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Congenital Heart AND Infant* AND Mortal*

Samantha C Butler, Anjali Sadhwani, Christian Stopp, Jayne Singer, David Wypij, Carolyn Dunbar-Masterson, Janice Ware, Jane W Newburger
OBJECTIVE: Mortality rates for children with congenital heart disease (CHD) have significantly declined, resulting in a growing population with associated neurodevelopmental disabilities. American Heart Association guidelines recommend systematic developmental screening for children with CHD. The present study describes results of inpatient newborn neurodevelopmental assessment of infants after open heart surgery. OUTCOME MEASURES: We evaluated the neurodevelopment of a convenience sample of high-risk infants following cardiac surgery but before hospital discharge using an adaptation of the Newborn Behavioral Observation...
October 15, 2018: Congenital Heart Disease
Charlène Bredy, François-Pierre Mongeon, Line Leduc, Annie Dore, Paul Khairy
Atrial septal defect (ASD) is the most common form of congenital heart disease. Left-to-right shunting leads to right ventricular (RV) volume overload with excessive pulmonary blood flow. Complications include exercise intolerance, pulmonary vascular disease, RV dysfunction, paradoxical thromboemboli, and atrial arrhythmias. Women with coexisting severe pulmonary hypertension should be counselled against pregnancy due to high incidence of maternal and fetal morbidity and mortality. In the absence of pulmonary hypertension, pregnancy is generally well tolerated in the setting of an ASD...
September 2018: Journal of Thoracic Disease
Ari Z Klein, Abeed Sarker, Haitao Cai, Davy Weissenbacher, Graciela Gonzalez-Hernandez
BACKGROUND: Although birth defects are the leading cause of infant mortality in the United States, methods for observing human pregnancies with birth defect outcomes are limited. OBJECTIVE: The primary objectives of this study were (i) to assess whether rare health-related events-in this case, birth defects-are reported on social media, (ii) to design and deploy a natural language processing (NLP) approach for collecting such sparse data from social media, and (iii) to utilize the collected data to discover a cohort of women whose pregnancies with birth defect outcomes could be observed on social media for epidemiological analysis...
October 4, 2018: Journal of Biomedical Informatics
Elza Cloete, Frank H Bloomfield, Lynn Sadler, Monique W M de Laat, A Kirsten Finucane, Thomas L Gentles
OBJECTIVE: To establish the impact that timing of diagnosis and place of birth have on neonatal outcomes in those with readily treatable critical congenital heart disease. STUDY DESIGN: This was a population-based study with a complete national cohort of live-born infants with transposition of the great arteries and aortic arch obstruction in New Zealand between 2006 and 2014. Timing of diagnosis, place of birth, survival to surgery, in-hospital events, and neonatal mortality were reviewed...
October 2, 2018: Journal of Pediatrics
Joseph T Mechak, Erika M Edwards, Kate A Morrow, Jonathan R Swanson, Jeffrey Vergales
Prematurity increases pre- and postoperative mortality in children with congenital heart disease. There are no large, multicentered, studies that have evaluated this relation specifically in neonates with hypoplastic left heart syndrome (HLHS). We sought to determine the impact of gestational age (GA) on survival to Stage 1 palliation surgery and hospital discharge in infants with HLHS. We reviewed data from 1,913 neonates with HLHS born at or transferred to a Vermont Oxford Network expanded member hospital in the United States from 2009 to 2014...
October 1, 2018: American Journal of Cardiology
Rajani M George, Anthony B Firulli
Congenital heart defects account for 1% of infant mortality and 10% of in utero deaths. As the vertebrate embryo develops, multiple tissue types develop in tandem to morphologically pattern the functional heart. Underlying cardiac development is a network of transcription factors known to tightly control these morphological events. Members of the Twist family of basic helix-loop-helix transcription factors, Hand1 and Hand2, are essential to this process. The expression patterns and functional role of Hand factors in neural crest cells, endocardium, myocardium, and epicardium is indicative of their importance during cardiogenesis; however, to date, an extensive understanding of the transcriptional targets of Hand proteins and their overall mechanism of action remain unclear...
October 5, 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Xin Xu, Sheng Nie, Aihua Zhang, Jianhua Mao, Hai-Peng Liu, Huimin Xia, Hong Xu, Zhangsuo Liu, Shipin Feng, Wei Zhou, Xuemei Liu, Yonghong Yang, Yuhong Tao, Yunlin Feng, Chunbo Chen, Mo Wang, Yan Zha, Jian-Hua Feng, Qingchu Li, Shuwang Ge, Jianghua Chen, Yongcheng He, Siyuan Teng, Chuanming Hao, Bi-Cheng Liu, Ying Tang, Wenjuan He, Pinghong He, Fan Fan Hou
BACKGROUND AND OBJECTIVES: High-quality epidemiologic data on AKI in children are particularly lacking in developing countries. This study aimed to assess the epidemiology and clinical correlates of AKI among hospitalized children in China. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a multicenter study, in a cohort of hospitalized children aged 1 month to 18 years, from 25 general and children's hospitals in China during 2013-2015. We obtained patient-level data from the electronic hospitalization information system and laboratory databases of all children who had at least two serum creatinine tests within any 7-day window during their first 30 days of hospitalization...
