Michelle Keir¹, Barbara Bailey¹, Angela Lee¹, Adrienne H. Kovacs^1,2, S. Lucy Roche^1,3

Congenital Heart Disease, Vol.13, No.5, pp. 740-747, 2018, DOI:10.1111/chd.12647

Abstract Background: With access to surgical care, >90% of today’s infants with congenital heart disease (CHD) will reach adulthood. During childhood, survivors accrue a wealth of health care experience and develop strategies for navigating life with a chronic disease.
Methods: Seeking to learn from this individualized process, we invited adults with complex CHD to participate in narrative analysis—an established qualitative research method for studying how individuals derive meaning from their personal stories. Audio recordings of 2‐4 hour free‐form interviews were transcribed and iteratively analyzed to identify common themes and detect similarities or differences in language, viewpoint and interpretation.… More >

Adam B. Christopher¹, Abraham Apfel², Tao Sun², Jackie Kreutzer¹, David S. Ezon³

Congenital Heart Disease, Vol.13, No.5, pp. 713-720, 2018, DOI:10.1111/chd.12637

Abstract Objective: The most accurate noninvasive parameter to predict whether a patient with aortic coarctation will meet interventional criteria at catheterization remains elusive. We aim to determine the best independent echocardiographic predictors of a coarctation peak‐to‐peak pressure gradient ≥20 mm Hg at catheterization, the ac‐ cepted threshold for intervention.
Design: Retrospective query of our catheterization database from 1/2007 to 7/2016 for the diagnostic code of aortic coarctation was performed. Multiple echocardio‐ graphic measurements and blood pressure gradients prior to cardiac catheterization were collected. Univariate correlation of variables with the continuous catheteriza‐ tion peak were calculated using Spearman’s rho.… More >

Anita T. Cote^1,2, Martin Hosking³, Christine Voss^1,3, Derek G. Human³, George G. S. Sandor^1,3, Kevin C. Harris^1,3

Congenital Heart Disease, Vol.13, No.5, pp. 663-670, 2018, DOI:10.1111/chd.12629

Abstract Objective: Pediatric heart transplant recipients are at risk of posttransplant coronary artery disease known as cardiac allograft vasculopathy (CAV), and also may develop diastolic dysfunction. As CAV begins with a process of progressive intimal thickening, these occult diffuse changes may be detected using optical coherence tomography (OCT). We hypothesized that the development of CAV, as identified via OCT, may be a mechanism of declining ventricular function. Accordingly, the purpose of this study was to assess coronary artery intimal thickening and LV strain in children who have undergone heart transplantation.
Methods: In 17 children, we analyzed OCT images… More >

Ashley E. Neal¹, Elizabeth Lehto¹, Karen Hughes Miller², Erin Davis³, Craig Ziegler²

Congenital Heart Disease, Vol.13, No.5, pp. 788-793, 2018, DOI:10.1111/chd.12626

Abstract Objective: The 2016 American Board of Pediatrics (ABP) content outline is comprehensive, including more than 50 cardiology-specific objectives within eight content areas. This study complements the quantitative analysis of a Kentucky-wide survey of trainees, pediatricians, and pediatric cardiologists asking them to identify “most important” cardiology content by analyzing their open-ended comments about “what should be added” and “why?” within these eight categories.
Design, Methods, Outcome Measures: This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives. We began an initial analysis of the qualitative data using Pandit’s version of Glaser and… More >

Doris P. Yimgang¹, John D. Sorkin², Charles F. Evans³, Danielle S. Abraham¹, Geoffrey L. Rosenthal^1,4

Congenital Heart Disease, Vol.13, No.4, pp. 533-540, 2018, DOI:10.1111/chd.12622

Abstract Introduction: Angiotensin converting enzyme inhibitors are commonly prescribed medications after the Norwood procedure. There are little data that can be used to determine if angiotensin converting enzyme inhibitors improve interstage outcomes in children with single ventricle defects. The objective of this study was to investigate the relationship between angiotensin converting enzyme inhibitors and interstage failure among infants born with hypoplastic left heart syndrome.
Methods: We conducted a retrospective cohort study using data from the National Pediatric Cardiology Quality Improvement Collaborative database (collected between 2008 and 2015). We used logistic regression models to assess the exposure-outcome associations and… More >

