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  • Open Access

    ARTICLE

    Pacemaker treatment after Fontan surgery—A Swedish national study

    Jenny Alenius Dahlqvist1, Jan Sunnegårdh2, Katarina Hanséus3, Eva Strömvall Larsson2, Anders Nygren2, Magnus Dalén4,5, Håkan Berggren6, Jens Johansson Ramgren7, Urban Wiklund8, Annika Rydberg1

    Congenital Heart Disease, Vol.14, No.4, pp. 582-589, 2019, DOI:10.1111/chd.12766

    Abstract Objective: Fontan surgery is performed in children with univentricular heart defects. Previous data regarding permanent pacemaker implantation frequency and indica‐ tions in Fontan patients are limited and conflicting. We examined the prevalence of and risk factors for pacemaker treatment in a consecutive national cohort of patients after Fontan surgery in Sweden.
    Methods: We retrospectively reviewed all Swedish patients who underwent Fontan surgery from 1982 to 2017 (n = 599).
    Results: After a mean follow‐up of 12.2 years, 13% (78/599) of the patients with Fontan circulation had received pacemakers. Patients operated with the extracardiac conduit (EC) type of total cavopulmonary connection… More >

  • 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: ECMO‐free survival, requiring… More >

  • Open Access

    ARTICLE

    Outcomes of Blalock-Taussig shunts in current era: A single center experience

    Navaneetha Sasikumar, Antony Hermuzi, Chun-Po Steve Fan, Kyong-Jin Lee, Rajiv Chaturvedi, Edward Hickey, Osami Honjo, Glen S. Van Arsdell, Christopher A. Caldarone, Arnav Agarwal, Lee Benson

    Congenital Heart Disease, Vol.12, No.6, pp. 808-814, 2017, DOI:10.1111/chd.12516

    Abstract Objectives: Mortality associated with the modified Blalock–Taussig shunt (MBTS) remains high despite advanced perioperative management. This study was formulated to provide data on (1) current indications, (2) outcomes, and (3) factors affecting mortality and morbidity.
    Design: A retrospective single center chart review identified 95 children (excluding hypoplastic left heart lesions) requiring a MBTS. Mortality and major morbidity were analyzed using the Kaplan Meier method and risk factor analysis using Cox’s proportional hazard regression.
    Results: Median age was 8 (0–126) days, weight 3.1(1.7–5.4) kg. Seventy-three percent were neonates, 58% duct dependent and 73% had single ventricle physiology. Ninety-seven percent had a… More >

  • Open Access

    ARTICLE

    Nutritional outcomes in infants with food allergy after cardiac surgery

    Wen-Yi Luo1, Zhuo-Ming Xu1, Li Hong2, Qian-Yue Wu1, Yue-Yue Zhang1

    Congenital Heart Disease, Vol.12, No.6, pp. 777-782, 2017, DOI:10.1111/chd.12489

    Abstract Background: Food allergy is a rapidly growing public health concern because of its increasing prevalence, as well as life-threatening potential. There is limited knowledge on the nutritional status for the pediatric congenital heart disease (CHD) patients with food allergy.
    Objective: This study investigated both clinical and nutritional outcomes according to the CHD infants with food allergy.
    Methods: Forty CHD infants with food allergy and 39 controls were recruited in Shanghai, China. The height and weight for age and weight for height were converted to z-scores to evaluate their effects on nutritional status before and after CHD operation.
    Results: Cow’s milk… More >

  • Open Access

    EDITORIAL

    From the Chair of the AAP Section on Cardiology & Cardiac Surgery

    Christopher Snyder

    Congenital Heart Disease, Vol.12, No.5, pp. 692-692, 2017, DOI:10.1111/chd.12542

    Abstract This article has no abstract. More >

  • Open Access

    ARTICLE

    Section on Cardiology and Cardiac Surgery Full Abstracts from the AAP National Conference & Exhibition September 15–17, 2017—Chicago, IL

