Congenital EP Featured Articles of July 2017

Congenital Pediatric Cardiac EP Reviews of July/August 2017 Manuscripts

 

A Multicenter Review of Ablation in the Aortic Cusps in Young People

Nguyen MB, Ceresnak SR, Janson CM, Fishberger SB, Love BA, Blaufox AD, Motonaga KS, Dubin AM, Nappo L, Pass RH.

Pacing and Clinical Electrophysiology. 2017; 40:798-802.

 

Take Home Points:

 

  • Catheter ablation in the aortic cusps for the treatment of arrhythmias in young patients is infrequently pursued, but can be performed safely and with high success.
  • Overall experience with aortic cusp ablation in young patients remains limited, but highly supports the following: comprehensive mapping of arrhythmia targets endocardially before pursuing the aortic cusp sites; appropriate imaging of the aortic cusps and coronary arterial origins before, during, and after ablation; and post-procedural assessments to evaluate aortic valve and ventricular function.

 

Philip-Chang_Headshot (small)Comment from Dr. Philip Chang (Gainesville, FL), section editor of Congenital Electrophysiology Journal Watch:  Though rarely done in young patients, overall experience with catheter ablation within the aortic cusps has been growing, primarily within the adult electrophysiology community, and published results have generally been favorable across a variety of arrhythmia types.  Experience with this ablation approach in young patients is limited and far less published.  In this study, Pass et al. sought to provide a multicenter review of the experience with this ablation approach from 5 medium-large sized pediatric EP centers.

 

Following IRB approval at all centers, retrospective review was performed and all cases in patients <21yo and involving aortic cusp ablation were included.  The authors collected general demographic data along with cardiac-specific data, procedural details, and any reported complications for descriptive analysis.

 

A total of 13 patients/cases were found and included with the cohort’s median age being 16yo (range 10-20.5yo), median weight 57.5 kg (range 31-108 kg), median BSA 1.58 m2 (range 1.12-2.33 m2), and fairly even gender distribution (54% male).  All subjects had structurally normal hearts, preserved ventricular function, and no aortic valve pathology.  Standard and conventional diagnostic EPS and conventional intracardiac mapping and attempted arrhythmia treatment were incorporated before pursuing aortic cusp mapping and ablation in all cases.  Electroanatomic mapping (EAM) was incorporated in the majority of cases (12/13).  When aortic cusp mapping and ablation was pursued, aortic root angiography was performed first in RAO and LAO projections.  Selective coronary angiography was not performed based on the procedural description and details provided by the authors.  A standard 4-mm tip RF ablation catheter was used in 11/13 cases (85%) while irrigated-tip RF ablation was performed in the remaining 2 cases.  For standard RF delivery, powers were limited to 30-50 W and maximum temperature limit was 60o C.  Power was <35 W for irrigated RF deliveries.  Cryoenergy was used in 1 case before changing to RF due to lack of success.  Acute success with aortic cusp ablation using RF energy was achieved in all cases.  Post-ablation aortic root angiography was performed in all cases.  Intracardiac echo (ICE) was utilized in the most recent 3 cases included in the cohort.  Post-procedural echo and ECG assessments were performed within 14 days after the procedure.  Of note, the authors did not report the exact percentage of cases that aortic cusp ablation accounted for at individual centers or collectively.  The approach to anticoagulation and target ACT values were not reported.

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Table 1 outlines the variables collected from the 13 cases included.  Ventricular arrhythmias (VT or PVCs) accounted for 69% of the arrhythmias treated (9/13 cases) and most of these were ablated within the noncoronary cusp (NCC; 8/9 cases).  The authors noted the unusually high proportion of NCC targets for ventricular arrhythmias in this young cohort in comparison to what is more typically noted in adult patients.  A total of 3 cases involved anteroseptal pathways (2 concealed, 1 WPW) and the last case involved ectopic atrial tachycardia.  Pseudoaneurysm involving the femoral arterial access site occurred in 1 patient.  Otherwise, no other complications were reported either acutely during the procedure or on post-procedural assessment.  Recurrence of PVCs occurred in 1 case over a median follow-up time of 20 months (range 7-86 months), which was described by the authors as involving very minimal intra-procedural PVC burden that prevented detailed mapping.  Table 2 outlines the respective cusps where ablation was performed in each arrhythmia subtype.  The authors did not report the total number of ablation lesions or duration of RF deliveries that were performed in each case or collectively.

 

Though limited by very small sample size despite its multicenter design, the study provides some important insights for consideration.  First, acute success with low complication rate can be achieved in the majority of patients where the target for ablation is mapped to the aortic cusps.  The authors acknowledged the sample size limitation, but also highlight this as a demonstration of how infrequent aortic cusp mapping and ablation appears to be of necessity (13 cases across 5 institutions over a 6-7 year period).  The exact percentages that these cases accounted for was not reported but would be expected to be extremely low.  While the low percentage likely reflects the low incidence of arrhythmia targets from the cusp locations, the authors also noted that the rarity may also reflect lack of performance secondary to concerns over potential complications.  The small sample size, along with relative paucity of published experience and data also call for more experience and pooling of data to determine best practices in terms of procedural setup, angiography, integration of ICE, necessity of EAM, and post-procedural monitoring and follow-up.

 

The Utility of Exercise Testing in Risk Stratification of Asymptomatic Patients with Type 1 Brugada Pattern

Subramanian M, Prabhu MA, Harikrishnan MS, Shekhar SS, Pai PG, Natarjan K.

J Cardiovasc Electrophysiol 2017; 28:677-683.

 

Take Home Points:

 

  • Treadmill exercise testing may provide data that can aid in the identification of higher risk groups of asymptomatic patients with type 1 Brugada pattern on ECG
  • Treadmill exercise testing in patients with type 1 Brugada pattern on ECG demonstrates ECG changes at peak exercise and recovery that reflect Na channel dysfunction as well as autonomic imbalances that may contribute, in part, to the basis of developing ventricular arrhythmias.

 

Comment from Dr. Philip Chang (Gainesville, FL), section editor of Congenital Electrophysiology Journal Watch:  Risk stratification of asymptomatic patients who are found to have type 1 Brugada patterns of standard 12-lead ECG remains challenging.  While ICD therapy can provide survival benefit, the low true sudden death event rate and relatively high complication rate with ICDs further complicates the determination of who warrants primary prevention ICD implantation in this patient population.  Subramanian et al. sought to evaluate the utility of standard treadmill exercise testing in uncovering ECG changes that could help identify higher risk patients among a group of subjects with type 1 Brugada patterns on ECG.

 

Following IRB approval, the authors performed a retrospective, case controlled analysis of their experience with exercise testing in otherwise asymptomatic patients >18yo with a spontaneous or pharmacologically induced type 1 Brugada pattern on ECG and no structural cardiac abnormalities over the time period January 2007-December 2015.  A total of 75 patients were included with the majority (72.2%) noted to have spontaneous type 1 patterns while the remaining subjects had an induced type 1 pattern with flecainide.  An ICD was implanted in 22/75 study patients with the majority (20/22) for inducible VT/VF during EPS and 1 patient each for family history of Brugada with sudden death (1/22) and history of spontaneous nonsustained VT (1/22).  The control group was comprised of age- and sex-matched healthy subjects.  Standard symptom-limited exercise testing with Bruce protocol was performed.  All subjects were not on any antiarrhythmic medications.  Testing involved 12-lead ECG collections at rest, at the end of each exercise stage, at peak exercise, and at 1-minute intervals during a 6-minute recovery phase (further divided into early and late recovery segments).  Clinical follow-up was conducted every 6 months or sooner if syncope or ICD therapy occurred (in patients implanted with ICDs).

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July 2017 ep 4

 

Tables 1 and 2 show baseline comparisons between study and control subjects (table 1) and comparisons between study subjects with and without major arrhythmic events (MAEs; table 2).  Subjects with type 1 Brugada patterns had significantly longer PR intervals and slower resting heart rates compared to controls.  Among type 1 Brugada patients with and without MAEs, there were no significant differences in variables.

July 2017 ep 5

Exercise testing resulted in measurable changes in S wave upslope, J point, and maximum ST segment elevation during exercise and recovery in patients with type 1 Brugada pattern, and particularly in those who experienced subsequent MAEs. (Figure 2)  Changes were noted in the precordial leads but interestingly, also in lead aVR as well.  The authors noted longer QRS complex durations at peak exercise in type 1 Brugada patients compared to controls (p <0.001).  They also noted significantly slower and delayed heart rate recovery during the recovery period among type 1 Brugada patients compared to controls (p <0.05).  Nonsustained VT occurred in early recovery in 1 patients with a type 1 Brugada pattern.  Over a mean follow-up duration of 77.9 ± 28.9 months, 8/72 study patients (11.1%) had MAEs (5 VT/VF on ICD and 3 sudden deaths) and 3 patients were lost to follow-up.

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Regression analysis showed precordial S wave upslope duration ratio ≥ 30% at peak exercise, aVR augmented J point elevation ≥ 0.3 mV in late recovery, and delayed heart rate recovery ≤ 40% of maximum heart rate in late recovery as being independent predictors of MAEs in type 1 Brugada patients. (Table 3)  Furthermore, they noted a cumulative risk with increasing number or risk factors in the same patient. (Figure 5)

July 2017 ep 7

This study offers several interesting insights with regards to the management of the asymptomatic type 1 Brugada pattern patient.  First, it offers insights into measurable changes on a noninvasive testing modality that is commonly done and widely available that could help to determine which asymptomatic patients may be at higher risk of arrhythmic events.  Second, the changes that occur during exercise testing also appear to highlight a potential autonomic influence, which may vary from patient to patient and may contribute to higher SCD risk in some compared to others.  This offers new avenues to pursue in terms of therapies to modulate autonomics and perhaps new functional analyses in certain genetic mutations which may be more affected by autonomic factors.  The notable ECG changes in lead aVR are also a novel insight, particularly as most attention is focused on the right precordial leads in Brugada syndrome.  Finally, the presence of measurable ECG changes with standard exercise testing also provides insights into ways to monitor treatment response and titrate medical therapy in Brugada syndrome (though pharmacotherapy to treat Brugada syndrome is very limited to begin with).

There are several limitations noted in this study, including some limitations to the applicability and extrapolation to pediatric patients since this was an adult cohort that excluded patients <18yo.  The overall sample size of the study cohort was small in this single institution study and there may be regional and international variations in disease phenotype and practice composition.  This may be 1 explanation as to the rather high MAE incidence of 11.1%.  Nearly a quarter of study patients also had pharmacologic testing done, though the authors did not disclose the reasons for testing and therefore whether these patients were truly asymptomatic is in question.  The integration of genetic testing was also not discussed.

 

 

CHD EP July 2017

 

  1. Management of postoperative junctional ectopic tachycardia in pediatric patients: a survey of 30 centers in Germany, Austria, and Switzerland.

Entenmann A, Michel M, Herberg U, Haas N, Kumpf M, Gass M, Egender F, Gebauer R.

Eur J Pediatr. 2017 Jul 21. doi: 10.1007/s00431-017-2969-x. [Epub ahead of print]

PMID: 28730319

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  1. Genotype Positive Long QT Syndrome in Patients With Coexisting Congenital Heart Disease.

Ebrahim MA, Williams MR, Shepard S, Perry JC.

Am J Cardiol. 2017 Jul 15;120(2):256-261. doi: 10.1016/j.amjcard.2017.04.018. Epub 2017 Apr 27.

PMID: 28532774

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  1. Increased risk of thromboembolic events in adult congenital heart disease patients with atrial tachyarrhythmias: Bias due to the data sparsity.

Ayubi E, Safiri S, Mansournia MA.

Int J Cardiol. 2017 Jul 15;239:20. doi: 10.1016/j.ijcard.2017.02.133. No abstract available.

PMID: 28560967

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  1. How to Perform Transconduit and Transbaffle Puncture in Patients who have previously undergone the Fontan or Mustard Operation.

Uhm JS, Kim NK, Kim TH, Joung B, Pak HN, Lee MH.

Heart Rhythm. 2017 Jul 14. pii: S1547-5271(17)30877-9. doi: 10.1016/j.hrthm.2017.07.020. [Epub ahead of print] No abstract available.

PMID: 28716702

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  1. A focus on pharmacological management of catecholaminergic polymorphic ventricular tachycardia.

Barbanti C, Maltret A, Sidi D.

Mini Rev Med Chem. 2017 Jul 7. doi: 10.2174/1389557517666170707100923. [Epub ahead of print]

PMID: 28685702

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  1. Does pharmacological therapy still play a role in preventing sudden death in surgically treated Tetralogy of Fallot?

Bronzetti G, Brighenti M, Bonvicini M.

Mini Rev Med Chem. 2017 Jul 7. doi: 10.2174/1389557517666170707101411. [Epub ahead of print]

PMID: 28685697

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  1. Major adverse events and atrial tachycardia in Ebstein’s anomaly predicted by cardiovascular magnetic resonance.

Rydman R, Shiina Y, Diller GP, Niwa K, Li W, Uemura H, Uebing A, Barbero U, Bouzas B, Ernst S, Wong T, Pennell DJ, Gatzoulis MA, Babu-Narayan SV.

Heart. 2017 Jul 6. pii: heartjnl-2017-311274. doi: 10.1136/heartjnl-2017-311274. [Epub ahead of print]

PMID: 28684436 Free Article

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  1. Prevention of Sudden Cardiac Death in Adults With Congenital Heart Disease: Do the Guidelines Fall Short?

Vehmeijer JT, Koyak Z, Budts W, Harris L, Silversides CK, Oechslin EN, Bouma BJ, Zwinderman AH, Mulder BJM, de Groot JR.

Circ Arrhythm Electrophysiol. 2017 Jul;10(7). pii: e005093. doi: 10.1161/CIRCEP.116.005093.

