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Nancy ghanayem

Jane W Newburger, Lynn A Sleeper, J William Gaynor, Danielle Hollenbeck-Pringle, Peter C Frommelt, Jennifer S Li, William T Mahle, Ismee A Williams, Andrew M Atz, Kristin M Burns, Shan Chen, James Cnota, Carolyn Dunbar-Masterson, Nancy S Ghanayem, Caren S Goldberg, Jeffrey P Jacobs, Alan B Lewis, Seema Mital, Christian Pizarro, Aaron Eckhauser, Paul Stark, Richard G Ohye
Background -In the Single Ventricle Reconstruction (SVR) trial, one-year transplant-free survival was better for the Norwood procedure with right ventricle-to-pulmonary artery shunt (RVPAS) compared with a modified Blalock-Taussig shunt (MBTS) in patients with hypoplastic left heart and related syndromes. At 6 years, we compared transplant-free survival and other outcomes between the groups. Methods -Medical history was collected annually using medical record review, telephone interviews, and the death index...
February 1, 2018: Circulation
Michael Gaies, David K Werho, Wenying Zhang, Janet E Donohue, Sarah Tabbutt, Nancy S Ghanayem, Mark A Scheurer, John M Costello, J William Gaynor, Sara K Pasquali, Justin B Dimick, Mousumi Banerjee, Steven M Schwartz
BACKGROUND: Few metrics exist to assess quality of care at pediatric cardiac surgical programs, limiting opportunities for benchmarking and quality improvement. Postoperative duration of mechanical ventilation (POMV) may be an important quality metric because of its association with complications and resource utilization. In this study we modelled case-mix-adjusted POMV duration and explored hospital performance across POMV metrics. METHODS: This study used the Pediatric Cardiac Critical Care Consortium clinical registry to analyze 4,739 hospitalizations from 15 hospitals (October 2013 to August 2015)...
February 2018: Annals of Thoracic Surgery
Shagun Sachdeva, Roni M Jacobsen, Ronald K Woods, Michael E Mitchell, Joseph R Cava, Nancy S Ghanayem, Peter C Frommelt, Peter J Bartz, James S Tweddell
We present our experience for patients who have undergone an anatomic repair (AR) for congenitally corrected transposition of the great arteries (CCTGA) at the Children's Hospital of Wisconsin. A retrospective chart review of patients who underwent AR for CCTGA from 2001 to 2015 was performed. The cohort consisted of 15 patients (74% male). Median age of anatomic repair was 15 months (range 4.5-45.6 months). Four patients had a bidirectional Glenn (BDG) prior to AR. At the time of AR,-9 (60%) underwent Senning/Rastelli procedure, 4 (26...
December 2017: Pediatric Cardiology
Krista E Tuomela, John B Gordon, Laura D Cassidy, Sarah Johaningsmeir, Nancy S Ghanayem
Congenital heart disease (CHD) is often associated with chronic extracardiac co-morbid conditions (ECC). The presence of ECC has been associated with greater resource utilization during the operative period; however, the impact beyond hospital discharge has not been described. This study sought to understand the scope of chronic ECC in infants with CHD as well as to describe the impact of ECC on resource utilization after discharge from the index cardiac procedure. IRB approved this retrospective study of infants <1 year who had cardiac surgery from 2006 and 2011...
June 2017: Pediatric Cardiology
William S Ragalie, Robert H Chun, Timothy Martin, Nancy S Ghanayem, Richard J Berens, David J Beste, Michael E Mitchell
BACKGROUND: Long segment tracheobronchial stenosis is a rare congenital anomaly that can also occur in combination with abnormal bronchial arborization. Long segment tracheal reconstruction in the setting of a supernumerary bridging bronchus has been reported; however, these repairs can be particularly complex. We present our experience using the bridging bronchus to augment long segment tracheal stenosis with a side-to-side tracheobronchoplasty. METHODS: Four patients with complex long segment tracheobronchial stenosis involving a bronchus suis (right upper lobe bronchus) and a bridging bronchus presented with refractory respiratory distress requiring urgent tracheal reconstruction...
August 2017: Annals of Thoracic Surgery
John A LoGiudice, Karri Adamson, Nancy Ghanayem, Ronald K Woods, Michael E Mitchell
BACKGROUND: Pediatric congenital heart disease patients are at risk for vascular injuries during surgical procedures or when the arterial system is accessed for monitoring or diagnostic studies. Our treatment of emergent situations in this patient population using microvascular techniques shows the feasibility of such techniques. METHODS: A retrospective chart review of patients aged 0-18 years with congenital heart disease identified six patients who underwent microvascular surgery by the senior surgeon from June 2007 to May 2015...
