Contemporary Research and Oral Abstracts

The 10 Most Important ACHD Research Publications in the Past 2 Years
Presented by Gary Webb, MD

webb-gary pic

Gary D. Webb, M.D. is a Professor of Pediatrics and Internal Medicine at the University of Cincinnati College of Medicine and, until May 2016, the Director of the Adult Congenital Heart Program at Cincinnati Children’s Hospital Heart Institute. After receiving a BSC and MDCM from McGill University in Montréal Québec, he went on to intern at the Royal Victoria Hospital in Montréal, and then to training in internal medicine and cardiology at the University of Toronto. After 8 years as chief of cardiology at the Wellesley Hospital in Toronto, he moved back to Toronto General Hospital. Beginning in 1980, he was codirector and then director of the Toronto Congenital Cardiac Center for Adults. For several years, he directed the adult cardiology training program at the University of Toronto. He is a Fellow of the Royal College of Physicians and Surgeons of Canada in both internal medicine and cardiology. He is a Fellow of the American College of Cardiology, and a life member of the European Society of Cardiology. In 2004, he relocated to Philadelphia, serving as director of the Philadelphia Adult Congenital Heart Center at the University of Pennsylvania. In 2009, he took up his position at Cincinnati Children’s Hospital.

 

Vascular Abnormalities in the Fontan Circulation:  Histomorphometric Changes in the Central Arteries and Veins      
Presented by Brandon Hayes MD
Cincinnati Children’s Hospital Medical Center
hays-brandon
Dr. Hays is a practicing pediatric cardiologist with Pediatric Cardiology Associates of Houston. He completed medical school at Columbia University College of Physicians and Surgeons followed by training in Pediatrics at the University of Minnesota and a fellowship in Pediatric Cardiology at Cincinnati Children’s Hospital Medical Center, where he was the Chief Fellow from 2015-2016.  His research focus during fellowship focused on the Fontan circulation, a palliation of single ventricle heart disease as well as exercise physiology and the pulmonary circulation. Dr. Hays’ research was recently selected as the winner of the American Academy of Pediatrics Young Investigator Award for Fellows-in-training.


Contraceptive Practices of Women with Complex Congenital         

Presented by  Pamela D. Miner, RN, MN, NP
Ahmanson/UCLA Adult Congenital Heart Disease Center

pamela-miner1Pamela Miner has been a nurse practitioner for the Ahmanson/UCLA Adult Congenital Heart Disease Center since 1991.  She was on the writing committee for the 2008 ACC/AHA Guidelines for Management of Adults with Congenital Heart Disease, and was one of the founding members of the Adult Congenital Cardiac Care Associates Research Network (an international multi-center ACHD research group for non-physicians).  She has been a medical advisory board member for the Adult Congenital Heart Association since its inception.  She has lectured to both nursing and physician audiences across the U.S. and internationally.   Her areas of clinical interest are in long-term clinical outcomes in postoperative complex congenital heart disease, in management of cyanotic congenital heart disease, and in the aging patient with CHD.  Her current research focuses on Contraceptive Practices in Women with Congenital Heart Disease.

 

Heart Disease: A Multi-Center North American Experience Hepatocellular Carcinoma after the Fontan Operation: A Multicenter Case Series.     
Joseph Poterucha, MD

 

Performance of Guideline Indications for ICD Implantation in Adults with Congenital Heart Disease.
Jim Vehmeijer, MD

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Perioperative ACHD

Prehabilitation–How to Make Surgery Safer
Presented by Luke Burchill MBBS PhD

burchill-lukeDr. Luke J Burchill MBBS PhD is an Assistant Professor of Medicine and Cardiologist in the Adult Congenital Heart Disease Program at the Knight Cardiovascular Research Institute, Oregon Health Science University (Portland, Oregon, USA). He received his medical degree and doctor of philosophy from the University of Melbourne (Melbourne, VIC, Australia) and subsequently completed postdoctoral fellowships in Adult Congenital Heart Disease (ACHD), Advanced Heart Failure & Heart Transplantation (Toronto General Hospital, ON, Canada), & Echocardiography (Cleveland Clinic, OH, USA). Dr. Burchill has made original contributions in the area of hormonal and genetic heart failure mechanisms, heart failure in ACHD, health care transitions for adolescents with ACHD, quality of life, and transplant outcomes in ACHD patients.

 

Cardiac Congenital Surgery and Short Term Mortality in the United Kingdom
Presented by Aleksander Kempny, MD

kempny-aleksanderDr. Aleksander Kempny is a Cardiologist for Adult Congenital Heart Disease at the Barts Heart Centre (formerly the Heart Hospital) in London, UK. He trained at the University Hospital in Muenster, Germany and at the Royal Brompton Hospital in London, UK. He is board certified in internal medicine, cardiology and echocardiography (ESC). His academic interest includes outcome analysis in patients with congenital heart disease as well as myocardial deformation analyses on echocardiography and MRI.  Dr. Kempny’s main clinical interest includes management of patients with congenital heart disease, with particular focus on patients with coexisting pulmonary hypertension, patients with cyanotic lesions and Fontan circulation.

 

Anesthesia Perspective on Improving Surgical Outcomes
Bryan Maxwell, MD, MPH
Randall Hospital Portland Oregon

maxwell hopkins headshotBryan G. Maxwell, MD, MPH is an anesthesiologist with the Oregon Anesthesiology Group in Portland, Oregon, and is Medical Director for Cardiac Anesthesiology for Legacy Emanuel Medical Center and Randall Children’s Hospital.  He is a full-time clinician and provides care for adult and pediatric cardiac populations, but has a particular interest in the care of adults with congenital heart disease (ACHD).

 

Hybrid Hype or Necessity? What Does a Combined Surgical/ Interventional Lab Offer in ACHD?
Thomas K. Jones, MD
University of Washington School of Medicine 

jones-thomasA Professor of Pediatrics and Adjunct Professor of Medicine at the University of Washington School of Medicine and the Director of the Cardiac Catheterization Laboratories at Seattle Children’s Hospital.  Dr. Jones is a graduate of the Jefferson Medical College in Philadelphia.  After completing his pediatrics residency at the University of Washington and his pediatric cardiology fellowship training at the University of Colorado and the Denver Children’s Hospital, Dr. Jones returned to Seattle where he spent the first 8 years of his career in private practice.  In 1991 Dr. Jones helped create the Children’s Heart Center at the Seattle Children’s Hospital.  In the same year he joined the academic faculty of the University of Washington and became the first Director of the Cardiac Catheterization Laboratories at the Seattle Children’s Hospital.

