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https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#1
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28736841/outcomes-of-blalock-taussig-shunts-in-current-era-a-single-center-experience
#2
Navaneetha Sasikumar, Antony Hermuzi, Chun-Po Steve Fan, Kyong-Jin Lee, Rajiv Chaturvedi, Edward Hickey, Osami Honjo, Glen S Van Arsdell, Christopher A Caldarone, Arnav Agarwal, Lee Benson
OBJECTIVES: Mortality associated with the modified Blalock-Taussig shunt (MBTS) remains high despite advanced perioperative management. This study was formulated to provide data on (1) current indications, (2) outcomes, and (3) factors affecting mortality and morbidity. DESIGN: A retrospective single center chart review identified 95 children (excluding hypoplastic left heart lesions) requiring a MBTS. Mortality and major morbidity were analyzed using the Kaplan Meier method and risk factor analysis using Cox's proportional hazard regression...
July 24, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28734628/adrenergic-receptor-genotypes-influence-postoperative-outcomes-in-infants-in-the-single-ventricle-reconstruction-trial
#3
Ronand Ramroop, George Manase, Danny Lu, Dorin Manase, Shan Chen, Richard Kim, Teresa Lee, William T Mahle, Kimberly McHugh, Mike Mitchell, Martin Tristani-Firouzi, Stephanie B Wechsler, Nicole S Wilder, Victor Zak, Myriam Lafreniere-Roula, Jane W Newburger, J William Gaynor, Mark W Russell, Seema Mital
OBJECTIVES: Adrenergic receptor (ADR) genotypes have been associated with adverse outcomes in heart failure. Our objective was to evaluate the association of ADR genotypes with post-Norwood outcomes in infants with hypoplastic left heart syndrome (HLHS). METHODS: Infants with HLHS participating in the Pediatric Heart Network Single-Ventricle Reconstruction Trial underwent genotyping for 4 single-nucleotide polymorphisms in 3 ADR genes: ADRB1_231A/G, ADRB1_1165G/C, ADRB2_5318C/G, and ADRA2A_2790C/T...
June 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28734439/coronary-sinus-orifice-atresia-after-the-fontan-completion-unique-repair-technique
#4
Shinya Yokoyama, Takeo Yonekura, Noboru Nishiwaki, Shigeki Taniguchi
We report a successful unroofing of the coronary sinus via a unique technique. Our patient was diagnosed with single ventricle morphology. Pulmonary artery banding and bidirectional cavopulmonary shunt were performed at 1 and 6 months old, respectively. Ordinary univentricular repair strategy was performed; extracardiac total cavopulmonary connection was achieved at 18 months old. Catheterization performed 1 year after the Fontan procedure revealed the coronary sinus orifice atresia, diffuse coronary artery stenosis, and sinusoid formation of the coronary system...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28734437/two-pumps-for-single-ventricle-mechanical-support-for-establishment-of-biventricular-circulation
#5
Stanislav Ovroutski, Oliver Miera, Thomas Krabatsch, Felix Berger, Joachim Photiadis, Evgenii Potapov
A 31-year-old patient with a univentricular heart and double-inlet left ventricle, moderate pulmonary stenosis, and severe mitral valve regurgitation experienced irreversible heart failure after mitral valve replacement. "Biventricular" mechanical circulatory support was initiated. The systemic circulation was supported using the HeartWare ventricular assist device (HVAD) (HeartWare, Framingham, MA) pump in the usual manner. The second pump was inserted into the right atrium and connected to the pulmonary artery after closure of the pulmonary valve and atrial separation...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28720202/a-novel-surgical-approach-to-mechanical-circulatory-support-in-univentricular-infants
#6
Avihu Z Gazit, Orlando Petrucci, Peter Manning, Mark Shepard, Sirine Baltagi, Kathleen Simpson, Chesney Castleberry, Charles Canter, Pirooz Eghtesady
BACKGROUND: Historically, the options for mechanical circulatory support in infants, particularly those with single-ventricle physiology, have been limited and outcomes have generally been poor. We report a new approach implemented for long-term support in a series of such patients. METHODS: This study is a single-center case series of 7 patients with single-ventricle physiology after stage 1 palliation supported with mechanical circulatory support using a novel technique, between May 2014 and September 2015...
