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Michelle Gurvitz

Georges Ephrem, Camden Hebson, Anitha John, Estella Moore, Maan Jokhadar, Ryan Ford, Gruschen Veldtman, Yoav Dori, Michelle Gurvitz, Brian Kogon, Adrienne Kovacs, Meghan Roswick, Michael McConnell, Wendy M Book, Fred Rodriguez
The initial "Frontiers in Fontan Failure" conference in 2015 in Atlanta, GA, provided an opportunity for experts in the field of pediatric cardiology and adult congenital heart disease to focus on the etiology, physiology, and potential interventions for patients with "Failing Fontan" physiology. Four types of "Fontan Failure" were described and then published by Dr Book et al. The acknowledgment that even Dr Fontan himself realized that the Fontan procedure "imposed a gradually declining functional capacity and premature late death after an initial period of often excellent palliation...
October 20, 2018: Congenital Heart Disease
Sarah S Pickard, Kimberlee Gauvreau, Michelle Gurvitz, Joshua J Gagne, Alexander R Opotowsky, Kathy J Jenkins, Ashwin Prakash
Adults with repaired coarctation of the aorta (CoA) suffer reduced long-term survival compared with the general population, in part due to coronary artery disease (CAD). There is conflicting evidence as to whether or not CoA is an independent risk factor for CAD. The primary aim was to determine if CoA is independently associated with premature myocardial infarction (MI) in the contemporary era. The secondary aim was to determine if CoA is independently associated with early coronary intervention. In a cross-sectional study using the National Inpatient Sample database from 2005 to 2014, we compared the age at MI and the age at coronary intervention (coronary artery bypass grafting or percutaneous coronary intervention, in the absence of MI diagnosis) in patients with and without CoA using weighted linear regression...
December 15, 2018: American Journal of Cardiology
Abigail Khan, Michelle Gurvitz
The worldwide population of adults with congenital heart disease (ACHD) has grown steadily over the last few decades, estimated at approximately 1.4 million people in 2010 (Gilboa et al., 2016). Innovations in surgical and medical treatment of children with congenital heart disease (CCHD) have dramatically improved survival, resulting in a growing population of ACHD patients with unique health needs (Marelli et al., 2014; Khairy et al., 2010). This growth has significant implications for health care providers and health systems, which must adapt to meet the demands of caring for this complex population...
August 17, 2018: Progress in Cardiovascular Diseases
Karen K Stout, Curt J Daniels, Jamil A Aboulhosn, Biykem Bozkurt, Craig S Broberg, Jack M Colman, Stephen R Crumb, Joseph A Dearani, Stephanie Fuller, Michelle Gurvitz, Paul Khairy, Michael J Landzberg, Arwa Saidi, Anne Marie Valente, George F Van Hare
No abstract text is available yet for this article.
August 10, 2018: Journal of the American College of Cardiology
Karen K Stout, Curt J Daniels, Jamil A Aboulhosn, Biykem Bozkurt, Craig S Broberg, Jack M Colman, Stephen R Crumb, Joseph A Dearani, Stephanie Fuller, Michelle Gurvitz, Paul Khairy, Michael J Landzberg, Arwa Saidi, Anne Marie Valente, George F Van Hare
No abstract text is available yet for this article.
August 10, 2018: Journal of the American College of Cardiology
Fred M Wu, Alexander R Opotowsky, Erica R Denhoff, Russell Gongwer, Michelle Z Gurvitz, Michael J Landzberg, Keri M Shafer, Anne Marie Valente, Ahmet Z Uluer, Jonathan Rhodes
While the Fontan procedure has improved life expectancy, patients with single ventricle physiology have impaired exercise capacity due to limited increase in pulmonary blood flow during activity. Enhancing the "thoracic pump" using inspiratory muscle training (IMT) may ameliorate this impairment. Adult nonsmokers with Fontan physiology were recruited through Boston Children's Hospital's outpatient clinic. Participants underwent cardiopulmonary exercise testing and pulmonary function testing, followed by 12 weeks of IMT and then repeat testing...
July 29, 2018: Seminars in Thoracic and Cardiovascular Surgery
Sarah S Pickard, Kimberlee Gauvreau, Michelle Gurvitz, Joshua J Gagne, Alexander R Opotowsky, Kathy J Jenkins, Ashwin Prakash
BACKGROUND: Adults with repaired coarctation of the aorta (CoA) have reduced long-term survival compared with the general population. This study aimed to determine whether CoA is independently associated with premature ischemic and hemorrhagic stroke in the contemporary era. METHODS AND RESULTS: This was a cross-sectional study utilizing the National Inpatient Sample database from 2005 to 2014. We hypothesized that patients with CoA are hospitalized with ischemic and hemorrhagic stroke at a younger age compared with the general population...