Dr. Jones’ lifelong work has focused on congenital and structural interventional cardiac catheterization in children and adults.  He has worked to pioneer several less invasive techniques to correct congenital heart conditions.  He has authored over 100 manuscripts, book chapters, and editorials and has participated as an investigator in over 30 multi-center clinical trials in the U.S.  Dr. Jones collaborates with emerging technology companies to develop and test new products designed to treat congenital and structural heart conditions. His research interests are currently focused on percutaneous heart valve implantation.  He continues to serve on national committees and task forces promoting clinical guidelines and practice standards for patients with congenital heart disease. He is collaborates with the FDA on novel approval pathways to improve patient access to more effective cardiovascular devices needed to treat the uncommon conditions that congenital cardiologists face every day.


What the Airline Industry Can Teach Us about Surgical Teams

Edward Hickey
The Hospital for Sick Children Toronto

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Innovation in Multicenter ACHD Data

The ROPAC Study and How We Did It
Presented by Jolien Roos-Hesselin

roos-hesselink-jolienJolien Roos-Hesselink is Professor of Cardiology at the Erasmus MC in Rotterdam, The Netherlands.  She is director of the Department of Adult Congenital Heart Disease. Her clinical work and research involves adult congenital heart disease, pregnancy in cardiac patients and aortic disease.

She has authored and co-authored over 200 scientific publications and mentored 10 PhD students. She is incoming-chair of the ESC working group on Adult Congenital Heart Disease. She participated in the Taskforce for writing ESC-guidelines on Pregnancy and cardiac disease, and on Endocarditis.

At the moment she is principal investigator of a multicentre study investigating bicuspid aortic valve disease and Turner syndrome and she is founder and co-chairperson of the Registry on Pregnancy and Cardiac Disease (ROPAC) on behalf of the European Society of Cardiology.

 

The NOTE Registry and How We Are Doing It
Presented by Barbara Mulder, MD
Academic Medical Center in Amsterdam, the Netherlands

mulder-barbaraBarbara JM Mulder is Professor of Cardiology in the Academic Medical Center in Amsterdam, the Netherlands. In 2001 she initiated the national registry and DNA bank for congenital heart disease, named CONCOR ( CONgenital CORvitia), in which presently over 16.000 patients have been included. She chaired the European Heart Survey on congenital heart disease with 79 participating centers from 24 countries.. From 2010 until 2012 she was president of the International Society of Adult Congenital Cardiology, ISACHD. At present, she is the president of the                                                  Netherlands Society of Cardiology.

 

Obstacles and Successes in Utilizing Administrative US Healthcare Data
Presented by Tara Karamlou, MD, MSc
UCSF Benioff Children’s Hospital

karamlou-taraTara Karamlou, MD is a pediatric cardiac surgeon and Assistant Professor of Surgery at UCSF. She is board-certified by the American Board of Thoracic Surgery in Thoracic and Cardiac Surgery and in Congenital Cardiac Surgery.
Dr. Karamlou received her MD from Baylor College of Medicine, completed surgical residencies at Oregon Health Science University and the University of Michigan. She is a past recipient of the Nina Braunwald Fellowship from the Thoracic Surgery Foundation for Research and Education, the John Kirklin Fellowship with the Congenital Heart Surgeons’ Society at the Hospital for Sick Children in Toronto, the Hawley Seiler Resident Award in 2004 and 2007, and the J. Maxwell Chamberlain Award from the Society of Thoracic Surgeons. Dr. Karamlou completed her pediatric cardiac surgery fellowship at Seattle Children’s Hospital and was on faculty there prior to her recruitment to UCSF in 2012.
Dr. Karamlou’s research and clinical interests are directed at quality improvement and health policy directives in pediatric and adult congenital cardiac surgery. She has focused on the volume-outcomes relationships in congenital cardiac surgery and the use of large datasets to answer clinical questions. She has received multiple grants for her work in development of miniaturized circuitry for pediatric extracorporeal circuits and evaluation of long-term functional health status in single ventricle lesions. At UCSF, Dr. Karamlou has spearheaded a home monitoring program to improve outcomes for patients with hypoplastic left heart syndrome, now in its second year. She is the chair of a California statewide collaborative that aims to improve value-based care and resolves socioeconomic healthcare disparities for patients with congenital heart dsease. Dr. Karamlou is a member of the STS National Database’s Access and Publications Committee and its Linked Registry Proposals and Longitudinal Taskforce. She is the associate statistical editor for the Journal of Thoracic and Cardiovascular Surgery and is a member of the Annals of Thoracic Surgery editorial board. She has published over 75 peer-reviewed publications in the field of pediatric cardiac surgery and has authored 10 book chapters.

 

Claims Data and Subspecialty Populations: Relevant for Adult Congenital Heart Disease Care?
Presented by Abigail Khan, MD

khan-abigailDr. Abigail May Khan received her medical degree from Harvard Medical School and went on to complete a residency in internal medicine at Massachusetts General Hospital. She completed her adult cardiology fellowship at the University of Pennsylvania and then an adult congenital heart disease fellowship at UPenn/The Children’s Hospital of Philadelphia.  She is currently an Assistant Professor of Medicine at the Knight Cardiovascular Institute at Oregon Health & Science University in Portland, Oregon. Dr. Khan has published in multiple areas of cardiology including biomarkers, risk assessment, and advanced imaging. Her current clinical and research interests include cardiac disease in pregnancy and the use of claims data to understand outcomes in the ACHD population.

