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  • Open Access

    ARTICLE

    A 20-Year Follow-up after the Fontan Operation in a Population with Hypoplastic Left Heart Syndrome

    Eleni P. Asimacopoulos*, Steven J. Staffa, Peter C. Laussen, Kirsten C. Odegard

    Congenital Heart Disease, Vol.17, No.5, pp. 579-590, 2022, DOI:10.32604/chd.2022.020334

    Abstract Background: Thromboembolic events are a cause of significant morbidity and mortality in the Fontan population. We previously reported on coagulation profile changes in a cohort of patients with hypoplastic left heart syndrome (HLHS) from Stage I through Fontan completion. In this report, we examine their clinical status, anticoagulation and incidence of thromboembolic events up to 20 years post Fontan. Methods: A retrospective chart review was conducted for twenty (20) surviving patients, from 1998 through December 2020. Patients who underwent orthotopic heart transplantation (OTx) were followed until their transplant. Patients who were found in the original study to have a factor… More >

  • Open Access

    ARTICLE

    Preoperative Feeding in Single Ventricle Neonates is Predictive of Shorter Time to Goal Feed

    Alyssia Venna1, Kathleen Reid2, Sarah Davis2, Jiaxiang Gai3, Yves d’Udekem1, Sarah Clauss2,*

    Congenital Heart Disease, Vol.17, No.5, pp. 505-518, 2022, DOI:10.32604/chd.2022.021571

    Abstract Background: Patients with single ventricle anatomy are at increased risk of growth failure and malnutrition. Amongst cardiac centers, there is little standardization of feeding practices in this complex population. We hypothesized that initiation of our center’s preoperative feeding protocol would result in decreased gastrostomy tube (G-tube) use, decreased length of stay and would not result in increased Necrotizing Enterocolitis (NEC) rates. Methods: A single institution review of 52 patients who had undergone stage I single ventricle palliative repair was performed. Patient diagnoses were hypoplastic left heart syndrome (39%), atrioventricular canal (15%), and other (46%). Postoperative parameters such as time to… More > Graphic Abstract

    Preoperative Feeding in Single Ventricle Neonates is Predictive of Shorter Time to Goal Feed

  • Open Access

    ARTICLE

    A Ring-Reinforced Right Ventricle to Pulmonary Artery Conduit is Associated with Better Regional Mechanics after Stage I Norwood Operation

    Benjamin Zielonka1,2,*, David M. Harrild1,2, Sunil J. Ghelani1,2, Eleni G. Elia1,2, Christopher W. Baird3,4, Andrew J. Powell1,2, Rahul H. Rathod1,2

    Congenital Heart Disease, Vol.17, No.5, pp. 591-603, 2022, DOI:10.32604/chd.2022.021509

    Abstract Background: The right ventricle to pulmonary artery conduit (RVPAC) may impair right ventricular (RV) function in patients with functional single right ventricles. Modification of the RVPAC using a ring-reinforced end with dunked insertion into the RV through a limited ventriculotomy may reduce the impact on RV function. We compared RV segmental strain between patients with a traditional RVPAC and ring-reinforced RVPAC using feature tracking cardiovascular magnetic resonance (CMR) imaging. Methods: Patients with CMR examinations after Stage I operation with RVPAC between 2000 and 2018 were reviewed. Ventricular mass, volumes, late gadolinium enhancement (LGE), and peak radial and circumferential strain of… More >

  • Open Access

    ARTICLE

    Effectiveness of Bilateral Pulmonary Artery Banding in Patients with Hypoplastic Left Heart Syndrome and Congenital Heart Defects with A Functional Single Ventricle: A Single-Center Retrospective Study

    Vitaliy Suvorov1,*, Vladimir Zaitcev1, Karolina Andrzejczyk2

    Congenital Heart Disease, Vol.17, No.3, pp. 365-374, 2022, DOI:10.32604/chd.2022.019126

    Abstract Background: Bilateral banding of the branches of the pulmonary artery in patients with hypoplastic left heart syndrome (HLHS) and other duct dependent critical neonatal heart malformations can significantly reduce the incidence of severe complications in the postoperative period, especially in severely unstable patients. In our study we compared different surgical techniques of bilateral pulmonary artery banding (PAB) in respect to their success in balancing systemic and pulmonary blood flow. Methods: We included 44 neonates with a HLHS and congenital heart diseases (CHD) with a functional single ventricle underwent a hybrid operation: bilateral PAB and patent ductus arteriosus stenting. The hybrid… More >

  • Open Access

    ARTICLE

    Longitudinal Evaluation of Right Ventricle Function after Right Ventricle-Pulmonary Artery Shunt vs. Blalock-Taussig Shunt

    Nunzia Borrelli1,2, Jolanda Sabatino1,3, Martina Avesani1,4, Josefa Paredes1, Manjit Josen1, Alain Fraisse1, Paolo Guccione2, Guido Michielon1, Giovanni Di Salvo1,4,*

    Congenital Heart Disease, Vol.16, No.1, pp. 27-37, 2021, DOI:10.32604/CHD.2021.012526

    Abstract Background: Still little is known about the impact on right ventricle function of the 2 main approaches to Norwood palliation in Hypoplastic left heart syndrome, the right ventricle-pulmonary artery shunt (RVPAS) and the modified Blalock-Taussig shunt (mBTS). Methods: The cohort included 27 patients with Hypoplastic left heart syndrome (10 in the mBTS group, 17 in the RVPAS group). Longitudinal strain, tricuspid annulus peak systolic excursion and fractional area change were evaluated before Norwood and in four different breakpoints in the steady-state after Norwood procedure (30-days, 90-days, 140-days and 200-days after Norwood). Results: No significant differences were found in all standard… More >

