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  • Open Access

    ARTICLE

    Stress echocardiography: An overview for use in pediatric and congenital cardiology

    Peter Ermis

    Congenital Heart Disease, Vol.12, No.5, pp. 624-626, 2017, DOI:10.1111/chd.12495

    Abstract Currently, the role of stress echocardiography primarily resides in diagnosing acquired coronary artery disease (CAD) in adults. Besides an increasing concern for traditional CAD in young patients due to obesity and other chronic pediatric diseases, there is also a growing population of adolescents and young adults with “at risk” coronary arteries due to: reimplanted coronaries in congenital heart disease, anomalous origin of the native coronary arteries, coronary abnormalities in Kawasaki’s disease, and posttransplant coronary vasculopathy. Stress echocardiography is well suited for routine screening and monitoring in these patients. Also, due to the ability of stress echocardiography to provide real-time cardiac… More >

  • Open Access

    ARTICLE

    Sudden cardiac death in the young: Epidemiology and overview

    Mark S. Link

    Congenital Heart Disease, Vol.12, No.5, pp. 597-599, 2017, DOI:10.1111/chd.12494

    Abstract Sudden cardiac death (SCD), particularly in the young athlete, is a rare though devastating event for families, institutions, and communities at large. It can also affect the nonathlete and occur at rest, although most commonly associated with exercise activities and/or sports participation. Common causes of SCD include cardiomyopathies, particularly hypertrophic cardiomyopathy in the United States, congenital coronary artery anomalies, channelopathies, among others. This report will explore an overview of the prevalence and causes of SCD in the young. More >

  • Open Access

    ARTICLE

    Decision making in anomalous aortic origin of a coronary artery

    Carlos M. Mery1,2

    Congenital Heart Disease, Vol.12, No.5, pp. 630-632, 2017, DOI:10.1111/chd.12493

    Abstract Anomalous aortic origin of a coronary artery (AAOCA) is the second most common cause of sudden cardiac death (SCD) in young athletes in United States. The exact pathophysiological mechanisms of SCD are unknown. There is lack of long-term outcome data on repaired and unrepaired AAOCA and our current risk stratification scheme for these patients is suboptimal. These patients are evaluated in a nonuniform manner across institutions in United States, and even by different providers residing in the same institution. The main objective of this article is to use what is known and unknown about this disease and to provide a… More >

  • Open Access

    ARTICLE

    Coronary artery bypass grafting in infants, children, and young adults for acquired and congenital lesions

    Constantine Mavroudis

    Congenital Heart Disease, Vol.12, No.5, pp. 644-646, 2017, DOI:10.1111/chd.12491

    Abstract Coronary artery disease ranges from congenital in origin such as anomalous aortic origin of a coronary artery (AAOCA) to acquired diseases such as Kawasaki disease, and previously repaired conditions such as transposition of the great arteries. It is not uncommon, in the long run, for proximal coronary stenosis to develop following arterial switch, AAOCA repair, Ross procedure and Kawasaki disease leading to coronary artery bypass grafing (CABG). The objective of this report is to discuss the indications, challenges, and outcomes of CABG in infants, children, and young adults with acquired and congenital lesions. More >

  • 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 in repair survivors… 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 an associated… 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 and control groups.… 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 2005… 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 in a mixed… More >

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