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The ACHD Field from All Angles

The 21st Century Patient: The Convergence of Information Technology and Empowerment

Presented by Ariane Marelli, MD, FRCP, MPH, FACC, FAHA
Professor of Medicine, McGill University
Director, McGill Adult Unit for Congenital Heart Disease
Director of Research and Academic Affairs, Cardiology, McGill University Health Center

marelli-arianeDr. Ariane Marelli is a Professor of Medicine at McGill University. She is the Director of Cardiovascular Research at the McGill University Health Centre. She is the Associate Director of Academic Affairs for Cardiology at the McGill University Health Centre. She completed her core training in adult cardiology and a fellowship in pediatric cardiology at McGill University. She obtained advanced fellowship training in Adult Congenital Heart Disease at the University of California in Los Angeles where she was the first person to graduate from the first adult congenital heart disease program in the US. She completed an MPH at the Harvard School of Public Health with a focus on methodology for large databases and health information technology. Dr. Marelli has written a book, papers and book chapters on congenital heart disease in children and adults. She lectures internationally on topics related to adults with congenital heart disease. She has received awards of excellence in research from McGill University, the Fonds de Recherche en Santé Québec and the Heart and Stroke Foundation of Canada as well as from the American Heart Association and the American College of Cardiology. Her research interests involve the impact of the changing epidemiology of congenital heart disease on health services delivery, quality and policy.

 

The ACHA Vision for the ACHD Community

Presented by Glenn R. Tringali
National Executive Director, Adult Congenital Heart Association

tringali-glennGlenn R. Tringali, National Executive Director, in partnership with the Board of Directors and Medical Advisory Board, is responsible for leading ACHA’s mission to improve and extend the lives of the millions born with heart defects through education, advocacy, and the promotion of research. Glenn has more than three decades of nonprofit administrative experience with small, mid-sized, and large national and international healthcare organizations. Prior to joining ACHA in 2104, Glenn previously served as Chief Executive Officer of the Cerebral Palsy International Research Foundation and the National Alliance for Autism Research and also held senior administrative and fund development positions with the Cancer Research Institute, Autism Speaks, Juvenile Diabetes Research Foundation, and March of Dimes.

 

Patient Perspectives on Championing the CHD Cause

Presented by Kelly Aicher
Vice President, The Children’s Heart Foundation

Kelly Aicher is a senior manager with The Bike Gallery and has been at the helm of the Lake Oswego Location since its opening in 1997. Kelly is a graduate of Whitman College, a former Firefighter and EMT and a has spent 25 years in the bicycle business including a position with Trek Bicycle that allowed him to visit 46 states during his career. He is an adult survivor of a Congenital Heart Defect, Tetralogy Of Fallot, for which he had corrective surgery in Portland in 1972. Kelly is a very active member and has served on the board of the Downtown Lake Oswego Rotary Club where he has been honored as a Paul Harris Fellow. In his free time, Kelly is an avid Oenophile, Audiophile and enjoys cycling, skiing, music and traveling with his wife Nicky and their 2 Beagles. He fulfilled a goal of running the Big Sur Marathon in 2007. Kelly’s passion for wine, cycling and the Children’s Heart foundation has led to the Wine Ride series that partners with some of the best wineries in Oregon in order to raise funds for CHF.

 

How Congenital Heart Disease Affects a Family

Presented by Julie LeGassick
President, The Children’s Heart Foundation

Julie LeGassick holds a bachelors of arts in Geology and, prior to 2009, Julie worked as a geologist for an environmental consulting firm. She specialized in historical research to pinpoint the presence of soil and groundwater contamination on commercial properties. She is currently staying home to take care of her three daughters. After the successful correction of her oldest daughter’s transposed great arteries, Julie hopes to help other families enjoy the happiness that is a healthy child. When not chasing her children, Julie enjoys playing volleyball, yoga, running, and biking.

 

Fit Bit Frenzy: Tips for Providers on Patient Self-Quantification

Presented by Tina Kaufman, PhD, PA-C
Knight Cardiovascular Institute, Oregon Health and Science University
kaufman-tina

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CHD Surgery Featured Articles of June 2016

  1. Impact of Timing of ECMO Initiation on Outcomes after Pediatric Heart Surgery: A Multi-Institutional Analysis.

Gupta P, Robertson MJ, Rettiganti M, Seib PM, Wernovsky G, Markovitz BP, Simsic J, Tobias JD.

Pediatr Cardiol. 2016 Jun;37(5):971-8. doi: 10.1007/s00246-016-1379-6. Epub 2016 Apr 1.

PMID: 27037549

Take Home Points:

  1. Most ECMO in the participating centers was initiated on the day of surgery (60%).
  2. The timing of ECMO initiation was not related to mortality or composite poor outcome. However, increasing duration of time from surgery to ECMO initiation was associated with prolonged length of ECMO, prolonged ICU LOS, prolonged hospital LOS, and prolonged ventilator requirement.  Although this relationship was statistically significant, the odds for prolonged length of ECMO, prolonged length of ventilation, prolonged length of ICU stay, and prolonged length of hospital stay increased by only 1–3% for every 1-day increase in ECMO that may be clinically insignificant.
  3. Furthermore, the study did not demonstrate any relationship between the timing of ECMO initiation and mortality among the patients of varying age groups, and patients undergoing cardiac surgery of varying complexity.

shashidharanCommentary from Dr. Subi Shashidharan (Atlanta), section co-editor of Congenital Heart Surgery Journal Watch:  This is a large retrospective dataset review obtained from the Pediatric Health Information System.  Date was reviewed from 2004 to 2013 from 42 hospitals in the USA.  A total of 2908 patients who had undergone cardiac surgery under the age of 18 were included in the study. The median timing for initiation of ECMO was 0 days. 60% had ECMO initiation on the day of cardiac surgery. 40% had ECMO initiation ≥1day. The overall mortality for the study population was 45%.  Mortality for patients who had ECMO initiation on the day of surgery was 41%.  Mortality for group with ECMO initiation ≥1 day was 51%.

 

  1. Comparison of Extracellular Matrix Patch and Standard Patch Material in the Pulmonary Arteries.

Y Fraint H, E Richmond M, A Bacha E, Turner ME.

Pediatr Cardiol. 2016 Jun 4. [Epub ahead of print]

PMID: 27262451

Take Home Points:

  1. As in several other studies, there is no clear benefit to using ECM for pulmonary artery reconstruction.
  2. The choice should be based on surgeon preference and cost.
  3. Aortic cross clamping had longer duration of re-intervention free survival, possibly since aortic cross clamping allowed for more extensive pulmonary arterioplasty.

