Robert W. Loar, Cory V. Noel, Hari Tunuguntla, John L. Colquitt, Ricardo H. Pignatelli

Congenital Heart Disease, Vol.13, No.1, pp. 5-15, 2018, DOI:10.1111/chd.12564

Abstract Chemotherapy-induced cardiotoxicity in adults and children is a topic with a growing interest in the cardiology literature. The ability to detect cardiac dysfunction in a timely manner is essential in order to begin adequate treatment and prevent further deterioration. This article aims to provide a review on the myocardial injury process, chemotherapeutic agents that lead to cardiotoxicity, the definition of cardiotoxicity, and the methods of timely detection and treatment. More >

Fred H. Rodriguez III^1,2,3,4, Georges Ephrem^1,2, Jennifer F. Gerardin^1,2, Cheryl Raskind-Hood⁵, Carol Hogue⁵, Wendy Book^1,2

Congenital Heart Disease, Vol.13, No.1, pp. 59-64, 2018, DOI:10.1111/chd.12563

Abstract Objective: Although the ICD-9-CM code 745.5 is widely used to indicate the presence of a secundum atrial septal defect (ASD), it is also used for patent foramen ovale (PFO) which is a normal variant and for “rule-out” congenital heart disease (CHD). The ICD-10-CM code Q21.1 perpetuates this issue. The objective of this study was to assess whether code 745.5 in isolation or in combination with unspecified CHD codes 746.9 or 746.89 miscodes for CHD, and if true CHD positives decrease with age.
Design: Echocardiograms of patients with an ICD-9-CM code of 745.5 in isolation or in combination with unspecified CHD… More >

Joshua A. Daily^1,2, Elijah Bolin^1,2, Brian K. Eble^1,2

Congenital Heart Disease, Vol.13, No.1, pp. 154-156, 2018, DOI:10.1111/chd.12561

Abstract Pediatric cardiologists teach complicated concepts to a diverse group of learners that include medical students, nurses, residents, fellows, patients, and parents. Unfortunately, much of what is taught is not retained. In order to increase the likelihood of long-term retention, a cardiologist should teach with both meaning and sense. The authors provide a review of these concepts and give specific examples of how to teach in ways that both make sense and are meaningful to a cardiologist’s leaners. More >

Ashley E. Neal¹, Elizabeth Lehto¹, Karen Hughes Miller², Craig Ziegler², Erin Davis²

Congenital Heart Disease, Vol.13, No.1, pp. 147-153, 2018, DOI:10.1111/chd.12559

Abstract Objective: Although pediatrician-reported relevance of Canadian cardiology-specific objectives has been studied, similar data are not available for the 2016 American Board of Pediatrics (ABP) cardiology-specific objectives. This study asked Kentucky trainees, pediatricians, and pediatric cardiologists to identify “most important” content within these objectives.
Design, Methods, Outcome Measures: This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives. We collected quantitative data (numerical indications of importance) and qualitative data (open-ended replies regarding missing content and difficulty in teaching and learning). Respondents indicated the top two choices of most important items within eight content areas. Descriptive… More >

William N. Evans^1,2, Ruben J. Acherman^1,2, Michael L. Ciccolo^1,3, Sergio A. Carrillo^1,2, Alvaro Galindo^1,2, Abraham Rothman^1,2, Gary A. Mayman^1,2, Elizabeth A. Adams^1,2, Leigh C. Reardon^1,4, Brody J. Winn⁵, Noel S. Yumiaco⁵, Lesley Shimuizu¹, Yoko Inanaga¹, Rowena J. Deleon¹, Humberto Restrepo^1,2

Congenital Heart Disease, Vol.13, No.1, pp. 38-45, 2018, DOI:10.1111/chd.12558

Abstract Objective: We hypothesized that clinic-based, hepatic-ultrasound, elastography measurements, either alone or in combination with other noninvasive variables, might correlate with liver-biopsy fibrosis scores in patients post-Fontan.
Methods: Between March 2012 and February 2017, we identified patients post-Fontan that underwent elective cardiac catheterization and simultaneous transvenous hepatic biopsy. From this group, we selected patients that met inclusion criteria for liver-ultrasound, shear-wave elastography. Utilizing the results of elastography, laboratory testing, and time post-Fontan, we constructed a composite Fontan hepatic index as a sum of elastography measurements in kilopascals, model for end-stage liver disease excluding INR scores, and the square root of the… More >

