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  • Open Access

    ARTICLE

    Predictors of extracorporeal membrane oxygenation support after surgery for adult congenital heart disease in children’s hospitals

    Stephen J. Dolgner1,2,3, Eric V. Krieger1,3, Jacob Wilkes4, Susan L. Bratton5, Ravi R. Thiagarajan6,7, Cindy S. Barrett8, Titus Chan1,2,9

    Congenital Heart Disease, Vol.14, No.4, pp. 559-570, 2019, DOI:10.1111/chd.12758

    Abstract Objective: Adult congenital heart disease (ACHD) patients who undergo cardiac surgery are at risk for poor outcomes, including extracorporeal membrane oxygenation support (ECMO) and death. Prior studies have demonstrated risk factors for mortality, but have not fully examined risk factors for ECMO or death without ECMO (DWE). We sought to identify risk factors for ECMO and DWE in adults undergoing congenital heart surgery in tertiary care children’s hospitals.
    Design: All adults (≥18 years) undergoing congenital heart surgery in the Pediatric Health Information System (PHIS) database between 2003 and 2014 were included. Patients were classified into three groups:… More >

  • Open Access

    ARTICLE

    Atrial fibrillation in adults with congenital heart disease following cardiac surgery in a single center: Analysis of incidence and risk factors

    Michael A. Brock, John‐Anthony Coppola, Jana Reid, Diego Moguillansky

    Congenital Heart Disease, Vol.14, No.6, pp. 924-930, 2019, DOI:10.1111/chd.12857

    Abstract Objective: The primary aim of our work is to determine the incidence of atrial fibrillation following cardiac surgery in adults with congenital heart disease. Secondary aims include identifying risk factors predictive of developing early postoperative atrial fibrillation and morbidities associated with early postoperative atrial fibrillation.
    Design: Retrospective analysis.
    Setting: Single center, quaternary care children’s hospital.
    Patients: This review included patients at least 18 years of age with known congenital heart disease who underwent cardiac surgery requiring a median sternotomy at our congenital heart center from January 1, 2012 to December 31, 2016.
    Interventions: None.
    Outcome Measures: The primary outcome was early… More >

  • Open Access

    ARTICLE

    Risk stratification models for congenital heart surgery in children: Comparative single‐center study

    Sara Bobillo‐Perez1,2, Joan Sanchez‐de‐Toledo3,4, Susana Segura2, Monica Girona‐Alarcon2, Maria Mele5, Anna Sole‐Ribalta2, Debora Cañizo Vazquez6, Iolanda Jordan2,7, Francisco Jose Cambra1,2

    Congenital Heart Disease, Vol.14, No.6, pp. 1066-1077, 2019, DOI:10.1111/chd.12846

    Abstract Objective: Three scores have been proposed to stratify the risk of mortality for each cardiac surgical procedure: The RACHS‐1, the Aristotle Basic Complexity (ABC), and the STS‐EACTS complexity scoring model. The aim was to compare the ability to predict mortality and morbidity of the three scores applied to a specific population.
    Design: Retrospective, descriptive study.
    Setting: Pediatric and neonatal intensive care units in a referral hospital.
    Patients: Children under 18 years admitted to the intensive care unit after surgery.
    Interventions: None.
    Outcome measures: Demographic, clinical, and surgical data were assessed. Morbidity was considered as prolonged length of stay (LOS > 75… More >

  • Open Access

    ARTICLE

    Coronary artery disease screening in adults with congenital heart disease prior to cardiac surgery

    Bradley Johnson1,2, Matthew Buelow1,2, Michael Earing1,2, Scott Cohen1,2, Peter Bartz1,2, Salil Ginde1,2

    Congenital Heart Disease, Vol.14, No.6, pp. 895-900, 2019, DOI:10.1111/chd.12839

    Abstract Objective: As adults with congenital heart disease (CHD) grow older, preoperative screening for coronary artery disease (CAD) may be indicated prior to CHD surgery. Data regarding the indications for preoperative CAD screening in this population are limited. Current practice is to follow guidelines for patients with valvular heart dis‐ ease; however, the risk for CAD in certain congenital heart diagnoses may be higher than the general population. This study aimed to assess the results of preoperative CAD screening in patients prior to CHD surgery.
    Design: Retrospective study.
    Setting: Single tertiary center.
    Patients: Patients ≥35 years that had CHD surgery… More >

  • Open Access

    ARTICLE

    Improvement in ventricular function with rhythm control of atrial arrhythmias may delay the need for atrioventricular valve surgery in adults with congenital heart disease

    Benjamin Zielonka1, Yuli Y. Kim2,3, Gregory E. Supple2, Sara L. Partington2,3, Emily S. Ruckdeschel2,3, Francis E. Marchlinski2, David S. Frankel2

    Congenital Heart Disease, Vol.14, No.6, pp. 931-938, 2019, DOI:10.1111/chd.12833

    Abstract Objective: Atrial arrhythmias and atrioventricular valve regurgitation (AVVR) are common causes of morbidity among adults with congenital heart disease (ACHD). The impact of rhythm control on AVVR in this population is unknown. We sought to determine whether a rhythm control strategy is associated with greater freedom from AV valve surgery than a rate control strategy.
    Design: Patients evaluated by both ACHD and electrophysiology specialists at a single academic center were screened for atrial arrhythmias and at least moderate‐severe AVVR. Clinical and electrographic data were abstracted. All echocardiograms were in‐ terpreted by a single echocardiographer blinded to treatment… More >