October 4, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Selma Alves Valente do Amaral Lopes, Isabel Cristina Britto Guimarães, Sofia Fontes de Oliva Costa, Angelina Xavier Acosta, Kyoko Abe Sandes, Carlos Maurício Cardeal Mendes
BACKGROUND: Congenital heart diseases are the most common type of congenital defects, and account for more deaths in the first year of life than any other condition, when infectious etiologies are ruled out. OBJECTIVES: To evaluate survival, and to identify risk factors in deaths in newborns with critical and/or complex congenital heart disease in the neonatal period. METHODS: A cohort study, nested to a randomized case-control, was performed, considering the Confidence Interval of 95% (95% CI) and significance level of 5%, paired by gender of the newborn and maternal age...
September 21, 2018: Arquivos Brasileiros de Cardiologia
Charles D Fraser, Kevin D Hill, Amelia Wallace, Karen Chiswell, Xun Zhou, Eric B Jelin, David Kays, Jeffrey P Jacobs, Narutoshi Hibino, Marshall L Jacobs, Luca A Vricella
OBJECTIVE: There has not been a multicenter investigation to elucidate the prevalence and impact of congenital diaphragmatic hernia (CDH) on children undergoing cardiac surgery. We investigated the prevalence of CDH across congenital cardiac diagnostic and procedural groups and its impact on outcomes. METHODS: The STS Congenital Heart Surgery Database was queried to identify children undergoing cardiac surgery who also had CDH. Baseline perioperative characteristics and postoperative outcomes were compared between groups...
September 26, 2018: Seminars in Thoracic and Cardiovascular Surgery
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Peter C Minneci, Michelle Knezevich, Thomas H Chelius, Cooper T Rapp, Deborah Billmire, Steven Bruch, R Carland Burns, Katherine J Deans, Mary E Fallat, Jason D Fraser, Julia Grabowski, Ferdynand Hebel, Michael A Helmrath, Ronald B Hirschl, Rashmi Kabre, Jonathan Kohler, Matthew P Landman, Charles M Leys, Grace Z Mak, Daniel J Ostlie, Jessica Raque, Beth Rymeski, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
PURPOSE: Right sided aortic arch (RAA) is a rare anatomic finding in infants with esophageal atresia with or without tracheoesophageal fistula (EA/TEF). In the presence of RAA, significant controversy exists regarding optimal side for thoracotomy in repair of the EA/TEF. The purpose of this study was to characterize the incidence, demographics, surgical approach, and outcomes of patients with RAA and EA/TEF. METHODS: A multi-institutional, IRB approved, retrospective cohort study of infants with EA/TEF treated at 11 children's hospitals in the United States over a 5-year period (2009 to 2014) was performed...
August 21, 2018: Journal of Pediatric Surgery
Juan Jesús Sánchez-Barriga
BACKGROUND: Congenital heart disease (CHD) represents a global health problem. In Mexico, in children <1 year of age it is the second cause of mortality. The aim was to determine mortality trends from CHD and the great vessels in children and adults nationwide, by state and socioeconomic region. METHODS: Records of mortality associated to CHD and the great vessels for 2000-2015 were obtained from the National Institute of Statistics and Geography. This information is collected from death certificates issued nationwide...
September 3, 2018: Congenital Heart Disease
Daniel Combs, Grant Skrepnek, Michael D Seckeler, Brent J Barber, Wayne J Morgan, Sairam Parthasarathy
STUDY OBJECTIVES: Sleep-disordered breathing (SDB) has adverse cardiovascular effects in children and adults. In adults with cardiac disease, SDB is highly prevalent and confers increased mortality risk. It is unknown if SDB confers a similar risk in infants with congenital heart disease (CHD). We evaluated clinical and economic outcomes associated with SDB among inpatient infants with CHD in the United States from 1997-2012. METHODS: This retrospective, cross-sectional study used discharge data from the Kids' Inpatient Database...
September 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Abhishek Chakraborty, Sudheer R Gorla, Sethuraman Swaminathan
OBJECTIVES: The objective of this study was to analyze the benefits associated with prenatal diagnosis of complex congenital heart disease (CHD) on preoperative morbidity, 30-day and 1-year mortality in this population. METHOD: This was a retrospective review of patients with complex CHD born at our tertiary care center over a 10-year period. Date analysis using Student t test and chi-square test. RESULTS: The overall rate of prenatal detection of complex CHD was 68...
