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Congenital heart disease quality

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https://www.readbyqxmd.com/read/28099323/anesthesia-and-databases-pediatric-cardiac-disease-as-a-role-model
#1
David F Vener, Sara K Pasquali, Emad B Mossad
Large data sets have now become ubiquitous in clinical medicine; they are particularly useful in high-acuity, low-volume conditions such as congenital heart disease where data must be collected from many centers. These data fall into 2 categories: administrative data arising from hospital admissions and charges and clinical data relating to specific diseases or procedures. In congenital cardiac diseases, there are now over a dozen of these data sets or registries focusing on various elements of patient care...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28092064/critical-congenital-heart-disease-newborn-screening-implementation-lessons-learned
#2
Monica R McClain, John S Hokanson, Regina Grazel, Kim Naarden Van Braun, Lorraine F Garg, Michelle R Morris, Kathleen Moline, Keri Urquhart, Amy Nance, Harper Randall, Marci K Sontag
Introduction The purpose of this article is to present the collective experiences of six federally-funded critical congenital heart disease (CCHD) newborn screening implementation projects to assist federal and state policy makers and public health to implement CCHD screening. Methods A qualitative assessment and summary from six demonstration project grantees and other state representatives involved in the implementation of CCHD screening programs are presented in the following areas: legislation, provider and family education, screening algorithms and interpretation, data collection and quality improvement, telemedicine, home and rural births, and neonatal intensive care unit populations...
January 16, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28070870/defining-the-risk-and-associated-morbidity-and-mortality-of-severe-respiratory-syncytial-virus-infection-among-infants-with-congenital-heart-disease
#3
REVIEW
Paul A Checchia, Bosco Paes, Louis Bont, Paolo Manzoni, Eric A F Simões, Brigitte Fauroux, Josep Figueras-Aloy, Xavier Carbonell-Estrany
INTRODUCTION: The REGAL (RSV Evidence-a Geographical Archive of the Literature) series provide a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This fourth publication covers the risk and burden of RSV infection in infants with congenital heart disease (CHD). METHODS: A systematic review was undertaken for articles published between January 1, 1995 and December 31, 2015 across PubMed, Embase, The Cochrane Library, and Clinicaltrials...
January 9, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28063770/a-post-operative-feeding-protocol-to-improve-outcomes-for-neonates-with-critical-congenital-heart-disease
#4
Jennifer Newcombe, Eileen Fry-Bowers
Neonates with critical congenital heart disease (CCHD) are vulnerable to malnutrition during the post-operative period due to hypermetabolism and hypercatabolism. To improve nutritional outcomes during hospitalization, a nurse led post-operative enteral feeding protocol was implemented at a large U.S. children's hospital. During an eight-month implementation period, twenty-one neonates met protocol inclusion criteria. Days for neonates to achieve goal caloric feedings (120kcal/kg/day) were decreased. A one-way repeated measures analysis of variance showed serum albumin levels and serial anthropometric measurements improved significantly throughout hospitalization (p<0...
January 4, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28062603/combining-qualitative-and-quantitative-operational-research-methods-to-inform-quality-improvement-in-pathways-that-span-multiple-settings
#5
Sonya Crowe, Katherine Brown, Jenifer Tregay, Jo Wray, Rachel Knowles, Deborah A Ridout, Catherine Bull, Martin Utley
BACKGROUND: Improving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors...
January 6, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28035425/myocardial-stress-perfusion-magnetic-resonance-initial-experience-in-a-pediatric-and-young-adult-population-using-regadenoson
#6
Cory V Noel, Ramkumar Krishnamurthy, Brady Moffett, Rajesh Krishnamurthy
BACKGROUND: Dipyridamole and adenosine are traditional pharmacological stressors for myocardial perfusion. Regadenoson, a selective adenosine A2A agonist, has a lower side effect profile with lower incidence of bronchospasm and bradycardia. There is a growing need for myocardial perfusion assessment within pediatrics. There is no report on the utility of regadenoson as a stress agent in children. OBJECTIVE: To observe the safety and feasibility of regadenoson as a pharmacologic stressor for perfusion cardiac MR in a pilot cohort of pediatric patients weighing more than 40 kg who have congenital heart disease and pediatric acquired heart disease...