PMID: 28696220

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  1. Where to Throw That Shoe? Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Congenital Heart Disease.

Sherwin ED, Berul CI.

Circ Arrhythm Electrophysiol. 2017 Jul;10(7). pii: e005525. doi: 10.1161/CIRCEP.117.005525. No abstract available.

PMID: 28687672

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  1. Atrioventricular Nodal Reentrant Tachycardia in Patients With Congenital Heart Disease: Outcome After Catheter Ablation.

Papagiannis J, Beissel DJ, Krause U, Cabrera M, Telishevska M, Seslar S, Johnsrude C, Anderson C, Tisma-Dupanovic S, Connelly D, Avramidis D, Carter C, Kornyei L, Law I, Von Bergen N, Janusek J, Silva J, Rosenthal E, Willcox M, Kubus P, Hessling G, Paul T; Pediatric and Congenital Electrophysiology Society.

Circ Arrhythm Electrophysiol. 2017 Jul;10(7). pii: e004869. doi: 10.1161/CIRCEP.116.004869. Epub 2017 Jul 7.

PMID: 28687669

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  1. Appearance of QRS fragmentation late after Mustard/Senning repair is associated with adverse outcome.

Helsen F, Vandenberk B, De Meester P, Van De Bruaene A, Gabriels C, Troost E, Gewillig M, Meyns B, Willems R, Budts W; FH and BV contributed equally to this study.

Heart. 2017 Jul;103(13):1036-1042. doi: 10.1136/heartjnl-2016-310512. Epub 2017 Feb 9.

PMID: 28183791

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  1. Localized atrial reentrant tachycardia in tetralogy of Fallot: Ultra-high-resolution mapping and termination by nonpropagated atrial pacing stimulus.

Lee A, Kite J, Davison O, Haqqani HM.

Heart Rhythm. 2017 Jul;14(7):1102-1103. doi: 10.1016/j.hrthm.2017.03.007. Epub 2017 Mar 18. No abstract available.

PMID: 28323170

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  1. Congenital heart block and immune mediated sensorineural hearing loss: possible cross reactivity of immune response.

Bason C, Pagnini I, Brucato A, Maestroni S, Puccetti A, Lunardi C, Cimaz R.

Lupus. 2017 Jul;26(8):835-840. doi: 10.1177/0961203316682099. Epub 2016 Dec 5.

PMID: 27913750

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  1. Atrial undersensing secondary to quiet timer blanking in pediatric and congenital heart disease patients.

von Alvensleben JC, Schaffer M, Brateng C, Collins KK.

Pacing Clin Electrophysiol. 2017 Jul;40(7):843-849. doi: 10.1111/pace.13101. Epub 2017 Jun 14.

PMID: 28436549

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  1. Discrimination between QRS and T Waves Using a Right Parasternal Lead for S-ICD in a Patient with a Single Ventricle.

Nishiyama T, Kimura T, Nishiyama N, Aizawa Y, Fukuda K, Takatsuki S.

Pacing Clin Electrophysiol. 2017 Jul;40(7):904-907. doi: 10.1111/pace.13046. Epub 2017 Mar 3.

PMID: 28185283

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  1. Pediatric Dosing of Intravenous Sotalol Based on Body Surface Area in Patients with Arrhythmia.

Li X, Zhang Y, Liu H, Jiang H, Ge H, Zhang Y.

Pediatr Cardiol. 2017 Jul 28. doi: 10.1007/s00246-017-1683-9. [Epub ahead of print]

PMID: 28755092

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  1. Radiofrequency ablation of fast ventricular tachycardia causing an ICD storm in an infant with hypertrophic cardiomyopathy.

Ergul Y, Ozyilmaz I, Bilici M, Ozturk E, Haydin S, Guzeltas A.

Pacing Clin Electrophysiol. 2017 Jul 27. doi: 10.1111/pace.13154. [Epub ahead of print]

PMID: 28749010

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  1. NS1643 enhances ionic currents in a G604S-WT hERG co-expression system associated with long QT syndrome 2.

Huo J, Guo X, Lu Q, Qiang H, Liu P, Bai L, Huang CLH, Zhang Y, Ma A.

Clin Exp Pharmacol Physiol. 2017 Jul 25. doi: 10.1111/1440-1681.12820. [Epub ahead of print]

PMID: 28741726

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  1. Contemporary Outcomes in Patients With Long QT Syndrome.

Rohatgi RK, Sugrue A, Bos JM, Cannon BC, Asirvatham SJ, Moir C, Owen HJ, Bos KM, Kruisselbrink T, Ackerman MJ.

J Am Coll Cardiol. 2017 Jul 25;70(4):453-462. doi: 10.1016/j.jacc.2017.05.046.

PMID: 28728690

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  1. What endocardial right ventricular pacing site shows better contractility and synchrony in children and adolescents?

Silvetti MS, Ammirati A, Palmieri R, Pazzano V, Placidi S, Ravà L, Remoli R, Saputo FA, Verticelli L, Drago F.

Pacing Clin Electrophysiol. 2017 Jul 25. doi: 10.1111/pace.13153. [Epub ahead of print]

PMID: 28744930

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  1. Potential utility of pulsed Doppler for prenatal diagnosis of fetal ventricular tachycardia secondary to long QT syndrome.

Miyoshi T, Sakaguchi H, Shiraishi I, Yoshimatsu J, Ikeda T.

Ultrasound Obstet Gynecol. 2017 Jul 25. doi: 10.1002/uog.18819. [Epub ahead of print]

PMID: 28741754

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  1. Plakophilin-2 is required for transcription of genes that control calcium cycling and cardiac rhythm.

Cerrone M, Montnach J, Lin X, Zhao YT, Zhang M, Agullo-Pascual E, Leo-Macias A, Alvarado FJ, Dolgalev I, Karathanos TV, Malkani K, Van Opbergen CJM, van Bavel JJA, Yang HQ, Vasquez C, Tester D, Fowler S, Liang F, Rothenberg E, Heguy A, Morley GE, Coetzee WA, Trayanova NA, Ackerman MJ, van Veen TAB, Valdivia HH, Delmar M.

Nat Commun. 2017 Jul 24;8(1):106. doi: 10.1038/s41467-017-00127-0.

PMID: 28740174 Free PMC Article

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  1. The impact of intrauterine treatment on fetal tachycardia: a nationwide survey in Japan.

Ueda K, Maeno Y, Miyoshi T, Inamura N, Kawataki M, Taketazu M, Nii M, Hagiwara A, Horigome H, Shozu M, Shimizu W, Yasukochi S, Yoda H, Shiraishi I, Sakaguchi H, Katsuragi S, Sago H, Ikeda T; ; on behalf of Japan Fetal Arrhythmia Group.

J Matern Fetal Neonatal Med. 2017 Jul 19:1-6. doi: 10.1080/14767058.2017.1350159. [Epub ahead of print]

PMID: 28720014

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  1. Utility of Echocardiography in Detecting Silent Complications After Pediatric Catheter Ablations.

Amdani SM, Sallaam S, Karpawich PP, Aggarwal S.

Pediatr Cardiol. 2017 Jul 15. doi: 10.1007/s00246-017-1680-z. [Epub ahead of print]

PMID: 28711964

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  1. Bridge to Success: A Better Method of Cryoablation for Atrioventricular Nodal Reentrant Tachycardia in Children.

Reddy CD, Ceresnak SR, Motonaga KS, Avasarala K, Feller C, Trela A, Hanisch D, Dubin AM.

Heart Rhythm. 2017 Jul 14. pii: S1547-5271(17)30875-5. doi: 10.1016/j.hrthm.2017.07.018. [Epub ahead of print]

PMID: 28716699

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  1. Uptake of Predictive Genetic Testing and Cardiac Evaluation for Children at Risk for an Inherited Arrhythmia or Cardiomyopathy.

Christian S, Atallah J, Clegg R, Giuffre M, Huculak C, Dzwiniel T, Parboosingh J, Taylor S, Somerville M.

J Genet Couns. 2017 Jul 11. doi: 10.1007/s10897-017-0129-0. [Epub ahead of print]

PMID: 28699125

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  1. Does pharmacological therapy still play a role in preventing sudden death in surgically treated Tetralogy of Fallot?

Bronzetti G, Brighenti M, Bonvicini M.

Mini Rev Med Chem. 2017 Jul 7. doi: 10.2174/1389557517666170707101411. [Epub ahead of print]

PMID: 28685697

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Select item 28687889

 

  1. Therapy Of Cardiac Arrhythmias In Children: An Emerging Role Of Electroanatomical Mapping Systems.

Matteo C, Maurizio M, Viviana T, Scarano M, Paolo B, Giuseppe D.

Curr Vasc Pharmacol. 2017 Jul 5. doi: 10.2174/1570161115666170705155542. [Epub ahead of print]

PMID: 28677509

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  1. [Clinical analysis of pacing therapy and treatment of complications during follow-up in children].

Zhao PJ, Chen YW, Li F, Li Y, Yang JP, Wu JJ.

Zhonghua Er Ke Za Zhi. 2017 Jul 2;55(7):514-518. doi: 10.3760/cma.j.issn.0578-1310.2017.07.009. Chinese.

PMID: 28728260

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  1. Successful use of sirolimus for refractory atrial ectopic tachycardia in a child with cardiac rhabdomyoma.

Ninic S, Kalaba M, Jovicic B, Vukomanovic V, Prijic S, Vucetic B, Kravljanac R, Vujic A, Kosutic J.

Ann Noninvasive Electrocardiol. 2017 Jul;22(4). doi: 10.1111/anec.12435. Epub 2017 Feb 19.

PMID: 28217909

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  1. Effects of Acute Carbon Monoxide Poisoning on ECG and Echocardiographic Parameters in Children.

Ozyurt A, Karpuz D, Yucel A, Tosun MD, Kibar AE, Hallioglu O.

Cardiovasc Toxicol. 2017 Jul;17(3):326-334. doi: 10.1007/s12012-016-9389-4.

PMID: 27778147

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Select item 27509882

 

  1. Risk factors for sudden cardiac death in childhood hypertrophic cardiomyopathy: A systematic review and meta-analysis.

Norrish G, Cantarutti N, Pissaridou E, Ridout DA, Limongelli G, Elliott PM, Kaski JP.

Eur J Prev Cardiol. 2017 Jul;24(11):1220-1230. doi: 10.1177/2047487317702519. Epub 2017 May 9.

PMID: 28482693

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  1. To the Editors-Risk factors for complications in the implantation of epicardial pacemakers in neonates and infants.

Kean AC, Rodefeld MD.

Heart Rhythm. 2017 Jul;14(7):e53. doi: 10.1016/j.hrthm.2017.03.021. Epub 2017 Apr 5. No abstract available.

PMID: 28389305

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Select item 28347833

 

  1. Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation.

Uradu A, Wan J, Doytchinova A, Wright KC, Lin AYT, Chen LS, Shen C, Lin SF, Everett TH 4th, Chen PS.

Heart Rhythm. 2017 Jul;14(7):964-971. doi: 10.1016/j.hrthm.2017.03.030. Epub 2017 Mar 24.

PMID: 28347833

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  1. Efficacy of Flecainide in the Treatment of Catecholaminergic Polymorphic Ventricular Tachycardia: A Randomized Clinical Trial.

Kannankeril PJ, Moore JP, Cerrone M, Priori SG, Kertesz NJ, Ro PS, Batra AS, Kaufman ES, Fairbrother DL, Saarel EV, Etheridge SP, Kanter RJ, Carboni MP, Dzurik MV, Fountain D, Chen H, Ely EW, Roden DM, Knollmann BC.

JAMA Cardiol. 2017 Jul 1;2(7):759-766. doi: 10.1001/jamacardio.2017.1320.

PMID: 28492868

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  1. Transesophageal and invasive electrophysiologic evaluation in children with Wolff-Parkinson-White pattern.

Koca S, Pac FA, Kavurt AV, Cay S, Mihcioglu A, Aras D, Topaloglu S.

Pacing Clin Electrophysiol. 2017 Jul;40(7):808-814. doi: 10.1111/pace.13100. Epub 2017 Jun 1.

PMID: 28436586

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CHD Intervention Featured Articles of July 2017

Interventional Cardiology Reviews of July 2017 Manuscripts

 

A Systematic Review of Infective Endocarditis in Patients with Bovine Jugular Vein Valves Compared With Other Valve Types.

Sharma A, Cote AT, Hosking MCK, Harris KC.

JACC Cardiovasc Interv. 2017 Jul 24;10(14):1449-1458. doi: 10.1016/j.jcin.2017.04.025.

PMID: 28728659

 

Take Home Points:

  • Bovine jugular vein valves have a higher reported cummulative incidence of IE than other valve types – with no difference between surgical or transcatheter implants.
  • The data presented must be interpreted with a full understanding of the study limitations – case ascertainment bias, lack of IE definition, patient overlap and the heterogeneity of the population.
  • Providers need to be aware of the risks of IE and have an appropriate level of suspicion when managing patients with implanted pulmonary valves.

Comment from Dr., section editor of Congenital Heart Disease Interventions Journal Watch: Pulmonary valve implants are necessary for many patients with congenital heart disease and bovine jugular vein (BJV) valves, implanted via surgical (Contegra) or trans-catheter techniques (Melody valve) are widely used. Prospective Melody valve trials identified that some portion of patients experience episodes of endocarditis post-implant. The incidence of infective endocarditis (IE) relative to other valve types and method of implant (surgery vs transcatheter) is unknown. The authors sought to systematically review the published research and conduct a meta-analysis of IE incidence in RV-PA conduits, comparing BJV valves with all others and compare surgical vs transcatheter implantation techniques.

 

The authors conducted a literature review and studies were deemed eligible for inclusion if all inclusion criteria were met: patients had a pulmonary valve replacement, incidence of IE in the RVOT was reported (both number of cases and cases of IE had to be reported), method of conduit placement surgery (surgical or transcatheter), type of conduit implanted and follow up duration.

