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Adult congenital heart

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https://www.readbyqxmd.com/read/29236965/management-errors-in-adults-with-congenital-heart-disease-prevalence-sources-and-consequences
#1
Rachael Cordina, Subha Nasir Ahmad, Irina Kotchetkova, Gry Eveborn, Lynne Pressley, Julian Ayer, Richard Chard, David Tanous, Peter Robinson, Jens Kilian, John E Deanfield, David S Celermajer
Aims: Improved survival has resulted in increasing numbers and complexity of adults with congenital heart disease (ACHD). International guidelines recommend specialized care but many patients are still not managed at dedicated ACHD centres. This study analysed referral sources and appropriateness of management for patients referred to our tertiary ACHD Centre over the past 3 years. Methods and results: We compared differences in care between patients referred from paediatric/ACHD-trained vs...
December 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29232296/morbid-obesity-does-not-increase-morbidity-or-mortality-in-robotic-cardiac-surgery
#2
Hiroto Kitahara, Brooke Patel, Mackenzie McCrorey, Sarah Nisivaco, Husam H Balkhy
OBJECTIVE: Morbid obesity (body mass index ≥ 35 kg/m) usually confers a higher perioperative risk in cardiac surgery. Robotic cardiac surgery may have many advantages for these high-risk patients. METHODS: We retrospectively reviewed patients undergoing robotic cardiac surgery from July 2013 to April 2017 at our institution. We compared the outcomes of morbidly obese patients versus nonobese patients. RESULTS: A total of 486 patients underwent robotic cardiac surgery (322 men, median age = 65 years)...
December 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29229372/invasive-and-noninvasive-hemodynamic-assessment-in-adults-with-fontan-palliation
#3
Alexander C Egbe, Heidi M Connolly, Nathaniel W Taggart, Mohamad Al-Otaibi, Barry A Borlaug
BACKGROUND/OBJECTIVES: Although echocardiographic-Doppler cardiac index (CI) assessment is widely used to guide heart failure management in patients with biventricular circulation, this application has not been studied in the Fontan population. The objective of this study was to: (1) determine the correlation between Doppler and cardiac catheterization CI calculation; (2) determine the association between Doppler CI and the occurrence of Fontan failure. METHODS: Retrospective review of adult Fontan patients followed at Mayo Clinic Adult Congenital Heart Disease program, 1994-2015...
December 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29226042/direct-insertion-of-the-papillary-muscle-into-the-anterior-mitral-leaflet-cadaveric-findings
#4
Sarvenaz Sheikh, Joe Iwanaga, Jocelyn R Gonzales, Tsuyoshi Saga, Marios Loukas, Rod J Oskouian, R Shane Tubbs
Direct insertion of the anterior papillary muscle (DPM) into the mitral valve is uncommon. During the routine dissection of an adult female, a DPM into the mitral valve with abnormal chordae tendinae was observed. This abnormal papillary muscle was measured as 28.0 mm in length from myocardial to insertion, 14.8 mm in width, and 7.0 mm in depth. The embryology, symptoms, associated cardiac diseases, and surgical precautions of this congenital malformation in the heart are reviewed.
October 5, 2017: Curēus
https://www.readbyqxmd.com/read/29224925/incidence-and-clinical-characteristics-of-sudden-cardiac-death-in-adult-congenital-heart-disease
#5
Benjamin Moore, Christopher Yu, Irina Kotchetkova, Rachael Cordina, David S Celermajer
BACKGROUND: The life expectancy of adults with congenital heart disease (CHD) has significantly improved in recent decades, with non-cardiovascular causes of death now competing with traditional cardiovascular causes. The risk of sudden cardiac death (SCD), a devastating event, still remains elevated above that of the general population. METHODS: We reviewed 2935 patients in our adult CHD database (age≥16years, seen at least once in our centre) and documented all cases of SCD between 2000-2015...
December 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29209541/a-rare-manifestation-of-asymptomatic-ebstein-s-anomaly-with-tricuspid-valve-endocarditis
#6
Carmel Moazez, Vicken Zeitjian, Christian Breburda, Ranjini Roy
Ebstein's anomaly is a rare congenital heart disease that presents with apical displacement of the septal and posterior leaflets of the tricuspid valve. It has a wide spectrum of clinical presentations and has been shown to manifest itself any time from birth to adulthood. Our patient is a 43-year-old male with a history of intravenous heroin abuse who presented to the emergency department with worsening shortness of breath and lower extremity edema. He denied any prior cardiac history. A transthoracic echo showed normal left ventricular function, but a large 2...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29207763/carbamazepine-induced-thrombocytopenia
#7
Ruhi Kumar, Sridhar Chivukula, Goutham Reddy Katukuri, U K Chandrasekhar, K N Shivashankar
Antiepileptic Drugs (AEDs) are commonly associated with haematological disorders, including anaemia, thrombocytopenia, neutropenia and even bone marrow failure. Fatal disorders like aplastic anaemia are uncommon. On exploring through the literature, older AEDs are more associated with haematological alterations than newer AEDs, and careful monitoring is warranted especially with phenytoin, carbamazepine and valproate. The exact cause of these alterations is not established, though immune mechanisms and pharmacology of individual drugs are the proposed mechanisms, a further research along this path is underway...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205923/home-based-interval-training-increases-endurance-capacity-in-adults-with-complex-congenital-heart-disease
#8
Camilla Sandberg, Magnus Hedström, Karin Wadell, Mikael Dellborg, Anders Ahnfelt, Anna-Klara Zetterström, Amanda Öhrn, Bengt Johansson
OBJECTIVE: The beneficial effects of exercise training in acquired heart failure and coronary artery disease are well known and have been implemented in current treatment guidelines. Knowledge on appropriate exercise training regimes for adults with congenital heart disease is limited, thus further studies are needed. The aim of this study was to examine the effect of home-based interval exercise training on maximal endurance capacity and peak exercise capacity. DESIGN: Randomized controlled trial...
