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  • Open Access

    ARTICLE

    Comparison of 2D and 4D Flow MRI Measurements for Hemodynamic Evaluation of the Fontan Palliation

    Elisa Listo1,#, Nicola Martini2,#, Stefano Salvadori3, Elisa Valenti3, Nicola Stagnaro1, Gianluca Trocchio4, Chiara Marrone5, Alberto Clemente6, Francesca Raimondi7,*, Pierluigi Festa5, Lamia Ait Ali5,8,*

    Congenital Heart Disease, Vol.18, No.6, pp. 627-638, 2023, DOI:10.32604/chd.2023.030312

    Abstract Background: The assessment of Fontan circuit’s flow is traditionally evaluated by multiple through-plane phase-contrast MRI acquisitions (2D flow), while recently, a single volumetric 4D-flow MRI acquisition is emerging as a comprehensive tool for the hemodynamic evaluation in congenital heart diseases. Purpose: To compare 2D and 4D-flow MRI measurements in patients after Fontan palliation and to evaluate parameters affecting potential disagreement. Methods: 39 patients after Fontan palliation (23 males, age 22 ± 11 years) who underwent cardiac MRI with 2D and 4D-flow MRI acquisition were included in the study. In all patients, blood flow quantification in the Fontan circuit and aorta… More > Graphic Abstract

    Comparison of 2D and 4D Flow MRI Measurements for Hemodynamic Evaluation of the Fontan Palliation

  • Open Access

    ARTICLE

    Analysis of Risk Factors for Early Mortality in Surgical Shunt Palliation: Time for a Change?

    François-Xavier Van Vyve1, Karlien Carbonez2, Jelena Hubrechts2, Geoffroy de Beco1, Jean E. Rubay1, Mona Momeni3, Thierry Detaille4, Alain J. Poncelet1,*

    Congenital Heart Disease, Vol.18, No.5, pp. 539-550, 2023, DOI:10.32604/chd.2023.042344

    Abstract Objectives: Over the last decade, neonatal repair has been advocated for many congenital heart diseases. However, specific subgroups of complex congenital heart disease still require temporary palliation for which both surgical and endovascular techniques are currently available. We reviewed our institutional experience with shunt palliation with an emphasis on risk factors for early mortality. Methods: This is a single-center retrospective study on 175 patients undergoing surgery for central shunt or modified Blalock-Taussig shunt. All data were extracted from a prospectively collected computerized database. We identified risk factors for early mortality by uni- and multi-variable analysis. All data were censored at… More >

  • Open Access

    ARTICLE

    Analysis of Pulmonary Arteries Growth after Initial Shunt Palliation in Neonates and Infants

    François-Xavier Van Vyve1,#, Karlien Carbonez2,#, Geoffroy de Beco1, Stéphane Moniotte2, Jean E. Rubay1, Mona Momeni3, Laurent Houtekie4, Alain J. Poncelet1,*

    Congenital Heart Disease, Vol.18, No.5, pp. 525-537, 2023, DOI:10.32604/chd.2023.042341

    Abstract Objective: Despite increasing enthusiasm for neonatal repair, patients with ductal-dependent circulation (pulmonary/systemic) or restrictive pulmonary blood flow still require initial palliation. Ductal stenting has emerged as an endovascular approach whereas modified-Blalock-Taussig and central shunt remain surgical references. In this study, we analyzed the relationship between pulmonary artery growth, sites of shunt connection, or antegrade pulmonary blood flow in surgically placed shunts. The need for secondary catheter-based interventions or pulmonary arterioplasty was also investigated. Methods: A retrospective single-center study analyzing 175 patients undergoing surgery for a central or modified-Blalock-Taussig shunt. Outcome growth variables were right pulmonary artery/left pulmonary artery diameters/Z scores,… More > Graphic Abstract

    Analysis of Pulmonary Arteries Growth after Initial Shunt Palliation in Neonates and Infants

  • Open Access

    ARTICLE

    Preliminary Evaluation of Hemodynamic Effects of Fontan Palliation on Renal Artery Using Computational Fluid Dynamics

    Jinlong Liu1,2,#, Jing Shi3,#, Weiru Luo1, Zhirong Tong1,2, Lefei Yang3, Peixuan Sun3, Tianyi Li3, Jun Du3,*, Qian Wang3,*

    Congenital Heart Disease, Vol.18, No.1, pp. 41-55, 2023, DOI:10.32604/chd.2023.025005

    Abstract Background: The assessment of renal function is important to the prognosis of patients needing Fontan palliation due to the reconstructed compromised circulation. To know the relationship between the kidney perfusion and hemodynamic characteristics during surgical design could reduce the risk of acute kidney injury (AKI) and the postoperative complications. However, the issue is still unsolved because the current clinical evaluation methods are unable to predict the hemodynamic changes in renal artery (RA). Methods: We reconstructed a three-dimensional (3D) vascular model of a patient requiring Fontan palliation. The technique of computational fluid dynamics (CFD) was utilized to explore the changes of… More > Graphic Abstract

    Preliminary Evaluation of Hemodynamic Effects of Fontan Palliation on Renal Artery Using Computational Fluid Dynamics

  • Open Access

    ARTICLE

    Multi-Institutional US Experience of the Occlutech© AFR Device in Congenital and Acquired Heart Disease

    Barry O’Callaghan1, Jenny Zablah1, Joseph Vettukattil2, Daniel Levi3,4, Morris Salem4, Allison Cabalka5, Jason Anderson6, Makram Ebeid6, Ryan Alexy7, Gareth J. Morgan1,*

