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H Kaemmerer, C Apitz, K Brockmeier, A Eicken, M Gorenflo, A Hager, F deHaan, M Huntgeburth, R Kozlik-Feldmann, O Miera, G P Diller
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. The guidelines contain detailed recommendations for different forms of PH, and specifically address PH associated with congenital heart disease (CHD). However, the practical implementation of the European Guidelines in Germany requires the consideration of several country-specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update already appears necessary...
October 2016: Deutsche Medizinische Wochenschrift
Sachin Talwar, Manikala V Kumar, Vishnubhatla Sreenivas, Shiv K Choudhary, Manoj Sahu, Balram Airan
BACKGROUND: The number of grown ups with congenital heart diseases (GUCHs) is steadily increasing. AIMS: To analyze factors predicting early cardiac morbidity following cardiac surgery in GUCH at a tertiary care center. SETTING AND DESIGN: Retrospective study at a multispeciality tertiary referral center. METHODS: Between January 2004 and December 2014, 1432 patients ≥13 years of age (acyanotic defects: 843, cyanotic defects: 589) underwent surgery for congenital heart defects...
September 2016: Annals of Pediatric Cardiology
Wolf H Rombouts, Natalia E Domeradzka, Marc W T Werten, Frans A M Leermakers, Renko J de Vries, Frits A de Wolf, Jasper van der Gucht
We study the self-assembly of protein polymers consisting of a silk-like block flanked by two hydrophilic blocks, with a cysteine residue attached to the C-terminal end. The silk blocks self-assemble to form fibers while the hydrophilic blocks form a stabilizing corona. Entanglement of the fibers leads to the formation of hydrogels. Under oxidizing conditions the cysteine residues form disulfide bridges, effectively connecting two corona chains at their ends to form a loop. We find that this leads to a significant increase in the elastic modulus of the gels...
November 2016: Biopolymers
Jürgen Hörer, Jelena Kasnar-Samprec, Julie Cleuziou, Martina Strbad, Michael Wottke, Harald Kaemmerer, Christian Schreiber, Rüdiger Lange
OBJECTIVES: Currently, there are few specific risk stratification models available to predict mortality following congenital heart surgery in adults. We sought to evaluate whether the predictive power of the common pediatric scores is applicable for adults. In addition, we evaluated a new grown-ups with congenital heart disease (GUCH) score specifically designed for adults undergoing congenital heart surgery. METHODS AND RESULTS: Data of all consecutive patients aged 18 years or more, who underwent surgery for congenital heart disease (CHD) between 2004 and 2013 at our institution, were collected...
July 2016: World Journal for Pediatric & Congenital Heart Surgery
Peter Zartner
Pacemaker therapy (PMT) in grown-up congenital heart disease (GUCH) must meet the demands of a young, dynamic and heterogeneous group of patients. The duration of the therapy has to be planned for several decades and should be accompanied by an invasive procedure at the very least. Most of the patients enter adulthood with their pacemaker (PM) already implanted; for others the indications can be derived from the published guidelines for GUCH and PMT, but need to be adjusted to the individual situation of the patient...
June 2016: Herzschrittmachertherapie & Elektrophysiologie
Ireneusz Haponiuk, Katarzyna Gierat-Haponiuk, Dominika Szalewska, Piotr Niedoszytko, Stanisław Bakuła, Maciej Chojnicki
Congenital heart defects (CHD) are the cause of reduced physical performance. The presence of congenital abnormalities in the heart of grown-up patients contributes to excessive hypo-kinesia. We present endurance parameters and a personalized comprehensive cardiac rehabilitation program before an extreme mountain climbing of a 27-year-old patient with an uncorrected ventricular septal defect (VSD). A 26-year-old female patient with an uncorrected congenital VSD was admitted to the department of cardiac rehabilitation before the planned high-mountain expedition...