Commentary from Dr. Subi Shashidharan (Atlanta), section co-editor of Congenital Heart Surgery Journal Watch:  The objective of this study was to compare patients who underwent PA patch augmentation with extracellular matrix patch (ECM) versus standard patch material (SP) in an effort to understand the difference in time to surgical or catheterization-based reintervention for residual or recurrent pulmonary stenosis.  Retrospective data was collected at Columbia University between 2004 and 2013.  221 patients were included in the study.  48 patients had ECM and 173 had standard patch (including autologous, allograft and synthetic materials). Most patients in both groups had bi-ventricular physiology, although single ventricle physiology was more likely to have a standard patch.   There was no difference in the period of intubation (1 day in ECM vs. 2 days in SP), or no difference in median duration of ICU stay.  There was no difference in post-operative complications between the two groups.  There was no difference in re-intervention free survival between the two patches.  In multivariable analysis, after adjusting for surgeon and patch type, longer re-intervention free survival was associated with SV physiology and aortic cross clamping.

 

  1. Factors Associated With Mortality in Neonates Requiring Extracorporeal Membrane Oxygenation for Cardiac Indications: Analysis of the Extracorporeal Life Support Organization Registry Data.

Ford MA, Gauvreau K, McMullan DM, Almodovar MC, Cooper DS, Rycus PT, Thiagarajan R.

Pediatr Crit Care Med. 2016 Jun 28. [Epub ahead of print]

PMID: 27355824

 

Take Home Points:

  1. This is a large study which shows overall trends in ECMO utilization. Some generalizations can be made from this study for potential causes of increased mortality.
  2. There is a clear linear increase in mortality as the birth weight reduces. Also, there was increased mortality with single ventricle physiology which multiplies with birth weight.
  3. Several other factors were also noted in non survivors, notably, time to initiation of ECMO, lower pH at initiation of ECMO, longer duration on ECMO, and increased RACH score for the procedure.
  4. 67% of neonates were able to separate from ECMO by day 8, but only 41% survived to discharge.

Commentary from Dr. Subi Shashidharan (Atlanta), section co-editor of Congenital Heart Surgery Journal Watch:  This is a large retrospective cohort study of the dataset from Extracorporeal Life Support Organization Registry between 2001 and 2011.  4471 neonates (<30 days) with congenital cardiac disease supported with ECMO from 230 US and international centers were included. Overall 41% of the neonates on ECMO survived to discharge.  Certain pre-ECMO demographics were associated with higher survival.  Survivors weighed ≥ 3.0kg (with a median weight of 3.2 kg) versus non survivors had weight of ≤ 3.0kg. 56% percent of the survivors had two ventricle physiology versus 65% for single ventricle physiology.  Survival was similar for patients who had surgery versus not.  Lower pH (≤7.2) was associated with increased mortality.  The odds of mortality were 1.74 times if pH was less than 7.01 compared with 1.2 times for pH between 7.01 and 7.2.   Increasing time from intubation to ECMO was associated with increasing mortality.  The odds of mortality increased from 1 for < 10 hours to 1.35 times between 10-71 hours and 1.8 times for >72 hours.

 

  1. Association of 24/7 In-House Intensive Care Unit Attending Physician Coverage With Outcomes In Children Undergoing Heart Operations.

Gupta P, Rettiganti M, Jeffries HE, Brundage N, Markovitz BP, Scanlon MC, Simsic JM.

Ann Thorac Surg. 2016 Jun 18. pii: S0003-4975(16)30372-1. doi: 10.1016/j.athoracsur.2016.04.042. [Epub ahead of print]

PMID: 27324525

Take Home Points:

  1. The findings of this large observational study demonstrated that the presence of 24-hour in-ICU attending-physician coverage in children undergoing cardiac operations is associated with an improved survival benefit compared with patients treated in ICUs staffed by on-demand attending-level intensivist coverage. The study also demonstrated a lower incidence of cardiac arrest, less frequent use of ECMO, a higher rate of extubation within 48 hours, a lower rate of reintubation, and a shorter duration of arterial line and central venous line use in the 24-hour in-ICU attending physician–coverage model.
  2. There was no difference in ICU stay or duration of mechanical ventilation between the two groups, which may be a function of the severity of illness and the complexity of the surgical procedure performed (and not the rate of complication).

Commentary from Dr. Subi Shashidharan (Atlanta), section co-editor of Congenital Heart Surgery Journal Watch:  This is a multi-center analysis of the effects of round the clock (24/7) in-house intensive care attending coverage on outcomes in children undergoing cardiac surgery using the Virtual Pediatric Systems database.  Multi-institution prospective data on a cohort of patients under the age of 18 from 54 hospitals between 2009 and 2014 were evaluated.  25,159 patients were included.  Overall ICU mortality was 2.9%.  Cardiac arrest occurred in 2.6%.  ECMO was employed in 3.6%.   ICU mortality was lower in 24/7 coverage versus no 24/7 coverage (2.8% versus 4.0%). There was no difference in ICU stay or duration of mechanical ventilation between the two groups.  Mortality was lower in 24/7 coverage for both high-complexity (8% versus 10.5%) and low-complexity cases (1.0% versus 1.8%).  Incidence of cardiac arrest, extubation within 48 hours, rate of re-intubation, duration of central venous line and arterial line use after operation were all significantly improved in the 24/7 group.  Both high volume (>250 cases) and low volume centers showed similar results comparing 24/7 coverage versus no 24/7 coverage.  The postulated reasons for improved outcomes with around-the-clock mandatory attending-level intensivist coverage include improved diagnostic and therapeutic efficiency, timely evaluation and documentation, and timely reductions of preventable medical errors in the immediate postoperative period. The other postulated reasons for implementing 24/7 coverage include improvement in staff and parental satisfaction and increased trainee supervision.

 

  1. Is the Lecompte technique the last word on transposition of the great arteries repair for all patients? A magnetic resonance imaging study including a spiral technique two decades postoperatively.

Rickers C, Kheradvar A, Sievers HH, Falahatpisheh A, Wegner P, Gabbert D, Jerosch-Herold M, Hart C, Voges I, Putman LM, Kristo I, Fischer G, Scheewe J, Kramer HH.

Interact Cardiovasc Thorac Surg. 2016 Jun;22(6):817-25. doi: 10.1093/icvts/ivw014. Epub 2016 Feb 25.

