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  • Open Access


    A 20-Year Follow-up after the Fontan Operation in a Population with Hypoplastic Left Heart Syndrome

    Eleni P. Asimacopoulos*, Steven J. Staffa, Peter C. Laussen, Kirsten C. Odegard

    Congenital Heart Disease, Vol.17, No.5, pp. 579-590, 2022, DOI:10.32604/chd.2022.020334

    Abstract Background: Thromboembolic events are a cause of significant morbidity and mortality in the Fontan population. We previously reported on coagulation profile changes in a cohort of patients with hypoplastic left heart syndrome (HLHS) from Stage I through Fontan completion. In this report, we examine their clinical status, anticoagulation and incidence of thromboembolic events up to 20 years post Fontan. Methods: A retrospective chart review was conducted for twenty (20) surviving patients, from 1998 through December 2020. Patients who underwent orthotopic heart transplantation (OTx) were followed until their transplant. Patients who were found in the original study to have a factor… More >

  • Open Access


    Congenital Coronary Artery Fistula in Children: A Review of 28 Cases with Clinical and Imaging Outcomes

    Pornrawee Plearntummakun1, Chodchanok Vijarnsorn1,*, Kritvikrom Durongpisitkul1, Prakul Chanthong1, Paweena Chungsomprasong1, Supaluck Kanjanauthai1, Thita Pacharapakornpong1, Jarupim Soongswang1, Thaworn Subtaweesin2

    Congenital Heart Disease, Vol.17, No.4, pp. 463-478, 2022, DOI:10.32604/chd.2022.021545

    Abstract Background: Congenital coronary artery fistula (CCAF) is a rare anomaly. Treatment strategies tend to close the defect with a symptomatic and significant shunt, primarily based on expert consensus and case series. Results for long-term follow-up in children are limited Methods: We conducted a retrospective study to assess clinical and imaging outcomes of children with CCAF at Siriraj Hospital, Thailand during 2000–2020. Patients with single ventricle were excluded. Treatment strategies [surgical closure (SC), and percutaneous closure (PC)] were classified and the clinical outcomes at the follow-up in 2021, including coronary thrombosis, myocardial ischemia, and the results of cardiovascular imaging were reviewed.… More > Graphic Abstract

    Congenital Coronary Artery Fistula in Children: A Review of 28 Cases with Clinical and Imaging Outcomes

  • Open Access


    Computational Fluid Dynamics Simulations at Micro-Scale Stenosis for Microfluidic Thrombosis Model Characterization

    Yunduo Charles Zhao1,2,#, Parham Vatankhah1,#, Tiffany Goh1,2,3, Jiaqiu Wang4, Xuanyi Valeria Chen1, Moein Navvab Kashani5,6, Keke Zheng7, Zhiyong Li4, Lining Arnold Ju1,2,3,*

    Molecular & Cellular Biomechanics, Vol.18, No.1, pp. 1-10, 2021, DOI:10.32604/mcb.2021.012598

    Abstract Platelet aggregation plays a central role in pathological thrombosis, preventing healthy physiological blood flow within the circulatory system. For decades, it was believed that platelet aggregation was primarily driven by soluble agonists such as thrombin, adenosine diphosphate and thromboxane A2. However, recent experimental findings have unveiled an intriguing but complementary biomechanical mechanism—the shear rate gradients generated from flow disturbance occurring at sites of blood vessel narrowing, otherwise known as stenosis, may rapidly trigger platelet recruitment and subsequent aggregation. In our Nature Materials 2019 paper [1], we employed microfluidic devices which incorporated micro-scale stenoses to elucidate the molecular insights underlying the… More >

  • Open Access


    Numerical Investigation of an Idealized Total Cavopulmonary Connection Physiology Assisted by the Axial Blood Pump With and Without Diffuser

    Zhenxin Zhao1,#, Tong Chen2,#, Xudong Liu3, Shengzhang Wang2,4,*, Haiyan Lu5,*

    CMES-Computer Modeling in Engineering & Sciences, Vol.125, No.3, pp. 1173-1184, 2020, DOI:10.32604/cmes.2020.013702

    Abstract In order to improve the surgical treatment of the congenital heart disease patient with single ventricle defect, two axial flow blood pumps, one with diffuser and the other without diffuser, were designed and virtually implanted into an idealized total cavopulmonary connection (TCPC) model to form two types of Pump-TCPC physiological structure. Computational fluid dynamics (CFD) simulations were performed to analyze the variations of the hemodynamic characteristics, such as flow field, wall shear stress (WSS), oscillatory shear index (OSI), relative residence time (RRT), between the two Pump-TCPC models. Numerical results indicate that the Pump-TCPC with diffuser has better flow field stability,… More >

  • Open Access


    Kawasaki disease: Medical therapies

    Jane W. Newburger

    Congenital Heart Disease, Vol.12, No.5, pp. 641-643, 2017, DOI:10.1111/chd.12502

    Abstract Medical therapies in patients with Kawasaki disease (KD) are administered to reduce the prevalence of coronary aneurysms, reduce systemic inflammation, and prevent coronary thrombosis. All patients with acute KD should be treated with intravenous immunoglobulin (IVIG) 2 g/kg, generally administered over 10–12 hours. Aspirin has never been shown to prevent aneurysms, but is given for its anti-inflammatory and antipyretic effects until the patient has been afebrile for 2 days, then lowered to an antiplatelet dose. Adjunctive therapy with a longer course of corticosteroids, together with IVIG and aspirin, may be considered for primary treatment in patients at high risk for… More >