December 4, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29198985/clinical-and-psychological-drivers-of-perceived-health-status-in-adults-with-congenital-heart-disease
#9
Jong Mi Ko, Kristen M Tecson, Vanessa Al Rashida, Sandeep Sodhi, Josh Saef, Mehwish Mufti, Kamila S White, Philip A Ludbrook, Ari M Cedars
The factors having the greatest impact on self-reported health status in adults with congenital heart disease (ACHD) remain incompletely studied. We conducted a single-site, cross-sectional study of ACHD patients followed at the Center for ACHD at Washington University School of Medicine, including retrospectively gathered clinical data and psychometric and health status assessments completed at the time of enrollment. To identify primary drivers of perceived health status, we investigated the impact of the demographic, clinical, and psychological variables on self-reported health status as assessed using the Rand 36-Item Short Form Health Survey...
November 3, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29198868/an-interagency-registry-for-mechanically-assisted-circulatory-support-intermacs-analysis-of-hospitalization-functional-status-and-mortality-after-mechanical-circulatory-support-in-adults-with-congenital-heart-disease
#10
Ari Cedars, Christina Vanderpluym, Devin Koehl, Ryan Cantor, Shelby Kutty, James K Kirklin
BACKGROUND: Adult congenital heart disease (ACHD) prevalence is increasing worldwide, with advanced heart failure (HF) as a leading cause of death. Limited data are available on durable mechanical circulatory support (MCS) in ACHD patients. METHODS: ACHD patients from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database were identified and propensity matched with non-ACHD patients using risk factors from the INTERMACS Seventh Annual Report...
November 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29196541/validation-of-the-grown-ups-with-congenital-heart-disease-score
#11
Jürgen Hörer, Régine Roussin, Emanuel LeBret, Mohamed Ly, Jarrah Abdullah, Rafaella Marzullo, Jelena Pabst von Ohain, Emre Belli
OBJECTIVES: Adults with congenital heart disease in need of heart surgery frequently present with significant comorbidity. Furthermore, additional technical difficulties often related to redo operations increase the risk for postoperative mortality and morbidity. Hence, next to the type of the procedure, additional procedure-dependent and procedure-independent factors have to be considered for risk evaluation. The recently proposed grown-ups with congenital heart disease (GUCH) mortality and morbidity scores account for these additional risk factors...
December 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29191503/management-of-adults-with-congenital-heart-disease-and-pulmonary-arterial-hypertension-in-the-uk-survey-of-current-practice-unmet-needs-and-expert-commentary
#12
Robert Tulloh, Kostas Dimopoulos, Robin Condliffe, Paul Clift
BACKGROUND: Pulmonary arterial hypertension (PAH) is a well-recognised complication of adult congenital heart disease (CHD). However, management is not currently standardised between centres and specific guidelines are lacking. In order to identify and understand the unmet needs related to PAH associated with CHD (PAH-CHD), a survey of physicians was performed. METHODS: An electronic survey was sent to two physician groups: (1) cardiologists registered in a UK cardiology directory; (2) specialist pulmonary hypertension (PH) physicians known to manage patients with adult PAH-CHD...
November 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29191297/verification-of-heart-disease-implications-for-a-new-heart-transplantation-allocation-system
#13
Pejman Raeisi-Giglou, E Rene Rodriguez, Eugene H Blackstone, Carmela D Tan, Eileen M Hsich
OBJECTIVES: This study sought to determine the accuracy of the pre-transplantation clinical diagnosis of heart disease in the United Network for Organ Sharing (UNOS) database. BACKGROUND: Because survival on the heart transplantation waitlist depends on underlying heart disease, a new allocation system will include the type of heart disease. Accuracy of the pre-transplantation clinical diagnosis and the effect of misclassification are unknown. METHODS: We included all adults who received transplants at our center between January 2009 to December 2015...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29189934/mechanical-deformation-in-adult-patients-with-unrepaired-aortic-coarctation
#14
Leonel Avendaño-Pérez, María Elena Soto, Nydia Ávila-Vanzzini, Guillermo Bracamontes-Castelo, José Carlos Ruán-Díaz, Erick Alexanderson-Rosas, Nilda Espinola-Zavaleta
Aortic coarctation is a congenital heart disease that causes an increased left ventricular afterload, resulting in increased systolic parietal tension, compensatory hypertrophy, and left ventricular systolic and diastolic dysfunction. The speckle tracking is a new echocardiographic technique that allows the detection of subclinic left ventricular systolic dysfunction. The aim of this study was to detect early left ventricular dysfunction using mechanical deformation by echocardiography in adults with un-repaired aortic coarctation...