March 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Ivan Malcić, Daniel Dilber, Hrvoje Kniewald, Darko Anić, Drazen Belina, Dalibor Sarić, Dorotea Bartonicek, Alen Hodalin, Andrea Dasović-Buljević, Sanja Dorner, Vitomir Metlicić, Karmen Markicević, Marija Srsen-Krstulović
AIM: 1. To present an epidemiological (population and clinical) study of congenital heart defects (CHD) in Croatia in a 16-year period (1995-2011). 2. To analyze outcomes of surgical procedures for all patients in a five-year period (2002-2007) and to compare the results between Croatian and foreign centers. 3. To present the progress in surgical care of CHD in Croatia while acknowledging the requirement of achieving postsurgical mortality rate of below 5%. 4. To evaluate the projection of positive development of CHD management in Croatia in cooperation with major cardiac surgical centers in the neighboring countries...
November 2015: Lijec̆nic̆ki Vjesnik
Cecilia Vecoli, Andrea Borghini, Ilenia Foffa, Lamia Ait-Ali, Eugenio Picano, Maria Grazia Andreassi
BACKGROUND/OBJECTIVES: Children with congenital heart disease are exposed by repeated imaging to ionizing radiation, which may have important implications for lifetime health risks. Leukocyte telomere length (LTL), a reliable biomarker of genomic instability, is associated with increased risk of cancer and cardiovascular disease. We investigated LTL in grown-up patients with CHD (GUCHs) and a positive history of medical radiation exposure as well as the influence of functional polymorphisms of genes involved in DNA repair...
February 1, 2016: International Journal of Cardiology
Katarzyna Gierat-Haponiuk, Ireneusz Haponiuk, Radosław Jaworski, Maciej Chojnicki, Dominika Szalewska, Katarzyna Leszczyńska, Stanisław Bakuła
INTRODUCTION: The group of grown-up patients with congenital heart defects (grown-up congenital heart - GUCH) complains of a number of specific medical and non-medical problems. The presented program of comprehensive cardiac rehabilitation (CCR-GUCH), dedicated to the above mentioned group, can potentially improve the physical activity of GUCH patients. AIM: The aim of the study was to assess the effect of the comprehensive cardiac rehabilitation program on the physical activity of GUCH patients...
December 2014: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Fernando Tadeu Vasconcelos Amaral, Paulo Henrique Manso, André Schmidt, Ricardo Nilson Sgarbieri, Walter Villela de Andrade Vicente, Clovis Carbone Junior, Jane Somerville
During the last decades, advances in diagnosis and treatment of congenital heart disease have allowed many individuals to reach adulthood. Due mainly to the great diagnostic diversity and to the co-morbidities usually present in this age group, these patients demand assistance in a multidisciplinary facility if an adequate attention is aimed. In this paper we reviewed, based in the international literature and also on the authors' experience, the structural conditions that should be available for these patients...
July 2015: Revista Brasileira de Cirurgia Cardiovascular
A A Guch, L M Chernukha, V I Smorzhevskiy, A O Bobrova
The blood horizontal reflux via insufficient perforating veins (PV) from the deep venous system into subcutaneous one is considered an important factor of formation of chronic venous insufficiency in varicose disease (VD) and its recurrences (VDR). The role of PV in a VD progressing and in a VDR postoperatively in 774 patients, operated on for primary VD and 243 - VDR, is discussed. While determining significance of the blood horizontal reflux and substantiation of necessity for the PV ligation there must be taken into account the data of the colour duplex scanning concerning their valve apparatus state and clinical estimation of the disease severity...
March 2015: Klinichna Khirurhiia
Martin Schweiger, Volkmar Falk, Mirko Biry, Michael Hübler, Markus J Wilhelm
INTRODUCTION: Miniaturization and surgical progress in the field of ventricular assist device (VAD) therapy will lead to an increasing use in grown-up patients with congenital heart disease (GUCH). VAD implantation in such patients, especially biventricular VAD (BVAD) placement, can be very challenging, potentially associated with high morbidity and mortality. METHODS AND RESULTS: We report on a 47-year-old male patient in terminal biventricular failure with pulmonary hypertension 40 years after a Mustard procedure...
