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  • Open Access

    Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization

    Jeannine M. Hoch1, Oluwatosin Fatusin2, Gayane Yenokyan3, W. Reid Thompson2, Maureen A. Lefton‐Greif4

    Congenital Heart Disease, Vol.14, No.3, pp. 438-445, 2019, DOI:10.1111/chd.12742

    Abstract Background: Tube feedings are often needed to achieve the growth and nutrition goals associated with decreased morbidity and mortality in patients with single ventricle anat‐ omy. Variability in feeding method through the interstage period has been previously described, however, comparable information following stage 2 palliation is lacking.
    Objectives: To identify types of feeding methods following stage 2 palliation and their influence on length of stay.
    Design: Secondary analysis of the National Pediatric Cardiology Quality Improvement Collaborative registry was performed on 932 patients. Demographic data, medical characteristics, postoperative complications, type of feeding method, and length of stay for stage 2 palliation… More >

  • Open Access

    ARTICLE

    S100B and its relation to cerebral oxygenation in neonates and infants undergoing surgery for congenital heart disease

    Jan Hinnerk Hansen1, Lydia Kissner1, Jana Logoteta1, Olaf Jung1, Peter Dütschke2, Tim Attmann3, Jens Scheewe3, Hans‐Heiner Kramer1,4

    Congenital Heart Disease, Vol.14, No.3, pp. 427-437, 2019, DOI:10.1111/chd.12741

    Abstract Objectives: Neonates and infants undergoing surgery for congenital heart disease are at risk for developmental impairment. Hypoxic‐ischemic brain injury might be one contributing factor. We aimed to investigate the perioperative release of the astro‐ cyte protein S100B and its relation to cerebral oxygenation.
    Methods: Serum S100B was measured before and 0, 12, 24, and 48 hours after sur‐ gery. Cerebral oxygen saturation was derived by near‐infrared spectroscopy. S100B reference values based on preoperative samples; concentrations above the 75th per‐ centile were defined as elevated. Patients with elevated S100B at 24 or 48 hours were compared to cases with S100B in… More >

  • Open Access

    ARTICLE

    Anticipatory perioperative management for patent ductus arteriosus surgery: Understanding postligation cardiac syndrome

    Regan E. Giesinger1, Adrianne R. Bischoff3, Patrick J. McNamara1,2

    Congenital Heart Disease, Vol.14, No.2, pp. 311-316, 2019, DOI:10.1111/chd.12738

    Abstract Ligation of a hemodynamically significant ductus arteriosus results in significant changes in loading conditions which have predictable consequences. Postligation cardiac syndrome, defined as hypotension requiring inotropic support and failure of oxygenation and ventilation, may occur 6‐12 hours following ligation due to left ven‐ tricular systolic and diastolic failure, respectively. Afterload is the primary driver of this decompensation. In this review, we describe the pathophysiological changes in loading conditions associated with postligation cardiac syndrome and other contrib‐ utors to cardiovascular dysfunction following ductal ligation. We present strategies for perioperative optimization and a physiology‐based algorithm for postoperative management guided by targeted neonatal… More >

  • Open Access

    ARTICLE

    Dysrhythmias in patients with a complete atrioventricular septal defect: From surgery to early adulthood

    Charlotte A. Houck1,2, Reinder Evertz3, Christophe P. Teuwen1, Jolien W. Roos‐Hesselink1, Janneke A. E. Kammeraad4, Anthonie L. Duijnhouwer3, Natasja M. S. de Groot3, Ad J. J. C. Bogers2

    Congenital Heart Disease, Vol.14, No.2, pp. 280-287, 2019, DOI:10.1111/chd.12724

    Abstract Objective: Outcomes after surgical repair of complete atrioventricular septal defect (cAVSD) have improved. With advancing age, the risk of development of dysrhythmias may increase. The aims of this study were to (1) examine development of sinus node dysfunction (SND), atrial and ventricular tachyarrhythmias, and (2) study progression of atrioventricular conduction abnormalities in young adult patients with repaired cAVSD.
    Study design: In this retrospective multicenter study, 74 patients (68% female) with a cAVSD repaired in childhood were included. Patients’ medical files were evaluated for occurrence of SND, atrioventricular conduction block (AVB), atrial and ventricular tachyarrhythmias.
    Results: Median age at repair was… More >

  • Open Access

    ARTICLE

    Vasopressor magnitude predicts poor outcome in adults with congenital heart disease after cardiac surgery

    Joseph T. Poterucha1, Saraschandra Vallabhajosyula2, Alexander C. Egbe2, Joseph S. Krien3, Devon O. Aganga4, Kimberly Holst5, Adele W. Golden6, Joseph A. Dearani5, Sheri S. Crow4

    Congenital Heart Disease, Vol.14, No.2, pp. 193-200, 2019, DOI:10.1111/chd.12717

    Abstract Background: High levels of vasoactive inotrope support (VIS) after congenital heart surgery are predictive of morbidity in pediatric patients. We sought to discern if this relationship applies to adults with congenital heart disease (ACHD).
    Methods: We retrospectively studied adult patients (≥18 years old) admitted to the intensive care unit after cardiac surgery for congenital heart disease from 2002 to 2013 at Mayo Clinic. Vasoactive medication dose values within 96 hours of admis‐ sion were examined to determine the relationship between VIS score and poor out‐ come of early mortality, early morbidity, or complication related morbidity.
    Results: Overall, 1040 ACHD patients… More >

  • Open Access

    ARTICLE

    Right thoracotomy for aortic valve replacement in the adolescents with bicuspid aortic valve