PMID: 26920722 Free Article

Take Home Points:

  1. Adult TGA patients 20 years after neonatal spiral anastomoses presented with a more physiological blood flow profiles in their great arteries compared with patients who underwent a Lecompte procedure.
  2. There is more LPA stenosis with the LeCompte procedure.

Commentary from Dr. Subi Shashidharan (Atlanta), section co-editor of Congenital Heart Surgery Journal Watch:  This is a review of small series of patients undergoing an arterial switch operation (ASO) by a single surgeon.  Comparison was made between ASO performed with the Lecompte maneuver versus ASO performed with maintaining the spiral anatomic arrangement.  9 patients underwent Lecompte and 6 had normal spiral arrangement. Patients were studied at a mean age of 20.8+/-2.1 years.  Cardiovascular magnetic resonance imaging (MRI) was used to comprehensively evaluate cardiovascular anatomy and function, including novel 3D time-resolved phase contrast MRI techniques (4D-flow) to assess blood flow dynamics in patients and controls.  Aortic root was larger in the TGA group (both Lecompte and spiral) compared to the control group.  The ascending aorta was smaller in the spiral group.  Cross sectional area of the left pulmonary artery was smaller in the Lecompte group and the aortic arch was steeper.  The angle of the aortic root changed significantly in the spiral group towards the control group.  No difference was noted in ventricular function, myocardial scarring and aortic elastic characteristics.  Pulmonary insufficiency was noted in 3 patients in the Lecompte group versus none in the spiral group.  Pulmonary stenosis was noted in 2 in the Lecompte group versus 1 in spiral group.  More than trace aortic regurgitation was noted in 2 patients in the Lecompte group versus none in the spiral group.

CHD Surgery Articles – June 2016

  1. Circulating histones for predicting prognosis after cardiac surgery: a prospective study.

Gao H, Zhang N, Lu F, Yu X, Zhu L, Mo X, Wang W.

Interact Cardiovasc Thorac Surg. 2016 Jun 29. pii: ivw198. [Epub ahead of print]

PMID: 27357468 Free Article

  1. The Impact of Concomitant Left Ventricular Non-compaction with Congenital Heart Disease on Perioperative Outcomes.

Ramachandran P, Woo JG, Ryan TD, Bryant R, Heydarian HC, Jefferies JL, Towbin JA, Lorts A.

Pediatr Cardiol. 2016 Jun 29. [Epub ahead of print]

PMID: 27357002

  1. Retrospective Cohort Study Comparing Redo Operations Using Ferromagnetic Dissection and Conventional Monopolar Dissection.

Starr JP, Gates RN, Palafox BA, Quill A.

Surg Innov. 2016 Jun 29. pii: 1553350616656279. [Epub ahead of print]

PMID: 27357105

  1. Effect of Induction Therapy on Graft Survival in Primary Pediatric Heart Transplantation: A Propensity Score Analysis of the UNOS Database.

Butts R, Davis M, Savage A, Burnette A, Kavarana M, Bradley S, Atz A, Nietert PJ.

Transplantation. 2016 Jun 29. [Epub ahead of print]

PMID: 27362312

  1. Factors Associated With Mortality in Neonates Requiring Extracorporeal Membrane Oxygenation for Cardiac Indications: Analysis of the Extracorporeal Life Support Organization Registry Data.

Ford MA, Gauvreau K, McMullan DM, Almodovar MC, Cooper DS, Rycus PT, Thiagarajan R.

Pediatr Crit Care Med. 2016 Jun 28. [Epub ahead of print]

PMID: 27355824

  1. Comparison of Intraoperative Aminophylline Versus Furosemide in Treatment of Oliguria During Pediatric Cardiac Surgery.

Onder AM, Rosen D, Mullett C, Cottrell L, Kanosky S, Grossman OK, Iqbal HI, Seachrist E, Samsell L, Gustafson K, Rhodes L, Gustafson R.

Pediatr Crit Care Med. 2016 Jun 28. [Epub ahead of print]

PMID: 27355823

  1. Aortic Valve Replacement in Children and Young Adults.

David TE.

J Am Coll Cardiol. 2016 Jun 21;67(24):2871-3. doi: 10.1016/j.jacc.2016.04.023. No abstract available.

PMID: 27311526

  1. Aortic Valve Replacement and the Ross Operation in Children and Young Adults.

Sharabiani MT, Dorobantu DM, Mahani AS, Turner M, Peter Tometzki AJ, Angelini GD, Parry AJ, Caputo M, Stoica SC.

J Am Coll Cardiol. 2016 Jun 21;67(24):2858-70. doi: 10.1016/j.jacc.2016.04.021.

PMID: 27311525

  1. Association of 24/7 In-House Intensive Care Unit Attending Physician Coverage With Outcomes In Children Undergoing Heart Operations.

Gupta P, Rettiganti M, Jeffries HE, Brundage N, Markovitz BP, Scanlon MC, Simsic JM.

Ann Thorac Surg. 2016 Jun 18. pii: S0003-4975(16)30372-1. doi: 10.1016/j.athoracsur.2016.04.042. [Epub ahead of print]

PMID: 27324525

  1. Humanitarian Outreach in Cardiothoracic Surgery: From Setup to Sustainability.

Dearani JA, Jacobs JP, Bolman RM 3rd, Swain JD, Vricella LA, Weinstein S, Farkas EA, Calhoon JH.

Ann Thorac Surg. 2016 Jun 17. pii: S0003-4975(16)30177-1. doi: 10.1016/j.athoracsur.2016.03.062. [Epub ahead of print] Review.

PMID: 27319988

  1. Prevalence of Noncardiac and Genetic Abnormalities in Neonates Undergoing Cardiac Operations: Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.

Patel A, Costello JM, Backer CL, Pasquali SK, Hill KD, Wallace AS, Jacobs JP, Jacobs ML.

Ann Thorac Surg. 2016 Jun 17. pii: S0003-4975(16)30317-4. doi: 10.1016/j.athoracsur.2016.04.008. [Epub ahead of print]

PMID: 27319986

  1. Association of nadir oxygen delivery on cardiopulmonary bypass with serum glial fibrillary acid protein levels in paediatric heart surgery patients.