  • Open Access

    ARTICLE

    Impact of feeding mode on neurodevelopmental outcome in infants and children with congenital heart disease

    Line Marie Holst1, Faridis Serrano2, Lara Shekerdemian2, Hanne Berg Ravn1, Danielle Guffey3, Nancy S. Ghanayem2, Sonia Monteiro4

    Congenital Heart Disease, Vol.14, No.6, pp. 1207-1213, 2019, DOI:10.1111/chd.12827

    Abstract Objective: To investigate the impact of feeding mode on neurodevelopmental outcomes in children with congenital heart defects.
    Design: A retrospective cohort study of 208 children with congenital heart disease (CHD), who had surgery from 1 January 2013 until 31 December 2016 at Texas Children’s Hospital, Houston, TX, US.
    Settings: University Hospital, Developmental Outcome Clinic.
    Outcomes measures: Standardized cognitive scores were assessed with Capute Scales and motor development with Revised Gesell Developmental Schedules. We analyzed anthropometrics, mode of feeding, surgical complexity, syndrome, and gen‐ der as predictors of developmental outcomes at four time points: hospital discharge, and 6, 12, and… More >

  • Open Access

    ARTICLE

    Transfusion‐related acute hepatic injury following postoperative platelets administration in pediatric patients undergoing the Fontan procedure

    Uri Pollak1,2,3,4,*, Tatyana Ruderman5,*, Sharon Borik‐Chiger5,6, David Mishaly5,7, Alain Serraf5,7, Amir Vardi5,8

    Congenital Heart Disease, Vol.14, No.6, pp. 968-977, 2019, DOI:10.1111/chd.12825

    Abstract Objective: The final common pathway of single ventricle patients is the Fontan procedure. Among the immediate postoperative complications is acute hepatic injury presented by marked elevation of liver enzymes (alanine transaminase [ALT] and aspartate transaminase [AST]). We aimed to determine the contribution of blood products transfusion to acute hepatic injury.
    Design: Single center retrospective cohort study.
    Setting: Pediatric Cardiac Intensive Care Unit at a tertiary medical center.
    Patients: Ninety‐nine pediatric patients undergoing the Fontan procedure between January 2009 and December 2016.
    Interventions: None.
    Measurements and Main Results: Out of the four types of blood products, transfusion of platelets was found to… More >

  • Open Access

    ARTICLE

    32 year follow up of patients following atrial redirection surgery for transposition of the great arteries

    M. Louise Morrison1, Brian Grant1, Brian A. McCrossan1,2, Andrew J. Sands1,2, Colum G. Owens2, Mark S. Spence2, Frank A. Casey1, Brian G. Craig1,2, Christopher J. Lockhart2

    Congenital Heart Disease, Vol.14, No.5, pp. 846-853, 2019, DOI:10.1111/chd.12822

    Abstract Objective: A significant body of patients who have undergone Mustard or Senning procedure require lifelong follow up. In this retrospective review, we examined the cohort of such patients currently attending our center.
    Design: Patients who had undergone either Mustard or Senning procedure were identified. We retrospectively reviewed medical records, recorded demographic in‐ formation and data regarding the clinical state, NHYA class, cardiopulmonary exer‐ cise testing, NT‐proBNP measurement, and recent cardiac MRI findings.
    Results: Forty‐six patients were identified, the mean age was 32.2 years (± 6.1 years), 67.4% were male. Thirty‐two patients (69.6%) had undergone a Senning procedure. The… More >

  • Open Access

    ARTICLE

    Catheter‐associated bloodstream infection incidence and outcomes in congenital cardiac surgery

    Brena Sue Haughey1, Shelby Coral White2, Michael David Seckeler2

    Congenital Heart Disease, Vol.14, No.5, pp. 811-813, 2019, DOI:10.1111/chd.12809

    Abstract Objective: Catheter‐associated bloodstream infections complicate and prolong hos‐ pitalizations. The incidence of catheter‐associated bloodstream infections in children undergoing congenital cardiac surgery has not been reported. This study sought to define the incidence of catheter‐associated bloodstream infections after congenital cardiac surgery in neonates and infants ≤12 months old and compare hospital out‐ comes and costs to those who underwent surgery and did not have a catheter‐associ‐ ated bloodstream infections.
    Design: Retrospective review of hospital admissions between October 2013 and November 2015 for neonates and infants ≤12 months old at admission with ICD‐9 codes for congenital cardiac surgery from… More >

  • Open Access

    ARTICLE

    Health care‐associated infections are associated with increased length of stay and cost but not mortality in children undergoing cardiac surgery

    Sarah Tweddell, Rohit S. Loomba, David S. Cooper, Alexis L. Benscoter

    Congenital Heart Disease, Vol.14, No.5, pp. 785-790, 2019, DOI:10.1111/chd.12779

    Abstract Introduction: Health care‐associated infections (HAIs) increase mortality, length of stay, and cost in hospitalized patients. The incidence of and risk factors for developing HAIs in the pediatric population after cardiac surgery have been studied. This study evaluates the impact of HAIs on length of stay, inpatient mortality, and cost of hospitalization in the pediatric population after cardiac surgery.
    Methods: TheKids’InpatientDatabasewasqueriedforanalysis.Patientsunder18years of age who underwent cardiac surgery from 1997 to 2012 were included. HAIs were defined as central line‐associated blood stream infections, catheter‐associated urinary tract infections, ventilator‐associated pneumonias, and surgical wound infections. Univariate analysis compared admissions with and… More >

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