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Congenital heart disease quality

Yang Liu, Weishuai Bian, Ping Liu, Xuefeng Zang, Xuyun Gu, Wei Chen
OBJECTIVES: Dexmedetomidine has been shown to decrease cardiac complications in adults undergoing cardiac surgery. Results from clinical trials of dexmedetomidine on outcomes following paediatric cardiac surgery are controversial. METHODS: We searched EMBASE, PubMed and Cochrane CENTRAL databases for randomized controlled trials comparing the effect of dexmedetomidine versus placebo or other anaesthetic drugs in paediatric patients undergoing cardiac surgery. The primary outcome was the duration of mechanical ventilation...
March 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Andreas Entenmann, Susann Dittrich, Vera Hessling, Christian Niederwanger, Gerard Cortina, Miriam Michel
BACKGROUND: Junctional ectopic tachycardia is a serious complication of surgery for paediatric congenital heart disease. R-wave synchronized atrial (AVT) pacing, an innovative temporary pacing technique, restores atrioventricular synchrony in these patients. The method is highly effective but technically complex. A standardized training model exists for doctors but not for paediatric intensive care nurses. AIMS: This study seeks to evaluate whether a standardized programme involving simulation and vignettes increases knowledge of AVT pacing and accuracy of its documentation, as well as recognition and management of specific complications...
March 6, 2018: Nursing in Critical Care
Mohan John, Leonard L Bailey
Neonatal heart transplantation was developed and established in the 1980's as a durable modality of therapy for complex-uncorrectable heart disease. Patients transplanted in the neonatal period have experienced unparalleled long-term survival, better than for any other form of solid-organ transplantation. However, the limited availability of neonatal and young infant donors has restricted the indications and applicability of heart transplantation among newborns in the current era. Indications for heart transplantation include congenital heart disease not amenable to other forms of surgical palliation, and cardiomyopathy, including some primary tumors...
January 2018: Annals of Cardiothoracic Surgery
Yuzo Yamasaki, Satoshi Kawanami, Takeshi Kamitani, Koji Sagiyama, Seitaro Shin, Takuya Hino, Kenichiro Yamamura, Hidetake Yabuuchi, Michinobu Nagao, Hiroshi Honda
We explored the clinical value of low-tube voltage prospective second-generation ECG-triggered 320-row CT angiography in infants with complex CHD (37 male, 23 female, aged 0-2 years). The diagnostic accuracy of 320-row CT in complex CHD was 99.4% for intracardiac cardiovascular malformations, 99.8% for extracardiac cardiovascular malformations, and 100% for other malformations. The average subjective overall image quality score for cardiac structures was 3.7 ± 0.5 points. Second-generation 320-row CT angiography with low-tube voltage and prospective ECG-triggered volume target scanning allows accurate diagnosis of cardiovascular anomalies in infants with complex CHD...
February 15, 2018: Clinical Imaging
Eric A F Simões, Louis Bont, Paolo Manzoni, Brigitte Fauroux, Bosco Paes, Josep Figueras-Aloy, Paul A Checchia, Xavier Carbonell-Estrany
INTRODUCTION: The REGAL (RSV Evidence - A Geographical Archive of the Literature) series has provided a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This seventh and final publication covers the past, present and future approaches to the prevention and treatment of RSV infection among infants and children. METHODS: A systematic review was undertaken of publications between January 1, 1995 and December 31, 2017 across PubMed, Embase and The Cochrane Library...
February 22, 2018: Infectious Diseases and Therapy
Christina E Holbein, Nicholas D Fogleman, Kevin Hommel, Silke Apers, Jessica Rassart, Philip Moons, Koen Luyckx, Maayke A Sluman, Junko Enomoto, Bengt Johansson, Hsiao-Ling Yang, Mikael Dellborg, Raghavan Subramanyan, Jamie L Jackson, Werner Budts, Adrienne H Kovacs, Stacey Morrison, Martha Tomlin, Kathy Gosney, Alexandra Soufi, Katrine Eriksen, Corina Thomet, Malin Berghammer, Luis Alday, Edward Callus, Susan M Fernandes, Maryanne Caruana, Samuel Menahem, Stephen C Cook, Gwen R Rempel, Kamila White, Paul Khairy, Shelby Kutty, Gruschen Veldtman
OBJECTIVE: First, to compare QOL and illness perceptions between patients with a Fontan circulation and patients with anatomically simple defects (ie, atrial septal defects [ASD] or ventricular septal defects [VSD]). Second, to explore illness perceptions as a mediator of the association between congenital heart disease (CHD) diagnosis and QOL. DESIGN: Cross-sectional observational study. SETTING: Twenty-four cardiology centers from 15 countries across five continents...