Magruder JT, Hibino N, Collica S, Zhang H, Harness HL, Heitmiller ES, Jacobs ML, Cameron DE, Vricella LA, Everett AD.

Interact Cardiovasc Thorac Surg. 2016 Jun 16. pii: ivw194. [Epub ahead of print]

PMID: 27316657 Free Article

  1. Evaluation of Acute Rejection by Measuring Strain and Strain Rate in Children With Heart Transplant: A Preliminary Report.

Gursu HA, Varan B, Sade E, Erdogan I, Sezgin A, Aslamaci S.

Exp Clin Transplant. 2016 Jun 15. doi: 10.6002/ect.2015.0330. [Epub ahead of print]

PMID: 27310367 Free Article

  1. Perioperative risk factors for impaired neurodevelopment after cardiac surgery in early infancy.

Gunn JK, Beca J, Hunt RW, Goldsworthy M, Brizard CP, Finucane K, Donath S, Shekerdemian LS.

Arch Dis Child. 2016 Jun 6. pii: archdischild-2015-309449. doi: 10.1136/archdischild-2015-309449. [Epub ahead of print]

PMID: 27272973

  1. Dexmedetomidine is Associated with an Increased Incidence of Bradycardia in Patients with Trisomy 21 After Surgery for Congenital Heart Disease.

Ueno K, Ninomiya Y, Shiokawa N, Hazeki D, Eguchi T, Kawano Y.

Pediatr Cardiol. 2016 Jun 6. [Epub ahead of print]

PMID: 27272693

  1. Predictors of Early Extubation After Pediatric Cardiac Surgery: A Single-Center Prospective Observational Study.

Ödek Ç, Kendirli T, Uçar T, Yaman A, Tutar E, Eyileten Z, Taşar M, Ramoğlu M, Ateş C, Uysalel A, İnce E, Atalay S.

Pediatr Cardiol. 2016 Jun 6. [Epub ahead of print]

PMID: 27272692

  1. [15 years of minimally invasive paediatric cardiac surgery; development and trends].

Gil-Jaurena JM, González-López MT, Pérez-Caballero R, Pita A, Castillo R, Miró L.

An Pediatr (Barc). 2016 Jun;84(6):304-10. doi: 10.1016/j.anpedi.2015.06.007. Epub 2015 Jul 26. Spanish.

PMID: 26216279 Free Article

  1. Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

Mastropietro CW, Benneyworth BD, Turrentine M, Wallace AS, Hornik CP, Jacobs JP, Jacobs ML.

Ann Thorac Surg. 2016 Jun;101(6):2285-92. doi: 10.1016/j.athoracsur.2016.01.046. Epub 2016 Apr 12.

PMID: 27083243

  1. Colonization of multidrug resistant pathogens in a hybrid pediatric cardiac surgery center.

Jaworski R, Haponiuk I, Steffens M, Arlukowicz E, Irga-Jaworska N, Chojnicki M, Kwasniak E, Zielinski J.

Arch Med Sci. 2016 Jun 1;12(3):639-44. doi: 10.5114/aoms.2016.59937. Epub 2016 May 18.

PMID: 27279859 Free PMC Article

  1. Repair of aortic coarctation in infancy: A 10-year clinical experience.

Bigdelian H, Sedighi M.

Asian Cardiovasc Thorac Ann. 2016 Jun;24(5):417-21. doi: 10.1177/0218492316643841. Epub 2016 Apr 15.

PMID: 27084872

  1. Predictors of outcomes in children awaiting heart transplantation: an experience from a National Paediatric Heart Transplantation Programme.

Shi WY, Rouse M, Weintraub RG, Zannino D, Shipp A, d’Udekem Y, Konstantinov IE.

Eur J Cardiothorac Surg. 2016 Jun;49(6):1711-8. doi: 10.1093/ejcts/ezv465. Epub 2016 Jan 22.

PMID: 26802205

  1. eComment: How to define operability in pulmonary hypertension secondary to congenital heart disease?

Myers PO, Lador F, Beghetti M.

Interact Cardiovasc Thorac Surg. 2016 Jun;22(6):859. doi: 10.1093/icvts/ivw131. No abstract available.

PMID: 27231252 Free Article

  1. Repair of complicated type B dissection with an aberrant right subclavian artery.

Zhu JM, Qi RD, Liu YM, Zheng J, Xing XY, Sun LZ.

Interact Cardiovasc Thorac Surg. 2016 Jun;22(6):718-22. doi: 10.1093/icvts/ivw043. Epub 2016 Mar 7.

PMID: 26956707 Free Article

  1. Closure of an atrial septal defect with a one-way flap patch in a patient with severe pulmonary hypertension.

Rosic M, Susak S, Redzek A, Velicki L.

Interact Cardiovasc Thorac Surg. 2016 Jun;22(6):856-8. doi: 10.1093/icvts/ivw032. Epub 2016 Feb 25.

PMID: 26920727 Free Article

  1. Is the Lecompte technique the last word on transposition of the great arteries repair for all patients? A magnetic resonance imaging study including a spiral technique two decades postoperatively.

Rickers C, Kheradvar A, Sievers HH, Falahatpisheh A, Wegner P, Gabbert D, Jerosch-Herold M, Hart C, Voges I, Putman LM, Kristo I, Fischer G, Scheewe J, Kramer HH.

Interact Cardiovasc Thorac Surg. 2016 Jun;22(6):817-25. doi: 10.1093/icvts/ivw014. Epub 2016 Feb 25.

PMID: 26920722 Free Article

  1. Vitamin D Status After Cardiopulmonary Bypass in Children With Congenital Heart Disease.

Abou Zahr R, Faustino EV, Carpenter T, Kirshbom P, Hall EK, Fahey JT, Kandil SB.

J Intensive Care Med. 2016 Jun 1. pii: 0885066616652077. [Epub ahead of print]

PMID: 27251108

  1. Intracardiac Thrombosis Involving All Four Cardiac Chambers after Extracardiac Membranous Oxygenation Associated with MTHFR Mutations.

Kim BJ, Song SH, Shin YR, Park HK, Park YH, Shin HJ.

Korean J Thorac Cardiovasc Surg. 2016 Jun;49(3):207-9. doi: 10.5090/kjtcs.2016.49.3.207. Epub 2016 Jun 5.

