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Pediatric Heart Network

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https://www.readbyqxmd.com/read/28822746/outcomes-of-early-adolescent-donor-hearts-in-adult-transplant-recipients
#1
Shivank Madan, Snehal R Patel, Peter Vlismas, Omar Saeed, Sandhya Murthy, Stephen Forest, William Jakobleff, Daniel Sims, Jacqueline M Lamour, Daphne T Hsu, Julia Shin, Daniel Goldstein, Ulrich P Jorde
OBJECTIVES: This study sought to determine outcomes of adult recipients of early adolescent (EA) (10 to 14 years) donor hearts. BACKGROUND: Despite a shortage of donor organs, EA donor hearts (not used for pediatric patients) are seldom used for adults because of theoretical concerns for lack of hormonal activation and changes in left ventricular mass. Nonetheless, the outcomes of adult transplantation using EA donor hearts are not clearly established. METHODS: All adult (≥18 years of age) heart transplant recipients in the United Network for Organ Sharing database between April 1994 and September 2015 were eligible for this analysis...
August 3, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28734628/adrenergic-receptor-genotypes-influence-postoperative-outcomes-in-infants-in-the-single-ventricle-reconstruction-trial
#2
Ronand Ramroop, George Manase, Danny Lu, Dorin Manase, Shan Chen, Richard Kim, Teresa Lee, William T Mahle, Kimberly McHugh, Mike Mitchell, Martin Tristani-Firouzi, Stephanie B Wechsler, Nicole S Wilder, Victor Zak, Myriam Lafreniere-Roula, Jane W Newburger, J William Gaynor, Mark W Russell, Seema Mital
OBJECTIVES: Adrenergic receptor (ADR) genotypes have been associated with adverse outcomes in heart failure. Our objective was to evaluate the association of ADR genotypes with post-Norwood outcomes in infants with hypoplastic left heart syndrome (HLHS). METHODS: Infants with HLHS participating in the Pediatric Heart Network Single-Ventricle Reconstruction Trial underwent genotyping for 4 single-nucleotide polymorphisms in 3 ADR genes: ADRB1_231A/G, ADRB1_1165G/C, ADRB2_5318C/G, and ADRA2A_2790C/T...
June 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28712678/impact-of-the-18th-birthday-on-waitlist-outcomes-among-young-adults-listed-for-heart-transplant-a-regression-discontinuity-analysis
#3
David M Peng, Qiuying Qu, Nancy McDonald, Seth A Hollander, Daniel Bernstein, Katsuhide Maeda, Beth D Kaufman, David N Rosenthal, Doff B McElhinney, Christopher S Almond
BACKGROUND: Patients listed for heart transplant after their 18th birthday purportedly wait longer to receive a donor heart compared with patients listed before their 18th birthday. It is unclear whether there is an actual difference in wait times and whether any difference in wait time is associated with lower likelihood of transplant and/or higher risk of mortality. METHODS: Organ procurement and transplant network data were used to identify all patients listed for heart transplant between 2006 and 2014 within a 1-year period before and after their 18th birthday...
May 19, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28711963/transfer-of-neonates-with-critical-congenital-heart-disease-within-a-regionalized-network
#4
Michael F Swartz, Jill M Cholette, Jennifer M Orie, Marshall L Jacobs, Jeffrey P Jacobs, George M Alfieris
Regionalization of pediatric cardiac surgical care varies between and within states. In most geographic regions, at least some neonates with critical heart disease are transferred from their birth hospital to a different hospital for surgery. The impact of neonatal transfer for surgery, particularly over a considerable distance (>10 miles), has been largely unexplored. We sought to examine the impact of transferring neonates for cardiac surgery. We queried the New York State Cardiac Surgery database (2005-2014) from a single institution to identify neonates born within the cardiac surgery center and those transferred for surgery...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28690004/health-insurance-coverage-among-young-adult-survivors-of-pediatric-heart-transplantation
#5
Dmitry Tumin, Susan S Li, Deipanjan Nandi, Robert J Gajarski, Christopher McKee, Joseph D Tobias, Don Hayes
OBJECTIVE: To describe the change in health insurance after heart transplantation among adolescents, and characterize the implications of this change for long-term transplant outcomes. STUDY DESIGN: Patients age 15-18 years receiving first-time heart transplantation between 1999 and 2011 were identified in the United Network for Organ Sharing registry and included in the analysis if they survived at least 5 years. The primary exposure was change or continuity of health insurance coverage between the time of transplant and the 5-year follow-up...