February 18, 2018: Congenital Heart Disease
Lindsay A Edwards, Christine Bui, Antonio G Cabrera, Jill Ann Jarrell
OBJECTIVE: To improve outpatient advanced care planning (ACP) for adults with congenital/pediatric heart disease followed in a pediatric heart failure (HF) and transplant clinic through quality improvement (QI) methodology. DESIGN: A one-year QI project was completed. We conducted quarterly chart reviews and incorporated feedback from the providers to direct subsequent interventions. PATIENTS AND SETTING: Patients ≥18 years of age seen in the HF and Transplant Clinic for follow-up visit were included in analysis...
February 18, 2018: Congenital Heart Disease
Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Edward Araujo Júnior
This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects...
January 2018: Indian Heart Journal
Tadahisa Sugiura, Goki Matsumura, Shinka Miyamoto, Hideki Miyachi, Christopher K Breuer, Toshiharu Shinoka
OBJECTIVE: Tissue engineering holds great promise for the advancement of cardiovascular surgery as well as other medical fields. Tissue-engineered vascular grafts have the ability to grow and remodel and could therefore make great advances for pediatric cardiovascular surgery. In 2001, we began a human clinical trial evaluating these grafts in patients with a univentricular physiology. Herein, we report the long-term results of patients who underwent implantation of tissue-engineered vascular grafts as extracardiac total cavopulmonary conduits...
February 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
Michael L O'Byrne, Kevin F Kennedy, Jonathan J Rome, Andrew C Glatz
Practice variation is a potentially important measure of healthcare quality. The IMPACT registry provides a representative national sample with which to study practice variation in trans-catheter interventions for congenital heart disease. METHODS: We studied cases for closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) in IMPACT between January 1, 2011, and September 30, 2015, using hierarchical multivariate models studying (1) the distribution of indications for closure and (2) in patients whose indication for closure was left (LVVO) or right ventricular volume overload (RVVO), the factors influencing probability of closure of a small defect (either in size or in terms of the magnitude of shunt)...
February 2018: American Heart Journal
Emily M Bucholz, Lynn A Sleeper, Jane W Newburger
BACKGROUND: Children with single ventricle heart disease require frequent interventions and follow-up. Low socioeconomic status (SES) may limit access to high-quality care and place these children at risk for poor long-term outcomes. METHODS AND RESULTS: Data from the SVR (Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use) data set were used to examine the relationship of US neighborhood SES with 30-day and 1-year mortality or cardiac transplantation and length of stay among neonates undergoing the Norwood procedure (n=525)...
February 2, 2018: Journal of the American Heart Association
QiaoRu Hou, Wei Gao, YuMin Zhong, AiMin Sun, Qian Wang, LiWei Hu, JingLei Wang
Tracheobronchial anomalies are common in congenital heart disease (CHD), including tracheobronchial stenosis, tracheal bronchus, cardiac bronchus, and bronchial isomerism, which can cause varying degrees of respiratory illness. It is necessary to assess tracheobronchial anomalies and make a preoperative airway evaluation. Multi-slice computed tomography (MSCT) and cardiac magnetic resonance imaging (MRI) are the most effective noninvasive modalities for the diagnosis of CHD and the associated tracheobronchial anomalies...
February 7, 2018: Scientific Reports
Koen Luyckx, Leen Oris, Koen Raymaekers, Jessica Rassart, Philip Moons, Ludo Verdyck, Teus Mijnster, Ruth E Mark
INTRODUCTION: Refractory epilepsy is an intrusive condition with important implications for daily functioning in emerging and young adulthood. The present study examined the degree to which refractory epilepsy is integrated in one's identity, and examined how such a sense of illness identity was related to health-related quality of life (HRQOL). METHODS: A total of 121 18- to 40-year-old patients with refractory epilepsy (56.2% women) completed self-report questionnaires assessing the four illness identity states of acceptance, enrichment, engulfment, and rejection (Illness Identity Questionnaire (IIQ)); HRQOL (Quality of Life in Epilepsy Inventory - 31); and seizure frequency and severity (Liverpool Seizure Severity Scale (LSSS))...
February 1, 2018: Epilepsy & Behavior: E&B
C Van Linthout, C Brulmans, X Capelle, F Kridelka, M C Seghaye
Optimal choice of delivery site after a diagnosis of congenital heart disease (CHD) improves neonatal mortality and morbidity. We report the CHU of Liège experience and review the international recommendations. Between 2011 and 2016, 54 fetuses were diagnosed with CHD in our service. Retrospectively we estimated the appropriateness of the site of delivery considering the postnatal outcome. We confronted our experience with the recent international recommendations for in utero transfer to a tertiary center...