May 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Sarah Tabbutt, Nancy Ghanayem, Melvin C Almodovar, John Charpie, Stephen J Roth, James Fortenberry, Ron Bronicki
As pediatric cardiac critical care becomes more sub-specialized it is reasonable to assume that dedicated units may provide a better infrastructure for improved multidisciplinary care, cardiac-specific patient safety initiatives, and dedicated training of fellows and residents. The knowledge base required to optimally manage pediatric patients with critical cardiac disease has evolved sufficiently to consider a standardized training curriculum and board certification for pediatric cardiac critical care. This strategy would potentially provide consistency of training and healthcare and improve quality of care and patient safety...
December 2016: Cardiology in the Young
Nancy S Ghanayem, Ronald K Woods
No abstract text is available yet for this article.
November 19, 2016: Journal of Thoracic and Cardiovascular Surgery
George M Hoffman, Nancy S Ghanayem, John P Scott, James S Tweddell, Michael E Mitchell, Kathleen A Mussatto
BACKGROUND: Circulatory vulnerability reflected by low systemic venous oxygen saturation after surgical palliation of hypoplastic left heart syndrome predicts adverse neurologic outcome and reduced survival, and targeting venous saturation may improve outcome. We herein test the hypothesis that near-infrared spectroscopy (NIRS)-derived cerebral and somatic/renal regional saturations can predict survival. METHODS: Patient data, from a prospective Institutional Review Board-approved registry of hemodynamic measures after initial palliation of hypoplastic left heart syndrome, were analyzed with logistic and multivariable mixed regression methods to determine relationships between standard hemodynamic measures, direct and NIRS measures of saturation, and outcome...
May 2017: Annals of Thoracic Surgery
Ronald K Woods, Nancy S Ghanayem, Michael E Mitchell, Steven Kindel, Robert A Niebler
Because of the inadequacies inherent to a circulation supported by a single ventricle, many Fontan patients will experience failure of their circulation. To date, there is no medical regimen that reliably and consistently restores circulatory function in these patients. Because of the shortage of donor organs and the fact that many of these patients present with features that either preclude or render heart transplantation a high risk, there is an intense need to better understand how mechanical circulatory support (MCS) may benefit these patients...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Garick D Hill, Nancy A Rudd, Nancy S Ghanayem, David A Hehir, Peter J Bartz
For infants with single-ventricle lesions with aortic arch hypoplasia, the interstage period from discharge following stage 1 palliation (S1P) until stage 2 palliation (S2P) remains high risk. Significant variability among institutions exists around the timing of S2P. We sought to describe institutional variation in timing of S2P, determine the association between timing of S2P and interstage mortality, and determine the impact of earlier S2P on hospital morbidity and mortality. The National Pediatric Cardiology Quality Improvement Collaborative registry was queried...
December 2016: Pediatric Cardiology
Sarah Tabbutt, James S Tweddell, Nancy Ghanayem
OBJECTIVES: In this review, we discuss the pathophysiology, treatment, and outcomes of patients with the hypoplastic left heart syndrome and other single ventricle variants prior to and following surgery. DATA SOURCE: MEDLINE and PubMed. CONCLUSIONS: Patients with shunted single ventricle physiology are at increased risk for acute hemodynamic decompensation owing to the increased myocardial workload, the dynamic balance between systemic and pulmonary circulations, and the potential for shunt obstruction...
August 2016: Pediatric Critical Care Medicine
Nancy S Ghanayem, George M Hoffman
OBJECTIVES: The objectives of this review are to discuss the technology and clinical interpretation of near infrared spectroscopy oximetry and its clinical application in patients with congenital heart disease. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Near infrared spectroscopy provides a continuous noninvasive assessment of tissue oxygenation. Over 20 years ago, near infrared spectroscopy was introduced into clinical practice for monitoring cerebral oxygenation during cardiopulmonary bypass in adults...
August 2016: Pediatric Critical Care Medicine
Rohit S Loomba, Gabrielle C Geddes, Donald Basel, Dudley W Benson, Steven R Leuthner, David A Hehir, Nancy Ghanayem, Amanda J Shillingford
Heterotaxy (HTX) is a laterality defect resulting in abnormal arrangement of the thoracic and abdominal organs across the right-left axis, and is associated with multiple anatomic and physiologic disruptions. HTX often occurs in association with complex congenital heart disease. Splenic abnormalities are also common and convey an increased risk of bacteremia (bacteremia) with a high associated mortality. We performed a systematic review of the literature studying the risk of infection in HTX patients and strategies that can be utilized to prevent such infections...
