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  • Open Access

    ARTICLE

    Neurocognitive functioning in adults with congenital heart disease

    Dawn Ilardi1,2, Kim E. Ono1,2, Rebecca McCartney3, Wendy Book4, Anthony Y. Stringer2

    Congenital Heart Disease, Vol.12, No.2, pp. 166-173, 2017, DOI:10.1111/chd.12434

    Abstract Objective: Adults with congenital heart disease (CHD) are at increased risk of psychological disorders and cognitive deficiencies due to structural/acquired neurological abnormalities and neurodevelopmental disorders as children. However, limited information is known about the neuropsychological functioning of adults with CHD. This study screened neuropsychological abilities and explored group differences related to cardiac disease severity and neurological risk factors in adults with CHD.
    Design: Participants completed brief neuropsychological testing. Information about neurobehavioral and psychological symptoms, employment, education, and disability were also collected from the patient and a family member.
    Results: Forty-eight participants with adult CHD completed neuropsychological testing. Visuospatial skills and… More >

  • Open Access

    ARTICLE

    Readmissions after adult congenital heart surgery: Frequency and risk factors

    Yuli Y. Kim1, Wei He2, Thomas E. MacGillivray3, Oscar J. Benavidez2

    Congenital Heart Disease, Vol.12, No.2, pp. 159-165, 2017, DOI:10.1111/chd.12433

    Abstract Objective: Despite their clinical importance, 30-day readmission after adult congenital heart surgery has been understudied. They sought to determine the frequency of unplanned readmissions after adult congenital heart surgery and to identify any potential associated risk factors.
    Design: Retrospective cohort study using State Inpatient Databases for Washington, New York, Florida, and California from 2009 to 2011.
    Setting: Federal and nonfederal acute care hospitals.
    Patients: Admissions of patients age 18–49 years with International Classification of Diseases, Ninth Revision, Clinical Modification codes indicating adult congenital heart surgery.
    Outcome Measures: Readmission was defined as any nonelective hospitalization for a given patient ≤30 days… More >

  • Open Access

    ARTICLE

    Coarctation repair normalizes left ventricular function and aorto-septal angle in neonates

    Haki Jashari1, Katarina Lannering2, Mats Mellander2, Pranvera Ibrahimi1, Annika Rydberg3, Michael Y. Henein1

    Congenital Heart Disease, Vol.12, No.2, pp. 218-225, 2017, DOI:10.1111/chd.12430

    Abstract Background and aims: Patients with coarctation of the aorta (CoA) have increased left ventricular (LV) afterload that has been shown to impact the LV and ascending aortic function. We aimed to examine the effect of coarctation on LV function and aorto-septal angle (AoSA) before and after surgical repair.
    Methods: We retrospectively studied 21 patients with surgically repaired CoA at a median age of 9 (2-53) days at three time points: (1) just before intervention, (2) at short-term follow-up, and (3) at medium-term follow-up after intervention. AoSA was measured from the parasternal long axis view, at three time points during the… More >

  • Open Access

    ARTICLE

    Appropriateness and diagnostic yield of inpatient pediatric echocardiograms

    Sean M. Lang1,2,3, Elijah Bolin1,2,3, Joshua A. Daily1,2,3, Xinyu Tang1,2,3, R. Thomas Collins II1,2,3

    Congenital Heart Disease, Vol.12, No.2, pp. 210-217, 2017, DOI:10.1111/chd.12428

    Abstract Objective: Multiple reports have shown echocardiograms for certain indications are neither costeffective nor of high diagnostic yield. Given the ease with which tests can be obtained at a tertiary academic children’s hospital, our aims were to: (1) determine the diagnostic yield of inpatient studies by in-hospital location; (2) evaluate inpatient echocardiograms to determine indications and level of appropriateness; and (3) evaluate the frequency of cardiology involvement prior to those echocardiograms.
    Design: All initial inpatient echocardiograms interpreted at our institution from February 2009 to December 2014 were reviewed retrospectively. Patient location was grouped as pediatric intensive care (PICU), emergency department (ED),… More >

  • Open Access

    ARTICLE

    Prevalence and pattern of executive dysfunction in school age children with congenital heart disease

    Jacqueline H. Sanz1,2, Madison M. Berl1,2, Anna C. Armour1, Jichuan Wang3,4, Yao I. Cheng3, Mary T. Donofrio5,6

    Congenital Heart Disease, Vol.12, No.2, pp. 202-209, 2017, DOI:10.1111/chd.12427

    Abstract Objective: Executive function, a set of cognitive skills important to social and academic outcomes, is a specific area of cognitive weakness in children with congenital heart disease (CHD). We evaluated the prevalence and profile of executive dysfunction in a heterogeneous sample of school aged children with CHD, examined whether children with executive dysfunction are receiving school services and support, and identified risk factors for executive dysfunction at school age.
    Design: Ninety-one school aged patients completed questionnaires, including the Behavior Rating Inventory of Executive Function (BRIEF) and a medical history questionnaire. An age- and gendermatched control sample was drawn from a… More >

  • Open Access

    ARTICLE

    Cerebral tissue oxygenation index and lactate at 24 hours postoperative predict survival and neurodevelopmental outcome after neonatal cardiac surgery