December 29, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/28033081/clinical-databases-and-registries-in-congenital-and-pediatric-cardiac-surgery-cardiology-critical-care-and-anesthesiology-worldwide
#7
David F Vener, Michael Gaies, Jeffrey P Jacobs, Sara K Pasquali
The growth in large-scale data management capabilities and the successful care of patients with congenital heart defects have coincidentally paralleled each other for the last three decades, and participation in multicenter congenital heart disease databases and registries is now a fundamental component of cardiac care. This manuscript attempts for the first time to consolidate in one location all of the relevant databases worldwide, including target populations, specialties, Web sites, and participation information...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28027746/image-quality-of-ct-angiography-using-model-based-iterative-reconstruction-in-infants-with-congenital-heart-disease-comparison-with-filtered-back-projection-and-hybrid-iterative-reconstruction
#8
Qianjun Jia, Jian Zhuang, Jun Jiang, Jiahua Li, Meiping Huang, Changhong Liang
PURPOSE: To compare the image quality, rate of coronary artery visualization and diagnostic accuracy of 256-slice multi-detector computed tomography angiography (CTA) with prospective electrocardiographic (ECG) triggering at a tube voltage of 80kVp between 3 reconstruction algorithms (filtered back projection (FBP), hybrid iterative reconstruction (iDose(4)) and iterative model reconstruction (IMR)) in infants with congenital heart disease (CHD). METHODS: Fifty-one infants with CHD who underwent cardiac CTA in our institution between December 2014 and March 2015 were included...
January 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28025066/executive-summary-trends-in-u-s-cardiovascular-care-2016-report-from-4-acc-national-cardiovascular-data-registries
#9
Frederick A Masoudi, Angelo Ponirakis, James A de Lemos, James G Jollis, Mark Kremers, John C Messenger, John W M Moore, Issam Moussa, William J Oetgen, Paul D Varosy, Robert N Vincent, Jessica Wei, Jeptha P Curtis, Matthew T Roe, John A Spertus
The National Cardiovascular Data Registries (NCDR) of the American College of Cardiology consists of ten national programs designed to measure quality of care for high impact cardiovascular conditions and procedures. The NCDR provides feedback with benchmarking of a broad range of quality metrics to participants; supports quality improvement interventions at the local and national level; and serves as the basis for cardiovascular health services and epidemiology research that informs contemporary clinical care...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28025065/trends-in-u-s-cardiovascular-care-2016-report-from-4-acc-national-cardiovascular-data-registries
#10
REVIEW
Frederick A Masoudi, Angelo Ponirakis, James A de Lemos, James G Jollis, Mark Kremers, John C Messenger, John W M Moore, Issam Moussa, William J Oetgen, Paul D Varosy, Robert N Vincent, Jessica Wei, Jeptha P Curtis, Matthew T Roe, John A Spertus
Cardiovascular disease (CVD) is a leading cause of death and disability in the United States. National quality programs such as the National Cardiovascular Data Registry (NCDR®) permit assessments of the quality of care and outcomes for broad populations of patients with CVD. This report provides data from 2014 from four NCDR® hospital quality programs: 1) CathPCI® for coronary angiography and percutaneous coronary intervention (667,424 procedures performed in 1,612 hospitals) ICD™ for implantable cardioverter defibrillators (158,649 procedures performed in 1,715 hospitals); 3) ACTION®-GWTG™ for acute coronary syndromes (182,903 patients admitted to 907 hospitals); and 4) IMPACT® for cardiac catheterization and intervention for pediatric and adult congenital heart disease (20,169 procedures in 76 hospitals)...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#11
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27992675/readmissions-after-adult-congenital-heart-surgery-frequency-and-risk-factors
#12
Yuli Y Kim, Wei He, Thomas E MacGillivray, Oscar J Benavidez
OBJECTIVE: Despite their clinical importance, 30-day readmission after adult congenital heart surgery has been understudied. They sought to determine the frequency of unplanned readmissions after adult congenital heart surgery and to identify any potential associated risk factors. DESIGN: Retrospective cohort study using State Inpatient Databases for Washington, New York, Florida, and California from 2009 to 2011. SETTING: Federal and nonfederal acute care hospitals...
December 19, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27989374/functional-quality-of-life-and-neurodevelopmental-outcomes-after-congenital-cardiac-surgery
#13
REVIEW
Megan L Ringle, Gil Wernovsky
Throughout the past few decades, advances in cardiology, neonatal intensive care, and surgical techniques have resulted in a growing cohort of thriving school-aged children with previously lethal complex congenital heart diseases. While survival has increased, there remains significant morbidity following repair including neurodevelopmental sequelae. Compared to children with a structurally normal heart, these infants and children have a higher frequency of abnormalities in tone, feeding, and delayed developmental milestones, as well as challenges with speech and learning disabilities, while a higher proportion of adolescents suffer from problems with processing speed, executive function, and a unique set of medical hardships related to exercise intolerance and obesity, medication burden, and mental health comorbidities...