 

The systemic search identified 1,048 studies and of these 50 papers (55 study populations) with 7,063 patients were included in the final analysis. There were 5 valve types identified: Melody, Contegra, homograft, bioprosthetic (bovine pericardial, procine) and 1 nonbovine surgical valve not specified. There was a total of 181 cases of endocarditis, giving a cumulative incidence of IE of 2.6%. The median incidence of IE was higher in the BJV group compared with other valve types (5.4% v 1.2%) with no difference in the incidence of BJV valves on the basis of method of implantation.

 

There are a number of important limitations in this meta-analysis. First, there is a clear case ascertainment bias. Melody valve studies were prospective with active follow-up while the surgical series were retrospective likely resulting in greater recognition of IE in the Melody cohort. The surgical series are likely limited by an under-recognition of IE cases treated medically. In addition, most studies did not report the exact time at which IE occurred making calculation of annualized incidence as well as assessment of risk factors for development of IE nearly impossible. Second, there is not a uniform definition of IE across studies which again disadvantages the Melody valve given strict definitions of IE in the prospective follow up for Melody valve implants. Third, there is a high probability of patient overlap which the authors do not fully address. Finally, the authors do not acknowledge the heterogeneity of the patient population with clear differences in patients receiving different types of implants.

 

The authors conclude that that BJV valves have a higher reported incidence of IE than other valve types with no difference based on method of implantation. They suggest that clinicians should have a heighted awareness of IE when caring for these patients. Further research is clearly warranted to determine the pathophysiology for development of IE, risk factors and methods to decrease the incidence of IE.

 

A multicenter study of the impella device for mechanical support of the systemic circulation in pediatric and adolescent patients.

Dimas VV, Morray BH, Kim DW, Almond CS, Shahanavaz S, Tume SC, Peng LF, McElhinney DB, Justino H.

Catheter Cardiovasc Interv. 2017 Jul;90(1):124-129. doi: 10.1002/ccd.26973. Epub 2017 Mar 15.

PMID: 28295963

 

Take Home Points:

  • Preliminary findings suggest that using Impella devices for temporary circulatory support in children is feasible and efficacious.
  • 30-day mortality is high but is similar to data from Impella use in adult populations for cardiogenic shock with a similar or slightly lower complication rate.

Averin , KonstantinComment from Dr. Konstantin Averin section editor of Congenital Heart Disease Interventions Journal Watch:  In the US, FDA app averinroved options for temporary pediatric circulatory support are limited to ECMO and intra-aortic balloon pump. The Impella family of devices are now approved for short-term support for treatment of cardiogenic shock (CGS) after AMI or following open heart surgery. Off-label use of the Impella in the pediatric population has grown but the published experience to date has been limited. The authors performed a multicenter retrospective study to describe a larger pediatric experience with the Impella family of catheters, with a focus on outcomes and complications.

 

Data on 39 implants in 38 patients (≤21-year old) from 2009-2015 were included, with all but 1 patient being unique. At implant, median age was 16 years (4-21 years), median weight 62kg (15-134kg), and mean BSA 1.62 ± 0.36. The most common diagnoses were congenital heart disease (28%), post-heart transplant rejection (26%), and dilated cardiomyopathy (23%) with the most common indication for implant being ventricular dysfunction with acute CGS (28/39).

 

Patients were supported via either femoral arterial access (85%) or axillary access (15%) with a surgically placed chimney graft required in 31% of cases. Device repositioning was required in 38% of implants and median duration of support was 45 hours. 32% of patients died within 30 days of implant with half of those deaths occurring after Impella explant. Major adverse events occurred in 8 patients and included device malfunction, hemolysis, neurologic dysfunction, vascular access complications, bleeding and infection. One patient developed critical limb ischemia necessitating device removal and subsequent below the knee amputation.

As the options for temporary circulatory support expand and new data in adult populations becomes available it is important to consider whether some of these devices may be suitable for use in pediatric patients. Dimas et al, describe the largest experience to date of mechanical support with the Impella family of devices in pediatric patients with CGS. Their data suggests that the use of these devices is feasible and efficacious with an acceptable safety profile. It is of particular interest that only 2 patients had vascular access complications given the need for large bore arterial access necessary for the Impella implant. More data will clearly be necessary but this publication is an important step in expanding support options for a high-risk population.

 

Midterm to long-term safety and efficacy of self-expandable nitinol stent implantation for coarctation of aorta in adults.

Haji Zeinali AM, Sadeghian M, Qureshi SA, Ghazi P.

Catheter Cardiovasc Interv. 2017 Jul 14. doi: 10.1002/ccd.27178. [Epub ahead of print]

PMID: 28707350

 

Take Home Points:

  • Transcatheter treatment of aortic coarctation has traditionally involved balloon angioplasty and/or placement of balloon expandable stents
  • The authors present a series of 62 adolescents and adults who underwent successful placement of OptiMed Sinus-XL self-expanding nitinol stents for treatment of aortic coarctation
  • After excellent early results, the majority of patients continued to do well after an average of almost 4 years of follow-up
  • Self-expanding nitinol stents may provide benefits over these techniques of less aortic wall injury, no risk for balloon rupture during stent deployment and the potential for constant low level radial forces as the nitinol attempts to return to its nominal size

 

Comment from Dr. section editor of Congenital Heart Disease Interventions Journal Watch: Haji Zeinali and colleagues present a prospective, observational study of the use of the OptiMed Sinus-XL self-expanding nitinol stent for treating aortic coarctation in adolescents and adults. The stent is available in 16 to 34 mm diameters with a closed-cell design to optimize radial strength and is delivery through a 10-French system.

 

Patients were considered if they were over 9 years and 35 kg, had a hemodynamically significant coarctation (gradient at least 20 mmHg) and anatomy favorable to transcatheter intervention. Patients with severe coarctation underwent serial balloon dilation before stent placement. Stent sizing was 20-30% greater than the distal aortic arch at the origin of the left subclavian artery.

 

62 patients were recruited, with a mean age of 30.7 (17-63) years. All but three were native coarctations and the mean systemic systolic blood pressure was 166.7 mmHg. Stents were successfully implanted in all patients with 3 requiring an additional stent to deal with migration of the first stent. Mean pressure gradient pre-intervention was 62.4 mmHg which reduced to 2.8 mmHg after stent placement; four patients required post-dilation of the stent for residual gradients up to 15 mmHg. No major complications were reported.

 

After a mean follow-up of 45.5 months, 42 of 48 patients with systemic hypertension were either complete off medication (28 patients) or on less medical therapy (14 patients). Two patients developed significant residual aortic obstruction: the first with a 60 mmHg gradient related to neointimal proliferation was treated with repeat angioplasty and the second had a 25 mmHg gradient but refused additional treatment.

 

This study provides good longer-term data regarding the efficacy of self-expanding nitinol stents to treat aortic coarctation. A major advantage of this type is less potential aortic wall injury and the constant low level of radial force that may have some benefit in aortic remodeling over time. Also, because of the stent design, there is no chance for balloon rupture while deploying the stent. The authors stress the importance of future studies to compare surgery, balloon-expandable stents and self-expanding nitinol stents for the treatment of aortic coarctation.

 

Complete heart block following transcatheter closure of perimembranous VSD using amplatzer duct occluder II.

Ghosh S, Sridhar A, Sivaprakasam M.

Catheter Cardiovasc Interv. 2017 Jul 14. doi: 10.1002/ccd.27177. [Epub ahead of print]

PMID: 28707408

 

Take Home Points:

  • Interventional congenital cardiologists are often forced to “get creative” and make use of interventional devices for off-label indications, including transcatheter VSD closure
  • The Amplatzer Duct Occluder II has become a popular device for transcatheter perimembranous VSD closure and the authors present two patients who develop complete heart block after device placement

 

Seckler, MikeComment from Dr. Mike Seckeler (Tucson), section editor of Congenital Heart Disease Interventions Journal Watch:  Ghosh and colleagues present two illustrative cases of transcatheter perimembranous VSD closure with the Amplatzer Duct Occluder II (ADO-II). This device has emerged as a an excellent off-label device for this intervention because of its small delivery system, ease of deployment and relative “softness”, which is felt to minimize the risk of complete heart block after intervention. Unfortunately, these two patients did develop complete heart block early (<24 hours) after catheterization. The authors recognized the heart block and the patients both underwent successful surgical intervention to remove the devices and close the VSD with complete return to sinus rhythm.

 

As interventional congenital cardiologists continue to try to push the envelope and undertake more complicated transcatheter interventions, we are frequently limited by the available technology, little of which is designed with our patient population in mind. While this does allow us to exercise our creative muscles and try to find ways to fit square pegs into round holes, the above cases also remind us that sometimes complications can arise, and we need to be aware of the risks and inform our patients clearly before the procedure.

 

Intervention on Surgical Systemic-to-Pulmonary Artery Shunts: Carotid Versus Femoral Access.

Ligon RA, Ooi YK, Kim DW, Vincent RN, Petit CJ.

JACC Cardiovasc Interv. 2017 Aug 9. pii: S1936-8798(17)30972-X. doi: 10.1016/j.jcin.2017.05.023. [Epub ahead of print]

PMID: 28823774

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Select item 28823771

 

Take Home Points:

 

  • Transcatheter interventions on Blalock-Taussig shunts (BTS) are effective and performed often, with “traditional” access approach being via the femoral artery.
  • Compared with femoral artery approach, in this study carotid artery access allowed for more successful BTS interventions and shorter time to BTS intervention.
  • Carotid artery access to the BTS for intervention should be considered more broadly and particularly in time critical situations.

 

Whiteside, WendyComment from Dr. Wendy Whiteside (Michigan), section editor of Congenital Heart Disease Interventions Journal Watch: Transcatheter interventions to treat BTS occlusion, including shunt angioplasty +/- stenting, have been demonstrated to be effective therapies to restore flow through the shunt. In some situations, in unstable patients with single source ductal dependent pulmonary blood flow, recanalization of the BTS is emergent and time sensitive.  Standard approach for these interventions has been via the femoral artery, however the carotid approach may provide a more direct route for access to the BTS.

 

Ligon et al describe their single center experience with percutaneous BTS interventions, comparing access via the femoral and carotid arteries.  Over a 5-year period, 34 patients underwent 42 BTS interventions. 32 cases began with femoral access and 10 with carotid access.  Overall, 39/42 interventions (93%) were ultimately successful with 100% success in accessing and intervening on the BTS in carotid cases and 75% success in the femoral cases.  5 initially femoral access cases were converted to carotid access during the same procedure due unsuccessful BTS intervention.  Particularly in cases with complete shunt occlusion and in a patient with saphenous vein graft and venous-valve occlusion, carotid access provided close sheath proximity and straight angle of approach contributing to successful and timely intervention.  Compared with the femoral access cohort, procedure time was lower in the carotid artery cohort (62 vs 104 minutes), time to arterial access was shorter (4 vs 9.3 minutes), time to placement of guidewire through the BTS was shorter (6.5 vs 13 minutes) and time from final sheath placement to BTS implantation was lower (9 vs 20 minutes).  There were no adverse events or complications associated with carotid artery access and no concerns for carotid patency by routine follow-up carotid ultrasound within 24 hours of access.

 

While carotid artery access has been considered in select patients and case types, the concern for embolic stroke and vascular complications has limited the more widespread use of this access site.  More recent studies, including this by Ligon et al, have found a low rate of thrombosis and risk of vascular access complications in fact lower than that with femoral access. While this is a small single center study, and while there is likely a learning curve to efficient and successful carotid artery access, the significantly shorter times to intervention in the carotid artery access reported here are notable and could be of significant importance in critically ill patients with shunt occlusion.  For efficient and direct access to the BTS, carotid artery access should be more readily considered.

      

Acute Success of Balloon Aortic Valvuloplasty in the Current Era: A National Cardiovascular Data Registry Study.

Boe BA, Zampi JD, Kennedy KF, Jayaram N, Porras D, Foerster SR, Armstrong AK.

JACC Cardiovasc Interv. 2017 Sep 11;10(17):1717-1726. doi: 10.1016/j.jcin.2017.08.001.

PMID:28882282

 

Take Home Points:

 

  • Balloon aortic valvuloplasty is considered first-line therapy for congenital aortic valve stenosis, however procedural outcomes and practice patterns across a large population have not been reassessed in the current era.
  • Using the IMPACT registry and a contemporary cohort, procedural success of balloon aortic valvuloplasty across all patients was 70%.
  • Adverse events occurred in 15.8% of patients, and were more frequent in procedures for critical vs non-critical aortic stenosis. There were no procedural deaths.

 

Comment from Dr. Wendy Whiteside (Michigan), section editor of Congenital Heart Disease Interventions Journal Watch: Large multi-center assessment of acute outcomes and practice patterns surrounding balloon aortic valvuloplasty (BAV) has not been performed since the VACA registry in the 1980-90s.  Since then, technology and procedural technique have changed significantly drawing into question the validity of this data in the current era. Using data from the IMPACT registry, a multi-center prospective registry beginning in 2011, Boe et al provided updated acute outcome data for balloon aortic valvuloplasty in isolated congenital aortic valve stenosis.