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28687711/the-optimal-timing-of-stage-2-palliation-for-hypoplastic-left-heart-syndrome-an-analysis-of-the-pediatric-heart-network-single-ventricle-reconstruction-trial-public-dataset
#6
James M Meza, Edward J Hickey, Eugene H Blackstone, Robert D B Jaquiss, Brett R Anderson, William G Williams, Sally Cai, Glen S Van Arsdell, Tara Karamlou, Brian W McCrindle
Background -In infants requiring three-stage single ventricle palliation for hypoplastic left heart syndrome, attrition after the Norwood procedure remains significant. The effect of the timing of stage-2-palliation (S2P), a physician-modifiable factor, on long term survival is not well understood. We hypothesized that an optimal interval between the Norwood and S2P that both minimizes pre-S2P attrition and maximizes post-S2P survival exists and is associated with individual patient characteristics. Methods -The NIH/NHLBI Pediatric Heart Network Single Ventricle Reconstruction Trial public dataset was used...
July 7, 2017: Circulation
https://www.readbyqxmd.com/read/28625502/a-computable-phenotype-improves-cohort-ascertainment-in-a-pediatric-pulmonary-hypertension-registry
#7
Alon Geva, Jessica L Gronsbell, Tianxi Cai, Tianrun Cai, Shawn N Murphy, Jessica C Lyons, Michelle M Heinz, Marc D Natter, Nandan Patibandla, Jonathan Bickel, Mary P Mullen, Kenneth D Mandl
OBJECTIVES: To compare registry and electronic health record (EHR) data mining approaches for cohort ascertainment in patients with pediatric pulmonary hypertension (PH) in an effort to overcome some of the limitations of registry enrollment alone in identifying patients with particular disease phenotypes. STUDY DESIGN: This study was a single-center retrospective analysis of EHR and registry data at Boston Children's Hospital. The local Informatics for Integrating Biology and the Bedside (i2b2) data warehouse was queried for billing codes, prescriptions, and narrative data related to pediatric PH...
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28618202/effects-of-persistent-fontan-fenestration-patency-on-cardiopulmonary-exercise-testing-variables
#8
M Elisabeth Heal, Lanier B Jackson, Andrew M Atz, Ryan J Butts
Cardiopulmonary exercise testing (CPET) aids in clinical assessment of patients with Fontan circulation. Effects of persistent fenestration on CPET variables have not been clearly defined. Associations between fenestration and CPET variables at anaerobic threshold (AT) and peak exercise were explored in the Pediatric Heart Network Fontan Cross-Sectional Study cohort. Fenestration patency was associated with a greater decrease in oxygen saturation from rest to peak exercise (fenestration -4.9 ± 3.8 v. nonfenestration -3 ± 3...
July 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28580351/transition-in-patients-with-congenital-heart-disease-in-germany-results-of-a-nationwide-patient-survey
#9
Paul C Helm, Harald Kaemmerer, Günter Breithardt, Elisabeth J Sticker, Roland Keuchen, Rhoia Neidenbach, Gerhard-Paul Diller, Oktay Tutarel, Ulrike M M Bauer
BACKGROUND: A growing number of adults with congenital heart disease (ACHD) pose a particular challenge for health care systems across the world. Upon turning into 18 years, under the German national health care system, ACHD patients are required to switch from a pediatric to an adult cardiologist or an ACHD-certified provider. To date, reliable data investigating the treatment situation of ACHD patients in Germany are not available. MATERIALS AND METHODS: An online survey was conducted in collaboration with patient organizations to address the life situation and the conditions of health care provision for ACHD patients in Germany...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28577680/results-of-a-phase-i-ii-multi-center-investigation-of-udenafil-in-adolescents-after-fontan-palliation
#10
RANDOMIZED CONTROLLED TRIAL
David J Goldberg, Victor Zak, Bryan H Goldstein, Shan Chen, Michelle S Hamstra, Elizabeth A Radojewski, Eileen Maunsell, Seema Mital, Shaji C Menon, Kurt R Schumacher, R Mark Payne, Mario Stylianou, Jonathan R Kaltman, Tina M deVries, James L Yeager, Stephen M Paridon
BACKGROUND: The Fontan operation results in a circulation that is dependent on low pulmonary vascular resistance to maintain an adequate cardiac output. Medical therapies that lower pulmonary vascular resistance may augment cardiac output and improve long-term outcomes. OBJECTIVES: This phase I/II clinical trial conducted by the Pediatric Heart Network was designed to evaluate short-term safety, pharmacokinetics (PK), and preliminary efficacy of udenafil in adolescents following Fontan...