Uri Pollak^1,2,3, David Mishaly^3,4, Gili Kenet^3,5, Amir Vardi^1,3

Congenital Heart Disease, Vol.13, No.1, pp. 16-25, 2018, DOI:10.1111/chd.12557

Abstract Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of heparin therapy. The risk for HIT correlates with the cumulative dosage of heparin exposure. In Fontan patients, recurrent systemic anticoagulation, traditionally with heparin, is used to alleviate the thrombotic complications that may occur postoperatively when the venous pressure rises and the systemic venous flow into the pulmonary arteries becomes sluggish, putting them at increased risk. As a pressure gradient-dependent circulation, elevation in systemic venous pressure, most often by venous thrombosis, contributes to circuit failure. Therefore, when HIT complicates patients after the Fontan procedure, it is associated with a high thrombotic morbidity and… More >

Yumi Shiina¹, Tomoaki Murakami², Noriko Matsumoto³, Daisuke Okamura⁴, Yuta Takahashi⁴, Yosuke Nishihata¹, Nobuyuki Komiyama¹, Koichiro Niwa¹

Congenital Heart Disease, Vol.13, No.1, pp. 79-84, 2018, DOI:10.1111/chd.12555

Abstract Objectives: To assess body composition and relationships among body composition, appetiterelated hormones, adipocytokines, and heart failure (HF) in adult patients with congenital heart disease (CHD).
Patients: This prospective study enrolled 46 consecutive adult patients with CHD and 12 agematched healthy controls. The patients and control subjects were divided into four groups: 13 patients with Fontan circulation (group A), 16 patients with cyanosis (group B), 17 patients who previously underwent biventricular repair (group C), and 12 age-matched healthy controls.
Design: Body composition was measured using InBody730, and levels of appetite-related hormones (ghrelin and leptin) and adipocytokines (leptin, interleukin-6, and tumor necrosis… More >

Daniel E. Ehrmann¹, Matthew Mulvahill², Shaunda Harendt^1,3, Jessica Church¹, Amy Stimmler¹, Piyagarnt Vichayavilas^1,4, Sanja Batz^1,5, Jennifer Rodgers^1,5, Michael DiMaria¹, James Jaggers¹, Cindy Barrett¹, Jon Kaufman¹

Congenital Heart Disease, Vol.13, No.1, pp. 31-37, 2018, DOI: 10.1111/chd.12550

Abstract Background: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care.
Methods: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center. A systematic feeding readiness assessment (FRA) was utilized to score infant feeding skills. FRA scores were assigned immediately prior to surgery and 1, 2, and 3 weeks after… More >

Sumeet S. Vaikunth^1,2, Roberta G. Williams³, Merujan Y. Uzunyan⁴, Han Tun⁵, Cheryl Barton³, Philip M. Chang⁵

Congenital Heart Disease, Vol.13, No.1, pp. 85-91, 2018, DOI:10.1111/chd.12549

Abstract Objective: Transition from pediatric to adult care is a critical time for patients with congenital heart disease. Lapses in care can lead to poor outcomes, including increased mortality. Formal transition clinics have been implemented to improve success of transferring care from pediatric to adult providers; however, data regarding outcomes remain limited. We sought to evaluate outcomes of transfer within a dedicated transition clinic for young adult patients with congenital heart disease.
Design, Setting, and Patients: We performed a retrospective analysis of all 73 patients seen in a dedicated young adult congenital heart disease transition clinic from January 2012 to December… More >

Astrida Kaugars¹, Clarissa Shields², Cheryl Brosig³

Congenital Heart Disease, Vol.13, No.1, pp. 72-78, 2018, DOI:10.1111/chd.12547

Abstract Objective: The study examined parent stress and health-related quality of life (HRQOL) among families of children with congenital heart disease (CHD) referred for psychological services.
Methods: Parents of 54 children (85% boys) aged 3 to 13 (M_age = 7.48, SD = 2.38) completed measures to assess parenting stress (Parenting Stress Index – Short Form; Pediatric Inventory for Parents) and the PedsQL Family Impact Module. Medical information was retrieved from medical record review.
Results: Half of parents of children with single ventricle anatomy had clinically significant levels of parenting stress. Parents of children with single ventricle anatomy reported more frequent illnessrelated… More >