November 30, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29188316/impact-of-bicuspid-aortic-valve-morphology-on-aortic-valve-disease-and-aortic-dilation-in-pediatric-patients
#15
Rebekah M Ward, Jordan M Marsh, Jeffrey M Gossett, Mallikarjuna R Rettiganti, R Thomas Collins
Bicuspid aortic valve (BAV) is the most common congenital heart defect. BAV is associated with aortic stenosis and insufficiency, and aortic dilation in adult groups, but data in pediatric groups are limited. We sought to assess the impact of BAV morphology on aortic valve disease and aortic dilation in pediatric patients. We performed a retrospective review of all echocardiograms in patients with isolated BAV who were followed at our institution from July 2002 to July 2012. BAV morphology, aortic valve stenosis and/or insufficiency, and aortic dimensions were measured manually...
November 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29187015/submitral-aneurysm-after-pulmonary-artery-banding-a-case-report
#16
Abid Iqbal, Sabarinath Menon, Baiju S Dharan, Kapilamoorthy Tirur Raman, Jayakumar Karunakaran
Submitral aneurysms are rare clinical entities occurring predominantly in young adults of African descent. A host of etiologies have been proposed for this entity. We present a unique case of submitral aneurysm which developed after pulmonary artery banding in a three-year-old girl with complex congenital heart disease. The aneurysmal sac was burrowing into the interatrial septum.
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29185163/cardiopulmonary-bypass-for-pediatric-cardiac-surgery
#17
Yasutaka Hirata
The management of cardiopulmonary bypass for pediatric cardiac surgery is more challenging than that in adults due to the smaller size, immaturity, and complexity of the anatomy in children. Despite major improvements in cardiopulmonary bypass, there remain many subjects of debate. This review article discusses the physiology of cardiopulmonary bypass for pediatric and congenital heart surgery, including topics related to hemodilution, hypothermia, acid-base strategies, inflammatory response, and myocardial protection...
November 28, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29181895/body-composition-appetite-related-hormones-adipocytokines-and-heart-failure-in-adult-patients-with-congenital-heart-disease-a-preliminary-study
#18
Yumi Shiina, Tomoaki Murakami, Noriko Matsumoto, Daisuke Okamura, Yuta Takahashi, Yosuke Nishihata, Nobuyuki Komiyama, Koichiro Niwa
OBJECTIVES: To assess body composition and relationships among body composition, appetite-related hormones, adipocytokines, and heart failure (HF) in adult patients with congenital heart disease (CHD). PATIENTS: This prospective study enrolled 46 consecutive adult patients with CHD and 12 age-matched healthy controls. The patients and control subjects were divided into four groups: 13 patients with Fontan circulation (group A), 16 patients with cyanosis (group B), 17 patients who previously underwent biventricular repair (group C), and 12 age-matched healthy controls...
November 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29180463/trends-of-out-of-hospital-sudden-cardiac-death-among-children-and-young-adults
#19
Iqbal El-Assaad, Sadeer G Al-Kindi, Peter F Aziz
BACKGROUND AND OBJECTIVES: Previous estimates of sudden cardiac death in children and young adults vary significantly, and population-based studies in the United States are lacking. We sought to estimate the incidence, causes, and mortality trends of sudden cardiac death in children and young adults (1-34 years). METHODS: Demographic and mortality data based on death certificates for US residents (1-34 years) were obtained (1999-2015). Cases of sudden death and sudden cardiac death were retrieved by using the International Classification of Diseases, 10th Revision codes...
November 27, 2017: Pediatrics
https://www.readbyqxmd.com/read/29171147/physical-activity-perceptions-and-behaviors-among-young-adults-with-congenital-heart-disease-a-mixed-methods-study
#20
Adam McKillop, Brian W McCrindle, Gina Dimitropoulos, Adrienne H Kovacs
OBJECTIVE: A physically active lifestyle can help maintain positive physical and psychosocial health outcomes among adults with congenital heart disease (CHD). This study explored the physical activity perceptions and behaviors among young adults with CHD. DESIGN: This was a cross-sectional, mixed-methods study that included objectively measured physical activity assessment (accelerometer), individual semistructured interviews, and psychosocial questionnaires. RESULTS: Fifteen participants (67% male; 21 ± 3 years old) with moderate (n = 10) or complex (n = 5) CHD were recruited from an outpatient adult CHD clinic...
November 23, 2017: Congenital Heart Disease
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