Michele M. Pasierb, Josiah M. Penalver, Margaret M. Vernon, Bhawna Arya

Congenital Heart Disease, Vol.13, No.4, pp. 571-577, 2018, DOI:10.1111/chd.12611

Abstract Background: Accurate prenatal diagnosis of congenital heart disease (CHD) allows for appropriate delivery and postnatal management. Geographic constraints limit access to fetal cardiology subspecialists. In our approach, general pediatric cardiologists are first line in regional prenatal cardiac screening. We aim to demonstrate the utility of this approach in diagnosing CHD requiring cardiac interventions within 30 days of life.
Methods: This is a retrospective review of fetal echocardiograms performed at Seattle Children’s Hospital regional cardiology sites (SCH-RC) from December 2008 to December 2015. Referrals to Seattle Children’s Hospital Prenatal Program (SCH-PNP) were evaluated for referral timing, indication, diagnostic… More >

Albert C. Hergenroeder¹, Douglas S. Moodie², Daniel J. Penny², Constance M. Wiemann¹, Blanca Sanchez-Fournier¹, Lauren K. Moore², Jane Head³

Congenital Heart Disease, Vol.13, No.4, pp. 548-553, 2018, DOI:10.1111/chd.12604

Abstract Objective: To describe changes in functional status between the last pediatric and first adult congenital heart disease (CHD) clinic visits in patients with moderate to severe CHD after implementing a healthcare transition (HCT) planning program.
Design: Quasi-experimental design. Patients were followed prospectively following the implementation of the intervention; Control patients transitioned from the Pediatric CHD Clinic into Adult CHD Clinic before the intervention.
Setting: Texas Children’s Hospital (TCH).
Patients: Sixteen to 25-year-olds, cognitively normal, English speaking patients with moderate to severe CHD who transitioned from the Pediatric to the Adult CHD clinic.
Interventions: An EMR-based transition planning tool (TPT) was… More >

Raymond P. Lorenzoni III¹, Jaeun Choi², Nadine F. Choueiter³, Iona M. Munjal¹, Chhavi Katyal⁴, Kenan W. D. Stern³

Congenital Heart Disease, Vol.13, No.3, pp. 470-475, 2018, DOI:10.1111/chd.12598

Abstract Objective: Kawasaki disease is the primary cause of acquired pediatric heart disease in developed nations. Timely diagnosis of Kawasaki disease incorporates transthoracic echocardiography for visualization of the coronary arteries. Sedation improves this visualization, but not without risks and resource utilization. To identify potential sedation criteria for suspected Kawasaki disease, we analyzed factors associated with diagnostically inadequate initial transthoracic echocardiography performed without sedation.
Design: This retrospective review of patients < 18 years old undergoing initial transthoracic echocardiography for the inpatient evaluation of suspected Kawasaki disease from 2009 to 2015 occurred at a medium-sized urban children’s hospital. The primary… More >

M. Louise Morrison¹, Corrina McMahon², Riona Tully¹, Noelle Enright¹, Ricardo Pignatelli³, Jeffrey A. Towbin⁴, Colin J. McMahon¹

Congenital Heart Disease, Vol.13, No.3, pp. 440-443, 2018, DOI:10.1111/chd.12592

Abstract Objectives: Incidence of sickle cell disease (SCD) in Ireland has dramatically increased. Disease survival has also steadily improved however cardiovascular manifestations remain important causes of morbidity. These include reports of left ventricular hypertrabeculation (LVHT)/noncompaction. We sought to investigate the prevalence of LVHT among a large cohort of children with SCD.
Methods: We retrospectively reviewed the records of all patients with a diagnosis of SCD who had undergone surveillance echocardiography at Our Lady’s Children’s Hospital Crumlin (OLCHC) from 1998 to 2015. Demographics, hemoglobin phenotype and treatment information was recorded. LV systolic function, evidence of LVHT, and possible pulmonary… More >

Melissa S.W. Yamauchi^1,2, Michael D. Puchalski^1,2, Hsin Ti Weng¹, Nelangi M. Pinto^1,2, Susan P. Etheridge^1,2, Angela P. Presson¹, Lloyd Y. Tani^1,2, L. LuAnn Minich^1,2, Richard V. Williams^1,2

Congenital Heart Disease, Vol.13, No.3, pp. 432-439, 2018, DOI:10.1111/chd.12591

Abstract Background: Disease progression of an isolated bicuspid aortic valve (BAV) in children is poorly understood and adult management guidelines may not be applicable. Thus, we sought to evaluate disease progression of pediatric isolated BAV and its relationship to current management practices.
Methods: Children with a BAV and ≤mild aortic stenosis (AS) and/or aortic regurgitation (AR) at the time of initial evaluation were included in this retrospective cohort study (1/2005-12/ 2014). Outcomes included change in z-scores for aortic root and ascending aorta diameters, cardiac interventions, adverse outcomes, recommended follow-up interval, and frequency of cardiac imaging studies at each… More >