 

Over the study period from 2011-2015, a total of 1,126 balloon aortic valvuloplasty procedures were recorded in the registry (the study population consists of 1,026 procedures after exclusion for incomplete data and additional procedures performed).  Neonates <1 month) and infants (1-11 months) comprised the largest age groups at 27.4% and 25.3% respectively, with the majority of patients having non-critical aortic stenosis (89.3%) and the majority of procedures occurring in the outpatient setting (68.8%). Access site was femoral arterial in 93.9%, carotid in 4.5%, and umbilical artery in 1.1%. Median effective final balloon to aortic annulus ratio was 0.94 (IQR 0.88-1.00). Successful BAV was considered a procedure with “optimal” (peak systolic ejection gradient (PSEG) ≤35 mmHg and no AI) or “adequate” (PSEG ≤35 mmHg and 1+ (mild) aortic insufficiency or no worsening AI in patients with mixed disease at baseline) result and occurred in 70% of patients.  Unsuccessful procedures were attributed to significant AI (worse than mild, or worse than baseline) in 12.1% of procedures, residual gradient ≥35 mmHg in 11.4% of procedures, and a combination in 6.5%. In the non-critical AS group, after multivariate adjustment, unsuccessful BAV was associated with prior cardiac catheterization, higher baseline AS gradient (>60), mixed aortic valve disease worse than mild baseline AI, presence of a trainee, and >1 balloon inflation.  Overall, adverse events occurred in 15.8% of cases; major events in 11.5%. Patients with critical AS had significantly higher total and major adverse event rates, with vascular complications being the most common of these complications.  There were no procedural deaths.

 

Compared with the VACA registry data, procedural success was increased in the contemporary cohort, with a slight decrease in procedural complications and no procedural mortality.  This study compares well with recent single center studies in terms of short term outcomes. This study, however, does not address long term outcomes and its comparison to surgical aortic valvuloplasty.

 

CHD Interventions July 2017

 

  1. A Systematic Review of Infective Endocarditis in Patients With Bovine Jugular Vein Valves Compared With Other Valve Types.

Sharma A, Cote AT, Hosking MCK, Harris KC.

JACC Cardiovasc Interv. 2017 Jul 24;10(14):1449-1458. doi: 10.1016/j.jcin.2017.04.025.

PMID: 28728659

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  1. Stenting complex aortic coarctation: simulation in a 3D printed model.

Pluchinotta FR, Giugno L, Carminati M.

EuroIntervention. 2017 Jul 20;13(4):490. doi: 10.4244/EIJ-D-16-00851. No abstract available.

PMID: 28169218

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Select item 28729908

 

  1. Inaccuracy of a continuous arterial pressure waveform monitor when used for congenital cardiac catheterization.

Seckeler MD, Typpo K, Deschenes J, Higgins R, Samson R, Lichtenthal P.

Congenit Heart Dis. 2017 Jul 18. doi: 10.1111/chd.12517. [Epub ahead of print]

PMID: 28719069

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Select item 28719049

 

  1. Pulmonary vein stenosis in patients with Smith-Lemli-Opitz syndrome.

Prosnitz AR, Leopold J, Irons M, Jenkins K, Roberts AE.

Congenit Heart Dis. 2017 Jul 18. doi: 10.1111/chd.12471. [Epub ahead of print]

PMID: 28719049

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Select item 28721547

 

  1. The Effect on Somatic Growth of Surgical and Catheter Treatment of Secundum Atrial Septal Defects.

Chlebowski MM, Dai H, Kaine SF.

Pediatr Cardiol. 2017 Jul 18. doi: 10.1007/s00246-017-1678-6. [Epub ahead of print]

PMID: 28721547

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Select item 28723882

 

  1. Fate of Duct-Dependent, Discontinuous Pulmonary Arteries After Arterial Duct Stenting.

Santoro G, Capozzi G, Giordano M, Gaio G, Palladino MT, Iacono C, Mahmoud HT, Russo MG.

Pediatr Cardiol. 2017 Jul 15. doi: 10.1007/s00246-017-1672-z. [Epub ahead of print]

PMID: 28711967

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Select item 28711965

 

  1. Midterm to long-term safety and efficacy of self-expandable nitinol stent implantation for coarctation of aorta in adults.

Haji Zeinali AM, Sadeghian M, Qureshi SA, Ghazi P.

Catheter Cardiovasc Interv. 2017 Jul 14. doi: 10.1002/ccd.27178. [Epub ahead of print]

PMID: 28707350

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  1. Intra-procedural continuous dialysis to facilitate interventional catheterization in pediatric patients with severe renal failure.

Opina AD, Qureshi AM, Brewer E, Elenberg E, Swartz S, Michael M, Justino H.

Catheter Cardiovasc Interv. 2017 Jul 12. doi: 10.1002/ccd.27188. [Epub ahead of print]

PMID: 28699323

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Select item 28703426

 

  1. Temporal relationship between instantaneous pressure gradients and peak-to-peak systolic ejection gradient in congenital aortic stenosis.

Boe BA, Norris MD, Zampi JD, Rocchini AP, Ensing GJ.

Congenit Heart Dis. 2017 Jul 12. doi: 10.1111/chd.12514. [Epub ahead of print]

PMID: 28703367

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Select item 28702947

 

  1. Can the Pulmonary Artery Wedge Pressure be Used Reliably as a Surrogate for the Left Atrial Mean Pressure in Pre-Fontan Evaluation?

Mohammad Nijres B, Abdulla RI, Awad S, Murphy J.

Pediatr Cardiol. 2017 Jul 12. doi: 10.1007/s00246-017-1681-y. [Epub ahead of print]

PMID: 28702716

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Select item 28709660

 

  1. Risk Factors for Peri-Procedural Arterial Ischaemic Stroke in Children with Cardiac Disease.

Asakai H, Stojanovski B, Galati JC, Zannino D, Cardamone M, Hutchinson D, Cheung MMH, Mackay MT.

Pediatr Cardiol. 2017 Jul 11. doi: 10.1007/s00246-017-1674-x. [Epub ahead of print]

PMID: 28695245

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Select item 28689504

 

  1. Noninfective Transcatheter Pulmonary Valve Thrombosis: A Rare Cause of Post-Implantation Pulmonary Valve Obstruction.

Verhoeven PA, Learn CP, Brown NM, Goldstein BH.

JACC Cardiovasc Interv. 2017 Jul 10;10(13):e119-e122. doi: 10.1016/j.jcin.2017.04.009. Epub 2017 Jun 14. No abstract available.

PMID: 28624383

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Select item 28691263

 

  1. Stenting the vertical ductus arteriosus via axillary artery access using “wire-target” technique.

Polat TB.

Congenit Heart Dis. 2017 Jul 9. doi: 10.1111/chd.12512. [Epub ahead of print]

PMID: 28691263

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  1. Lower Hospital Charges and Societal Costs for Catheter Device Closure of Atrial Septal Defects.

Sanchez JN, Seckeler MD.

Pediatr Cardiol. 2017 Jul 5. doi: 10.1007/s00246-017-1671-0. [Epub ahead of print]

PMID: 28681132

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  1. Multimodality imaging for interventional cardiology.

Celi S, Martini N, Pastormerlo LE, Positano V, Berti S.

Curr Pharm Des. 2017 Jul 4. doi: 10.2174/1381612823666170704171702. [Epub ahead of print]

PMID: 28677508

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Select item 28687271

 

  1. Anesthesia challenges in patent ductus arteriosus stenting for congenital heart disease.

Nanditha S, Kapoor PM, Sarin K.

Ann Card Anaesth. 2017 Jul-Sep;20(3):389-390. doi: 10.4103/aca.ACA_76_17. No abstract available.

PMID: 28701619 Free Article

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Select item 28701609

 

  1. Intraoperative Stenting of Pulmonary Artery Stenosis in Children With Congenital Heart Disease.

Meot M, Lefort B, El Arid JM, Soulé N, Lothion-Boulanger J, Lengellé F, Chantepie A, Neville P.

Ann Thorac Surg. 2017 Jul;104(1):190-196. doi: 10.1016/j.athoracsur.2016.12.012. Epub 2017 Mar 6.

PMID: 28274523

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  1. Comparison of self-expandable and balloon-expanding stents for hybrid ductal stenting in hypoplastic left heart complex.

Goreczny S, Qureshi SA, Rosenthal E, Krasemann T, Nassar MS, Anderson DR, Morgan GJ.

Cardiol Young. 2017 Jul;27(5):837-845. doi: 10.1017/S1047951116001347.

PMID: 28555538

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Select item 28077189

 

  1. A multicenter study of the impella device for mechanical support of the systemic circulation in pediatric and adolescent patients.

Dimas VV, Morray BH, Kim DW, Almond CS, Shahanavaz S, Tume SC, Peng LF, McElhinney DB, Justino H.

Catheter Cardiovasc Interv. 2017 Jul;90(1):124-129. doi: 10.1002/ccd.26973. Epub 2017 Mar 15.

PMID: 28295963

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Select item 28112463

 

  1. Circulatory support using the impella device in fontan patients with systemic ventricular dysfunction: A multicenter experience.

Morray BH, Dimas VV, Lim S, Balzer DT, Parekh DR, Van Mieghem NM, Ewert P, Kim DW, Justino H, McElhinney DB, Jones TK.

Catheter Cardiovasc Interv. 2017 Jul;90(1):118-123. doi: 10.1002/ccd.26885. Epub 2017 Jan 23.

PMID: 28112463

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  1. Percutaneous closure of acute aorto-right ventricular fistula following transcatheter bicuspid aortic valve replacement.

Nakamura K, Passeri JJ, Inglessis-Azuaje I.

Catheter Cardiovasc Interv. 2017 Jul;90(1):164-168. doi: 10.1002/ccd.26705. Epub 2016 Aug 22.

PMID: 27545308

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Select item 28696220

 

  1. Adult Congenital Interventions in Heart Failure.

Suradi HS, Hijazi ZM.

Interv Cardiol Clin. 2017 Jul;6(3):427-443. doi: 10.1016/j.iccl.2017.03.011. Review.

PMID: 28600095

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  1. Invasive Hemodynamics of Adult Congenital Heart Disease: From Shunts to Coarctation.

Veeram Reddy SR, Nugent AW, Zellers TM, Dimas VV.

Interv Cardiol Clin. 2017 Jul;6(3):345-358. doi: 10.1016/j.iccl.2017.03.005. Review.

PMID: 28600089

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  1. Cerebral High-Intensity Transient Signals during Pediatric Cardiac Catheterization: A Pilot Study Using Transcranial Doppler Ultrasonography.

LaRovere KL, Kapur K, McElhinney DB, Razumovsky A, Kussman BD.

J Neuroimaging. 2017 Jul;27(4):381-387. doi: 10.1111/jon.12426. Epub 2017 Jan 31.

PMID: 28140493

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  1. Radiation Safety in Children With Congenital and Acquired Heart Disease: A Scientific Position Statement on Multimodality Dose Optimization From the Image Gently Alliance.

Hill KD, Frush DP, Han BK, Abbott BG, Armstrong AK, DeKemp RA, Glatz AC, Greenberg SB, Herbert AS, Justino H, Mah D, Mahesh M, Rigsby CK, Slesnick TC, Strauss KJ, Trattner S, Viswanathan MN, Einstein AJ; Image Gently Alliance.

JACC Cardiovasc Imaging. 2017 Jul;10(7):797-818. doi: 10.1016/j.jcmg.2017.04.003. Epub 2017 May 18. Review.

PMID: 28514670 Free Article

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  1. Outcomes Associated with the Off-label Use of Medical Devices in Congenital Heart Disease at a Single Institute.

Kong YH, Song J, Huh J, Kang IS.

Korean Circ J. 2017 Jul;47(4):509-515. doi: 10.4070/kcj.2016.0311. Epub 2017 Jul 27.

PMID: 28765743 Free PMC Article

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  1. A comparison of the in vivo neoendothelialization and wound healing processes of three atrial septal defect occluders used during childhood in a nonrandomized prospective trial.

Aydın Şahin D, Başpınar O, Sülü A, Karslıgil T, Kul S.

Anatol J Cardiol. 2017 Jul 25. doi: 10.14744/AnatolJCardiol.2017.7540. [Epub ahead of print]

PMID: 28761023 Free Article

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  1. Thrombus formation 4 years after percutaneous transcatheter closure of an atrial septal defect.

Furuta A, Nagashima M, Sugiyama H, Sakamoto T, Yamazaki K.

J Card Surg. 2017 Jul 25. doi: 10.1111/jocs.13178. [Epub ahead of print] No abstract available.

PMID: 28743158

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Select item 28707558

 

  1. Traditional Long-Term Central Venous Catheters Versus Transhepatic Venous Catheters in Infants and Young Children.

Marshall AM, Danford DA, Curzon CL, Anderson V, Delaney JW.

Pediatr Crit Care Med. 2017 Jul 25. doi: 10.1097/PCC.0000000000001276. [Epub ahead of print]

PMID: 28746169

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  1. Trans-splenic Access for Portal Venous Interventions in Children: Do Benefits Outweigh Risks?

Pimpalwar S, Chinnadurai P, Hernandez A, Kukreja K, Siddiqui S, Justino H.

Cardiovasc Intervent Radiol. 2017 Jul 24. doi: 10.1007/s00270-017-1756-4. [Epub ahead of print]

PMID: 28741138

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  1. Congenital heart disease and cardiac procedural outcomes in patients with trisomy 21 and Turner syndrome.

Morales-Demori R.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12521. [Epub ahead of print]

PMID: 28736822

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Select item 28737122

 

  1. The Cow Deserves a Fair Trial.

Jones TK.

JACC Cardiovasc Interv. 2017 Jul 24;10(14):1459-1461. doi: 10.1016/j.jcin.2017.05.057. No abstract available.

PMID: 28728660

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  1. Transcatheter pulmonary valve implantation: valve technology and procedural outcome.

Salavitabar A, Flynn P, Holzer RJ.

Curr Opin Cardiol. 2017 Jul 18. doi: 10.1097/HCO.0000000000000444. [Epub ahead of print]

PMID: 28723838

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Select item 28722763

 

  1. Complete heart block following transcatheter closure of perimembranous VSD using amplatzer duct occluder II.

Ghosh S, Sridhar A, Sivaprakasam M.

Catheter Cardiovasc Interv. 2017 Jul 14. doi: 10.1002/ccd.27177. [Epub ahead of print]

PMID: 28707408

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Select item 28707365

 

  1. Use of 3-D digital subtraction rotational angiography during cardiac catheterization of infants and adults with congenital heart diseases.