December 2016: Congenital Heart Disease
David N Rosenthal, Christopher S Almond, Robert D Jaquiss, Christine E Peyton, Scott R Auerbach, David R Morales, Deirdre J Epstein, Ryan S Cantor, Robert L Kormos, David C Naftel, Ryan J Butts, Nancy S Ghanayem, James K Kirklin, Elizabeth D Blume
BACKGROUND: Ventricular assist devices (VADs) have been used in children on an increasing basis in recent years. One-year survival rates are now >80% in multiple reports. In this report we describe adverse events experienced by children with durable ventricular assist devices, using a national-level registry (PediMACS, a component of INTERMACS) METHODS: PediMACS is a national registry that contains clinical data on patients who are <19 years of age at the time of VAD implantation...
May 2016: Journal of Heart and Lung Transplantation
Punkaj Gupta, Mallikarjuna Rettiganti, Howard E Jeffries, Matthew C Scanlon, Nancy S Ghanayem, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
BACKGROUND: Multi center data regarding cardiac arrest in children undergoing heart operations of varying complexity are limited. METHODS: Children <18 years undergoing heart surgery (with or without cardiopulmonary bypass) in the Virtual Pediatric Systems (VPS, LLC) Database (2009-2014) were included. Multivariable mixed logistic regression models were adjusted for patient's characteristics, surgical risk category (STS-EACTS Categories 1, 2, and 3 classified as "low" complexity and Categories 4 and 5 classified as "high" complexity), and hospital characteristics...
August 2016: Resuscitation
Vijay Anand, David M Kwiatkowski, Nancy S Ghanayem, David M Axelrod, James DiNardo, Darren Klugman, Ganga Krishnamurthy, Stephanie Siehr, Daniel Stromberg, Andrew R Yates, Stephen J Roth, David S Cooper
The increase in pediatric cardiac surgical procedures and establishment of the practice of pediatric cardiac intensive care has created the need for physicians with advanced and specialized knowledge and training. Current training pathways to become a pediatric cardiac intensivist have a great deal of variability and have unique strengths and weaknesses with influences from critical care, cardiology, neonatology, anesthesiology, and cardiac surgery. Such variability has created much confusion among trainees looking to pursue a career in our specialized field...
January 2016: World Journal for Pediatric & Congenital Heart Surgery
Jeffrey A Alten, Leslie A Rhodes, Sarah Tabbutt, David S Cooper, Eric M Graham, Nancy Ghanayem, Bradley S Marino, Mayte I Figueroa, Nikhil K Chanani, Jeffrey P Jacobs, Janet E Donohue, Sunkyung Yu, Michael Gaies
UNLABELLED: Introduction The optimal perioperative feeding strategies for neonates with CHD are unknown. In the present study, we describe the current feeding practices across a multi-institutional cohort. METHODS: Inclusion criteria for this study were as follows: all neonates undergoing cardiac surgery admitted to the cardiac ICU for ⩾24 hours preoperatively between October, 2013 and July, 2014 in the Pediatric Cardiac Critical Care Consortium registry. RESULTS: The cohort included 251 patients from eight centres...
December 2015: Cardiology in the Young
Robert A Niebler, Katherine J Woods, Kathleen Murkowski, Nancy S Ghanayem, George Hoffman, Michael E Mitchell, Rowena C Punzalan, J Paul Scott, Pippa Simpson, James S Tweddell
Neonates have low levels of antithrombin. Inadequate anticoagulation during cardiopulmonary bypass (CPB) due to low antithrombin activity may result in a poor preservation of the coagulation system during bypass. We hypothesize that antithrombin replacement to neonates prior to CPB will preserve the hemostatic system and result in less postoperative bleeding. A randomized, double-blinded, placebo-controlled pilot study of antithrombin replacement to neonates prior to CPB was conducted. Preoperative antithrombin levels determined the dose of recombinant antithrombin or placebo to be given...
January 2016: Artificial Organs
Ryan Graf, Nancy S Ghanayem, Raymond Hoffmann, Mahua Dasgupta, Maryanne Kessel, Michael E Mitchell, James S Tweddell, Ronald K Woods
BACKGROUND: We sought to evaluate outcomes of congenital heart operations and resource use in patients with intrauterine growth restriction (IUGR). METHODS: This was a retrospective matched case-control study of 41 consecutive patients with IUGR matched 1:2 with a comparison cohort of 82 contemporaneous patients without IUGR who underwent congenital heart operations during the interval from January 1, 2000 to January 1, 2012. Matching was based on the Risk Adjustment for Congenital Heart Surgery (RACHS)-1 risk category, diagnostic category, age at operation, and gestational age...
October 2015: Annals of Thoracic Surgery
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