Tyler H. Harris¹, Mark Adler², Sharon M. Unti³, Mary E. McBride⁴

Congenital Heart Disease, Vol.12, No.4, pp. 546-553, 2017, DOI:10.1111/chd.12483

Abstract Background: Training guidelines state that pediatricians should be able to diagnose, manage, and triage patients with heart disease. Acutely ill cardiac patients present infrequently and with high acuity, yet residents receive less exposure to acute cardiac conditions than previous generations. Trainees must learn to manage these situations despite this gap. Simulation has been used successfully to train learners to provide acute care. We hypothesized that a simulation-based cardiac curriculum would improve residents’ ability to manage cardiac patients.
Methods: Pediatric residents completed 4 simulation cases followed by debriefing and a computer presentation reviewing the learning objectives. Subjects returned… More >

Waldemar F. Carlo¹, Steven T. Clark², Santiago Borasino³, Jeffrey A. Alten³

Congenital Heart Disease, Vol.12, No.4, pp. 540-545, 2017, DOI:10.1111/chd.12482

Abstract Objective: Acute kidney injury (AKI) is a frequent complication after cardiopulmonary bypass (CBP) for cardiac surgery in neonates. It is unclear if exposure to computed tomography angiography (CTA) in the preoperative period increases the risk of AKI. We hypothesized a short interval between CTA and CPB surgery would be associated with higher rates of AKI in infants.
Design: In this single center retrospective review of patients between 2012 and 2015, neonates less than one month old were analyzed if they had CTA prior to cardiac surgery with CPB. Baseline, demographic, fluid balance, and laboratory data was analyzed.… More >

Shankar Baskar¹, Philippa Horne², Samantha Fitzsimmons³, Philip R. Khoury¹, Joseph Vettukattill⁴, Koichiro Niwa⁵, Teiji Agaki⁶, Mark Spence⁷, Hisanori Sakazaki⁸, Gruschen Veldtman¹

Congenital Heart Disease, Vol.12, No.4, pp. 512-519, 2017, DOI:10.1111/chd.12481

Abstract Background: Patients with Eisenmenger syndrome have a shorter lifespan than the general population. A significant proportion develop arrhythmia and some, sudden death.
Objective: The aims of this study were to characterize the frequency, type and effects of arrhythmias in adult patients with Eisenmenger’s syndrome and to identify risk factors for arrhythmias.
Methods: This retrospective study included patients aged ≥18 years of age with Eisenmenger’s syndrome from three institutions. Arrhythmias were noted from electrocardiograms and Holter study reviews.
Results: A total of 167 patients, 96 females, 63 males (gender not available in 9 patients) were included in this study. The… More >

Lubica Kovacikova¹, Martin Zahorec¹, Peter Skrak¹, Brian D. Hanna², R. Lee Vogel²

Congenital Heart Disease, Vol.12, No.4, pp. 491-496, 2017, DOI:10.1111/chd.12480

Abstract Background: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities.
Objective: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology.
Methods: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children’s Hospital of Philadelphia (CHOP), USA. During 1.5–2 hours videoconferences, 2–3 patients with similar complex clinical scenarios were presented to CHOP experts. The main goal of the project… More >

Chih-Hsin Hsu^1,2, Jun-Neng Roan^1,3, Jieh-Neng Wang⁴, Chien-Chi Huang⁵, Chao-Jung Shih³, Jyh-Hong Chen^2,6, Jing-Ming Wu⁴, Chen-Fuh Lam^7,8

Congenital Heart Disease, Vol.12, No.4, pp. 533-539, 2017, DOI:10.1111/chd.12479

Abstract Objectives: Atrial septal defects may result in pulmonary hypertension and right heart remodeling. We analyzed improvements in patients with flow-induced pulmonary hypertension and the activation of endothelial progenitor cells after flow reduction.
Design: This prospective cohort study included 37 patients who were admitted for an occluder implantation. Blood samples were collected before and after the procedure. We determined the number of endothelial progenitor cells in outgrowth colonies and serum Hsp27 concentrations. Daily performance and cardiothoracic ratio were reevaluated later.
Results: Closure of the defect significantly reduced the pulmonary pressure and B-type natriuretic peptide levels. The cardiothoracic ratio and… More >

Shaun Mohan¹, Brady S. Moffett², Wilson Lam², Caridad de la Uz², Christina Miyake², Santiago O. Valdes², Jeffrey J. Kim²

Congenital Heart Disease, Vol.12, No.4, pp. 507-511, 2017, DOI:10.1111/chd.12478

Abstract Objective: As survivors of congenital heart disease (CHD) continue to age, healthcare utilization by this population has increased. It is unknown how often these patients utilize the emergency department (ED) at children’s hospitals and how arrhythmias play a role in their utilization of care.
Design: Using a retrospective cohort design, the Pediatric Hospital Information System (PHIS) database was investigated and we studied adults (≥18 years) with CHD (ACHD) who presented to pediatric EDs from 2004 to 2014.
Setting: Tertiary care pediatric hospitals.
Results: Of the 6310 encounters to pediatric EDs, 1594 (25%) were for arrhythmias. The median age was… More >

Takaya Hoashi¹, Toru Iwasa², Koji Kagisaki¹, Masatoshi Shimada¹, Kenichi Kurosaki², Isao Shiraishi², Hajime Ichikawa¹

Congenital Heart Disease, Vol.12, No.4, pp. 441-447, 2017, DOI:10.1111/chd.12477

Abstract Objective: To review long-term respiratory outcomes for tetralogy of Fallot and absent pulmonary valve (TOF/APV) in respiratory symptomatic populations.
Methods: Of 25 consecutive patients undergoing primary total correction for TOF/APV between 1987 and 2016, Sixteen patients (64%) with a preoperative respiratory disturbance were enrolled. The median age at operation was 1.9 months old, including 4 neonates and 12 infants. Ten patients (62.5%) preoperatively necessitated mechanical ventilator support. During operation, dilated central pulmonary arteries (cPAs) were plicated and retracted anteriorly in all patients, except for the first patient of the study cohort. VSD was completely closed, and the… More >

Karrie F. Downing^1,2, Matthew E. Oster^1,3, 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 >

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 >

Magalie Ladouceur^1,2,3, Nadjia Kachenoura⁴, Gilles Soulat^1,3, Emilie Bollache⁴, Alban Redheuil⁴, Michel Azizi³, Christophe Delclaux³, Gilles Chatellier³, Pierre Boutouyrie^1,3, Laurence Iserin³, Damien Bonnet^2,3, Elie Mousseaux^1,3

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 >