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  • Open Access

    ARTICLE

    Surveillance and screening practices of New England congenital cardiologists for patients after the Fontan operation

    Brooke T. Davey1, Olga H. Toro‐Salazar1, Naomi Gauthier2,3, Anne Marie Valente2, Robert W. Elder4, Fred M. Wu2, Norman Berman3, Phyllis Pollack5, Ji Hyun Lee1, Rahul H. Rathod2

    Congenital Heart Disease, Vol.14, No.6, pp. 1013-1023, 2019, DOI:10.1111/chd.12854

    Abstract Introduction: Surveillance and management guidelines for Fontan patients are lacking due to the paucity of evidence in the literature of screening efficacy on outcome measures.
    Methods: The Fontan Working Group within the New England Congenital Cardiology Association designed an electronic survey to assess surveillance practices for pa‐ tients with Fontan procedures among New England congenital cardiologists and to explore variability in screening low‐risk vs high‐risk Fontan patients across regional programs.
    Results: Fifty‐six cardiologists representing 12 regional programs responded to the survey, comprising ~40% of the total New England congenital cardiac physicians. The majority of desired testing and consultation… More >

  • Open Access

    ARTICLE

    Kidney injury biomarkers after cardiac angiography in children with congenital heart disease

    Masashi Nishida, Shingo Kubo, Yuma Morishita, Kosuke Nishikawa, Kazuyuki Ikeda, Toshiyuki Itoi, Hajime Hosoi

    Congenital Heart Disease, Vol.14, No.6, pp. 1087-1093, 2019, DOI:10.1111/chd.12853

    Abstract Objective: This study aims to investigate the changes in renal function and levels of urinary biomarkers before and after cardiac angiography in children with congenital heart disease (CHD).
    Setting: Children with CHD are at a risk for kidney injury during contrast exposure in cardiac angiography.
    Outcome Measures: We measured urinary protein, albumin, N‐acetyl‐β‐D‐glucosaminidase (NAG), β2‐microglobulin (BMG), and liver‐type fatty acid‐binding protein (L‐FABP) levels, as well as serum creatinine and cystatin C levels, before and after cardiac angiography in 33 children with CHD.
    Results: No significant decrease was noted in either the creatinine‐based or cystatin C‐based estimated glomerular filtration rate… More >

  • Open Access

    ARTICLE

    Screening performance of congenital heart defects in first trimester using simple cardiac scan, nuchal translucency, abnormal ductus venosus blood flow and tricuspid regurgitation

    Natasa Karadzov Orlic1, Amira Egic1, Barbara Damnjanovic‐Pazin MD2 | Relja Lukic1, Ivana Joksic3, Zeljko Mikovic1

    Congenital Heart Disease, Vol.14, No.6, pp. 1094-1101, 2019, DOI:10.1111/chd.12852

    Abstract Objective: The objective of this study was to analyze if the addition of simple cardiac scan in cases with increased nuchal translucency (NT) and/or abnormal ductus venosus (DV) blood flow, and/or tricuspid regurgitation (TCR) can improve detection of congenital heart defects (CHD) in chromosomally normal fetuses without non‐ cardiac defects at 11‐13 + 6 gestational weeks in a population of singleton pregnancies.
    Methods: During the 10 years period, all singleton pregnancies at 11‐13 + 6 weeks were routinely scanned for NT, DV blood flow and TCR assessment and, if a sin‐ gle of these parameters was abnormal,… More >

  • Open Access

    ARTICLE

    Impact of durable ventricular assist devices on post‐transplant outcomes in adults with congenital heart disease

    Ari Cedars1, Luke Burchill2, S. Lucy Roche3, Jonathan Menachem4, Kelly Axsom5, Kristen Tecson6

    Congenital Heart Disease, Vol.14, No.6, pp. 958-962, 2019, DOI:10.1111/chd.12851

    Abstract Background: There are no published data on post‐transplant outcomes in durable ven‐ tricular assist device (VAD)‐supported adult congenital heart disease (ACHD) patients.
    Methods: We compared post‐transplant outcomes in VAD‐supported vs non‐VAD‐ supported ACHD patients using the Scientific Registry of Transplant Recipients.
    Results: At 1 year, there was no difference in post‐transplant mortality between VAD‐supported (12 patients) and non‐VAD‐supported (671 patients) ACHD patients.
    Conclusions: In appropriate ACHD patients, VAD use as a bridge to transplant is a reasonable strategy. More >

  • Open Access

    ARTICLE

    Exercise responses in children and adults with a Fontan circulation at simulated altitude

    Tim Takken1, Alyanne Evertse1, Fleur de Waard1, Mandy Spoorenburg1, Martijn Kuijpers1, Christian Schroer2,3, Erik H. Hulzebos1

    Congenital Heart Disease, Vol.14, No.6, pp. 1005-1012, 2019, DOI:10.1111/chd.12850