  • Open Access


    Tissue plasminogen activator for neonatal coronary thrombosis presenting with mitral valve regurgitation and impaired ventricular function

    Delaram Molkara, Jose A. Silva Sepulveda, Thomas Do, Christopher Davis, Gregory P. Goldstein, John W. Moore, Howaida G El-Said

    Congenital Heart Disease, Vol.12, No.3, pp. 270-274, 2017, DOI:10.1111/chd.12432

    Abstract Objective: Neonatal coronary thrombosis is a rarely reported disorder, with variable outcomes described. This study assessed the feasibility and safety of an institutional protocol using tissue plasminogen activator (tPA) administration for the treatment of neonatal coronary artery thrombi.
    Methods: They reviewed the outcome of three neonates with clinical evidence of myocardial infarction secondary to coronary thrombosis. All three underwent the tPA treatment protocol.
    Results: The three described cases presented at 5 hours, 15 hours, and 10 days of life. The patients identified underwent the tPA protocol at least once. There was clinical evidence of improvement in coronary flow, as well… More >

  • Open Access


    Risk factors for hyperuricemia in congenital heart disease patients and its relation to cardiovascular death

    Juan Lizandro Rodríguez‐Hernández1, Fayna Rodríguez‐González2, Marta Riaño‐Ruiz3, Efrén Martínez‐Quintana1,4

    Congenital Heart Disease, Vol.13, No.5, pp. 655-662, 2018, DOI:10.1111/chd.12620

    Abstract Introduction: Hyperuricemia has been associated with cardiovascular risk factors but it remains controversial if uric acid is an independent predictor of cardiac mortality.
    Methods: A total of 503 CHD patients (457 nonhypoxemic and 46 hypoxemic) and 772 control patients fulfilled inclusion criteria. Demographic, clinical, and analytical data [serum uric acid and 24h urine uric acid levels, N‐terminal pro‐B‐type natriuretic peptide (NT‐pro‐BNP), and C‐reactive‐protein (CRP) concentrations] were studied. Survivals curves to determine cardiac death and arterial thrombosis in CHD patients were also examined.
    Results: Noncyanotic and cyanotic CHD patients had significant higher serum uric acid concentration (5.2 ± 1.5 vs 4.9 ± 1.3mg/dL, P = .007 and… More >

  • Open Access


    Novel oral anticoagulant use in adult Fontan patients: A single center experience

    Justin Georgekutty1, Amir Kazerouninia2, YunFei Wang3, Peter R. Ermis4, Dhaval R. Parekh4, Wayne J. Franklin4, Wilson W. Lam4

    Congenital Heart Disease, Vol.13, No.4, pp. 541-547, 2018, DOI:10.1111/chd.12603

    Abstract Objective: Adult Fontan patients are at increased risk for thrombosis and thromboembolic complications leading to increased morbidity and mortality. Most are prescribed antiplatelet or anticoagulant therapy for thromboprophylaxis; novel oral anticoagulants (NOACs) are uncommonly used given lack of data on their use in this population and generalized concerns regarding Fontan patients’ abnormal coagulation. We report the largest single-center experience with the use of NOACs for treatment and prophylaxis of thrombosis and thromboembolism in adult Fontan patients.
    Results: A retrospective chart review identified 21 patients (11 female, 10 male), median age 33 years (18-50) at first initiation, who were prescribed a… More >

  • Open Access


    Diabetes and Thrombosis: The Dark Side of the Force

    Lining Arnold Ju1,2,3,4,6,†,*, James McFadyen4,†, Saheb Al-Daher4,†, Imala Alwis1,2,3,4, Yunfeng Chen6,7,8, Mark E. Cooper9, Cheng Zhu1,2,3,5,6,7, Shaun P. Jackson1,2,3,4,8

    Molecular & Cellular Biomechanics, Vol.16, Suppl.2, pp. 96-96, 2019, DOI:10.32604/mcb.2019.06979

    Abstract Thrombotic diseases where platelets form clots and obstruct blood vessels remains the leading cause of death and disability in the world. Despite intense investigation over the last 40 years into the discovery and development of more effective drugs, less than 1 in 6 patients taking anti-thrombotic therapies avoid a fatal event. This situation is likely to worsen in younger generations due to the rapidly growing incidence of diabetes, which makes people more prone to thrombosis and resistant to existing anti-thrombotics with unknown reasons.
    To investigate this, I have developed the ‘Biomembrane Force Probe’ as the first-of-its-kind. This nanotool represents… More >

  • Open Access


    The Degree of Question Mark of Aorta Can Predict the Thrombosis Rate in the False Lumen of a Type-B Aortic Dissection After TEVAR

    Da Li1,#, Liqing Peng2,#, Yi Wang3, Ding Yuan4, Tinghui Zheng1,*

    Molecular & Cellular Biomechanics, Vol.16, Suppl.1, pp. 39-39, 2019, DOI:10.32604/mcb.2019.05718

    Abstract Objective: Thoracic endovascular aortic repair (TEVAR) of type B aortic dissection (AD) is to initiate the thrombosis in the false lumen to eventually result in aortic remodeling. We aim to find out whether the false lumen (FL) thrombosis rate after TEVAR can be predicted accurately by an index that expresses the degree of aortic arch angulation. Method: Three-dimensional aortic arch geometry of 39 type B AD patients (mean age: 48 years) after TEVR were reconstructed from post-operative CT images. For the first time, the question mark which takes into account the curvature of both aortic arch and the descending aorta… More >

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