September 1, 2018: Prenatal Diagnosis
Shawn Shah, Alfred Asante-Korang, Sharon R Ghazarian, Gary Stapleton, Carrie Herbert, Jamie Decker, Melvin C Almodovar, Tom R Karl, Nhue L Do, James A Quintessenza, Constantine Mavroudis, Luca A Vricella, Hugh M van Gelder, Vyas Kartha, Plato Alexander, Jennifer Carapellucci, Diane Krasnopero, Jade Hanson, Ernest Amankwah, Joeli Roth, Jeffrey P Jacobs
BACKGROUND: This article reviews all patients who underwent heart transplantation (HTx) within a single institution (172 patients underwent 179 HTx [167 first-time HTxs, 10 second HTxs, 2 third HTxs]) to describe diagnostic characteristics, management protocols, and risk factors for mortality. METHODS: Descriptive analysis was performed for the entire cohort using mean, standard deviation, median, interquartile range, and overall range, as appropriate. Univariable and multivariable Cox proportional hazards models were performed to identify prognostic factors for outcomes over time...
September 2018: World Journal for Pediatric & Congenital Heart Surgery
Resham Kaur, Dilli Bhurtel, Mark R Bielefeld, J Mark Morales, Lucian A Durham
Many infants with congenital heart disease undergo palliative shunt procedures. In our center, cryopreserved saphenous vein and polytetrafluoroethylene (PTFE) are used as grafts to construct these shunts. In this retrospective review, we compare morbidity, mortality, and freedom from reoperation associated with the use of these graft materials. We conducted a retrospective study of 136 consecutive patients who were palliated with shunts between 2006 and 2015. A total of 136 patients were identified, 9 had incomplete data; thus, 127 patients were included: 69 saphenous and 58 PTFE...
September 2018: World Journal for Pediatric & Congenital Heart Surgery
Engin Deniz, Emily K Mis, Maura Lane, Mustafa K Khokha
In the US and Europe, birth defects are the leading cause of infant mortality. Among birth defects, Congenital Heart Disease (CHD) occurs in approximately 8 out of 1000 live births, affects 1.3 million newborns per year worldwide, and has the highest mortality rate. While there is evidence to indicate that CHD does have a genetic basis, most of the CHD burden remains unexplained genetically. Fortunately, new genomics technologies are enabling genetic analyses of CHD patients. Whole exome sequencing of trios as well as copy number variations assayed by high-density SNP arrays can now be obtained at high efficiency and relatively low cost...
2018: Methods in Molecular Biology
Kathleen Fenton, Marcelo Cardarelli, Frank Molloy, William Novick
Congenital heart disease is the most common birth defect worldwide, and accounts for a high proportion of the world's infant mortality. About 9 of every 10 babies born each year are born in areas without adequate access to heart surgery; overcoming this problem will necessitate addressing the worldwide shortage of an estimated 3,700 pediatric cardiac surgeons. Establishing sustainable heart surgery programs requires more than an investment of money: political, social, and cultural issues unique to each environment need to be addressed...
August 24, 2018: Thoracic and Cardiovascular Surgeon
Jennifer A Courtney, James F Cnota, Helen N Jones
Congenital heart disease (CHD) is the most common birth defect, affecting ~1% of all live births (van der Linde et al., 2011). Despite improvements in clinical care, it is the leading cause of infant mortality related to birth defects (Yang et al., 2006) and burdens survivors with significant morbidity (Gilboa et al., 2016). Furthermore, CHD accounts for the largest proportion (26.7%) of birth defect-associated hospitalization costs-up to $6.1 billion in 2013 (Arth et al., 2017). Yet after decades of research with a primary focus on genetic etiology, the underlying cause of these defects remains unknown in the majority of cases (Zaidi and Brueckner, 2017)...
2018: Frontiers in Physiology
Sebastian K Welsh, Alicia M Casey, Martha P Fishman
AIM: Pulmonary hemorrhage in infancy is rare, with challenges in determining its incidence, causes, and outcomes across diverse groups. Our aim was to better understand the incidence and identified causes. We further analyzed the subgroup of patients meeting criteria for acute idiopathic pulmonary hemorrhage of infancy (AIPHI) to determine recurrence, mortality, and treatment. METHODS: We performed a 10-year retrospective cohort study of infants with pulmonary hemorrhage in a large tertiary care center...
August 20, 2018: Pediatric Pulmonology
Bradford L Therrell, Carmencita D Padilla
PURPOSE OF REVIEW: We review newborn screening (NBS) publications from the developing countries to identify global progress in improving child health. RECENT FINDINGS: Many developing countries do not yet have national NBS. As infant mortality rates decline, NBS gains in public health priority. Local incidence and outcome data are used to persuade health officials to include screening in priority health spending. Congenital hypothyroidism is the most cost-effective screened condition in most countries...
August 16, 2018: Current Opinion in Pediatrics
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