Surendran S, Waller BR, Elijovich L, Agrawal V, Kuhls-Gilcrist A, Johnson J, Fagan T, Sathanandam SK.

Catheter Cardiovasc Interv. 2017 Jul 14. doi: 10.1002/ccd.27180. [Epub ahead of print]

PMID: 28707365

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Select item 28708333

 

  1. Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study.

Soliman R, Mofeed M, Momenah T.

Ann Card Anaesth. 2017 Jul-Sep;20(3):313-317. doi: 10.4103/aca.ACA_24_17.

PMID: 28701596 Free Article

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Select item 28510313

 

  1. Perventricular Implantation of Melody Valve in Child With Pulmonary Hypertension After a Potts Shunt.

Mroczek T, Demkow M, Moszura T, Morka A, Skalski J.

Ann Thorac Surg. 2017 Jul;104(1):e67-e69. doi: 10.1016/j.athoracsur.2017.01.084.

PMID: 28633267

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Select item 28633265

 

  1. Again, Two Melodies in Concert: Transcatheter Double Valve Replacement in Hedinger Syndrome.

De Rosa R, Schranz D, Zeiher AM, Fichtlscherer S.

Ann Thorac Surg. 2017 Jul;104(1):e61-e63. doi: 10.1016/j.athoracsur.2017.01.063.

PMID: 28633265

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  1. Renal artery stenting in a 2-year-old child with resistant hypertension and neurofibromatosis.

Varghese K, Adhyapak SM, Lohitashwa SB, Pais P, Iyengar AA.

Cardiovasc Interv Ther. 2017 Jul;32(3):274-278. doi: 10.1007/s12928-016-0415-z. Epub 2016 Jul 22.

PMID: 27448024

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  1. Hemolytic Anemia due to Right Ventricular to Pulmonary Artery Conduit Stenosis.

Rao S, Creaden JA, Gong S, Rigsby C, Costello JM.

J Pediatr Hematol Oncol. 2017 Jul;39(5):e290-e292. doi: 10.1097/MPH.0000000000000801.

PMID: 28267085

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CHD Surgery Featured Articles of July 2017

 

Congenital Heart Surgery Reviews of August 2017 Manuscripts

 

Long-Term Outcomes of Pediatric Cardiac Patients Supported by Extracorporeal Membrane Oxygenation.
Elias MD, Achuff BJ, Ittenbach RF, Ravishankar C, Spray TL, Fuller S, Montenegro LM, Gaynor JW, O’Connor MJ.
Pediatr Crit Care Med. 2017 Aug;18(8):787-794. doi: 10.1097/PCC.0000000000001227.
PMID: 28598945
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Take Home Points:

  • Patients with cardiac disease who require ECMO support and survive report favorable long-term health.
  • A history of ECMO support was associated with decreased self- and proxy-reported quality of life in children but not in adolescents late-term.

  

jeremy-herrmannCommentary from Dr. Jeremy Herrmann (Indianapolis), section editor of Congenital Heart Surgery Journal Watch:  This report from Elias and colleagues details a single institution’s evaluation of long-term quality of life for patients with cardiac disease who survived following a period of ECMO support. During an 18-year period, 396 patients were managed with ECMO with 170 (43%) known survivors. Patients and families of survivors were surveyed using the age-appropriate Pediatric Quality of Life Inventory (PedsQL). The authors received a 38% response rate to the phone survey and 19% response rate to the written survey with a median follow-up of 6 years.

 

The proportion of patients with single ventricle physiology was 36%, and 14% had no history of congenital cardiac disease. The most common indications for ECMO support were failure to separate from bypass or postoperative low cardiac output (combined 28%) and cardiopulmonary arrest (53%). The median age at ECMO was 78 days, the median duration of ECMO was 100.4 hours, and the median overall length of stay was 33 days.

 

In the verbal survey, 90% of patients or their proxy reported current health as “good” or “excellent”, and 86% indicated having mild or no physical limitation. The surveys also indicated that 23.3% reported below-average school performance, 46.8% reported a learning disability, and 4.6% indicated the presence of a behavior disorder. Additional therapy use was frequent with 43.1% utilizing speech therapy, 43.1% tutoring, and 16.9% a neurologist.

 

When compared with normative samples, self-reported and proxy-reported scores for children were lower for both biventricular and single ventricle groups (Figure 1). However, adolescent scores were not significantly different than the normative data (Figure 1). The authors report that in univariate analysis, no patient-related variables were associated with current health status or limitations.

 

The study includes a heterogeneous group of patients and comparisons were not made between those with or without congenital heart disease. For older patients with congenital heart disease (e.g., Fontan patients), quality of life may be affected by other health issues. We also do not know how many patients required further intervention (including advanced heart failure therapies) that may have affected future quality of life. It would also be interesting to know if there was any era effect as the care of single ventricle patients has continued to be refined. Potential response and institutional biases must also be taken into consideration.

 

These findings indicate that patients with cardiac disease who require ECMO support and survive may be able to achieve an acceptable quality of life at least in the mid-term. These patients may require significant therapies and educational support, however. Despite the limitations of this study, this information may be helpful for counseling patients and families about longer-term outcomes. Hopefully, ongoing prospective data registries will eventually include surveying for these important factors of quality of life.

July 2017 surgery 1

 

 

Functional status of United States children supported with a left ventricular assist device at heart transplantation.
Bulic A, Maeda K, Zhang Y, Chen S, McElhinney DB, Dykes JC, Hollander AM, Hollander SA, Murray J, Reinhartz O, Gowan MA, Rosenthal DN, Almond CS.
J Heart Lung Transplant. 2017 Aug;36(8):890-896. doi: 10.1016/j.healun.2017.02.024. Epub 2017 Mar 2.
PMID: 28363739
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Select item 28342709

 

Take Home Points:

  • Pediatric heart failure patients supported with VAD therapy may have improved functional status at the time of heart transplant and up to one year after compared with those who receive vasoactive infusions alone.
  • VAD therapy was associated with slightly more renal dysfunction and neurologic complications than vasoactive infusion therapy.

 

Commentary from Dr. Jeremy Herrmann (Indianapolis), section editor of Congenital Heart Surgery Journal Watch:  The management of advanced heart failure can include the use of vasoactive/inotropic infusions, ventricular assist devices (VAD), or both. Whether either the use of vasoactive infusions for VAD therapies improves functional status in pediatric patients prior to and after heart transplantation remains unknown. The authors used Organ Procurement and Transplant data for U.S. patients age 1-21 years with dilated cardiomyopathy who were supported with either vasoactive infusions or left ventricular assist device (LVAD therapy) who underwent heart transplantation. They compared patient functional status at the time of listing, at the time of transplant, and at one year following heart transplant.

 

A total of 701 patients were included: 430 (61%) supported with vasoactive infusions and 271 (39%) with an VAD at time of transplant. Patients were excluded if they were on mechanical ventilatory support, biventricular assist device support, combined LVAD and vasoactive infusion therapy, or extracorporeal membrane oxygenation at time of transplant. Multiorgan transplant recipients were also excluded.

 

Patients in the VAD group were slightly older with a median age at listing of 15 years in the vasoactive infusion group and 13 years in the vasoactive infusion group (p = 0.02). The percentage of patients ≥18 years of age in the vasoactive infusion group was 20% and in the VAD group 25%. There was a slightly higher percentage of patients listed status 1A in the VAD group (73%) compared to the vasoactive infusion group (67%). Discharge to home before transplant occurred for 46% of VAD patients compared with 26% patients receiving vasoactive infusions. VAD patients more likely to have renal dysfunction including need for dialysis at time of OHT and had a longer waiting list time (median 74 vs 28 days, p<0.001). Neurologic injury occurred in 3 LVAD patients and in one vasoactive infusion therapy patient (p=0.04). The types of VAD used were not specified though the authors report that in a sub-group analysis, there was no difference in FS between pulsatile and continuous-flow devices.

 

Functional status was assessed using the 10-point Karnofsky and Lansky scale. At the time of listing, the vasoactive infusion group had a slightly higher FS score than the VAD group. However, the FS improved in the VAD group but decreased in the vasoactive infusion group by the time of transplant. One-year following transplant, there was no difference in FS between groups. Overall survival at two years was also similar.

 

This study did not evaluate outpatient VAD programs, which may vary significantly between institutions and which may determine the discharge to home rate of patient. Rates of discharge to home were also were not evaluated by age group, and it is possible medical and device compliance may be better with adolescent and young adult patients. Other adverse outcomes of VAD therapy (e.g., thromboembolic events, antigen sensitization, etc.) were not available from that registry but could also factor into the risk profile of that management pathway.

 

The authors raise the question of whether a 1-2 point improvement in a FS scale is worth the possible additional renal and neurologic risks of LVAD therapy. At least in this editor’s anecdotal experience, school-age children who receive an implantable VAD prior to heart transplant may be able to resume some normalcy in life such as returning to school and re-engaging socially after discharge to home. However, this requires a tremendous amount of familial and outpatient VAD program support, which may not be as available at all institutions. Comparing quality of life between these groups may be helpful as would determining whether there is any cost difference between management strategies, especially in the outpatient setting.

 

CHD Surgery July 2017

 

  1. The Society of Thoracic Surgeons CongenitalHeart Surgery Database: 2017 Update on Research.

Jacobs ML, Jacobs JP, Hill KD, Hornik C, O’Brien SM, Pasquali SK, Vener D, Kumar SR, Habib RH, Shahian DM, Edwards FH, Fernandez FG.

Ann Thorac Surg. 2017 Jul 28. pii: S0003-4975(17)30926-8. doi: 10.1016/j.athoracsur.2017.07.001. [Epub ahead of print]

PMID: 28760477

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Select item 28760475

 

  1. Cardiac Progenitor Cells Enhance Neonatal Right Ventricular Function After Pulmonary Artery Banding.

Wehman B, Pietris N, Bigham G, Siddiqui O, Mishra R, Li T, Aiello E, Jack G, Wang W, Murthi S, Sharma S, Kaushal S.

Ann Thorac Surg. 2017 Jul 28. pii: S0003-4975(17)30662-8. doi: 10.1016/j.athoracsur.2017.04.058. [Epub ahead of print]

PMID: 28760475

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  1. Open-heart surgery in neonates: current practice.

Cho MY, Boettcher W, Redlin M, Wloch A, Schulz A, Miera O, Berger F, Sinzobahamvya N, Photiadis J.

J Cardiovasc Surg (Torino). 2017 Jul 26. doi: 10.23736/S0021-9509.17.10043-1. [Epub ahead of print] No abstract available.

PMID: 28747048

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Select item 27824616

 

  1. Outcomes of Blalock-Taussig shunts in current era: A single center experience.

Sasikumar N, Hermuzi A, Fan CS, Lee KJ, Chaturvedi R, Hickey E, Honjo O, Van Arsdell GS, Caldarone CA, Agarwal A, Benson L.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12516. [Epub ahead of print]

PMID: 28736841

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Select item 28736836

 

  1. Congenital heart disease and cardiac procedural outcomes in patients with trisomy 21 and Turner syndrome.

Morales-Demori R.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12521. [Epub ahead of print]

PMID: 28736822

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Select item 28739807

 

  1. AKI after pediatric cardiac surgery for congenital heart diseases-recent developments in diagnostic criteria and early diagnosis by biomarkers.

Toda Y, Sugimoto K.

J Intensive Care. 2017 Jul 20;5:49. doi: 10.1186/s40560-017-0242-z. eCollection 2017. Review.

PMID: 28729908 Free PMC Article

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Select item 28726068

 

  1. Long-term alteration of the hypothalamic-pituitary-adrenal axis in children undergoing cardiac surgery in the first 6 months of life.

McGauran M, Jordan B, Beijers R, Janssen I, Franich-Ray C, de Weerth C, Cheung M.

Stress. 2017 Jul 18:1-8. doi: 10.1080/10253890.2017.1349748. [Epub ahead of print]

PMID: 28720027

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Select item 28532774

 

  1. Efficacy of an Extracellular Matrix in Systemic Loading Conditions in Congenital Heart Surgery.

Ashfaq A, Iyengar A, Kwon OJ, Soroya MS, Nguyen S, Ou R, Reemtsen B.

Pediatr Cardiol. 2017 Jul 15. doi: 10.1007/s00246-017-1666-x. [Epub ahead of print]

PMID: 28711965

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Select item 28711963

 

  1. Effect of Gastrointestinal Malformations on the Outcomes of Patients With Congenital Heart Disease.

Mery CM, De León LE, Rodriguez JR, Nieto RM, Zhang W, Adachi I, Heinle JS, Kane LC, McKenzie ED, Fraser CD Jr.

Ann Thorac Surg. 2017 Jul 11. pii: S0003-4975(17)30605-7. doi: 10.1016/j.athoracsur.2017.04.042. [Epub ahead of print]

PMID: 28709660

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Select item 28709631

 

  1. Patient-specific biomechanical model of hypoplastic left heart to predict post-operative cardio-circulatory behaviour.

Cutrì E, Meoli A, Dubini G, Migliavacca F, Hsia TY, Pennati G.

Med Eng Phys. 2017 Jul 8. pii: S1350-4533(17)30163-7. doi: 10.1016/j.medengphy.2017.06.024. [Epub ahead of print]

PMID: 28698113

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Select item 28689328

 

  1. 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.

Meza JM, Hickey EJ, Blackstone EH, Jaquiss RDB, Anderson BR, Williams WG, Cai S, Van Arsdell GS, Karamlou T, McCrindle BW.

Circulation. 2017 Jul 7. pii: CIRCULATIONAHA.117.028481. doi: 10.1161/CIRCULATIONAHA.117.028481. [Epub ahead of print]

PMID: 28687711

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Select item 28683534

 

  1. Pharmacokinetics of Fentanyl and Its Derivatives in Children: A Comprehensive Review.

Ziesenitz VC, Vaughns JD, Koch G, Mikus G, van den Anker JN.