June 1, 2018: Journal of the American Heart Association
Michael J Landzberg, Michelle Gurvitz
No abstract text is available yet for this article.
April 24, 2018: Journal of the American College of Cardiology
Saurabh Rajpal, Laith Alshawabkeh, Nureddin Almaddah, Caroline M Joyce, Keri Shafer, Michelle Gurvitz, Sushrut S Waikar, Finnian R Mc Causland, Michael J Landzberg, Alexander R Opotowsky
Importance: Albuminuria is associated with adverse outcomes in diverse groups of patients, but the importance of albuminuria in the emerging population of increasingly complex adults with congenital heart disease (ACHD) remains unknown. Objective: To assess the prevalence, risk factors, and prognostic implications of albuminuria in ACHD. Design, Setting, and Participants: This prospective study assessed a cohort of ambulatory patients aged 18 years and older who were examined at an ACHD referral center and enrolled in the Boston ACHD Biobank between May 17, 2012, to August 5, 2016...
April 1, 2018: JAMA Cardiology
Rose Y Hardy, Michelle Gurvitz, Jamie L Jackson, Susan May, Paula Miller, Rachel Daskalov, Elyse Foster
As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. PARTICIPANTS: A case of a male with CHD presenting to the college health clinic with a new onset headache. METHODS: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD...
May 2018: Journal of American College Health: J of ACH
Sarah Cohen, Aihua Liu, Michelle Gurvitz, Liming Guo, Judith Therrien, Claudie Laprise, Jay S Kaufman, Michal Abrahamowicz, Ariane J Marelli
BACKGROUND: Adults with congenital heart disease (CHD) are exposed to increasing amounts of low-dose ionizing radiation (LDIR) from cardiac procedures. Cancer prevalence in this population is higher than in the general population. This study estimates the association between LDIR exposure from cardiac procedures and incident cancer in adult patients with CHD. METHODS: The study population derived from the Quebec Congenital Heart Disease Database. We measured cumulative numbers of LDIR-related cardiac procedures for each patient until 1 year before the time of cancer diagnosis or administrative censoring...
March 27, 2018: Circulation
Curt J Daniels, Elisa A Bradley, Mike J Landzberg, Jamil Aboulhosn, Robert H Beekman, Wendy Book, Michelle Gurvitz, Anitha John, Binu John, Ariane Marelli, Bradley S Marino, L LuAnn Minich, John J Poterucha, Elizabeth B Rand, Gruschen R Veldtman
Over the past decade, as the majority of patients with single ventricle anatomy who have undergone the Fontan operation reach adulthood, a newly recognized disease process, Fontan-associated liver disease (FALD), has emerged. FALD is an extracardiac complication that may lead to substantial comorbid disease and premature mortality. The risk factors, pathophysiology, longitudinal consequences, and therapeutic options related to FALD remain poorly defined. Although we recognize that Fontan circulatory properties are associated with extracardiac organ dysfunction, numerous gaps in our understanding of the nature of this relationship exist...
December 26, 2017: Journal of the American College of Cardiology
Devyani Chowdhury, Michelle Gurvitz, Ariane Marelli, Jeffrey Anderson, Carissa Baker-Smith, Karim A Diab, Thomas C Edwards, Tom Hougen, Roy Jedeikin, Jonathan N Johnson, Peter Karpawich, Wyman Lai, Jimmy C Lu, Stephanie Mitchell, Jane W Newburger, Daniel J Penny, Michael A Portman, Gary Satou, David Teitel, Juan Villafane, Roberta Williams, Kathy Jenkins
The American College of Cardiology Adult Congenital and Pediatric Cardiology (ACPC) Section had attempted to create quality metrics (QM) for ambulatory pediatric practice, but limited evidence made the process difficult. The ACPC sought to develop QMs for ambulatory pediatric cardiology practice. Five areas of interest were identified, and QMs were developed in a 2-step review process. In the first step, an expert panel, using the modified RAND-UCLA methodology, rated each QM for feasibility and validity. The second step sought input from ACPC Section members; final approval was by a vote of the ACPC Council...
February 7, 2017: Journal of the American College of Cardiology
Michelle Gurvitz, Raluca Ionescu-Ittu, Liming Guo, Mark J Eisenberg, Michal Abrahamowicz, Louise Pilote, Ariane J Marelli
The prevalence rate of cancer among adult patients with congenital heart disease (CHD) in North America has not been previously described. The Quebec adult CHD database was used to determine the prevalence rate of cancer among adult patients with CHD measured as the number of adults with CHD and cancer alive in 2005 per 1,000 adults with CHD. This prevalence rate was compared with the prevalence rate of cancer in the general population of adults in Canada. Types of cancer among the CHD group were described by gender and age...
