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Pediatric Heart Network

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https://www.readbyqxmd.com/read/28501374/the-effect-of-the-superior-cavopulmonary-anastomosis-on-ventricular-remodeling-in-infants-with-single-ventricle
#1
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...
May 10, 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
#2
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
#3
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
#4
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
#5
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
#6
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...
March 11, 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
#7
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
#8
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...
March 23, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28329463/current-practices-in-the-timing-of-stage-2-palliation
#9
James M Meza, Robert D B Jaquiss, Brett R Anderson, Michael-Alice Moga, James K Kirklin, George Sarris, William G Williams, Brian W McCrindle
BACKGROUND: Mortality through single-ventricle palliation remains high and the effect of the timing of stage 2 palliation (S2P) is not well understood. We investigated current practice patterns in the timing of S2P across two professional societies and compared them to actual practice patterns from two databases of patients who underwent S2P. METHODS: A ten-question survey was distributed to the members of the Congenital Heart Surgeons' Society (CHSS) and the European Congenital Heart Surgeons' Association (ECHSA)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28274558/morbidity-and-mortality-prediction-in-pediatric-heart-surgery-physiological-profiles-and-surgical-complexity
#10
John T Berger, Richard Holubkov, Ron Reeder, David L Wessel, Kathleen Meert, Robert A Berg, Michael J Bell, Robert Tamburro, J Michael Dean, Murray M Pollack
OBJECTIVES: Outcome prediction for pediatric heart surgery has focused on mortality but mortality has been significantly reduced over the past 2 decades. Clinical care practices now emphasize reducing morbidity. Physiology-based profiles assessed by the Pediatric Risk of Mortality (PRISM) score are associated with new significant functional morbidity detected at hospital discharge. Our aims were to assess the relationship between new functional morbidity and surgical risk categories (Risk Adjustment for Congenital Heart Surgery [RACHS] and Society for Thoracic Surgery Congenital Heart Surgery Database Mortality Risk [STAT]), measure the performance of 3-level (intact survival, survival with new functional morbidity, or death) and 2-level (survival or death) PRISM prediction algorithms, and assess whether including RACHS or STAT complexity categories improves the PRISM predictive performance...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28274556/comparison-of-right-ventricle-pulmonary-artery-shunt-position-in-the-single-ventricle-reconstruction-trial
#11
Nicholas D Andersen, James M Meza, Matthew R Byler, Andrew J Lodge, Kevin D Hill, Christoph P Hornik, Robert D B Jaquiss
OBJECTIVE: Placement of a right ventricle-pulmonary artery shunt to the left or right of the neoaorta may influence reinterventions, pulmonary artery development, and survival after the Norwood procedure because of differences in shunt and pulmonary artery geometry and blood flow. METHODS: We analyzed the Pediatric Heart Network Single Ventricle Reconstruction Trial public use dataset. Comparisons were made between patients who received a left- or right-sided right ventricle-pulmonary artery shunt during the Norwood procedure in both the overall (n = 274) and the propensity score-matched (67 pairs) patient cohorts...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28267897/outcomes-of-pediatric-kidney-transplantation-in-recipients-of-a-previous-non-renal-solid-organ-transplant
#12
G Hamdani, B Zhang, C Liu, J Goebel, Y Zhang, E Nehus
Children who receive a non-renal solid organ transplant may develop secondary renal failure requiring kidney transplantation. We investigated outcomes of 165 pediatric kidney transplant recipients who previously received a heart, lung, or liver transplant using data from 1988 to 2012 reported to the United Network for Organ Sharing. Patient and allograft survival were compared with 330 matched primary kidney transplant (PKT) recipients. Kidney transplantation after solid organ transplant (KASOT) recipients experienced similar allograft survival: 5- and 10-year graft survival was 78% and 60% in KASOT recipients, compared to 80% and 61% in PKT recipients (p = 0...
March 7, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28251816/inferior-outcomes-on-the-waiting-list-in-low-volume-pediatric-heart-transplant-centers
#13
A Rana, C D Fraser, B B Scully, J S Heinle, E D McKenzie, W J Dreyer, M Kueht, H Liu, E D Brewer, T K Rosengart, C A O'Mahony, J A Goss
Low case volume has been associated with poor outcomes in a wide spectrum of procedures. Our objective was to study the association of low case volume and worse outcomes in pediatric heart transplant centers, taking the novel approach of including waitlist outcomes in the analysis. We studied a cohort of 6482 candidates listed in the Organ Procurement and Transplantation Network for pediatric heart transplantation between 2002 and 2014; 4665 (72%) of the candidates underwent transplantation. Candidates were divided into groups according to the average annual transplantation volume of the listing center during the study period: more than 10, six to 10, three to five, or fewer than three transplantations...