    Safwat A. Aly1, David Zurakowski2, Penny Glass3, Kami Skurow-Todd4, Richard A. Jonas5, Mary T. Donofrio4

    Congenital Heart Disease, Vol.12, No.2, pp. 188-195, 2017, DOI:10.1111/chd.12426

    Abstract Importance: There are no well-established noninvasive biomarkers for identifying patients at risk for poor outcome after surgery for congenital heart disease. Few studies have assessed prognostic accuracy of cerebral tissue oxygenation index (cTOI) measured by near infrared spectroscopy (NIRS).
    Objective: To assess the utility of noninvasive NIRS monitoring as a predictor of outcomes after neonatal cardiac surgery through measurement of cTOI. To examine the utility of noninvasive NIRS monitoring in combination with lactate concentration and inotropic score in prediction of outcomes after neonatal cardiac surgery.
    Design: Prospective longitudinal cohort study.
    Setting: Operating room and cardiac intensive care unit, Children’s National… More >

  • Open Access

    ARTICLE

    Trends, microbiology, and outcomes of infective endocarditis in children during 2000–2010 in the United States

    Shipra Gupta1, Ankit Sakhuja2, Eric McGrath1, Basim Asmar1

    Congenital Heart Disease, Vol.12, No.2, pp. 196-201, 2017, DOI:10.1111/chd.12425

    Abstract Background: We studied the incidence, trend, underlying conditions, microbiology, and outcomes of infective endocarditis (IE) in children during 11 years using Nationwide Inpatient Sample (NIS) database. This is the largest all-payer inpatient care database in the United States containing data for more than 8 million hospital stays from over 1000 hospitals.
    Methods: NIS data from 2000 to 2010 of primary discharge diagnosis of IE in children aged ≤19 years old were studied. Children with underlying congenital heart defects and acquired heart conditions were identified. Microbiological causative agents were recorded. Linear regression was used to assess trend of incidence over time.
    More >

  • Open Access

    ARTICLE

    Ability of noninvasive criteria to predict hemodynamically significant aortic obstruction in adults with coarctation of the aorta

    Marco Astengo1,2*, Caroline Berntsson3*, Åse A. Johnsson3,4, Peter Eriksson1,2, Mikael Dellborg1,2

    Congenital Heart Disease, Vol.12, No.2, pp. 174-180, 2017, DOI:10.1111/chd.12424

    Abstract Objective: Coarctation of the aorta (CoA) is a common condition. Adult patients with newly diagnosed CoA and patients with recurring or residual CoA require evaluation of the severity of aortic obstruction. Cardiac catheterization is considered the gold standard for the evaluation of hemodynamically significant CoA. The European Society of Cardiology (ESC) Guidelines for the management of grown-up congenital heart disease (GUCH) include noninvasive criteria for identifying significant CoA. Our aim was to investigate the ability of the Class I and Class IIa ESC recommendations to identify significant CoA at cardiac catheterization.
    Design: Sixty-six adult patients with native or recurrent CoA… More >

  • Open Access

    ARTICLE

    Effect of solute temperature in the measurement of cardiac output in children using the thermodilution technique

    Shyam Sathanandam1, Pooja Kashyap1, David Zurakowski2, Lindsey Bird1, Vera McGhee3, Jeffrey Towbin1, Benjamin Rush Waller III1

    Congenital Heart Disease, Vol.12, No.2, pp. 181-187, 2017, DOI:10.1111/chd.12423

    Abstract Objectives: The primary aim of this study was to compare thermodilution (TD) cardiac index (TDCi) measured by injecting cold saline (C-TDCi) to saline at room temperature (R-TDCi). The secondary aim was to assess the change in body temperature with cold saline injections in children.
    Design: This is a prospective, case control study.
    Setting: Cardiac catheterization lab at Le Bonheur Children’s Hospital, Memphis, Tennessee.
    Patients: Eighty-six children ≤18 years of age that underwent cardiac catheterization between April 2013 and April 2015, excluding patients with admixing lesions, on inotropic support and with ejection fraction < 30%.
    Interventions: A TD catheter in the… More >

  • Open Access

    ARTICLE

    Serial cardiac MRIs in adult Fontan patients detect progressive hepatic enlargement and congestion

    Matthew J. Lewis1, Elizabeth Hecht2, Jonathan Ginns1, Joshua Benton2, Martin Prince2, Marlon S. Rosenbaum1

    Congenital Heart Disease, Vol.12, No.2, pp. 153-158, 2017, DOI:10.1111/chd.12422

    Abstract Background: The progression of hepatic disease in adult Fontan patients is not well understood. They reviewed the experience with serial cardiac MRIs (CMR) in adult Fontan patients to determine if hepatic anatomic markers of prolonged Fontan exposure were present and if clinical predictors of progressive hepatic congestion could be identified.
    Methods and Results: A retrospective cohort study of all adult Fontan patients who had undergone at least two CMRs was performed. Hepatic dimensions, inferior vena cava (IVC) size, right hepatic vein (RHV) size and spleen diameter were determined from images acquired at the time of clinically guided CMR. Two radiologists… More >

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