July 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28711963/transfer-of-neonates-with-critical-congenital-heart-disease-within-a-regionalized-network
#7
Michael F Swartz, Jill M Cholette, Jennifer M Orie, Marshall L Jacobs, Jeffrey P Jacobs, George M Alfieris
Regionalization of pediatric cardiac surgical care varies between and within states. In most geographic regions, at least some neonates with critical heart disease are transferred from their birth hospital to a different hospital for surgery. The impact of neonatal transfer for surgery, particularly over a considerable distance (>10 miles), has been largely unexplored. We sought to examine the impact of transferring neonates for cardiac surgery. We queried the New York State Cardiac Surgery database (2005-2014) from a single institution to identify neonates born within the cardiac surgery center and those transferred for surgery...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28709664/current-results-of-single-ventricle-palliation-of-patients-with-double-inlet-left-ventricle
#8
Bahaaldin Alsoufi, Courtney McCracken, Kirk Kanter, Subhadra Shashidharan, Brian Kogon
BACKGROUND: Double inlet left ventricle (DILV) is a heterogeneous single ventricle anomaly in which initial presentation, and consequently, timing and palliation mode vary based on morphology and degree of pulmonary or systemic outflow obstruction. Very few reports, mostly old, focused on palliation outcomes of DILV. We report current-era results and examine whether morphologic and subsequently surgical factors influence survival. METHODS: Fifty-eight infants with DILV underwent single ventricle palliation...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28702716/can-the-pulmonary-artery-wedge-pressure-be-used-reliably-as-a-surrogate-for-the-left-atrial-mean-pressure-in-pre-fontan-evaluation
#9
Bassel Mohammad Nijres, Ra-Id Abdulla, Sawsan Awad, Joshua Murphy
The correlation between mean pulmonary artery wedge pressure (PAWP) and left atrial mean pressure (LAMP) has been poorly studied in patients with single ventricle (SV) physiology (Bernstein et al. in Pediatr Cardiol 33: 15-20 2012). The aim of this study is to determine if the PAWP can be used safely as a surrogate to the LAMP to calculate the pulmonary vascular resistance (PVR) during the pre-Fontan evaluation. Also, we aimed to understand if the presence of significant systemic-to-pulmonary collaterals (SPCs) is a confounding factor for accurate estimation of the LAMP...
July 12, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28698113/patient-specific-biomechanical-model-of-hypoplastic-left-heart-to-predict-post-operative-cardio-circulatory-behaviour
#10
Elena Cutrì, Alessio Meoli, Gabriele Dubini, Francesco Migliavacca, Tain-Yen Hsia, Giancarlo Pennati
Hypoplastic left heart syndrome is a complex congenital heart disease characterised by the underdevelopment of the left ventricle normally treated with a three-stage surgical repair. In this study, a multiscale closed-loop cardio-circulatory model is created to reproduce the pre-operative condition of a patient suffering from such pathology and virtual surgery is performed. Firstly, cardio-circulatory parameters are estimated using a fully closed-loop cardio-circulatory lumped parameter model. Secondly, a 3D standalone FEA model is build up to obtain active and passive ventricular characteristics and unloaded reference state...
