Michael Perez¹, Tk Susheel Kumar², Deepthi Hoskoppal³, Yada Akkhawattanangkul⁴, Kimberly Allen⁵, Christopher J. Knott-Craig², Benjamin Rush Waller¹, Shyam Sathanandam¹

Congenital Heart Disease, Vol.12, No.3, pp. 340-349, 2017, DOI:10.1111/chd.12449

Abstract Objectives: The primary objective of this study was to demonstrate that pulmonary artery (PA) debanding via cardiac catheterization using balloon angioplasty is feasible and safe in swine. The secondary objectives were to determine the acute and long-term effects of this therapy.
Design: This is a chronic survival experimental study in newborn swine.
Background: PA bands are used in infants for transient palliation of congenital heart defects with excessive pulmonary blood flow. Although rare, if these defects should close spontaneously or become hemodynamically insignificant, a sternotomy and occasionally cardiopulmonary bypass may still be required for band removal. Alternatively, debanding… More >

Rohit S. Loomba¹, Gabrielle Geddes¹, Amanda J. Shillingford², David A. Hehir²

Congenital Heart Disease, Vol.12, No.3, pp. 332-339, 2017, DOI:10.1111/chd.12448

Abstract Background: Splenic dysfunction is common in heterotaxy syndrome, and increases the risk of bacteremia and bacteremia related mortality. Despite the risks associated with bacteremia in this setting, best practice guidelines for management of infectious concerns are lacking. We conducted a survey of pediatric cardiologists to characterize practice regarding the diagnosis of splenic dysfunction, approach to antibiotic prophylaxis, and management of possible bacterial infection.
Methods: A 22-item web-based survey was distributed via email to pediatric cardiologists in North America.
Results: We received 230 responses from 63 centers, for a response rate of 22%. The majority (83%) always obtain abdominal… More >

Stephanie M. Ford¹, Matthew T. McPheeters², Yves T. Wang³, Pei Ma¹³, Shi Gu³, James Strainic⁴, Christopher Snyder⁴, Andrew M. Rollins³, Michiko Watanabe², Michael W. Jenkins²

Congenital Heart Disease, Vol.12, No.3, pp. 322-331, 2017, DOI:10.1111/chd.12443

Abstract Background: The relationship between changes in endocardial cushion and resultant congenital heart diseases (CHD) has yet to be established. It has been shown that increased regurgitant flow early in embryonic heart development leads to endocardial cushion defects, but it remains unclear how abnormal endocardial cushions during the looping stages might affect the fully septated heart. The goal of this study was to reproducibly alter blood flow in vivo and then quantify the resultant effects on morphology of endocardial cushions in the looping heart and on CHDs in the septated heart.
Methods: Optical pacing was applied to create… More >

Waldemar F. Carlo¹, James F. Cnota², Robert J. Dabal³, Jeffrey B. Anderson²

Congenital Heart Disease, Vol.12, No.3, pp. 315-321, 2017, DOI:10.1111/chd.12442

Abstract Objective: The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) was established in 2008 to improve outcomes of hypoplastic left heart syndrome (HLHS) during the interstage period. They evaluated changes in patient variables and practice variation between early and late eras.
Design: Data including demographic, operative, discharge, and follow-up variables from the first 100 patients (6/2008–1/2010) representing 18 centers were compared with the most recent 100 patients (1/2014–11/2014) from these same centers.
Results: Prenatal diagnosis increased from 69% to 82% (P = .05). There were no differences in gestational age or weight at Norwood. A composite of any preoperative… More >

Paul Cooper¹, Morgan Hindes², Timothy M. Maul^3,4, Stephen C. Cook⁵

Congenital Heart Disease, Vol.12, No.3, pp. 309-314, 2017, DOI:10.1111/chd.12441

Abstract Objective: Medical residents are exposed to increasing numbers of adults with congenital heart disease (ACHD). While inadequate ACHD knowledge may lead to inappropriate practice, this educational deficit has not been investigated. Our aim was to analyze residents’ attitudes, perceived ability, and knowledge of ACHD medicine.
Design, Methods, Outcome Measures: A single center, multiprogram cross-sectional study was conducted in 2015 using an electronic survey to assess 472 medical residents’ perceived knowledge and self-assessed skills related to ACHD medicine. Demographic data obtained included age, gender, level of training and program type.
Results: The survey was completed by 25% of surveyed… More >