March 1, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28183375/translating-clinical-trials-into-clinical-practice-a-survey-assessing-the-potential-impact-of-the-pediatric-heart-network-infant-single-ventricle-trial
#14
Victor Zak, Daphne T Hsu, Victoria L Pemberton, Jami C Levine, Andrew M Atz, James F Cnota, Chitra Ravishankar, Piers Barker, Linda M Lambert, Brian W McCrindle, Michele A Frommelt, Karen Altmann, Shan Chen, Richard V Williams
BACKGROUND: A few studies have evaluated the impact of clinical trial results on practice in paediatric cardiology. The Infant Single Ventricle (ISV) Trial results published in 2010 did not support routine use of the angiotensin-converting enzyme inhibitor enalapril in infants with single-ventricle physiology. We sought to assess the influence of these findings on clinical practice. METHODS: A web-based survey was distributed via e-mail to over 2000 paediatric cardiologists, intensivists, cardiothoracic surgeons, and cardiac advance practice nurses during three distribution periods...
February 10, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28125462/united-states-trends-in-pediatric-ventricular-assist-implantation-as-bridge-to-transplantation
#15
Chet R Villa, Muhammad S Khan, Farhan Zafar, David Ls Morales, Angela Lorts
Ventricular assist devices (VADs) are increasingly used to support children to heart transplant however, it is unclear if this trend is broadly applicable across the age/size spectrum. Children (<18years) listed for transplant were identified within in the United Network of Organ Sharing (UNOS) database from 1/2006-6/2014. Patients were stratified by era (Early: 2006-2010, Current: 2011-2014), size (<25 kg, 25-50 kg, > 50 kg) and device type. Of 3986 patients, 531 (13%) were supported by a VAD. The proportion of patients supported with a VAD has increased in the current era (16% vs...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#16
Shannon Tew, Manuel L Fontes, Nathaniel H Greene, Miklos D Kertai, George Ofori-Amanfo, Robert D B Jaquiss, Andrew J Lodge, Warwick A Ames, Hercilia Mayumi Homi, Kelly A Machovec, Edmund H Jooste
OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pediatric population. Our objective was to investigate this relationship and examine independent predictors of AKI. DESIGN: After IRB approval, we performed a retrospective review of the institution's medical records and database...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28073609/interaction-of-older-donor-age-and-survival-after-weight-matched-pediatric-heart-transplantation
#17
Thomas C Westbrook, David L S Morales, Muhammad S Khan, Roosevelt Bryant, Chesney Castleberry, Clifford Chin, Farhan Zafar
BACKGROUND: Donors are matched for weight in pediatric heart transplantation (PHT), yet age differences are not considered in this decision. In this study we attempt to identify the effect of age differences in weight-matched patients and the effect these differences have on post-transplant survival. METHODS: The United Network of Organ Sharing (UNOS) database was queried for the period from October 1987 to March 2014 for all pediatric heart transplant patients...
May 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28043455/validation-of-a-simple-score-to-determine-risk-of-hospital-mortality-after-the-norwood-procedure
#18
Shahryar M Chowdhury, Eric M Graham, Andrew M Atz, Scott M Bradley, Minoo N Kavarana, Ryan J Butts
The ability to quantify patient-specific hospital mortality risk before the Norwood procedure remains elusive. This study aimed to develop an accurate and clinically feasible score to assess the risk of hospital mortality in neonates undergoing the Norwood procedure. All patients (n = 549) in the publically available Pediatric Heart Network Single Ventricle Reconstruction trial database were included in the analysis. Patients were randomly divided into a derivation (75%) and validation (25%) cohort. Preoperative factors found to be associated with mortality upon univariable analysis (P < 0...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28009713/outcomes-and-trends-of-ventricular-assist-device-selection-in-children-with-end-stage-heart-failure
#19
Jacob R Miller, Timothy S Lancaster, Deirdre J Epstein, Nicholas C DuPont, Kathleen E Simpson, Chesney Castleberry, Charles E Canter, Pirooz Eghtesady, Umar S Boston
We aimed to examine trends in VAD selection, continuous-flow devices (CFD) versus pulsatile (PFD), and their associated outcomes in children eligible for both device types. To accomplish this, the United Network for Organ Sharing database was reviewed for pediatric patients listed for heart transplant (HT) from January of 2007 through June of 2014. Patients were included if a durable VAD was present at wait listing or when removed from the waiting list, and who met size eligibility for a CFD (BSA > 1.0 m2)...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27939495/development-and-impact-of-arrhythmias-after-the-norwood-procedure-a-report-from-the-pediatric-heart-network
#20
Matthew E Oster, Shan Chen, Nicholas Dagincourt, Yaniv Bar-Cohen, Matthew Brothers, Nicole Cain, Steven D Colan, Richard J Czosek, Jamie A Decker, David G Gamboa, Salim F Idriss, Joel A Kirsh, Martin J LaPage, Richard G Ohye, Elizabeth Radojewski, Maully Shah, Eric S Silver, Anoop K Singh, Joel D Temple, John Triedman, Jonathan R Kaltman
OBJECTIVES: The study objective was to determine the predictors of new-onset arrhythmia among infants with single-ventricle anomalies during the post-Norwood hospitalization and the association of those arrhythmias with postoperative outcomes (ventilator time and length of stay) and interstage mortality. METHODS: After excluding patients with preoperative arrhythmias, we used data from the Pediatric Heart Network Single Ventricle Reconstruction Trial to identify risk factors for tachyarrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, junctional ectopic tachycardia, and ventricular tachycardia) and atrioventricular block (second or third degree) among 544 eligible patients...
March 2017: Journal of Thoracic and Cardiovascular Surgery
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