Clin Pharmacokinet. 2017 Jul 7. doi: 10.1007/s40262-017-0569-6. [Epub ahead of print] Review.

PMID: 28688027

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Select item 28685702

 

  1. National Variation in the Use of Tracheostomy in Patients With Congenital Heart Disease.

Johnson JT, Marino BS, Klugman D, Shamszad P.

Pediatr Crit Care Med. 2017 Jul 6. doi: 10.1097/PCC.0000000000001286. [Epub ahead of print]

PMID: 28691936

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Select item 28681178

 

  1. Acute kidney injury in congenital cardiac surgery: Comparison of pRIFLE &amp; AKIN.

Tanyildiz M, Ekim M, Kendirli T, Tutar E, Eyileten Z, Ozcakar ZB, Kavaz A, Yalcınkaya F, Uysalel A, Atalay S.

Pediatr Int. 2017 Jul 3. doi: 10.1111/ped.13359. [Epub ahead of print]

PMID: 28672079

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Select item 28672054

 

  1. Improving risk adjustment in the PRAiS (Partial Risk Adjustment in Surgery) model for mortality after paediatric cardiac surgery and improving public understanding of its use in monitoring outcomes.

Pagel C, Rogers L, Brown K, Ambler G, Anderson D, Barron D, Blackshaw E, Crowe S, English K, Franklin R, Jesper E, Meagher L, Pearson M, Rakow T, Salamonowicz M, Spiegelhalter D, Stickley J, Thomas J, Tibby S, Tsang V, Utley M, Witter T.

Southampton (UK): NIHR Journals Library; 2017 Jul.

PMID: 28763186 Free Books & Documents

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Select item 28625386

 

  1. Hemodynamic determinants of mortality after Fontan operation.

Ohuchi H, Miyazaki A, Negishi J, Hayama Y, Nakai M, Nishimura K, Ichikawa H, Shiraishi I, Yamada O.

Am Heart J. 2017 Jul;189:9-18. doi: 10.1016/j.ahj.2017.03.020. Epub 2017 Apr 2.

PMID: 28625386

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Select item 28301892

 

  1. The Insight From Foresight: Near-Infrared Spectroscopy in Cyanotic Congenital Heart Disease.

Adler AC, Stayer SA.

Anesth Analg. 2017 Jul;125(1):18-19. doi: 10.1213/ANE.0000000000002154. No abstract available.

PMID: 28628576

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Select item 28514318

 

  1. Cerebral Oxygen Saturation in Children With Congenital Heart Disease and Chronic Hypoxemia.

Kussman BD, Laussen PC, Benni PB, McGowan FX Jr, McElhinney DB.

Anesth Analg. 2017 Jul;125(1):234-240. doi: 10.1213/ANE.0000000000002073.

PMID: 28514318

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Select item 28375677

 

  1. Randomized comparative study of intravenous infusion of three different fixed doses of milrinone in pediatric patients with pulmonary hypertension undergoing open heart surgery.

Barnwal NK, Umbarkar SR, Sarkar MS, Dias RJ.

Ann Card Anaesth. 2017 Jul-Sep;20(3):318-322. doi: 10.4103/aca.ACA_231_16.

PMID: 28701597 Free Article

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Select item 28019051

 

  1. Primary Pulmonary Vein Stenosis: Outcomes, Risk Factors, and Severity Score in a Multicentric Study.

Kalfa D, Belli E, Bacha E, Lambert V, di Carlo D, Kostolny M, Salminen J, Nosal M, Poncelet A, Horer J, Berggren H, Yemets I, Hazekamp M, Maruszewski B, Sarris G, Pozzi M, Ebels T, Lacour-Gayet F; European Congenital Heart Surgeons Association.

Ann Thorac Surg. 2017 Jul;104(1):182-189. doi: 10.1016/j.athoracsur.2017.03.022.

PMID: 28633223

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Select item 28318514

 

  1. Incorporating Comorbidity Within Risk Adjustment for UK Pediatric Cardiac Surgery.

Brown KL, Rogers L, Barron DJ, Tsang V, Anderson D, Tibby S, Witter T, Stickley J, Crowe S, English K, Franklin RC, Pagel C.

Ann Thorac Surg. 2017 Jul;104(1):220-226. doi: 10.1016/j.athoracsur.2016.12.013. Epub 2017 Mar 18.

PMID: 28318514 Free Article

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Select item 28318513

 

  1. Improving Risk Adjustment for Mortality After Pediatric Cardiac Surgery: The UK PRAiS2 Model.

Rogers L, Brown KL, Franklin RC, Ambler G, Anderson D, Barron DJ, Crowe S, English K, Stickley J, Tibby S, Tsang V, Utley M, Witter T, Pagel C.

Ann Thorac Surg. 2017 Jul;104(1):211-219. doi: 10.1016/j.athoracsur.2016.12.014. Epub 2017 Mar 18.

PMID: 28318513 Free Article

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Select item 28274523

 

  1. [Frequency, type and predictors of pleuropulmonary complications during the first thirty days after cardiopulmonary bypass surgery in children].

Hernández-López JJ, Solano-Gutiérrez A, Rosas-Aragón FT, Antúnez-Soto AG, Flores-Lujano J, Nuñez-Enríquez JC.

Arch Cardiol Mex. 2017 Jul 1. pii: S1405-9940(17)30048-4. doi: 10.1016/j.acmx.2017.06.003. [Epub ahead of print] Spanish.

PMID: 28676203

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Select item 28610439

 

  1. Congenitally corrected transposition: complex anatomic repair or Fontan pathway?

Marathe SP, Jones MI, Ayer J, Sun J, Orr Y, Verrall C, Nicholson IA, Chard RB, Sholler GF, Winlaw DS.

Asian Cardiovasc Thorac Ann. 2017 Jul;25(6):432-439. doi: 10.1177/0218492317717412. Epub 2017 Jun 13.

PMID: 28610439

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Select item 28215395

 

  1. Early postoperative extubation of unstable patients following total cavopulmonary connection: impact on circulation and outcome.

Georgiev S, Balling G, Ruf B, Ackermann K, von Ohain JP, Schreiber C, Ewert P.

Cardiol Young. 2017 Jul;27(5):860-869. doi: 10.1017/S1047951116001402. Epub 2016 Oct 18.

PMID: 27751196

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Select item 27751192

 

  1. Anatomical considerations for the management of a left-sided superior caval vein draining to the roof of the left atrium.

Saundankar J, Ho AB, Salmon AP, Anderson RH, Magee AG.

Cardiol Young. 2017 Jul;27(5):846-850. doi: 10.1017/S1047951116001384. Epub 2016 Sep 29.

PMID: 27680401

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Select item 28295963

 

  1. Association of Surgeon Age and Experience With Congenital Heart Surgery Outcomes.

Anderson BR, Wallace AS, Hill KD, Gulack BC, Matsouaka R, Jacobs JP, Bacha EA, Glied SA, Jacobs ML.

Circ Cardiovasc Qual Outcomes. 2017 Jul;10(7). pii: e003533. doi: 10.1161/CIRCOUTCOMES.117.003533.

PMID: 28710297

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Select item 26577068

 

  1. Brain injury with systemic inflammation in newborns with congenital heart disease undergoing heart surgery.

Pironkova RP, Giamelli J, Seiden H, Parnell VA, Gruber D, Sison CP, Kowal C, Ojamaa K.

Exp Ther Med. 2017 Jul;14(1):228-238. doi: 10.3892/etm.2017.4493. Epub 2017 May 22.

PMID: 28672919 Free PMC Article

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Select item 28621552

 

  1. Significance of right atrial tension for the development of complications in patients after atriopulmonary connection Fontan procedure: potential indicator for Fontan conversion.

Izumi G, Senzaki H, Takeda A, Yamazawa H, Takei K, Furukawa T, Inai K, Shinohara T, Nakanishi T.

Heart Vessels. 2017 Jul;32(7):850-855. doi: 10.1007/s00380-016-0941-8. Epub 2017 Jan 7.

PMID: 28064364

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Select item 28337699

 

  1. Tricuspid valve repair and pulmonary valve replacement in adults with repaired tetralogy of Fallot.

Roubertie F, Séguéla PE, Jalal Z, Iriart X, Roques X, Kreitmann B, Al-Yamani M, Pillois X, Thambo JB.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):214-223. doi: 10.1016/j.jtcvs.2016.12.062. Epub 2017 Feb 10.

PMID: 28292589

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Select item 28262288

 

  1. Pictorial Review of Surgical Anatomy in Adult Congenital Heart Disease.

De Cecco CN, Muscogiuri G, Madrid Pérez JM, Eid M, Suranyi P, Lesslie VW, Bastarrika G.

J Thorac Imaging. 2017 Jul;32(4):217-232. doi: 10.1097/RTI.0000000000000273.

PMID: 28549022

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Select item 28624000

 

  1. Experience with Mechanical Circulatory Support for Medically Intractable Low Cardiac Output in a Pediatric Intensive Care Unit.

Park JB, Kwak JG, Lim HG, Kim WH, Lee JR, Kim YJ.

Korean Circ J. 2017 Jul;47(4):490-500. doi: 10.4070/kcj.2016.0320. Epub 2017 Jul 27.

PMID: 28765741 Free PMC Article

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Select item 28704916

 

  1. Outcomes and Costs of Cardiac Surgery in Adults with Congenital Heart Disease.

Nasr VG, Faraoni D, Valente AM, DiNardo JA.

Pediatr Cardiol. 2017 Jul 1. doi: 10.1007/s00246-017-1669-7. [Epub ahead of print]

PMID: 28669107

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Select item 28489637

 

  1. Pilot Study Comparing Closed Versus Open Tracheal Suctioning in Postoperative Neonates and Infants With Complex Congenital Heart Disease.

Tume LN, Baines PB, Guerrero R, Hurley MA, Johnson R, Kalantre A, Ramaraj R, Ritson PC, Walsh L, Arnold PD.

Pediatr Crit Care Med. 2017 Jul;18(7):647-654. doi: 10.1097/PCC.0000000000001192.

PMID: 28489637

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Select item 28571730

 

  1. Serum Neuronal Biomarkers in Neonates With Congenital Heart Disease Undergoing Cardiac Surgery.

Trakas E, Domnina Y, Panigrahy A, Baust T, Callahan PM, Morell VO, Munoz R, Bell MJ, Sanchez-de-Toledo J.

Pediatr Neurol. 2017 Jul;72:56-61. doi: 10.1016/j.pediatrneurol.2017.04.011. Epub 2017 Apr 21.

PMID: 28571730

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Select item 28549654

 

  1. Oncotic pressure and paediatric cardiopulmonary bypass: establishing baseline data for complex congenital cardiac surgery and its relation to risk stratification.

Crook R, Issitt R.

Perfusion. 2017 Jul;32(5):378-382. doi: 10.1177/0267659117690251. Epub 2017 Jan 23.

PMID: 28110616

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Select item 27511883

 

  1. Risk Factors for Mortality in Reoperations for Pediatric and Congenital Heart Surgery in a Developing Country.

Villa-Hincapie CA, Carreno-Jaimes M, Obando-Lopez CE, Camacho-Mackenzie J, Umaña-Mallarino JP, Sandoval-Reyes NF.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):435-439. doi: 10.1177/2150135117704657.

PMID: 28696882

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Select item 28696881

 

  1. Persistent Left Superior Vena Cava: Incidence and Management in Patients Undergoing Repair of Partial Anomalous Pulmonary Venous Connection.

Clarke NS, Murthy RA, Guleserian KJ.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):440-444. doi: 10.1177/2150135117708706.

PMID: 28696881

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Select item 28696879

 

  1. Outcomes of Patients Undergoing Primary Fontan Operation Beyond First Decade of Life.

Talwar S, Singh S, Sreenivas V, Kapoor KS, Gupta SK, Ramakrishnan S, Kothari SS, Saxena A, Juneja R, Choudhary SK, Airan B.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):487-494. doi: 10.1177/2150135117713696.

PMID: 28696879

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Select item 28696876

 

  1. Experience Using Kaolin-Impregnated Sponge to Minimize Perioperative Bleeding in Norwood Operation.

Shinkawa T, Holloway J, Tang X, Gossett JM, Imamura M.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):475-479. doi: 10.1177/2150135117713698.

PMID: 28696876

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Select item 28696875

 

  1. Modified Aortic Uncrossing Procedure: A Novel Approach for Norwood Palliation of Complex Univentricular Congenital Heart Disease With a Circumflex Aorta.

Bryant R 3rd, Wallen W, Rizwan R, Morales DL.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):507-510. doi: 10.1177/2150135117712248.

PMID: 28696873

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Select item 28696872

 

  1. Anomalous Origin of Pulmonary Artery From Aorta: Neonatal Autologous Aortopulmonary Reconstruction.

Eason AJ, Shafer B, Murdison KA, Polimenakos AC.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):502-506. doi: 10.1177/2150135117710939.

PMID: 28696871

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Select item 27647341

 

  1. Constrictive Pericarditis Following Correction of Partial Anomalous Pulmonary Venous Drainage.

Ong CS, Shankar S, Yip JWL, Tay ELW, Teo LLS, Quek SC.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):540-542. doi: 10.1177/2150135116652116. Epub 2016 Sep 19.

PMID: 27647341

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Select item 27297083

 

  1. [Values of combination of urinary L-FABP and NGAL in early diagnosis of acute kidney injury after cardiac surgery in children].

Tang R, Ao X, Zhong Y, Wang RL, Zhou QL.

Zhongguo Dang Dai Er Ke Za Zhi. 2017 Jul;19(7):770-775. Chinese.