    Anoymous

    Congenital Heart Disease, Vol.12, No.5, pp. 649-691, 2017, DOI:10.1111/chd.12538

    Abstract This article has no abstract. More >

  • Open Access

    ARTICLE

    Introduction to anomalous aortic origin of a coronary artery

    Julie A. Brothers1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 600-602, 2017, DOI:10.1111/chd.12497

    Abstract Anomalous aortic origin of a coronary artery (AAOCA) occurs when both coronary arteries arise from the same aortic sinus from a single ostium or two separate ostia. While most coronary anomalies are benign, the two most common subtypes that predispose to sudden cardiac death in the young are interarterial anomalous right coronary artery and interarterial anomalous left coronary artery. Practitioners face many challenges with AAOCA. Diagnosing patients may be difficult because children and adolescents are often asymptomatic and first presentation may be sudden death or sudden cardiac arrest. Risk stratification is also challenging as determining which unique characteristics place the… More >

  • Open Access

    ARTICLE

    Improvement in perioperative care in pediatric cardiac surgery by shifting the primary focus of treatment from cardiac output to perfusion pressure: Are beta stimulants still needed?

    Amir-Reza Hosseinpour1, Mathieu van Steenberghe1, Marc-André Bernath2, Stefano Di Bernardo3, Marie-Hélène Pérez4, David Longchamp4, Mirko Dolci2, Yann Boegli2, Nicole Sekarski3, Javier Orrit1, Michel Hurni1, René Prêtre1, Jacques Cotting4

    Congenital Heart Disease, Vol.12, No.5, pp. 570-577, 2017, DOI:10.1111/chd.12485

    Abstract Objective: An important aspect of perioperative care in pediatric cardiac surgery is maintenance of optimal hemodynamic status using vasoactive/inotropic agents. Conventionally, this has focused on maintenance of cardiac output rather than perfusion pressure. However, this approach has been abandoned in our center in favor of one focusing primarily on perfusion pressure, which is presented here and compared to the conventional approach.
    Design: A retrospective study.
    Setting: Regional center for congenital heart disease. University Hospital of Lausanne, Switzerland.
    Patients: All patients with Aristotle risk score ≥8 that underwent surgery from 1996 to 2012 were included. Patients operated between 1996 and 2005… More >

  • Open Access

    ARTICLE

    Impact of contrast exposure from computed tomography angiography on acute kidney injury after neonatal cardiopulmonary bypass surgery

    Waldemar F. Carlo1, Steven T. Clark2, Santiago Borasino3, Jeffrey A. Alten3

    Congenital Heart Disease, Vol.12, No.4, pp. 540-545, 2017, DOI:10.1111/chd.12482

    Abstract Objective: Acute kidney injury (AKI) is a frequent complication after cardiopulmonary bypass (CBP) for cardiac surgery in neonates. It is unclear if exposure to computed tomography angiography (CTA) in the preoperative period increases the risk of AKI. We hypothesized a short interval between CTA and CPB surgery would be associated with higher rates of AKI in infants.
    Design: In this single center retrospective review of patients between 2012 and 2015, neonates less than one month old were analyzed if they had CTA prior to cardiac surgery with CPB. Baseline, demographic, fluid balance, and laboratory data was analyzed. AKI was staged… More >

  • Open Access

    ARTICLE

    Current trends in racial, ethnic, and healthcare disparities associated with pediatric cardiac surgery outcomes

    Jennifer K. Peterson1, Yanjun Chen2, Danh V. Nguyen3, Shaun P. Setty1

    Congenital Heart Disease, Vol.12, No.4, pp. 520-532, 2017, DOI:10.1111/chd.12475

    Abstract Objective: Despite overall improvements in congenital heart disease outcomes, racial and ethnic disparities have continued. The purpose of this study is to examine the effect of race and ethnicity, as well as other risk factors on congenital heart surgery length of stay and in-hospital mortality.
    Design: From the 2012 Healthcare Cost and Utilization Project Kids Inpatient Database (KID), we identified 13 130 records with Risk Adjustment in Congenital Heart Surgery complexity scoreeligible procedures. Multivariate logistic and linear regression modeling with survey weights, stratification and clustering was used to examine the relationships between predictor variables and length of stay as well… More >

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