December 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27986229/vi%C3%A1-n-tim-institut-du-coeur-success-of-a-congenital-heart-disease-center-in-a-developing-country
#14
EDITORIAL
Paul S Lajos, Alain F Carpentier
OBJECTIVE: The goal of the Viện Tim Institute du Coeur is to provide high quality cardiac surgical care to the Vietnamese population with 25% of care allocated to the indigent. This article discusses the history; functional and financial implementation of creating a long-term fully sustainable adult and pediatric cardiac surgery center in Southeast Asia in a developing country. METHODS: The Institut du Coeur in Ho Chi Minh City, Vietnam is a fully functional and financially solvent cardiac surgery center that was formed 28 years ago...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27978593/fetal-neurosonogaphy-ultrasound-and-magnetic-resonance-imaging-in-competition
#15
S Tercanli, F Prüfer
Both in routine diagnostics and detailed, highly specialized workups, major advances have been observed in many areas of ultrasound due to an increase in expertise and improved technology in recent years. This is particularly true in the case of fetal neurosonography 1 2 3 4. Malformations of the CNS together with fetal heart defects are among the most common congenital anomalies. From the embryonic phase to the late third trimester, the CNS undergoes extensive development and maturation processes. The diagnosis of CNS anomalies is therefore primarily dependent on the time at which the examination is performed and the experience of the examiner...
December 2016: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/27957813/neurocognitive-functioning-in-adults-with-congenital-heart-disease
#16
Dawn Ilardi, Kim E Ono, Rebecca McCartney, Wendy Book, Anthony Y Stringer
OBJECTIVE: Adults with congenital heart disease (CHD) are at increased risk of psychological disorders and cognitive deficiencies due to structural/acquired neurological abnormalities and neurodevelopmental disorders as children. However, limited information is known about the neuropsychological functioning of adults with CHD. This study screened neuropsychological abilities and explored group differences related to cardiac disease severity and neurological risk factors in adults with CHD...
December 13, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27925466/a-prospective-evaluation-of-contrast-and-radiation-dose-and-image-quality-in-cardiac-ct-in-children-with-complex-congenital-heart-disease-using-low-concentration-iodinated-contrast-agent-and-low-tube-voltage-and-current
#17
Qiao-Ru Hou, Wei Gao, Yu Min Zhong, Ai Min Sun, Qian Wang, Hai Sheng Qiu, Fang Wang, Jian Ying Li, Liwei Hu
OBJECTIVE: To assess image quality, contrast dose and radiation dose in cardiac CT in children with congenital heart disease using low-concentration iodinated contrast agent and low tube voltage and current in comparison with standard-dose protocol. METHODS: 110 patients with congenital heart disease were randomized to one of the two scan protocols: Group A (n=45) with 120mA tube current and contrast agent of 270mgI/ml in concentration (Visipaque, GE Healthcare), and Group B (n=65) with the conventional 160mA and 370mgI/mL concentration contrast (Iopamiro, Bracco)...
December 7, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27912205/the-prevalence-of-sexual-dysfunction-and-its-association-with-quality-of-life-in-adults-with-congenital-heart-disease
#18
Alexandra Neiman, Salil Ginde, Michael G Earing, Peter J Bartz, Scott Cohen
BACKGROUND: The prevalence of sexual dysfunction (SD) and its impact on quality of life (QOL) in adults with congenital heart disease (CHD) is not well known. The aims of this study were to: determine the prevalence of SD, evaluate the risk factors associated with SD, and determine the association between SD and QOL in adults with CHD. METHODS: This was a cross-sectional study of adults (≥18years) with CHD presenting for routine follow-up at our institution. Subjects completed the CDC HRQOL-14 "Health Days Measure" to assess mental and physical health, and either the Sexual Health Inventory for Men or the Female Sexual Function Index to assess sexual function...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27904846/complete-congenital-heart-block-in-a-neonate-with-a-complex-congenital-heart-defect-in-africa
#19
Clovis Nkoke, Edvine Yonta Wawo, Liliane Kuate Mfeukeu, Larissa Makamte, Sandrine Dikosso Edie, Flore Esiene Balana
Congenital heart block (CHB) is rare disorder that has a higher mortality when associated with structural congenital heart defects. Very few cases have been reported in Sub-Saharan Africa (SSA). We present a case of complete CHB associated with a complex congenital heart defect in a neonate in Cameroon. A 1-month-old neonate in Cameroon was referred for the evaluation of bradycardia. The obstetrical ultrasound done during pregnancy revealed fetal bradycardia without further evaluation. Clinical examination showed well a developed neonate with bradycardia at 62 beats/minute, and mild cyanosis with oxygen saturation at 93% at room air...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27894758/the-impact-of-cardiac-risk-factors-on-short-term-outcomes-for-children-undergoing-a-ladd-procedure
#20
Luke R Putnam, Kathryn T Anderson, KuoJen Tsao, Lillian S Kao, Jane A Lugo, Kevin P Lally, Akemi L Kawaguchi
BACKGROUND/PURPOSE: The purpose of this study was to describe the outcomes of children with and without congenital heart disease who undergo a Ladd procedure. METHODS: The 2012-2014 National Surgical Quality Improvement Program Pediatric (NSQIP-P) data were queried for patients undergoing a Ladd procedure. Utilizing NSQIP-P definitions, patients were categorized into four cardiac risk groups (none, minor, major, severe) based on severity of cardiac anomalies, previous cardiac procedure(s), and ongoing cardiac dysfunction...
October 21, 2016: Journal of Pediatric Surgery
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