    Congenital Heart Disease, Vol.17, No.1, pp. 107-116, 2022, DOI:10.32604/CHD.2022.018590

    Abstract Objectives: To detail the US multi-institutional experience with the Occlutech© (Occlutech International AB, Helsingborg, Sweden) atrial flow regulator (AFR) in children and adults with acquired or congenital heart disease. Background: The creation of a long-term atrial communication is desirable in several cardiovascular disease phenotypes, most notably pulmonary arterial hypertension, disorders of increased left ventricular filling and increased cavopulmonary pressures in patients with a Fontan type circulation. Methods: Patients were identified for inclusion from the AFR device manufacturer database. Data was collected using a RedCap database following IRB approval. 8 weeks of follow up data was sought for each patient based… More >

  • Open Access

    ARTICLE

    Natural History of Kawashima Palliation in Single-Ventricle and Interrupted Inferior Vena Cava Heart Disease in China 11 Years Result

    Yajuan Zhang, Jun Yan*, Qiang Wang, Shoujun Li, Jing Sun, Shuo Dong, Jiachen Li

    Congenital Heart Disease, Vol.16, No.4, pp. 383-392, 2021, DOI:10.32604/CHD.2021.015479

    Abstract Background: The long-term outcomes of patients treated with a Kawashima procedure and keeping the antegrade pulmonary blood flow (AnPBF) in single-ventricle (SV) and interrupted inferior vena cava (IVC) heart disease is still uncertain as yet. Methods: We investigated 18 patients who underwent the Kawashima procedure with SV physiology and an interrupted IVC between January 2009 and June 2018, perioperative, operative and postoperative characteristics were recorded. Results: A total of 18 patients underwent the Kawashima procedure at a median age of 2.7 years (range 0.5–24.7 years), of which 12 (66.7%) were male and 6 (33.3%) were female. The mean saturation was… More >

  • Open Access

    ARTICLE

    Arrhythmic Risk in Paediatric Patients Undergoing Surgical Repair for Pulmonary Atresia with Intact Ventricular Septum

    Pietro Paolo Tamborrino1,2, Corrado Di Mambro1,2,*, Cecilia Marcolin1,2, Walter Vignaroli3, Giulia Cafiero4, Gianluca Brancaccio3, Sonia Albanese3, Massimo Stefano Silvetti1,2, Adriano Carotti3, Fabrizio Drago1,2

    Congenital Heart Disease, Vol.16, No.1, pp. 85-94, 2021, DOI:10.32604/CHD.2021.013038

    Abstract Introduction: While previous studies only focused on the arrhythmic risk associated with specific correction strategies, this study evaluates this risk in a large cohort of paediatric patients with all phenotypes of PA-IVS after surgical repair. Methods: In this single centre observational cohort study, we retrospectively evaluated 165 patients with a diagnosis of PA-IVS and we excluded those with an exclusively percutaneous treatment, patients lost or with insufficient follow-up and those affected by other arrhythmic syndromes. Surgical history and clinical outcomes were reviewed. Results: 86 patients were included in the study (54 male [62.8%], mean age 16.4 ± 6.1 years), with… More >

  • Open Access

    ARTICLE

    Prevalence and Risk Factors Associated with Renal Dysfunction in Patients with Single Ventricle Congenital Heart Disease after Fontan Palliation

    Sheetal R. Patel1,2,*, David M. Kwiatkowski3, Adin-Cristian Andrei2, Ankita Devareddy2, Hangzhi Shi2, Catherine D. Krawczeski4, Natalie Ebert5, Barbara J. Deal1,2, Craig B. Langman2,6, Bradley S. Marino1,2

    Congenital Heart Disease, Vol.15, No.4, pp. 181-195, 2020, DOI:10.32604/CHD.2020.012097

    Abstract Objectives: The Fontan operation has increased survival in patients with single-ventricle congenital heart defects. However, Fontan survivors are at risk of other organ dysfunctions, such as renal dysfunction (RD). The objectives of this study are to assess the prevalence of and potential risk factors for RD among Fontan survivors. Design, setting, and patients: We performed a two-center, cross-sectional study that included Fontan survivors evaluated in outpatient-clinics for routine follow up between 01/08-12/16. Outcome measures: The primary outcome was the presence of RD defined by estimated glomerular filtration rate (eGFR) of <90 ml/min/1.73 m2 derived using the serum creatinine-based Full Age… 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

    Utility of a standardized postcardiopulmonary bypass epicardial echocardiography protocol for stage I Norwood palliation

    Kenan W.D. Stern1,2, Kimberlee Gauvreau1,2, Sitaram Emani3,4, Tal Geva1,2

    Congenital Heart Disease, Vol.12, No.3, pp. 350-356, 2017, DOI:10.1111/chd.12450

    Abstract Objective: Stage 1 Norwood palliation is one of the highest risk procedures in congenital cardiac surgery. Patients with superior technical performance scores have more favorable outcomes. Intraoperative epicardial echocardiography may allow the surgeon to address residual lesions prior to leaving the operating room, resulting in improved technical performance. The ability of intraoperative epicardial echocardiography to visualize the relevant anatomy and its association with outcomes is not known.
    Design: A standardized intraoperative epicardial echocardiography protocol was developed and performed at the conclusion of Stage 1 Norwood palliation. Data pertaining to visualization of relevant anatomy, and comparison of intraoperative echocardiogram findings with… More >

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