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  • Open Access

    ARTICLE

    Preparing adolescents with heart problems for transition to adult care, 2009–2010 National Survey of Children with Special Health Care Needs

    Karrie F. Downing1,2, Matthew E. Oster1,3, Sherry L. Farr1

    Congenital Heart Disease, Vol.12, No.4, pp. 497-506, 2017, DOI:10.1111/chd.12476

    Abstract Objective: A substantial percentage of children with congenital heart disease (CHD) fail to transfer to adult care, resulting in increased risk of morbidity and mortality. Transition planning discussions with a provider may increase rates of transfer, yet little is known about frequency and content of these discussions. We assessed prevalence and predictors of transition-related discussions between providers and parents of children with special healthcare needs (CSHCN) and heart problems, including CHD.
    Design: Using parent-reported data on 12- to 17-year-olds from the 2009–2010 National Survey of CSHCN, we calculated adjusted prevalence ratios (aPR) for associations between demographic factors… 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… More >

  • Open Access

    ARTICLE

    Impaired atrioventricular transport in patients with transposition of the great arteries palliated by atrial switch and preserved systolic right ventricular function: A magnetic resonance imaging study

    Magalie Ladouceur1,2,3, Nadjia Kachenoura4, Gilles Soulat1,3, Emilie Bollache4, Alban Redheuil4, Michel Azizi3, Christophe Delclaux3, Gilles Chatellier3, Pierre Boutouyrie1,3, Laurence Iserin3, Damien Bonnet2,3, Elie Mousseaux1,3

    Congenital Heart Disease, Vol.12, No.4, pp. 458-466, 2017, DOI:10.1111/chd.12472

    Abstract Objectives: We aimed (1) determine if systemic right ventricle filling parameters influence systemic right ventricle stroke volume in adult patients with D-transposition of the great arteries (D-TGA) palliated by atrial switch, using cardiac magnetic resonance imaging and echocardiography, and (2) to study relationship of these diastolic parameters with exercise performance and BNP, in patients with preserved systolic systemic right ventricle function.
    Design: Single-center, cross-sectional, prospective study.
    Setting: In patients with D-TGA palliated by atrial switch, diastolic dysfunction of the systemic right ventricle may precede systolic dysfunction.
    Methods: Forty-five patients with D-TGA and atrial switch and 45 age and sex-matched… More >

  • Open Access

    ARTICLE

    Pulmonary vein stenosis in patients with Smith-Lemli-Opitz syndrome

    Aaron R. Prosnitz1, Jane Leopold2, Mira Irons3, Kathy Jenkins1, Amy E. Roberts1

    Congenital Heart Disease, Vol.12, No.4, pp. 475-483, 2017, DOI:10.1111/chd.12471

    Abstract Objective: To describe a group of children with co-incident pulmonary vein stenosis and SmithLemli-Opitz syndrome and to generate hypotheses as to the shared pathogenesis of these disorders.
    Design: Retrospective case series.
    Patients: Five subjects in a pulmonary vein stenosis cohort of 170 subjects were diagnosed with Smith-Lemli-Opitz syndrome soon after birth.
    Results: All five cases were diagnosed with Smith-Lemli-Opitz syndrome within 6 weeks of life, with no family history of either disorder. All cases had pathologically elevated 7-dehydrocholesterol levels and two of the five cases had previously reported pathogenic 7-dehydrocholesterol reductase mutations. Smith-Lemli-Opitz syndrome severity scores ranged from mild… More >

  • Open Access

    ARTICLE

    Forced vital capacity predicts morbidity and mortality in adults with repaired tetralogy of Fallot

    Katie E. Cohen1, Matthew W. Buelow1, Jennifer Dixon1, Ruta Brazauskas2, Scott B. Cohen3, Michael G. Earing1,3, Salil Ginde1

    Congenital Heart Disease, Vol.12, No.4, pp. 435-440, 2017, DOI:10.1111/chd.12470

    Abstract Objective: Abnormal lung function characterized by a reduced forced vital capacity (FVC) is common in adults with repaired tetralogy of Fallot (TOF) and is associated with previous thoracotomies and sternotomies. The impact of abnormal lung function on clinical outcomes in adult patients with repaired TOF is unclear. The aim of this study was to determine the impact of abnormal lung function on the outcome of hospitalization and death in adults with repaired TOF when analyzed with other traditional cardiac risk factors.
    Design: Retrospective study of adults with repaired TOF, who underwent spirometry between 2000 and 2014. FVC… More >

  • Open Access

    ARTICLE

    The effect of an electronic health record–based tool on abnormal pediatric blood pressure recognition