June 2017: American Heart Journal
https://www.readbyqxmd.com/read/28571639/longitudinal-outcomes-of-patients%C3%A2-with%C3%A2-single-ventricle-after%C3%A2-the%C3%A2-fontan%C3%A2-procedure
#11
MULTICENTER STUDY
Andrew M Atz, Victor Zak, Lynn Mahony, Karen Uzark, Nicholas D'agincourt, David J Goldberg, Richard V Williams, Roger E Breitbart, Steven D Colan, Kristin M Burns, Renee Margossian, Heather T Henderson, Rosalind Korsin, Bradley S Marino, Kaitlyn Daniels, Brian W McCrindle
BACKGROUND: Multicenter longitudinal objective data for survival into adulthood of patients who have undergone Fontan procedures are lacking. OBJECTIVES: This study sought to describe transplant-free survival and explore relationships between laboratory measures of ventricular performance and functional status over time. METHODS: Exercise testing, echocardiography, B-type natriuretic peptide, functional health assessment, and medical history abstraction were repeated 9...
June 6, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28568112/factors-associated-with-early-extubation-after-superior-cavopulmonary-connection-analysis-from-single-ventricle-reconstruction-trial
#12
D Zakaria, M Rettiganti, J M Gossett, P Gupta
BACKGROUND: To evaluate the landscape of early extubation, and identify factors associated with early extubation (≤ 24 h) after superior cavopulmonary connection (stage 2 operation) among children with single ventricle anatomy. METHODS: Patients undergoing stage 2 operation after Norwood operation from the Pediatric Heart Network Single Ventricle Reconstruction (SVR) trial public-use dataset were included. Elastic net regularized logistic regression models were fitted to evaluate the factors associated with early extubation after stage 2 operation...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28501374/the-effect-of-the-superior-cavopulmonary-anastomosis-on-ventricular-remodeling-in-infants-with-single-ventricle
#13
Renee Margossian, Victor Zak, Amanda J Shillingford, Anthony M Hlavacek, James F Cnota, Michael D Puchalski, Jami C Levine, Brian W McCrindle, Meryl S Cohen, Karen Altmann, Piers C Barker, Daphne T Hsu, Steven D Colan
BACKGROUND: Infants with single ventricular physiology have volume and pressure overload that adversely affect ventricular mechanics. The impact of superior cavopulmonary anastomosis (SCPA) on single left ventricles versus single right ventricles is not known. METHODS: As part of the Pediatric Heart Network placebo-controlled trial of enalapril in infants with single ventricular physiology, echocardiograms were obtained before SCPA and at 14 months and analyzed in a core laboratory...
July 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28490416/development-and-assessment-of-an-e-learning-course-on-pediatric-cardiology-basics
#14
Ana Cristina Oliveira, Sandra Mattos, Miguel Coimbra
BACKGROUND: Early detection of congenital heart disease is a worldwide problem. This is more critical in developing countries, where shortage of professional specialists and structural health care problems are a constant. E-learning has the potential to improve capacity, by overcoming distance barriers and by its ability to adapt to the reduced time of health professionals. OBJECTIVE: The study aimed to develop an e-learning pediatric cardiology basics course and evaluate its pedagogical impact and user satisfaction...