    Raffaele Giordano1, Massimiliano Cantinotti2, Giuseppe Comentale1, Luigi Di Tommaso1, Gabriele Iannelli11, Emanuele Pilato1, Gaetano Palma1

    Congenital Heart Disease, Vol.14, No.2, pp. 162-166, 2019, DOI:10.1111/chd.12680

    Abstract Background: In this study, we compared our experience about early and midterm follow‐up outcomes for right anterolateral minithoracotomy (RAMT) vs full sternot‐ omy (FS) in surgical aortic valve replacement (AVR) among adolescents with bicuspid aortic valve (BAV).
    Methods: Patients were retrospectively enrolled from January 2008 to December 2017. Inclusion criteria were patients with BAV who had to undergo to AVR. They were divided in two groups: RAMT and FS. The choice of RAMT was based on indi‐ vidual surgeon’s preferences or when expressly requested by patient that was in‐ formed of nonconventional approach.
    Results: We enrolled 61 patients, 23 in… More >

  • Open Access

    ARTICLE

    Neurocognitive and executive functioning in adult survivors of congenital heart disease

    Leda Klouda1, Wayne J. Franklin1, Anita Saraf1,2, Dhaval R. Parekh1, David D. Schwartz3

    Congenital Heart Disease, Vol.12, No.1, pp. 91-98, 2017

    Abstract Objective: Congenital heart disease (CHD) can affect the developing central nervous system, resulting in neurocognitive and behavioral deficits. Preoperative neurological abnormalities as well as sequelae of the open heart operations required to correct structural abnormalities of the heart contribute to these deficits. There are few studies examining the neurocognitive functioning of adults with CHD. This study sought to investigate multiple domains of neurocognitive functioning in adult survivors of CHD who had childhood cardiac surgery with either moderate or severe disease complexity.
    Design: A total of 48 adults (18–49 years of age) who had undergone cardiac surgery for CHD prior to… More >

  • Open Access

    ARTICLE

    “Frontiers in Fontan failure: A summary of conference proceedings”

    Camden Hebson1,2, Wendy Book1, Robert W. Elder3, Ryan Ford4, Maan Jokhadar1, Kirk Kanter5, Brian Kogon5, Adrienne H. Kovacs6, Rebecca D. Levit1, Michael Lloyd1, Kevin Maher2, Preeti Reshamwala4, Fred Rodriguez III1,2, Rene Romero7, Thor Tejada1, Anne Marie Valente8, Gruschen Veldtman9, Michael McConnell1,2

    Congenital Heart Disease, Vol.12, No.1, pp. 6-16, 2017

    Abstract “Frontiers in Fontan Failure” was the title of a 2015 conference sponsored by Children’s Healthcare of Atlanta and Emory University School of Medicine. In what is hoped to be the first of many such gatherings, speakers and attendees gathered to discuss the problem of long-term clinical deterioration in these patients. Specific focuses included properly defining the problem and then discussing different treatment strategies, both medical and surgical. The health of the liver after Fontan palliation was a particular point of emphasis, as were quality of life and future directions. More >

  • Open Access

    ARTICLE

    Surgical outcome in pediatric patients with Ebstein’s anomaly: A multicenter, long-term study

    Lianne M. Geerdink1,2, Gideon J. du Marchie Sarvaas3, Irene M. Kuipers4, Willem A. Helbing5, Tammo Delhaas6, Henriette ter Heide7, Lieke Rozendaal8, Chris L. de Korte9, Sandeep K. Singh10, Tjark Ebels11, Mark G. Hazekamp12, Felix Haas13, Ad J. J. C. Bogers14, Livia Kapusta1,15

    Congenital Heart Disease, Vol.12, No.1, pp. 32-39, 2017

    Abstract Objective: Surgical outcomes of pediatric patients with Ebstein’s anomaly are often described as part of all-age-inclusive series. Our objective is to focus on patients treated surgically in childhood (0-18 y). We study the intended treatment (biventricular or 1.5 ventricle repair or univentricular palliation), freedom from unplanned reoperation and survival of this specific age group, in a nationwide study.
    Design: Records of all Ebstein’s anomaly patients born between 1980 and 2013 were reviewed. Demographic variables, intraoperative procedures and postoperative outcomes were analyzed.
    Results: Sixty-three patients underwent 109 operations. Median follow-up after diagnosis was 121 months (range 0-216 months). Twenty-nine (46%) patients… More >

  • Open Access

    ARTICLE

    Comparative Evaluation of Flow Quantification across the Atrioventricular Valve in Patients with Functional Univentricular Heart after Fontan’s Surgery and Healthy Controls: Measurement by 4D Flow Magnetic Resonance Imaging and Streamline Visualization

    Hoi Lam She*, Arno A.W. Roest, Emmeline E. Calkoen, Pieter J. van den Boogaard, Rob J. van der Geest, Mark G. Hazekamp§, Albert de Roos, Jos J.M. Westenberg

    Congenital Heart Disease, Vol.12, No.1, pp. 40-48, 2017

    Abstract Purpose. To evaluate the inflow pattern and flow quantification in patients with functional univentricular heart after Fontan’s operation using 4D flow magnetic resonance imaging (MRI) with streamline visualization when compared with the conventional 2D flow approach.
    Method. Seven patients with functional univentricular heart after Fontan’s operation and twenty-three healthy controls underwent 4D flow MRI. In two orthogonal two-chamber planes, streamline visualization was applied, and inflow angles with peak inflow velocity (PIV) were measured. Transatrioventricular flow quantification was assessed using conventional 2D multiplanar reformation (MPR) and 4D MPR tracking the annulus and perpendicular to the streamline inflow at PIV, and they… More >

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