    Sarah A. Twichell1, Corinna J. Rea1, Patrice Melvin2, Andrew J. Capraro1, Joshua C. Mandel1, Michael A. Ferguson1, Daniel J. Nigrin1, Kenneth D. Mandl1, Dionne Graham2, Justin P. Zachariah3

    Congenital Heart Disease, Vol.12, No.4, pp. 484-490, 2017, DOI:10.1111/chd.12469

    Abstract Background: Recognition of high blood pressure (BP) in children is poor, partly due to the need to compute age-sex-height referenced percentiles. This study examined the change in abnormal BP recognition before versus after the introduction of an electronic health record (EHR) app designed to calculate BP percentiles with a training lecture.
    Methods and results: Clinical data were extracted on all ambulatory, non-urgent encounters for children 3–18 years old seen in primary care, endocrinology, cardiology, or nephrology clinics at an urban, academic hospital in the year before and the year after app introduction. Outpatients with at least 1… More >

  • Open Access

    ARTICLE

    Predicting long-term mortality after Fontan procedures: A risk score based on 6707 patients from 28 studies

    Tarek Alsaied1, Jouke P. Bokma2, Mark E. Engel3, Joey M. Kuijpers2, Samuel P. Hanke1, Liesl Zuhlke4, Bin Zhang5, Gruschen R. Veldtman6

    Congenital Heart Disease, Vol.12, No.4, pp. 393-398, 2017, DOI:10.1111/chd.12468

    Abstract Background: Reported long-term outcome measures vary greatly between studies in Fontan patients making comprehensive appraisal of mortality hazard challenging. We sought to create a clinical risk score to assist monitoring of Fontan patients in the outpatient setting.
    Methods: A systematic review was conducted to evaluate risk factors for long-term (beyond the first postoperative year) mortality in Fontan patients. Studies were eligible for inclusion if ≥90 patients were included or ≥20 long-term mortalities we reported. Risk factors for long-term mortality were determined. The pooled hazard ratios were used to create components of a clinical score for long-term mortality… More >

  • Open Access

    ARTICLE

    Mitral valve prolapse and Marfan syndrome

    Amitabh Thacoor

    Congenital Heart Disease, Vol.12, No.4, pp. 430-434, 2017, DOI:10.1111/chd.12467

    Abstract Marfan syndrome is a multisystemic genetic condition affecting connective tissue. It carries a reduced life expectancy, largely dependent on cardiovascular complications. More common cardiac manifestations such as aortic dissection and aortic valve incompetence have been widely documented in the literature. Mitral valve prolapse (MVP), however, has remained poorly documented. This article aims at exploring the existing literature on the pathophysiology and diagnosis of MVP in patients with Marfan syndrome, defining its current management and outlining the future developments surrounding it. More >

  • Open Access

    ARTICLE

    NT-proBNP predicts mortality in adults with transposition of the great arteries late after Mustard or Senning correction

    Jana Rubáčková Popelová, MD1,2 | Markéta Tomková1,3 | Jakub Tomek1,4

    Congenital Heart Disease, Vol.12, No.4, pp. 448-457, 2017, DOI:10.1111/chd.12466

    Abstract Objective: The patients after Mustard and Senning corrections of transposition of the great arteries (TGA) are at an increased risk of unexpected death. The aim of this study was to identify markers allowing risk stratification of patients after atrial switch correction of TGA to provide them with optimum care.
    Methods and Results: In this study, 87 patients were retrospectively evaluated after atrial switch correction of TGA followed-up between 2005 and 2015. The mortality during the follow-up was 9% (8 cardiac deaths). Markers significantly predictive of death using univariable Cox proportional hazard ratio survival analysis were: N-terminal pro-B-type… More >

  • Open Access

    ARTICLE

    Rates of autism and potential risk factors in children with congenital heart defects

    Jessica L. Bean Jaworski, Thomas Flynn, Nancy Burnham, Jesse L. Chittams, Therese Sammarco, Marsha Gerdes, Judy C. Bernbaum, Robert R. Clancy, Cynthia B. Solot, Elaine H. Zackai, Donna M. McDonald-McGinn, J. William Gaynor

    Congenital Heart Disease, Vol.12, No.4, pp. 421-429, 2017, DOI:10.1111/chd.12461

    Abstract Objective: Atypical development, behavioral difficulties, and academic underachievement are common morbidities in children with a history of congenital heart defects and impact quality of life. Language and social-cognitive deficits have been described, which are associated with autism spectrum disorders. The current study aimed to assess the rates of autism spectrum disorders in a large sample of children with a history of congenital heart defects and to assess medical, behavioral, and individual factors that may be associated with the risk of autism spectrum disorders.
    Design: Participants included 195 children with a history of congenital heart defects, who are… More >

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