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  • Open Access

    ARTICLE

    Coronary artery anomalies: A multidisciplinary approach to shape the landscape of a challenging problem

    Silvana Molossi1,2, Hitesh Agrawal1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 596-596, 2017, DOI:10.1111/chd.12490

    Abstract Coronary artery anomalies, particularly anomalous aortic origin of a coronary artery with an interarterial course, are associated with sudden cardiac arrest or death in the young. There is paucity of data on risk stratification and longitudinal follow up is lacking in these patients. Collaboration and sharing of data among specialized centers might shed much needed light in this complex problem. More >

  • Open Access

    ARTICLE

    Long-term outcomes after aortic coarctation repair in Maltese patients: A population-based study

    Maryanne Caruana1, Victor Grech2

    Congenital Heart Disease, Vol.12, No.5, pp. 588-595, 2017, DOI:10.1111/chd.12488

    Abstract Objectives: To investigate survival and freedom from reintervention after aortic coarctation repair in Maltese patients and to compare cardiovascular mortality in coarctation repair survivors with that in the general population.
    Design: All 72 aortic coarctation patients with any type of repair, born by end-1997 and logged in the local database were included. Trends in timing and type of repair were determined by comparing patients born before and after 1985. Kaplan-Meier analyses of survival and reintervention-free survival were performed on the 59 repair survivors with complete follow-up data (mean follow-up 26.13 ± 9.62 (range 1.05–44.55 years). Cardiovascular mortality… More >

  • Open Access

    ARTICLE

    Right aortic arch with situs solitus frequently heralds a vascular ring

    William N. Evans1,2, Ruben J. Acherman1,2, Michael L. Ciccolo1,3, Sergio A. Carrillo1,3, Gary A. Mayman1,2, Carlos F. Luna1,2, Robert C. Rollins1,2, William J. Castillo1,2, Alvaro Galindo1,2, Abraham Rothman1,2, John A. Alexander1,2, Tina W. Kwan1,2, Humberto Restrepo1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 583-587, 2017, DOI:10.1111/chd.12487

    Abstract Objective: We hypothesized that a right aortic arch in situs solitus, with or without an associated cardiovascular malformation, is often associated with a vascular ring.
    Methods: From those born in Southern Nevada between March 2012 and March 2017, we identified 50 (3.6 per 10,000 live births) with a right aortic arch and situs solitus. From the 50 patients, 6 did not meet inclusion criteria for further analysis.
    Results: Of the 44 remaining, 33 (75%) had a vascular ring. Of the 33 with a vascular ring, 26 (79%) occurred with an isolated right aortic arch, and 7 (21%) had More >

  • Open Access

    ARTICLE

    Use of 3D models of vascular rings and slings to improve resident education

    Trahern W. Jones, Michael D. Seckeler

    Congenital Heart Disease, Vol.12, No.5, pp. 578-582, 2017, DOI:10.1111/chd.12486

    Abstract Objective: Three-dimensional (3D) printing is a manufacturing method by which an object is created in an additive process, and can be used with medical imaging data to generate accurate physical reproductions of organs and tissues for a variety of applications. We hypothesized that using 3D printed models of congenital cardiovascular lesions to supplement an educational lecture would improve learners’ scores on a board-style examination.
    Design and Intervention: Patients with normal and abnormal aortic arches were selected and anonymized to generate 3D printed models. A cohort of pediatric and combined pediatric/emergency medicine residents were then randomized to intervention… More >

  • Open Access

    ARTICLE

    Improvement in perioperative care in pediatric cardiac surgery by shifting the primary focus of treatment from cardiac output to perfusion pressure: Are beta stimulants still needed?

    Amir-Reza Hosseinpour1, Mathieu van Steenberghe1, Marc-André Bernath2, Stefano Di Bernardo3, Marie-Hélène Pérez4, David Longchamp4, Mirko Dolci2, Yann Boegli2, Nicole Sekarski3, Javier Orrit1, Michel Hurni1, René Prêtre1, Jacques Cotting4

    Congenital Heart Disease, Vol.12, No.5, pp. 570-577, 2017, DOI:10.1111/chd.12485

    Abstract Objective: An important aspect of perioperative care in pediatric cardiac surgery is maintenance of optimal hemodynamic status using vasoactive/inotropic agents. Conventionally, this has focused on maintenance of cardiac output rather than perfusion pressure. However, this approach has been abandoned in our center in favor of one focusing primarily on perfusion pressure, which is presented here and compared to the conventional approach.
    Design: A retrospective study.
    Setting: Regional center for congenital heart disease. University Hospital of Lausanne, Switzerland.
    Patients: All patients with Aristotle risk score ≥8 that underwent surgery from 1996 to 2012 were included. Patients operated between 1996 and… More >

  • Open Access

    ARTICLE

    Knowledge-based reconstruction for measurement of right ventricular volumes on cardiovascular magnetic resonance images in a mixed population

    Elise D. Pieterman1,2, Ricardo P. J. Budde2, Danielle Robbers-Visser1,2, Ron T. van Domburg3, Willem A. Helbing1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 561-569, 2017, DOI:10.1111/chd.12484

    Abstract Objective: Follow-up of right ventricular performance is important for patients with congenital heart disease. Cardiac magnetic resonance imaging is optimal for this purpose. However, observerdependency of manual analysis of right ventricular volumes limit its use. Knowledge-based reconstruction is a new semiautomatic analysis tool that uses a database including knowledge of right ventricular shape in various congenital heart diseases. We evaluated whether knowledge-based reconstruction is a good alternative for conventional analysis.
    Design: To assess the inter- and intra-observer variability and agreement of knowledge-based versus conventional analysis of magnetic resonance right ventricular volumes, analysis was done by two observers… More >

  • Open Access

    ARTICLE

    Pediatric heart disease simulation curriculum: Educating the pediatrician

    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 >

  • Open Access

    ARTICLE

    Impact of contrast exposure from computed tomography angiography on acute kidney injury after neonatal cardiopulmonary bypass surgery

    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 >

  • Open Access

    ARTICLE

    Arrhythmia burden and related outcomes in Eisenmenger syndrome

    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 >

  • Open Access

    ARTICLE

    Transatlantic medical consultation and second opinion in pediatric cardiology has benefit past patient care: A case study in videoconferencing

    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 >

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