July 8, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28687711/the-optimal-timing-of-stage-2-palliation-for-hypoplastic-left-heart-syndrome-an-analysis-of-the-pediatric-heart-network-single-ventricle-reconstruction-trial-public-dataset
#11
James M Meza, Edward J Hickey, Eugene H Blackstone, Robert D B Jaquiss, Brett R Anderson, William G Williams, Sally Cai, Glen S Van Arsdell, Tara Karamlou, Brian W McCrindle
Background -In infants requiring three-stage single ventricle palliation for hypoplastic left heart syndrome, attrition after the Norwood procedure remains significant. The effect of the timing of stage-2-palliation (S2P), a physician-modifiable factor, on long term survival is not well understood. We hypothesized that an optimal interval between the Norwood and S2P that both minimizes pre-S2P attrition and maximizes post-S2P survival exists and is associated with individual patient characteristics. Methods -The NIH/NHLBI Pediatric Heart Network Single Ventricle Reconstruction Trial public dataset was used...
July 7, 2017: Circulation
https://www.readbyqxmd.com/read/28680470/a-case-of-successfully-managed-pregnancy-in-a-patient-with-complex-cyanotic-congenital-heart-disease
#12
J Y Liu, W K Tan, E L Tan, J L Tan, L K Tan
Medical advances have increased survival of patients with congenital heart disease. However, cardiac disease in pregnancy carries significant maternal and fetal risks, posing enormous challenges to obstetricians. Cyanotic congenital heart disease is associated with maternal complications such as arrhythmias, thromboembolic events and death. Fetal complications include small for gestational age, miscarriage and prematurity. Cyanotic congenital heart disease patients who continue their pregnancies require holistic multidisciplinary team care with early and coordinated planning for delivery...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28661911/pump-in-parallel-mechanical-assistance-of-partial-cavopulmonary-circulation-using-a-conventional-ventricular-assist-device
#13
Pranava Sinha, Nina Deutsch, Kanishka Ratnayaka, Dingchao He, Murfad Peer, Mustafa Kurkluoglu, Mark Nuszkowski, Erin Montague, Gerald Mikesell, David Zurakowski, Richard Jonas
Mechanical assistance of systemic single ventricle is effective in pulling blood through a cavopulmonary circuit. In patients with superior cavopulmonary connection, this strategy can lead to arterial desaturation secondary to increased inferior caval flow. We hypothesized that overall augmentation in cardiac output with mechanical assistance compensates for the drop in oxygen saturation thereby maintaining tissue oxygen delivery (DO2). Bidirectional Glenn (BDG) was established in seven swine (25 kg) after a common atrium had been established by balloon septostomy...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28658196/late-term-gestation-is-associated-with-improved-survival-in-neonates-with-congenital-heart-disease-following-postoperative-extracorporeal-life-support
#14
Jane M McKenzie, Thomas Scodellaro, Yves d'Udekem, Roberto Chiletti, Warwick Butt, Siva P Namachivayam
OBJECTIVE: Several population-based studies have shown that gestational age 39-40 weeks at birth is associated with superior outcomes in various pediatric settings. A high proportion of births for neonates with congenital heart disease occur before 39 weeks. We aimed to assess the influence of late-term gestation (39-40 wk) on survival in neonates requiring extracorporeal life support following surgery for congenital heart disease. DESIGN: Retrospective cohort study...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28651677/influence-of-weight-at-the-time-of-first-palliation-on-survival-in-patients-with-a-single-ventricle
#15
Sushitha Surendran, T K Susheel Kumar, Ben Tansey, Jerry Allen, David Zurakowski, Umar Boston, Samir H Shah, Christopher J Knott-Craig
BACKGROUND: Numerous advances in surgical techniques and understanding of single-ventricle physiology have resulted in improved survival. We sought to determine the influence of various demographic, perioperative, and patient-specific factors on the survival of single-ventricle patients following stage 1 palliation at our institution. METHODS: We conducted a retrospective study of all single-ventricle patients who had undergone staged palliation at our institution over an 8-year period...