PMID: 27298801 Free PMC Article

  1. Aortic Root Translocation with Arterial Switch for Transposition of the Great Arteries or Double Outlet Right Ventricle with Ventricular Septal Defect and Pulmonary Stenosis.

Lee HP, Bang JH, Baek JS, Goo HW, Park JJ, Kim YH.

Korean J Thorac Cardiovasc Surg. 2016 Jun;49(3):190-4. doi: 10.5090/kjtcs.2016.49.3.190. Epub 2016 Jun 5.

PMID: 27298797 Free PMC Article

  1. Results of Extracorporeal Cardiopulmonary Resuscitation in Children.

Shin HJ, Song S, Park HK, Park YH.

Korean J Thorac Cardiovasc Surg. 2016 Jun;49(3):151-6. doi: 10.5090/kjtcs.2016.49.3.151. Epub 2016 Jun 5.

PMID: 27298791 Free PMC Article

  1. Factors Affecting Length of Postoperative Hospitalization for Pediatric Cardiac Operations in a Large North American Registry (1982-2007).

Al-Haddad BJ, Menk JS, Kochilas L, Vinocur JM.

Pediatr Cardiol. 2016 Jun;37(5):884-91. doi: 10.1007/s00246-016-1364-0. Epub 2016 Mar 10.

PMID: 26965705

  1. Clinical Factors Associated with Dose of Loop Diuretics After Pediatric Cardiac Surgery: Post Hoc Analysis.

Haiberger R, Favia I, Romagnoli S, Cogo P, Ricci Z.

Pediatr Cardiol. 2016 Jun;37(5):913-8. doi: 10.1007/s00246-016-1367-x. Epub 2016 Mar 9.

PMID: 26961571

  1. Challenging Argatroban Management of a Child on Extracorporeal Support and Subsequent Heart Transplant.

Latham GJ, Jefferis Kirk C, Falconer A, Dickey R, Albers EL, McMullan DM.

Semin Cardiothorac Vasc Anesth. 2016 Jun;20(2):168-74. doi: 10.1177/1089253215624766. Epub 2015 Dec 31.

PMID: 26721808

  1. Vascular rings.

Backer CL, Mongé MC, Popescu AR, Eltayeb OM, Rastatter JC, Rigsby CK.

Semin Pediatr Surg. 2016 Jun;25(3):165-75. doi: 10.1053/j.sempedsurg.2016.02.009. Epub 2016 Feb 22.

PMID: 27301603

  1. Hypomagnesemia in Pediatric Heart Transplant Patients Treated with Tacrolimus.

Erdogan I, Gursu HA, Varan B, Ozkan M, Sezgin A.

Exp Clin Transplant. 2016 Jun 29. doi: 10.6002/ect.2015.0371. [Epub ahead of print]

PMID: 27364480 Free Article

  1. Effect of Induction Therapy on Graft Survival in Primary Pediatric Heart Transplantation: A Propensity Score Analysis of the UNOS Database.

Butts R, Davis M, Savage A, Burnette A, Kavarana M, Bradley S, Atz A, Nietert PJ.

Transplantation. 2016 Jun 29. [Epub ahead of print]

PMID: 27362312

  1. When is the right time for Fontan conversion? The role of cardiopulmonary exercise test.

Egbe AC, Connolly HM, Dearani JA, Bonnichsen CR, Niaz T, Allison TG, Johnson JN, Poterucha JT, Said SM, Ammash NM.

Int J Cardiol. 2016 Jun 28;220:564-568. doi: 10.1016/j.ijcard.2016.06.209. [Epub ahead of print]

PMID: 27390988

  1. Batista Procedure for a Coronary Anomaly in an Infant: Long-Term Follow-Up.

González-López MT, Cuenca-Peiró V, Castillo-Martín R, Zabala-Argüelles JI, Gil-Jaurena JM.

J Card Surg. 2016 Jun 27. doi: 10.1111/jocs.12775. [Epub ahead of print]

PMID: 27345819

  1. Three-dimensional printing of a complex CHD to plan surgical repair.

Hadeed K, Dulac Y, Acar P.

Cardiol Young. 2016 Jun 20:1-3. [Epub ahead of print]

PMID: 27321706

  1. Preoperative and Intraoperative Predictive Factors of Immediate Extubation After Neonatal Cardiac Surgery.

Varghese J, Kutty S, Abdullah I, Hall S, Shostrom V, Hammel JM.

Ann Thorac Surg. 2016 Jun 18. pii: S0003-4975(16)30359-9. doi: 10.1016/j.athoracsur.2016.04.030. [Epub ahead of print]

PMID: 27324528

  1. Association of nadir oxygen delivery on cardiopulmonary bypass with serum glial fibrillary acid protein levels in paediatric heart surgery patients.

Magruder JT, Hibino N, Collica S, Zhang H, Harness HL, Heitmiller ES, Jacobs ML, Cameron DE, Vricella LA, Everett AD.

Interact Cardiovasc Thorac Surg. 2016 Jun 16. pii: ivw194. [Epub ahead of print]

PMID: 27316657 Free Article

  1. Dilatation and Dysfunction of the Neo-aortic Root and in 76 Patients After the Ross Procedure.

Zimmermann CA, Weber R, Greutmann M, Dave H, Müller C, Prêtre R, Seifert B, Buechel EV, Kretschmar O, Jost CH.

Pediatr Cardiol. 2016 Jun 14. [Epub ahead of print]

PMID: 27300557

  1. Risk Adjustment for Congenital Heart Surgery Score as a Risk Factor for Candidemia in Children Undergoing Congenital Heart Defect Surgery.

Motta FA, Dalla-Costa LM, Muro MD, Lenzi A, Picharski GL, Burger M.

Pediatr Infect Dis J. 2016 Jun 10. [Epub ahead of print]

PMID: 27294310

  1. Early Postoperative Albumin Administration Contributes to Morbidity After the Fontan Operation.

Zaccagni HJ, Alten JA, Cleveland DC, Tyler Argent R, Law MA, Bryant AS, Borasino S.

Pediatr Cardiol. 2016 Jun 9. [Epub ahead of print]

PMID: 27278633

  1. Donation after circulatory death in pediatric patients: Current utilization in the United States.

Nandi D, Miyamoto SD, Pietra BA, Shaddy RE, Rossano JW.