PMID: 28697829 Free Article

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Select item 28697826

 

  1. The Mid-term Results of Mitral Valve Repair for Isolated Mitral Regurgitation in Infancy and Childhood.

Shi Y, Xu H, Yan J, Wang Q, Li S, Yi T, Zhang Y, Liu W.

Pediatr Cardiol. 2017 Jul 31. doi: 10.1007/s00246-017-1701-y. [Epub ahead of print]

PMID: 28762165

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Select item 28762164

 

  1. Erratum to: Critically Underdeveloped Left Heart Morphology Associated with Prematurity and Low Birth Weight: Conditional Staged Rehabilitation Towards Biventricular Repair and Time-Related Growth of Left Heart Structures.

Ahmad F, Mangano R, Shore S, Polimenakos A.

Pediatr Cardiol. 2017 Jul 31. doi: 10.1007/s00246-017-1687-5. [Epub ahead of print] No abstract available.

PMID: 28762164

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Select item 28704131

 

  1. Ventricular function and vascular dimensions after Norwood and hybrid palliation of hypoplastic left heart syndrome.

Latus H, Nassar MS, Wong J, Hachmann P, Bellsham-Revell H, Hussain T, Apitz C, Salih C, Austin C, Anderson D, Yerebakan C, Akintuerk H, Bauer J, Razavi R, Schranz D, Greil G.

Heart. 2017 Jul 28. pii: heartjnl-2017-311532. doi: 10.1136/heartjnl-2017-311532. [Epub ahead of print]

PMID: 28754809

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Select item 28755092

 

  1. Single-Stage Correction for Taussig-Bing Anomaly Associated With Aortic Arch Obstruction.

Luo K, Zheng J, Wang S, Zhu Z, Gao B, Xu Z, Liu J.

Pediatr Cardiol. 2017 Jul 27. doi: 10.1007/s00246-017-1694-6. [Epub ahead of print]

PMID: 28752325

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Select item 28752324

 

  1. A Novel Surgical Approach to Mechanical Circulatory Support in Univentricular Infants.

Gazit AZ, Petrucci O, Manning P, Shepard M, Baltagi S, Simpson K, Castleberry C, Canter C, Eghtesady P.

Ann Thorac Surg. 2017 Jul 15. pii: S0003-4975(17)30584-2. doi: 10.1016/j.athoracsur.2017.04.023. [Epub ahead of print]

PMID: 28720202

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Select item 28743483

 

  1. Modified Single-Patch Technique Versus Two-Patch Technique for the Repair of Complete Atrioventricular Septal Defect: A Meta-Analysis.

Li D, Fan Q, Iwase T, Hirata Y, An Q.

Pediatr Cardiol. 2017 Jul 15. doi: 10.1007/s00246-017-1684-8. [Epub ahead of print]

PMID: 28711966

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Select item 28711965

 

  1. Conversion from Calcineurin Inhibitors to mTOR Inhibitors as Primary Immunosuppressive Drugs in Pediatric Heart Transplantation.

Asante-Korang A, Carapellucci J, Krasnopero D, Doyle A, Brown B, Amankwah E.

Clin Transplant. 2017 Jul 14. doi: 10.1111/ctr.13054. [Epub ahead of print]

PMID: 28708333

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Select item 28716702

 

  1. Incorporating Comorbidity Within Risk Adjustment for UK Pediatric Cardiac Surgery.

Brown KL, Rogers L, Barron DJ, Tsang V, Anderson D, Tibby S, Witter T, Stickley J, Crowe S, English K, Franklin RC, Pagel C.

Ann Thorac Surg. 2017 Jul;104(1):220-226. doi: 10.1016/j.athoracsur.2016.12.013. Epub 2017 Mar 18.

PMID: 28318514 Free Article

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Select item 28318513

 

  1. Improving Risk Adjustment for Mortality After Pediatric Cardiac Surgery: The UK PRAiS2 Model.

Rogers L, Brown KL, Franklin RC, Ambler G, Anderson D, Barron DJ, Crowe S, English K, Stickley J, Tibby S, Tsang V, Utley M, Witter T, Pagel C.

Ann Thorac Surg. 2017 Jul;104(1):211-219. doi: 10.1016/j.athoracsur.2016.12.014. Epub 2017 Mar 18.

PMID: 28318513 Free Article

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Select item 27225398

 

  1. Fontan completion in reverse order out of necessity: secondary Glenn after primary extracardiac inferior cavopulmonary artery connection.

Dodge-Khatami J, Aggarwal A, Taylor MB, Maposa D, Salazar JD, Dodge-Khatami A.

Cardiol Young. 2017 Jul;27(5):925-928. doi: 10.1017/S1047951116001839. Epub 2016 Oct 28.

PMID: 27788695

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Select item 27751196

 

  1. Early postoperative extubation of unstable patients following total cavopulmonary connection: impact on circulation and outcome.

Georgiev S, Balling G, Ruf B, Ackermann K, von Ohain JP, Schreiber C, Ewert P.

Cardiol Young. 2017 Jul;27(5):860-869. doi: 10.1017/S1047951116001402. Epub 2016 Oct 18.

PMID: 27751196

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Select item 27655153

 

  1. Brain injury with systemic inflammation in newborns with congenital heart disease undergoing heart surgery.

Pironkova RP, Giamelli J, Seiden H, Parnell VA, Gruber D, Sison CP, Kowal C, Ojamaa K.

Exp Ther Med. 2017 Jul;14(1):228-238. doi: 10.3892/etm.2017.4493. Epub 2017 May 22.

PMID: 28672919 Free PMC Article

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  1. Fontan survival: As good as it gets?

Thankavel P, Jaquiss RDB.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):241-242. doi: 10.1016/j.jtcvs.2017.03.114. Epub 2017 Apr 4. No abstract available.

PMID: 28434620

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Select item 28341469

 

  1. Long-term survival after the Fontan operation: Twenty years of experience at a single center.

Downing TE, Allen KY, Glatz AC, Rogers LS, Ravishankar C, Rychik J, Faerber JA, Fuller S, Montenegro LM, Steven JM, Spray TL, Nicolson SC, Gaynor JW, Goldberg DJ.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):243-253.e2. doi: 10.1016/j.jtcvs.2017.01.056. Epub 2017 Mar 6.

PMID: 28341469

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Select item 28292589

 

  1. Elevated intrathoracic CO2 pressure during thoracoscopic surgery decreases regional cerebral oxygen saturation in neonates and infants-A pilot study.

Neunhoeffer F, Warmann SW, Hofbeck M, Müller A, Fideler F, Seitz G, Schuhmann MU, Kirschner HJ, Kumpf M, Fuchs J.

Paediatr Anaesth. 2017 Jul;27(7):752-759. doi: 10.1111/pan.13161. Epub 2017 May 24.

PMID: 28544108

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Select item 28205419

 

  1. Serum Neuronal Biomarkers in Neonates With Congenital Heart Disease Undergoing Cardiac Surgery.

Trakas E, Domnina Y, Panigrahy A, Baust T, Callahan PM, Morell VO, Munoz R, Bell MJ, Sanchez-de-Toledo J.

Pediatr Neurol. 2017 Jul;72:56-61. doi: 10.1016/j.pediatrneurol.2017.04.011. Epub 2017 Apr 21.

PMID: 28571730

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Select item 28435986

 

  1. Intra-Atrial Y-Graft Fontan for Univentricular Heart With Discontinuous Pulmonary Arteries.

Sharma R, Baruah SD, Marwah A, Chauhan CPS.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):529-532. doi: 10.1177/2150135117705638.

PMID: 28696884

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Select item 28696880

 

  1. Surgical Options for Uhl’s Anomaly.

Kalita JP, Dutta N, Awasthy N, Chowdhuri KR, Girotra S, Radhakrishnan S, Srivastava S, Iyer PU, Iyer KS.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):470-474. doi: 10.1177/2150135117710940.

PMID: 28696874

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Select item 28696872

 

  1. Surgical Removal of Embolized Ventricular Septal Occluder Device.

Vaidhya N, Mishra A, Siddiqui S, Joshi H, Patel H.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):537-539. doi: 10.1177/2150135116648306. Epub 2016 May 19.

PMID: 27198525

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ACHD Featured Articles of July 2017

Adult Congenital Heart Reviews of July/August 2017 Manuscripts

 

Physical activity in adults with congenital heart disease and associations with functional outcomes.

Müller J, Amberger T, Berg A, Goeder D, Remmele J, Oberhoffer R, Ewert P, Hager A.

Heart. 2017 Jul;103(14):1117-1121. doi: 10.1136/heartjnl-2016-310828. Epub 2017 Mar 8.

PMID: 28274955

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Take Home Points:

 

  • Utilizing the International Physical Activity Questionnaire (IPAQ) divided patients into the 3 activity categories: health-enhancing physical activity (HEPA) – 50%, minimal activity (30.2%)and inactivity (19.5%) – the results of the questionnaire correlated well with objectively measures exercise capacity and health-related quality of life.
  • The group partaking in health enhancing physical activity was associated with a higher exercise capacity and better mental and physical health related quality of life scores when compared to minimally active and inactive patients.
  • Pacemakers were independently associated with poorer quality of life scores.

 

 

Blanche CupidoCommentary by Dr. Blanche Cupido (Cape Town), section editor of ACHD Journal Watch:

A good exercise capacity predicts favorable long-term morbidity and mortality in patients with CHD. Cardiopulmonary exercise testing (CPET) and accelerometry currently represent the gold standard for physical activity but is costly and not readily available. In this study, the authors utilize the International Physical Activity Questionnaire (IPAQ) to assess self-reported physical activity within the last 7 days. Exercise capacity is also objectively measured with cardiopulmonary exercise testing and assess quality of life using the SF-36(Health related quality of life) questionnaire.

 

786 patients filled out the IPAQ and SF-36 questionnaires. The mean age was 31 year and the mean BMI 23.7kg/m2.  A wide variety of pathologies were included. IPAQ identified 3 levels of activity: health-enhancing physical activity, minimally active and inactive.  Cyanotic patients (those with oxygen saturations of <90% at rest or on exercise) were included in the analysis irrespective of heart rate or RER.

 

50% of patients reported health enhancing physical activity (HEPA), 30.2% minimal activity and 19.8% inactivity. Men had higher activity levels compared to women (p=0,086) but no significant differences were observed between the different pathology subgroups or their level of disease severity. Compared to the HEPA group, the inactive group had lower peak oxygen uptake (74.2% vs 86.7%, p<0.001). They also had lower mental (97.1% vs 104.1%, p<0.001) and physical (91% vs 97.4%, p<0.001) health related quality of life scores. (see attached figure)

July 2017 ACHD 1

Betablocker use, male gender, pacemaker, oxygen saturation at rest and severity class were associated with impaired exercise capacity. Pacemakers were associated with lower physical quality of life (p=0.021) and a lower mental quality of life as well (p=0.014).

 

Long-term survival after the Fontan operation: Twenty years of experience at a single center.

Downing TE, Allen KY, Glatz AC, Rogers LS, Ravishankar C, Rychik J, Faerber JA, Fuller S, Montenegro LM, Steven JM, Spray TL, Nicolson SC, Gaynor JW, Goldberg DJ.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):243-253.e2. doi: 10.1016/j.jtcvs.2017.01.056. Epub 2017 Mar 6.

PMID: 28341469

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Select item 28320512

  

Take Home Points:

 

  • Despite the early improvements in post-operative outcomes, long-term survival after the Fontan has not improved appreciably over the last decade
  • In this contemporary Fontan cohort, late survival with an intact Fontan was as follows: 94% at 1 year (95% confidence interval 92% -95%), 90% at 10 years (CI, 88% -92% ), 85%  at 15 years (CI, 82% -88% ), and 74%  at 20 years (CI, 67% -80% ). Risk factors were identifiable as exerting an early influence, i.e. within the 1st year or late influence, after 1 year.  Specific early risk factors identified included prolonged pleural drainage, intensive care unit stay> 1 week, Fontan before 1997, preoperative atrioventricular valve regurgitation, and longer cross-clamp time. Only independent late risk factor was pre-operative AV-valve regurgitation
  • Early mortality was determined by the presence of higher pre-operative pulmonary artery pressures >15mm Hg, prolonged pleural drainage, longer aortic cross clamp time, and earlier surgical era. Late mortality was determined by the presence of atrioventricular valve regurgitation only. There no correlations between ventricular morphology and outcomes.

 

Moe_Tabitha-WEBCommentary by Dr. Tabitha G. Moe (Phoenix), section editor of ACHD Journal WatchThis is a large single center retrospective presentation of Fontan outcomes in 773 patients.  Patients underwent the Fontan procedure between 1992 and 2009, and all had a cavo-pulmonary connection. Late outcomes were determined from local medical records, and utilization of the National Death Index, and the Scientific Registry of Transplant Recipients for patients that were cared for remote from CHOP. In this cohort greater than 50% of patients carried the diagnosis of hypoplastic left heart syndrome.   A total of 114 (13%) reached the common endpoint of death (n=79), heart transplantation 9n=25) or Fontan takedown (n=10). Of the 79 total deaths, 27 occurred during the initial surgical hospitalization, and 37 within the first post-operative year, and the remaining 15 occurred late.  This accounted for a 94%- 1 year mortality, 90%- 10 year mortality, and 85%- 15yr mortality. The 20 year estimate for survival with an intact Fontan circulation was 74%, and overall 20-year survival was 79%. Ventricular morphology and type of Fontan operation (lateral tunnel vs. extracardiac) were not associated with either early or late outcomes.

 

Interestingly risk factors identified for morality appeared to be active within the 1 post-operative year only, these include prolonged pleural effusions >2 weeks, prolonged aortic cross clamp time, and earlier surgical era’s. Pre-operative pulmonary artery pressures > 15mmHg was able to identify those at greatest risk in the early post-operative period.

The presence of Atrioventricular valve regurgitation > mild was able to identify those at risk for late mortality.