  • Open Access

    ARTICLE

    Systolic/diastolic ratio correlates with end diastolic pressures in pediatric patients with single right ventricles

    Clifford L. Cua1, Melissa Moore‐Clingenpeel1, Nazia Husain2, Ralf Holzer3, John P. Cheatham1, Janaki Gokhale4

    Congenital Heart Disease, Vol.14, No.4, pp. 609-613, 2019, DOI:10.1111/chd.12755

    Abstract Background: Increased ventricular end‐diastolic pressure (VEDP) is a known risk fac‐ tor for morbidity and mortality in patients with single right ventricle (RV) physiology. Previous studies have shown mixed results correlating echocardiographic measure‐ ments with catheter‐derived VEDP in this population. Goal of this study was to eval‐ uate if echocardiographic systolic/diastolic ratio (S/D) correlated with VEDP.
    Methods: Patients with single RV physiology who underwent simultaneous echocar‐ diography and catheterization were evaluated. Systolic and diastolic durations were measured using tricuspid inflow durations from Doppler analysis to calculate the S/D ratio. VEDP was obtained from the catheterization report.
    Results: Twenty‐seven studies were… More >

  • Open Access

    ARTICLE

    Clinical findings in right ventricular noncompaction in hypoplastic left heart syndrome

    Monique M. Gardner, Meryl S. Cohen

    Congenital Heart Disease, Vol.12, No.6, pp. 783-786, 2017, DOI:10.1111/chd.12506

    Abstract Background: Noncompaction is a poorly understood form of cardiomyopathy that typically affects the left ventricle and may be associated with congenital heart disease. Right ventricular noncompaction (RVNC) may occur when the left ventricle is affected but is rarely seen in isolation. RVNC may have clinical significance affecting surgical and long-term outcomes. We describe the diagnosis and clinical course in three patients at our institution.
    Methods: We performed a retrospective review of patients diagnosed with RVNC over a 12- month period at our institution and reviewed their imaging and clinical course.
    Results: Three patients were identified. All had diagnosis of RVNC… More >

  • Open Access

    ARTICLE

    Dysphagia in infants with single ventricle anatomy following stage 1 palliation: Physiologic correlates and response to treatment

    Katlyn Elizabeth McGrattan1,2,3,4, Heather McGhee2,3, Allan DeToma5, Elizabeth G. Hill5, Sinai C. Zyblewski6, Maureen Lefton-Greif7,8,9, Lucinda Halstead1,2, Scott M. Bradley10, Bonnie Martin-Harris1,2,3,4

    Congenital Heart Disease, Vol.12, No.3, pp. 382-388, 2017, DOI:10.1111/chd.12456

    Abstract Background: Deficits in swallowing physiology are a leading morbidity for infants with functional single ventricles and systemic outflow tract obstruction following stage 1 palliation. Despite the high prevalence of this condition, the underlying deficits that cause this post-operative impairment remain poorly understood.
    Objective: Identify the physiologic correlates of dysphagia in infants with functional single ventricles and systemic outflow tract obstruction following stage 1 palliative surgery.
    Methods: Postoperative fiberoptic laryngoscopies and videofluoroscopic swallow studies (VFSS) were conducted sequentially on infants with functional single ventricles following stage 1 palliative surgery. Infants were dichotomized as having normal or impaired laryngeal function based on… More >

  • Open Access

    ARTICLE

    Practice trends over time in the care of infants with hypoplastic left heart syndrome: A report from the National Pediatric Cardiology Quality Improvement Collaborative

    Waldemar F. Carlo1, James F. Cnota2, Robert J. Dabal3, Jeffrey B. Anderson2

    Congenital Heart Disease, Vol.12, No.3, pp. 315-321, 2017, DOI:10.1111/chd.12442

    Abstract Objective: The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) was established in 2008 to improve outcomes of hypoplastic left heart syndrome (HLHS) during the interstage period. They evaluated changes in patient variables and practice variation between early and late eras.
    Design: Data including demographic, operative, discharge, and follow-up variables from the first 100 patients (6/2008–1/2010) representing 18 centers were compared with the most recent 100 patients (1/2014–11/2014) from these same centers.
    Results: Prenatal diagnosis increased from 69% to 82% (P = .05). There were no differences in gestational age or weight at Norwood. A composite of any preoperative risk factor… More >

  • Open Access

    ARTICLE

    Incidence of aspiration in infants with single‐ventricle physiology following hybrid procedure

    Jennifer P. Lundine1,2, Robert Dempster3,4, Kirby Carpenito5, Holly Miller‐Tate5, Wendelin Burdo‐Hartman4,6, Elizabeth Halpin2, Omar Khalid4,5

    Congenital Heart Disease, Vol.13, No.5, pp. 706-712, 2018, DOI:10.1111/chd.12636

    Abstract Background: Swallowing dysfunction is a known complication for infants with complex congenital heart disease (CHD), but few studies have examined swallowing outcomes following the hybrid procedure for stage 1 palliation in children with single ventricle physiology.
    Objectives: (1) Identify the incidence of aspiration in all infants with single ventricle physiology who underwent the hybrid procedure and (2) Compare results of clinical bedside and instrumental swallowing evaluations to examine the predictive value of a less invasive swallowing assessment for this population of high‐risk infants.
    Methods: This was a retrospective cohort chart review study. All patients with single‐ventricle physiology who underwent the… More >

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