J Heart Lung Transplant. 2016 Jun 7. pii: S1053-2498(16)30171-1. doi: 10.1016/j.healun.2016.05.027. [Epub ahead of print] No abstract available.

PMID: 27363738

  1. Predictors of Early Extubation After Pediatric Cardiac Surgery: A Single-Center Prospective Observational Study.

Ödek Ç, Kendirli T, Uçar T, Yaman A, Tutar E, Eyileten Z, Taşar M, Ramoğlu M, Ateş C, Uysalel A, İnce E, Atalay S.

Pediatr Cardiol. 2016 Jun 6. [Epub ahead of print]

PMID: 27272692

  1. Comparison of Extracellular Matrix Patch and Standard Patch Material in the Pulmonary Arteries.

Y Fraint H, E Richmond M, A Bacha E, Turner ME.

Pediatr Cardiol. 2016 Jun 4. [Epub ahead of print]

PMID: 27262451

  1. Thoracic Duct Decompression for Protein-Losing Enteropathy in Failing Fontan Circulation.

António M, Gordo A, Pereira C, Pinto F, Fragata I, Fragata J.

Ann Thorac Surg. 2016 Jun;101(6):2370-3. doi: 10.1016/j.athoracsur.2015.08.079.

PMID: 27211948

  1. Pulmonary Valve Repair for Patients With Acquired Pulmonary Valve Insufficiency.

Said SM, Mainwaring RD, Ma M, Tacy TA, Hanley FL.

Ann Thorac Surg. 2016 Jun;101(6):2294-301. doi: 10.1016/j.athoracsur.2016.01.035. Epub 2016 Apr 12.

PMID: 27083251

  1. Postoperative Outcomes of Children With Tetralogy of Fallot, Pulmonary Atresia, and Major Aortopulmonary Collaterals Undergoing Reconstruction of Occluded Pulmonary Artery Branches.

Asija R, Koth AM, Velasquez N, Chan FP, Perry SB, Hanley FL, McElhinney D.

Ann Thorac Surg. 2016 Jun;101(6):2329-34. doi: 10.1016/j.athoracsur.2015.12.049. Epub 2016 Mar 4.

PMID: 26947013

  1. Modern Outcomes of Mechanical Circulatory Support as a Bridge to Pediatric Heart Transplantation.

Wehman B, Stafford KA, Bittle GJ, Kon ZN, Evans CF, Rajagopal K, Pietris N, Kaushal S, Griffith BP.

Ann Thorac Surg. 2016 Jun;101(6):2321-7. doi: 10.1016/j.athoracsur.2015.12.003. Epub 2016 Feb 22.

PMID: 26912304

  1. Acute biventricular interaction in pediatric patients with continuous or pulsatile flow LVAD: a simulation study.

Di Molfetta A, Ferrari G, Iacobelli R, Fresiello L, Pilati M, Toscano A, Filippelli S, Morelli S, Amodeo A.

ASAIO J. 2016 Jun 1. [Epub ahead of print]

PMID: 27258223

  1. A contemporary review of paediatric heart transplantation and mechanical circulatory support.

Kindel SJ, Everitt MD.

Cardiol Young. 2016 Jun;26(5):851-9. doi: 10.1017/S1047951116000184. Epub 2016 Mar 16.

PMID: 26979140

  1. Twenty-year experience with the Ross-Konno procedure.

Schneider AW, Bökenkamp R, Bruggemans EF, Hazekamp MG.

Eur J Cardiothorac Surg. 2016 Jun;49(6):1564-70. doi: 10.1093/ejcts/ezv434. Epub 2015 Dec 30.

PMID: 26719409

  1. Infants with Trisomy 18 and Complex Congenital Heart Defects Should Not Undergo Open Heart Surgery.

Graham EM.

J Law Med Ethics. 2016 Jun;44(2):286-91. doi: 10.1177/1073110516654122.

PMID: 27338604

  1. Venovenous extracorporeal membrane oxygenation for patients with single-ventricle anatomy: A registry report.

Aydin SI, Duffy M, Rodriguez D, Rycus PT, Friedman P, Thiagarajan RR, Weinstein S.

J Thorac Cardiovasc Surg. 2016 Jun;151(6):1730-6. doi: 10.1016/j.jtcvs.2015.12.029. Epub 2016 Jan 6.

PMID: 26832211

  1. Statins and acute kidney injury following cardiac surgery: has the last word been told?

Romagnoli S, Ricci Z.

J Thorac Dis. 2016 Jun;8(6):E451-4. doi: 10.21037/jtd.2016.04.34. No abstract available.

PMID: 27294251 Free PMC Article

  1. Erratum to: Aiming to Preserve Pulmonary Valve Function in Tetralogy of Fallot Repair: Comparing a New Approach to Traditional Management.

Sen DG, Najjar M, Yilmaz B, Levasseur SM, Kalessan B, Quaegebeur JM, Bacha EA.

Pediatr Cardiol. 2016 Jun;37(5):990. No abstract available.

PMID: 27072543

  1. Impact of Timing of ECMO Initiation on Outcomes After Pediatric Heart Surgery: A Multi-Institutional Analysis.

Gupta P, Robertson MJ, Rettiganti M, Seib PM, Wernovsky G, Markovitz BP, Simsic J, Tobias JD.

Pediatr Cardiol. 2016 Jun;37(5):971-8. doi: 10.1007/s00246-016-1379-6. Epub 2016 Apr 1.

PMID: 27037549

  1. Posterior reversible encephalopathy syndrome after pediatric heart transplantation: Increased risk for children with preexisting Glenn/Fontan physiology.

Eilers B, Albers E, Law Y, McMullan DM, Shaw D, Kemna M.

Pediatr Transplant. 2016 Jun;20(4):552-8. doi: 10.1111/petr.12702. Epub 2016 May 3.

PMID: 27139146

  1. Allosensitization does not alter post-transplant outcomes in pediatric patients bridged to transplant with a ventricular assist device.

Castleberry C, Zafar F, Thomas T, Khan MS, Bryant R, Chin C, Morales DL, Lorts A.

Pediatr Transplant. 2016 Jun;20(4):559-64. doi: 10.1111/petr.12706. Epub 2016 Apr 21.

PMID: 27102953

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