    Abstract Background: Traveling to high altitude has become more popular. High‐altitude exposure causes hypobaric hypoxia. Exposure to acute high altitude, during air travel or mountain stays, seems to be safe for most patients with congenital heart disorders (CHD). Still, current guidelines for CHD patients express concerns regarding safety of altitude exposure for patients with a Fontan circulation. Therefore, investigating hemodynamic and pulmonary responses of acute high‐altitude exposure (±2500 m) at rest and during maximal exercise in patients with Fontan circulation can provide clarity in this dispute and may contribute to improvement of clinical counseling.
    Methods: Twenty‐one Fontan patients… More >

  • Open Access

    ARTICLE

    Utilization of inhaled nitric oxide after surgical repair of truncus arteriosus: A multicenter analysis

    Christine M. Riley1, Christopher W. Mastropietro2, Peter Sassalos3, Jason R. Buckley4, John M. Costello4, Ilias Iliopoulos5, Aimee Jennings6, Katherine Cashen7, Sukumar Suguna Narasimhulu8, Keshava M. N. Gowda9, Arthur J. Smerling10, Michael Wilhelm11, Aditya Badheka12, Adnan Bakar13,14, Elizabeth A. S. Moser15, Venu Amula16

    Congenital Heart Disease, Vol.14, No.6, pp. 1078-1086, 2019, DOI:10.1111/chd.12849

    Abstract Background: Elevated pulmonary vascular resistance (PVR) is common following repair of truncus arteriosus. Inhaled nitric oxide (iNO) is an effective yet costly therapy that is frequently implemented postoperatively to manage elevated PVR.
    Objectives: We aimed to describe practice patterns of iNO use in a multicenter cohort of patients who underwent repair of truncus arteriosus, a lesion in which recovery is often complicated by elevated PVR. We also sought to identify patient and center factors that were more commonly associated with the use of iNO in the postoperative period.
    Design: Retrospective cohort study.
    Setting: 15 tertiary care pediatric referral centers.
    Patients:More >

  • Open Access

    ARTICLE

    Progressive loss of bone mass in children with Fontan circulation

    Simone Goa Diab1, Kristin Godang2, Lil‐Sofie Ording Müller3, Runar Almaas4, Charlotte de Lange3, Leif Brunvand1, Kari Margrethe Hansen1, Anne Grethe Myhre5, Gaute Døhlen1, Erik Thaulow1,6, Jens Bollerslev2,6, Thomas Möller1

    Congenital Heart Disease, Vol.14, No.6, pp. 996-1004, 2019, DOI:10.1111/chd.12848

    Abstract Objective: We investigated bone mineral density (BMD) at different ages after the Fontan completion, and we evaluated the relationship between BMD, vitamin D levels, and pertinent patient variables.
    Methods: A cross‐sectional sample of 64 patients was examined with dual‐energy X‐ray absorptiometry (DXA) scans to determine BMD. Of these patients, 24 were also examined with BoneXpert software to determine bone mass density (BMX), expressed as the bone health index (BHI). Blood samples from all patients were analyzed. Patients were divided into three different age groups; A: 4‐9 years old (n = 22), B: 10‐15 years old (n =… More >

  • Open Access

    ARTICLE

    Prolonged Tpeak‐Tend interval is a risk factor for sudden cardiac death in adults with congenital heart disease

    Jim T. Vehmeijer1, Zeliha Koyak1, A. Suzanne Vink1, Werner Budts2,3, Louise Harris4, Candice K. Silversides4, Erwin N. Oechslin4, Aeilko H. Zwinderman5, Barbara J.M. Mulder1,6, Joris R. de Groot1

    Congenital Heart Disease, Vol.14, No.6, pp. 952-957, 2019, DOI:10.1111/chd.12847

    Abstract Objective: Adult congenital heart disease (ACHD) patients are at risk of sudden cardiac death (SCD). However, methods for risk stratification are not yet well‐ defined. The Tpeak‐Tend (TpTe) interval, a measure of dispersion of ventricular repolari‐ zation, is a risk factor for SCD in non‐ACHD patients. We aim to evaluate whether TpTe can be used in risk stratification for SCD in ACHD patients.
    Design: From an international multicenter cohort of 25 790 ACHD patients, we iden‐ tified all SCD cases. Cases were matched to controls by age, gender, congenital de‐ fect, and (surgical) intervention.
    Outcome Measures: TpTe was measured… 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

    Metabolic syndrome in adults with congenital heart disease and increased intima‐media thickness

    Anna‐Luisa Häcker1,2, Renate Oberhoffer1,2, Alfred Hager1, Peter Ewert1, Jan Müller1,2

    Congenital Heart Disease, Vol.14, No.6, pp. 945-951, 2019, DOI:10.1111/chd.12845

    Abstract Aims: Age‐related cardiovascular diseases are a relevant risk in the aging population of adults with congenital heart diseases (ACHD). Risk factors such as the metabolic syndrome (MetS) impact the risk of increased carotid intima‐media thickness (cIMT) and thereby long‐term cardiovascular diseases. The aim of the study was to assess MetS in ACHD and outline a possible association to cIMT.
    Methods and Results: In total, 512 ACHD (43.0 ± 9.6 years, 48.9% female) were screened for MetS by the standards of the International Diabetes Federation, and their cIMT by ultrasound from January 2017 to June 2019. MetS was… More >

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