Maryanne Caruana¹, Victor Grech²

Congenital Heart Disease, Vol.12, No.3, pp. 301-308, 2017, DOI:10.1111/chd.12439

Abstract Objectives: To determine overall and reintervention-free survival for repaired Maltese tetralogy of Fallot patients and to investigate the potential impact of gender, age at repair, genetic syndromes, previous palliation, and type of repair on these outcomes.
Design: All 130 tetralogy of Fallot patients born before the end of 1997 included in the local database were extracted. Surgical repair type, age at repair and operative survival were analyzed among the 103/130 repaired patients. Kaplan–Meier survival analyses were performed on the 75 repair survivors with complete follow-up data (mean follow-up 26.37 ± 9.27 (range 9.95–51.21) years).
Results: Patients born after… More >

Antonio R. Mott¹, Steven R. Neish², Melissa Challman³, Timothy F. Feltes⁴

Congenital Heart Disease, Vol.12, No.3, pp. 294-300, 2017, DOI:10.1111/chd.12438

Abstract Background: The treatment of children with cardiac disease is one of the most prevalent and costly pediatric inpatient conditions. The design of inpatient medical services for children admitted to and discharged from noncritical cardiology care units, however, is undefined. North American Pediatric Cardiology Programs were surveyed to define noncritical cardiac care unit models in current practice.
Method: An online survey that explored institutional and functional domains for noncritical cardiac care unit was crafted. All questions were multi-choice with comment boxes for further explanation. The survey was distributed by email four times over a 5-month period.
Results: Most programs… More >

Xinghua Gu¹, Qiuwang Zhang², Hourong Sun¹, Jianchun Fei¹, Xiquan Zhang¹, Michael J. Kutryk²

Congenital Heart Disease, Vol.12, No.3, pp. 289-293, 2017, DOI:10.1111/chd.12437

Abstract Objective: To present our experience in transcatheter closure of calcified patent ductus arteriosus (PDA) in older adult patients, which has rarely been reported.
Patients: From 2009 to 2014, a total of 16 patients (median age 58 years) with calcified PDA underwent transcatheter closure in our center. All patients were symptomatic with major symptoms being exertional dyspnea (in 12), palpitations (in 8), and fatigue (in 5). A continuous murmur was heard in all patients. The median ductus diameter was 4 mm (range 3–7 mm). The median Qp/Qs was 1.6 (range 1.4–2.9).
Interventions: Transcatheter closure was performed for all patients.… More >

Jeffrey H. Sacks^1,2, Michael Kelleman², Courtney McCracken², Michelle Glanville¹, Matthew Oster^1,2

Congenital Heart Disease, Vol.12, No.3, pp. 282-288, 2017, DOI:10.1111/chd.12436

Abstract Objective: Hospital readmissions are increasingly becoming a metric for quality in the current landscape of changing and cost effective medicine. However, no 30-d readmission rates have been established for pediatric cardiac medical patients in the United States. Thus, the objective was to determine 30 d readmission rates and risk factors associated with readmission for pediatric cardiac patients, hypothesizing that pediatric cardiac patients would have significantly higher readmission rates than their general pediatric counterparts.
Design: This was a retrospective cohort study.
Setting: The study took place at a large urban academic children’s hospital.
Patients: The 1124 included patients were discharged… More >

Janet M. Simsic, Kirby-Rose Carpenito, Kristin Kirchner, Stephanie Peters, PNP-AC, Holly Miller-Tate, Brian Joy, Mark Galantowicz

Congenital Heart Disease, Vol.12, No.3, pp. 275-281, 2017, DOI:10.1111/chd.12435

Abstract Objective: Enteral feeding is associated with decreased infection rates, decreased mechanical ventilation, decreased hospital length of stay, and improved wound healing. Enteral feeding difficulties are common in congenital heart disease. Our objective was to develop experience-based newborn feeding guidelines for the initiation and advancement of enteral feeding in the cardiothoracic intensive care unit.
Design: This is a retrospective analysis of a quality improvement project.
Setting: This quality improvement project was performed in a cardiothoracic intensive care unit.
Patients: Newborns admitted to the cardiothoracic intensive care unit for cardiac surgery from January 2011 to May 2015 were retrospectively reviewed.
Intervention: Newborn… More >