December 1, 2016: American Journal of Cardiology
Maria Jorina, Ayesha Cammaerts, Janice Singer, Al Ozonoff, Eugenia Chan, Richard Antonelli, Michelle Gurvitz, Kathy Jenkins
OBJECTIVE: To describe the measure review and evaluation process used to identify new measures of care coordination for children with behavioral health needs conducted as part of Massachusetts' Children's Health Insurance Program Reauthorization Act Quality Demonstration Grant. METHOD: The Massachusetts Child Health Quality Coalition identified a shortage of pediatric measures of care coordination in behavioral health. After an extensive literature review, the Measure Development Committee applied the Care Coordination Key Elements Framework (Framework), which was designed as part of the grant work, and used a modified RAND Delphi method to conduct feasibility and validity evaluation and propose the new candidate measures for further rigorous testing...
October 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
Michelle Gurvitz, Kristin M Burns, Ralph Brindis, Craig S Broberg, Curt J Daniels, Stephanie M P N Fuller, Margaret A Honein, Paul Khairy, Karen S Kuehl, Michael J Landzberg, William T Mahle, Douglas L Mann, Ariane Marelli, Jane W Newburger, Gail D Pearson, Randall C Starling, Glenn R Tringali, Anne Marie Valente, Joseph C Wu, Robert M Califf
Congenital heart disease (CHD) is the most common birth defect, affecting about 0.8% of live births. Advances in recent decades have allowed >85% of children with CHD to survive to adulthood, creating a growing population of adults with CHD. Little information exists regarding survival, demographics, late outcomes, and comorbidities in this emerging group, and multiple barriers impede research in adult CHD. The National Heart, Lung, and Blood Institute and the Adult Congenital Heart Association convened a multidisciplinary working group to identify high-impact research questions in adult CHD...
April 26, 2016: Journal of the American College of Cardiology
Virginie Beauséjour Ladouceur, Patrick R Lawler, Michelle Gurvitz, Louise Pilote, Mark J Eisenberg, Raluca Ionescu-Ittu, Liming Guo, Ariane J Marelli
BACKGROUND: The burden of low-dose ionizing radiation (LDIR) exposure from medical procedures among individuals with congenital heart disease (CHD) is unknown. In this longitudinal population-based study, we sought to determine exposure to LDIR-related cardiac imaging and therapeutic procedures in children and adults with CHD. METHODS AND RESULTS: In an analysis of the Quebec CHD database, exposure to the following LDIR-related cardiac procedures was recorded: catheter-based diagnostic procedures, structural heart interventions, coronary interventions, computed tomography scans of the chest, nuclear procedures, and pacemaker/implantable cardioverter-defibrillator insertion and repair...
January 5, 2016: Circulation
Diego Porras, Michelle Gurvitz, Audrey C Marshall, Sitaram M Emani
We describe a hybrid method for minimally invasive pulmonary valve replacement without the use of cardiopulmonary bypass in 3 patients with high surgical risk and dilated right ventricular outflow tracts incompatible with currently available transcatheter devices. This procedure entails surgical creation of a landing zone in the main pulmonary artery through an anterior thoracotomy, followed by transcatheter Melody valve pulmonary valve replacement. Particularly in high-risk patients, this approach may limit morbidity and mortality associated with traditional surgical pulmonary valve replacement...
November 2015: Annals of Thoracic Surgery
Keri Shafer, Michelle Gurvitz
Providing medical care for adults with congenital heart disease (CHD) is a complex endeavor requiring an understanding of all aspects of the health system. Adult patients with CHD often have multiple medical issues related to the underlying CHD, the sequelae of surgical or catheter interventions, and the addition of typical conditions of adulthood superimposed on the CHD. In this article, the authors first frame the assessment of quality in the health care system as a whole and then focus on CHD and the unique approach required in the care of the adult with CHD...
November 2015: Cardiology Clinics
Craig Broberg, Jiri Sklenar, Luke Burchill, Curt Daniels, Arianne Marelli, Michelle Gurvitz
BACKGROUND: In order to determine the feasibility of tracking quality of care in adults with congenital heart disease (ACHD), we aimed to estimate the availability of relevant data in electronic medical records (EMR) used in North American ACHD centers. METHODS: Previously proposed quality indicators (QIs) were reviewed to consider what types of data would be required for each. ACHD program directors were surveyed about the nature of electronic data in existing EMRs...
November 2015: Congenital Heart Disease
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