. Gray2, Saul Flores3

    Congenital Heart Disease, Vol.13, No.5, pp. 646-654, 2018, DOI:10.1111/chd.12662

    Abstract Introduction: Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, particularly pulmonary vascular resistance and systemic vascular resistance. We per‐ formed a meta‐analysis of studies investigating the effects of ketamine on hemodynamics.
    Methods: A systematic review was conducted to identify studies characterizing the hemodynamic effects of ketamine in children with congenital heart disease. Studies were assessed for quality and those of satisfactory quality with pre‐ and postketa‐ mine hemodynamics for each patient… 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 measured in… More >

  • Open Access

    ARTICLE

    Pulmonary hypertension: Barrier or just a bump in the road in transplanting adults with congenital heart disease

    Jonathan N. Menachem1, Edo Y. Birati2, Payman Zamani2, Anjali T. Owens2, Pavan Atluri3, Christian A. Bermudez3, David Drajpuch2, Stephanie Fuller4, Yuli Y. Kim2, Christopher E. Mascio4, Vikram Palanivel2, J. Eduardo Rame2, Joyce Wald2, Michael A. Acker3, Jeremy A. Mazurek2

    Congenital Heart Disease, Vol.13, No.4, pp. 492-498, 2018, DOI:10.1111/chd.12606

    Abstract Background: Heart failure (HF) is the leading cause of death in adults with congenital heart disease (ACHD). Identification of disease progression and timing of referral for advanced therapies is often delayed. However, increased awareness and understanding of ACHD and improvements in the approach to treatment have led to improved outcomes. Pulmonary hypertension (PH) is a common barrier to HT. In ACHD, the approach to PH and HT is quite complicated, given the anatomic heterogeneity and lower prevalence and experience. However, in some cases, PH is a result of elevated systemic filling pressures and low output.
    Methods: We describe the approach… More >

  • Open Access

    ARTICLE

    NT-pro BNP—A marker for worsening respiratory status and mortality in infants and young children with pulmonary hypertension

    Shahnawaz M. Amdani1, Muhammad Umair M. Mian2, Ron L. Thomas3, Robert D. Ross4

    Congenital Heart Disease, Vol.13, No.4, pp. 499-505, 2018, DOI:10.1111/chd.12601

    Abstract Aim: To evaluate predictors of morbidity and mortality in pediatric patients with pulmonary hypertension (PH), laboratory and echocardiographic measures of PH were analyzed.
    Methods: A retrospective review of all infants and children< 2 years of age with PH from January 2011 to August 2016 was conducted. Correlations were determined using Spearman’s rank correlation coefficients. Differences in characteristics between survivors and nonsurvivors were analyzed and Kaplan-Meier survival curves were generated.
    Results: Of 56 patients, the majority were extremely premature; of African American ethnicity; and had bronchopulmonary dysplasia. Patients who died were more likely to have underlying congenital heart disease; have a… More >

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