January 2018: Revue Médicale de Liège
Mahshid Givi, Nizal Sarrafzadegan, Mohammad Garakyaraghi, Ghasem Yadegarfar, Masoumeh Sadeghi, Alireza Khosravi, Amir Hossein Azhari, Mohammad Reza Samienasab, Davood Shafie, Mohammad Saadatnia, Hamidreza Roohafza, Navid Paydari, Azam Soleimani, Mohsen Hosseinzadeh, Seyed Abdulah Ahmadi, Leila Dehghani, Jamshid Najafian, Elham Andalib, Javad Shahabi, Mohammad Reza Sabri
BACKGROUND: Our aim was to create and establish a database called "Persian Registry Of cardioVascular diseasE (PROVE)" in order to be used for future research and in addition, as a tool to develop national guidelines for diagnosis, treatment, and prevention of cardiovascular disease (CVD). In this paper, the design and methodology of the PROVE pilot study will be discussed, launched in Isfahan, Iran, in 2015-2016. METHODS: Through establishing PROVE, patients' data were collected from hospitals and outpatient clinics prospectively or retrospectively and followed up for a maximum of three years based on the type of CVDs...
September 2017: ARYA Atherosclerosis
Libby Rogers, Christina Pagel, Ian D Sullivan, Muhammed Mustafa, Victor Tsang, Martin Utley, Catherine Bull, Rodney C Franklin, Kate L Brown
OBJECTIVE: To describe the long-term outcomes, treatment pathways and risk factors for patients diagnosed with hypoplastic left heart syndrome (HLHS) in England and Wales. METHODS: The UK's national audit database captures every procedure undertaken for congenital heart disease and updated life status for resident patients in England and Wales. Patients with HLHS born between 2000 and 2015 were identified using codes from the International Paediatric and Congenital Cardiac Code...
January 25, 2018: Heart: Official Journal of the British Cardiac Society
Jeffrey W Miller, Lili Ding, Joel B Gunter, Jennifer E Lam, Erica P Lin, Joanna R Paquin, Bi Lian Li, James P Spaeth, Renee N Kreeger, Allison Divanovic, Mohamed Mahmoud, Andreas W Loepke
BACKGROUND: Acquisition of transthoracic echocardiographic (TTEcho) images in children often requires sedation. The optimal sedative for TTEcho has not been determined. Children with congenital heart disease are repeatedly exposed to sedatives and anesthetics that may affect brain development. Dexmedetomidine, which in animals alters brain structure to a lesser degree, may offer advantages in this vulnerable population. METHODS: A prospective, randomized, double-blind trial enrolled 280 children 3-24 months of age undergoing outpatient TTEcho, comparing 2...
January 23, 2018: Anesthesia and Analgesia
A Beningfield, A Jones
BACKGROUND: Chest physiotherapy (CPT) is implemented before and after congenital heart disease (CHD) surgery in paediatrics to prevent and treat postoperative pulmonary complications (PPC). Currently, there are no systematic reviews or meta-analyses on the efficacy of CPT in this population. OBJECTIVE: To conduct a systematic review and meta-analysis to determine whether peri-operative CPT is safe and effective for paediatric patients with CHD. DATA SOURCES: A literature search was conducted on PEDro, MEDLINE, CINAHL, Informit, The Cochrane Library and Scopus in March and April 2016...
December 5, 2017: Physiotherapy
Nóra Ambrus, Kálmán Havasi, Krisztina Berek, Anita Kalapos, István Hartyánszky, Gábor Bogáts, Tamás Forster, Attila Nemes
INTRODUCTION: The prognostic role of B-type natriuretic peptide (BNP) level was confirmed in chronic heart failure and congenital heart diseases irrespective of the aetiology. AIM: The aim of this study was to compare NT‑proBNP measured in the clinical practice and important clinical and echocardiographic parameters in patients with adult congenital heart diseases under our care. METHOD: Data of a total of 70 patients were analysed; 34 patients had corrected tetralogy of Fallot and 19 patients had corrected transposition of the great arteries...
January 2018: Orvosi Hetilap
Pei-Ni Jone, Ruthanne Gould, Cindy Barrett, Adel K Younoszai, Brian Fonseca
Echocardiography is the primary diagnostic modality for congenital heart disease patients. The written report is used to communicate with the care team and organization is often divided into the body with detailed findings and the conclusions with important findings summarized. Strategies to increase workflow efficiency include batch writing of reports after performance of multiple echocardiograms and the use of report templates which may contribute to discrepancies within report leading to potential downstream medical errors...
January 19, 2018: Pediatric Cardiology
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