June 27, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28651676/anomalous-origin-of-the-left-coronary-artery-from-the-right-pulmonary-artery-in-a-univentricular-heart
#16
Ziyad M Binsalamah, Diego A Lara, Emmett D McKenzie
Anomalous origin of the left coronary artery from the right pulmonary artery in single ventricles is a very rare congenital anomaly. Failure to recognise it preoperatively may lead to adverse outcomes, including death. We report the case of a neonate with a univentricular heart in the form of a double-outlet right ventricle, mitral atresia with discrete coarctation of the aorta, and an incidental intraoperative finding of an anomalous origin of the left coronary artery from the right pulmonary artery. The patient underwent a successful repair with an uneventful postoperative course...
June 27, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28632651/imaging-in-adult-congenital-heart-disease
#17
Stephanie S Gaydos, Akos Varga-Szemes, Rochelle N Judd, Pal Suranyi, David Gregg
There has been tremendous growth in the population of adults with congenital heart disease (CHD) over the last few decades because of advances in medical care. Whereas some cases are cured during childhood, most patients instead undergo palliation, which leaves them at risk for late complications. Lifelong clinical follow-up involving serial multimodality imaging is helpful to monitor and guide the treatment of late complications. Imaging of these individuals is challenging because of their unique anatomy and therefore requires careful consideration on a case-by-case basis...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28631208/pulmonary-vein-doppler-patterns-in-infants-with-single-right-ventricle-anomalies-after-initial-staged-palliations
#18
Edward C Kirkpatrick, Jessica Steltzer, Pippa Simpson, Amy Pan, Andrea Dragulescu, Christine B Falkensammer, Sarah Gelehrter, Wyman W Lai, Jami Levine, Stephen Miller, Thomas A Miller, Jay Pruetz, Ritu Sachdeva, Deepika Thacker, Peter Frommelt
The aim of this study was to describe serial changes in echocardiographic Doppler pulmonary vein flow (PVF) patterns in infants with single right ventricle (RV) anomalies enrolled in the Single Ventricle Reconstruction trial. Measurement of PVF peak systolic (S) and diastolic (D) velocities, velocity time integrals (VTI), S/D peak velocity and VTI ratios, and frequency of atrial reversal (Ar) waves were made at three postoperative time points in 261 infants: early post-Norwood, pre-stage II surgery, and 14 months...
August 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28608149/exercise-capacity-and-self-efficacy-are-associated-with-moderate-to-vigorous-intensity-physical-activity-in-children-with-congenital-heart-disease
#19
Laura Banks, Shelly Rosenthal, Cedric Manlhiot, Chun-Po Steve Fan, Adam McKillop, Patricia E Longmuir, Brian W McCrindle
This study sought to determine whether exercise capacity, self-efficacy, and gross motor skills are associated with moderate-to-vigorous physical activity (MVPA) levels in children, and if these associations differ by congenital heart disease (CHD) type. Medical history was abstracted from chart review. We assessed MVPA levels (via accelerometry), percent-predicted peak oxygen consumption ([Formula: see text] cardiopulmonary exercise test), gross motor skill percentiles (test of gross motor development version-2), and self-efficacy [children's self-perceptions of adequacy and predilection for physical activity scale (CSAPPA scale)]...
June 12, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28608148/hypoplastic-left-heart-syndrome-sequencing-reveals-a-novel-notch1-mutation-in-a-family-with-single-ventricle-defects
#20
Matthew D Durbin, Adrian G Cadar, Charles H Williams, Yan Guo, David P Bichell, Yan Ru Su, Charles C Hong
Hypoplastic left heart syndrome (HLHS) has been associated with germline mutations in 12 candidate genes and a recurrent somatic mutation in HAND1 gene. Using targeted and whole exome sequencing (WES) of heart tissue samples from HLHS patients, we sought to estimate the prevalence of somatic and germline mutations associated with HLHS. We performed Sanger sequencing of the HAND1 gene on 14 ventricular (9 LV and 5 RV) samples obtained from HLHS patients, and WES of 4 LV, 2 aortic, and 4 matched PBMC samples, analyzing for sequence discrepancy...
August 2017: Pediatric Cardiology
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