April 2015: International Journal of Artificial Organs
A Haddad, R Bourezak, M Aouiche, R Ait Mohand, A Hamzaoui, S E Bourezak
INTRODUCTION: With advances in recent decades in the field of congenital heart disease both for imaging in medical therapy, a large number of heart disease is diagnosed before birth. Many of them benefit from surgery and reach adulthood, they do not require further action. Some of them develop later in their lives other problems requiring reoperation in adulthood. This sparked the birth of a subspecialty within the department of congenital heart disease: GUCH Unit "grown up congenital heart disease"...
September 2015: Annales de Cardiologie et D'angéiologie
S P Galich, A Iu Dabizha, O A Gindich, Ia P Ogorodnik, I V Al'tman, I V Gomoliako, A A Guch
An arteriovenous malformation (AVM) is a vascular developmental abnormality conditioned by impaired embryonic morphogenesis and characterized by the development of an abnormal connection between arteries and veins. More than 50% of the total number of patients suffering from this pathology are those having the pathological foci localizing in the area of the head and neck. At present, a combined method is both a generally accepted and the most radical one used for treatment for AVM. However, in the majority of cases, excision of the malformation leaves an extensive and complicated defect of tissues, whose direct closure leads to coarse cicatricious deformities...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Katarzyna Gierat-Haponiuk, Ireneusz Haponiuk, Dominika Szalewska, Maciej Chojnicki, Radosław Jaworski, Piotr Niedoszytko, Katarzyna Leszczyńska, Stanisław Bakuła
BACKGROUND: Comprehensive cardiac rehabilitation (CCR) is an important element of the comprehensive management of grown-up congenital heart disease (GUCH) patients after surgical correction of congenital heart disease (CHD) but access to this treatment is still limited. We still lack Polish guidelines on CCR, including controlled training in young adults several years after surgical correction of CHD. AIM: To assess the effect of a CCR program on physical capacity, exercise tolerance, quality of life, and severity of depressive symptoms in GUCH patients long-term after surgical correction of CHD...
2015: Kardiologia Polska
Richard Hatchett, Susan McLaren, Philomena Corrigan, Lynda Filer
The purpose of this study was to evaluate grown-up congenital heart (GUCH) patients' experiences and satisfaction with the delivery of a nurse specialist service, including perceived priorities and recommendations for future service delivery. A service evaluation utilizing descriptive, cross-sectional survey principles was conducted over a 2 year period. Postal questionnaires were sent to three patient cohorts (general adult n = 747; pregnancy n = 202; learning disability n = 72). Quantitative data were analysed using descriptive statistics...
October 2015: International Journal of Nursing Practice
Erich Sorantin, Bernd Heinzl
Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images...
September 2014: European Journal of Radiology
Sandhya Santharam, Maria Theodosiou, Sara Thorne, Paul Clift, Lucy Hudsmith, Joseph De Bono
BACKGROUND: Sustained ventricular tachycardia (VT) and cardiac arrest are a major cause of mortality in adult congenital heart disease patients. Implantable cardioverter defibrillators (ICD) can protect against this. ESC guidelines state that ICDs should be considered following spontaneous sustained VT and in all survivors of cardiac arrest; and in patients at high risk of this. METHODS: All ICD recipients in the GUCH database were included (n = 40). Medical records were retrospectively analysed...
June 2014: Heart: Official Journal of the British Cardiac Society
Timothy Cotts, Brahmajee K Nallamothu, Joseph D Kay
Cardiologists from the USA provide information from earlier experiences in this emerging specialty.
March 2014: European Heart Journal
B Miltner, P Lancellotti, M-C Seghaye
The number of patients with Grown-Up Congenital Heart disease (GUCH) consulting adult cardiologists is steadily increasing. These patients have either a non-diagnosed congenital heart disease revealed at adulthood, or a diagnosed congenital heart disease for which one or multiple interventions have possibly been performed during childhood. In this article, we summarize the recommendations of the European Society of Cardiology of 2010 for complex congenital heart disease.
January 2014: Revue Médicale de Liège
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