May 10, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28454797/toward-evidence-based-diagnosis-of-myocarditis-in-children-and-adolescents-rationale-design-and-first-baseline-data-of-mykke-a-multicenter-registry-and-study-platform
#15
MULTICENTER STUDY
Daniel R Messroghli, Thomas Pickardt, Marcus Fischer, Bernd Opgen-Rhein, Konstantin Papakostas, Dorothée Böcker, André Jakob, Markus Khalil, Goetz C Mueller, Florian Schmidt, Michael Kaestner, Floris E A Udink Ten Cate, Robert Wagner, Bettina Ruf, Daniela Kiski, Gesa Wiegand, Franziska Degener, Ulrike M M Bauer, Tim Friede, Stephan Schubert
The aim of this registry is to provide data on age-related clinical features of suspected myocarditis and to create a study platform allowing for deriving diagnostic criteria and, at a later stage, testing therapeutic interventions in patients with myocarditis. STUDY DESIGN AND RESULTS: After an initial 6-month pilot phase, MYKKE was opened in June 2014 as a prospective multicenter registry for patients from pediatric heart centers, university hospitals, and community hospitals with pediatric cardiology wards in Germany...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#16
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28410774/maintaining-the-gift-of-life-achieving-adherence-in-adolescent-heart-transplant-recipients
#17
Rachael Steuer, Sabrina Opiola McCauley
Since the beginning of United Network of Organ Sharing data collection in 1987, a total of 8,333 pediatric patients have received a heart transplant in the United States. Because these patients now have longer graft success with improved care and immunosuppression, many of them are entering adolescence and young adulthood. Primary care pediatric nurse practitioners need to be alert to the prevalence of noncompliance with treatment in heart transplant patients, which continues to be highest in adolescence. Low compliance in adolescence increases morbidity, contributes to decreasing quality of life, and is the leading reason for graft failure and mortality in this age group...
April 12, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28366553/implications-and-outcomes-of-cardiac-grafts-refused-by-pediatric-centers-but-transplanted-by-adult-centers
#18
Farhan Zafar, Raheel Rizwan, Angela Lorts, Roosevelt Bryant, James S Tweddell, Clifford Chin, David L Morales
BACKGROUND: According to Organ Procurement Transplant Network policy, hearts from donors age <18 years are offered to pediatric recipients before being offered to adults of the same health status. We aimed to analyze differences in the use of adolescent donor hearts between adult and pediatric candidates and also to analyze the outcomes of pediatric candidates in which an adolescent donor heart was refused and later used in an adult recipient. METHODS: All adolescent donors (age 12-17 years) for 2000 to 2015 were identified using the standard United Network of Organ Sharing dataset and matched against the Potential Transplant Recipient dataset...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28363739/functional-status-of-united-states-children-supported-with-a-left-ventricular-assist-device-at-heart-transplantation
#19
Anica Bulic, Katsuhide Maeda, Yulin Zhang, Sharon Chen, Doff B McElhinney, John C Dykes, Amanda M Hollander, Seth A Hollander, Jenna Murray, Olaf Reinhartz, Mary Alice Gowan, David N Rosenthal, Christopher S Almond
BACKGROUND: As survival with pediatric left ventricular assist devices (LVADs) has improved, decisions regarding the optimal support strategy may depend more on quality of life and functional status (FS) rather than mortality alone. Limited data are available regarding the FS of children supported with LVADs. We sought to compare the FS of children supported with LVADs vs vasoactive infusions to inform decision making around support strategies. METHODS: Organ Procurement and Transplant Network data were used to identify all United States children aged between 1 and 21 years at heart transplant (HT) between 2006 and 2015 for dilated cardiomyopathy and supported with an LVAD or vasoactive infusions alone at HT...
March 2, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28330522/passive-range-of-motion-exercise-to-enhance-growth-in-infants-following-the-norwood-procedure-a-safety-and-feasibility-trial
#20
Linda M Lambert, Felicia L Trachtenberg, Victoria L Pemberton, Janine Wood, Shelley Andreas, Robin Schlosser, Teresa Barnard, Kaitlyn Daniels, Ann T Harrington, Nicholas Dagincourt, Thomas A Miller
OBJECTIVE: The aim of this study was to evaluate the safety and feasibility of a passive range of motion exercise programme for infants with CHD. Study design This non-randomised pilot study enrolled 20 neonates following Stage I palliation for single-ventricle physiology. Trained physical therapists administered standardised 15-20-minute passive range of motion protocol, for up to 21 days or until hospital discharge. Safety assessments included vital signs measured before, during, and after the exercise as well as adverse events recorded through the pre-Stage II follow-up...
September 2017: Cardiology in the Young
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