 

It should be noted that of the 25 patients who underwent heart transplantation, there was a 50% survival at 5 years.  As this is a single-center study local clinical practices may affect outcomes, for example 90% of this cohort was fenestrated, and the current status of the fenestration is unknown. Further study of late patency of the fenestration, and the burden of pre-Fontan AP collaterals will be important in further follow-up studies.

 

Long-term survival after the Fontan operation: Twenty years of experience at a single center.

Downing TE, Allen KY, Glatz AC, Rogers LS, Ravishankar C, Rychik J, Faerber JA, Fuller S, Montenegro LM, Steven JM, Spray TL, Nicolson SC, Gaynor JW, Goldberg DJ.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):243-253.e2. doi: 10.1016/j.jtcvs.2017.01.056. Epub 2017 Mar 6.

PMID: 28341469

Similar articles

Select item 28320512

  

Take Home Points:

 

  • Despite the early improvements in post-operative outcomes, long-term survival after the Fontan has not improved appreciably over the last decade
  • In this contemporary Fontan cohort, late survival with an intact Fontan was as follows: 94% at 1 year (95% confidence interval 92% -95%), 90% at 10 years (CI, 88% -92% ), 85%  at 15 years (CI, 82% -88% ), and 74%  at 20 years (CI, 67% -80% ). Risk factors were identifiable as exerting an early influence, i.e. within the 1st year or late influence, after 1 year.  Specific early risk factors identified included prolonged pleural drainage, intensive care unit stay> 1 week, Fontan before 1997, preoperative atrioventricular valve regurgitation, and longer cross-clamp time. Only independent late risk factor was pre-operative AV-valve regurgitation
  • Early mortality was determined by the presence of higher pre-operative pulmonary artery pressures >15mm Hg, prolonged pleural drainage, longer aortic cross clamp time, and earlier surgical era. Late mortality was determined by the presence of atrioventricular valve regurgitation only. There no correlations between ventricular morphology and outcomes.

 

Commentary by Dr. Tabitha G. Moe (Phoenix), section editor of ACHD Journal Watch:  This is a large single center retrospective presentation of Fontan outcomes in 773 patients.  Patients underwent the Fontan procedure between 1992 and 2009, and all had a cavo-pulmonary connection. Late outcomes were determined from local medical records, and utilization of the National Death Index, and the Scientific Registry of Transplant Recipients for patients that were cared for remote from CHOP. In this cohort greater than 50% of patients carried the diagnosis of hypoplastic left heart syndrome.   A total of 114 (13%) reached the common endpoint of death (n=79), heart transplantation 9n=25) or Fontan takedown (n=10). Of the 79 total deaths, 27 occurred during the initial surgical hospitalization, and 37 within the first post-operative year, and the remaining 15 occurred late.  This accounted for a 94%- 1 year mortality, 90%- 10 year mortality, and 85%- 15yr mortality. The 20 year estimate for survival with an intact Fontan circulation was 74%, and overall 20-year survival was 79%. Ventricular morphology and type of Fontan operation (lateral tunnel vs. extracardiac) were not associated with either early or late outcomes.

 

Interestingly risk factors identified for morality appeared to be active within the 1 post-operative year only, these include prolonged pleural effusions >2 weeks, prolonged aortic cross clamp time, and earlier surgical era’s. Pre-operative pulmonary artery pressures > 15mmHg was able to identify those at greatest risk in the early post-operative period.

The presence of Atrioventricular valve regurgitation > mild was able to identify those at risk for late mortality.

 

It should be noted that of the 25 patients who underwent heart transplantation, there was a 50% survival at 5 years.  As this is a single-center study local clinical practices may affect outcomes, for example 90% of this cohort was fenestrated, and the current status of the fenestration is unknown. Further study of late patency of the fenestration, and the burden of pre-Fontan AP collaterals will be important in further follow-up studies.

 

Number of thoracotomy predicts impairment in lung function and exercise capacity in patients with congenital heart disease.

Muller J, Ewert P, Hager A.

J Cardiol. 2017 Jul 4. pii: S0914-5087(17)30157-0. doi: 10.1016/j.jjcc.2017.05.005. [Epub ahead of print]

PMID:28687271

 

Take Home Points:

 

  • Thoracotomies at the time of cardiac surgery may lead to restrictive lung function and decreased exercise capacity.
  • For every thoracotomy, there is a reciprocal 1.8 –fold increase in the prevalence of restrictive lung function.
  • Multiple thoracotomies did not lead to a reduced exercise capacity; rather, it leads to restrictive lung function which leads to reduced exercise capacity.

 

Leong Ming ChernCommentary by Dr. M.C. Leong (Kuala Lumpur), section editor of ACHD Journal Watch: Thoracotomies, performed at the time of cardiac surgeries, may cause chest deformities and adversely altered chest wall compliances, accumulation of fibrotic tissue from surgical scars, weakened inspiratory muscles and diaphragmatic palsy. They contribute to restrictive lung function and decreased exercise capacity. This study aimed to study the relationship between the number of thoracotomies and lung function, exercise capacity and survival.

 

The authors retrospectively analyzed 1372 adolescents (624 females, 746 males; age : 32.4 ± 11.5 years) with congenital heart disease who were referred for cardiopulmonary testing and spirometry at their center from January 2010 to September 2015. 563 (41%) patients had restrictive ventilator pattern.July 2017 ACHD 2 In multivariate analysis, for every thoracotomy and the presence of cyanosis, the odds ratio for a restrictive ventilatory pattern was increased by 81.5% (OR: 1.815, CI: 1.606–2.050, p < 0.001) and 3.0-fold (OR: 3.021, CI: 1.812– 5.038, p < 0.001).

July 2017 ACHD 3
The complexity of the congenital heart disease, cyanosis and the need for beta-blocker, which causes chronotropic incompetence, and older age were associated with poorer exercise capacity while having a higher body mass index, female sex and a higher forced vital capacity were noted to be associated with better exercise capacity. Interestingly, the authors found that multiple thoracotomies did not directly cause limitation in exercise capacity, but they caused a restrictive ventilatory pattern which led to limited exercise capacity.

July 2017 ACHD 4

During a mean follow-up of 2.1 ± 1.6 years, 21 patients died. The number of thoracotomies, oxygen saturation at rest and forced vital capacity were not predictive of mortality. Probability of survival was increased by 6.3% (CI: 1.032–1.095; p < 0.001) for every percentage increase in peak oxygen uptake.

July 2017 ACHD 5

 

Impaired exercise tolerance and poor lung function have previously been linked to poorer survival. Exercise intolerance is, in turn, affected not only by cardiac haemodynamics but also by lung function. Many patients with congenital heart disease, have both chest deformities and history of thoracotomies. Future studies teasing out the relative effects of congenital chest wall deformity vs. surgically induced restrictive changes may be informative as to the exact aetiological mechanisms.

 

ACHD July 2017

 

  1. Infective endocarditis in adults with congenital heart disease remains a lethal disease.

Tutarel O, Alonso-Gonzalez R, Montanaro C, Schiff R, Uribarri A, Kempny A, Grübler MR, Uebing A, Swan L, Diller GP, Dimopoulos K, Gatzoulis MA.

Heart. 2017 Jul 28. pii: heartjnl-2017-311650. doi: 10.1136/heartjnl-2017-311650. [Epub ahead of print]

PMID: 28754810

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Select item 28754809

 

  1. Identification of adults with congenital heart disease of moderate or great complexity from administrative data.

Steiner JM, Kirkpatrick JN, Heckbert SR, Habib A, Sibley J, Lober W, Randall Curtis J.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12524. [Epub ahead of print]

PMID: 28736836

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Select item 28736822

 

  1. Organisation of care for pregnancy in patients with congenital heart disease.

Roos-Hesselink JW, Budts W, Walker F, De Backer JFA, Swan L, Stones W, Kranke P, Sliwa-Hahnle K, Johnson MR.

Heart. 2017 Jul 24. pii: heartjnl-2017-311758. doi: 10.1136/heartjnl-2017-311758. [Epub ahead of print] Review.

PMID: 28739807

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Select item 28728659

 

  1. Strengths, Limitations, and Geographical Discrepancies in the Eligibility Criteria for Sport Participation in Young Patients With Congenital Heart Disease.

Cantinotti M, Giordano R, Assanta N, Murzi B, Melo M, Franchi E, Crocetti M, Iervasi G, Kutty S.

Clin J Sport Med. 2017 Jul 21. doi: 10.1097/JSM.0000000000000474. [Epub ahead of print]

PMID: 28742603

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Select item 28730319

 

  1. Cardiac defects, morbidity and mortality in patients affected by RASopathies. CARNET study results.

Calcagni G, Limongelli G, D’Ambrosio A, Gesualdo F, Digilio MC, Baban A, Albanese SB, Versacci P, De Luca E, Ferrero GB, Baldassarre G, Agnoletti G, Banaudi E, Marek J, Kaski JP, Tuo G, Russo MG, Pacileo G, Milanesi O, Messina D, Marasini M, Cairello F, Formigari R, Brighenti M, Dallapiccola B, Tartaglia M, Marino B.

Int J Cardiol. 2017 Jul 21. pii: S0167-5273(17)31761-8. doi: 10.1016/j.ijcard.2017.07.068. [Epub ahead of print]

PMID: 28768581

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Select item 28733436

 

  1. Erratum for “Lesion-Specific Factors Contributing to In-hospital Costs in Adults With Congenital Heart Disease” Am J Cardiol 2016;117:1821-1825.
[No authors listed]

Am J Cardiol. 2017 Jul 15;120(2):339. doi: 10.1016/j.amjcard.2016.10.004. Epub 2016 Nov 28. No abstract available.

PMID: 27908445

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Select item 28178426

 

  1. Are adults with congenital heart disease informed about their risk for infective endocarditis and treated in accordance to current guidelines?

Bauer UMM, Helm PC, Diller GP, Asfour B, Schlensak C, Schmitt K, Ewert P, Tutarel O.

Int J Cardiol. 2017 Jul 15. pii: S0167-5273(17)31833-8. doi: 10.1016/j.ijcard.2017.07.040. [Epub ahead of print]

PMID: 28743483

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Select item 28560967

 

  1. Adult congenital heart disease in Greece: Preliminary data from the CHALLENGE registry.

Giannakoulas G, Vasiliadis K, Frogoudaki A, Ntellos C, Tzifa A, Brili S, Manginas A, Papaphylactou M, Parcharidou D, Kampouridis N, Pitsis A, Chamaidi A, Kolios M, Papadopoulos G, Douras A, Davlouros P, Ntiloudi D, Karvounis H, Kalangos A, Tsioufis C, Rammos S; CHALLENGE investigators.

Int J Cardiol. 2017 Jul 13. pii: S0167-5273(17)32552-4. doi: 10.1016/j.ijcard.2017.07.024. [Epub ahead of print]

PMID: 28743482

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Select item 28702718

 

  1. Comprehensive Multi-Dimensional MRI for the Simultaneous Assessment of Cardiopulmonary Anatomy and Physiology.

Cheng JY, Zhang T, Alley MT, Uecker M, Lustig M, Pauly JM, Vasanawala SS.

Sci Rep. 2017 Jul 13;7(1):5330. doi: 10.1038/s41598-017-04676-8.

PMID: 28706270 Free PMC Article

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Select item 28711428

 

  1. Employment after heart transplantation among adults with congenital heart disease.

Tumin D, Chou H, Hayes D Jr, Tobias JD, Galantowicz M, McConnell PI.

Congenit Heart Dis. 2017 Jul 12. doi: 10.1111/chd.12513. [Epub ahead of print]

PMID: 28703426

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Select item 28703367

 

  1. A case of Alagille syndrome presenting with chronic cholestasis in an adult.

Kim J, Yang B, Paik N, Choe YH, Paik YH.

Clin Mol Hepatol. 2017 Jul 7. doi: 10.3350/cmh.2016.0057. [Epub ahead of print]

PMID: 28683534 Free Article

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Select item 28688027

 

  1. Factors associated with aortic root dilatation after surgically repaired ventricular septal defect.

Saito C, Fukushima N, Fukushima K, Matsumura G, Ashihara K, Hagiwara N.

Echocardiography. 2017 Jul 6. doi: 10.1111/echo.13622. [Epub ahead of print]

PMID: 28681451

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Select item 28684436

 

  1. Heart Disease and Pregnancy.

Ashrafi R, Curtis SL.

Cardiol Ther. 2017 Jul 5. doi: 10.1007/s40119-017-0096-4. [Epub ahead of print] Review.

PMID: 28681178

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Select item 28675906

 

  1. Clinical implications of eicosapentaenoic acid/arachidonic acid ratio (EPA/AA) in adult patients with congenital heart disease.

Kanoh M, Inai K, Shinohara T, Tomimatsu H, Nakanishi T.

Heart Vessels. 2017 Jul 5. doi: 10.1007/s00380-017-1015-2. [Epub ahead of print]

PMID: 28681101

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Select item 28681132

 

  1. Number of thoracotomies predicts impairment in lung function and exercise capacity in patients with congenital heart disease.

Müller J, Ewert P, Hager A.

J Cardiol. 2017 Jul 4. pii: S0914-5087(17)30157-0. doi: 10.1016/j.jjcc.2017.05.005. [Epub ahead of print]

PMID: 28687271

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Select item 28614966

 

  1. Myocardial bridges: Overview of diagnosis and management.

Rogers IS, Tremmel JA, Schnittger I.

Congenit Heart Dis. 2017 Jul 3. doi: 10.1111/chd.12499. [Epub ahead of print]

PMID: 28675696

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Select item 28678047

 

  1. Imaging of the pulmonary valve in the adults.

Pignatelli RH, Noel C, Reddy SCB.

Curr Opin Cardiol. 2017 Jul 3. doi: 10.1097/HCO.0000000000000436. [Epub ahead of print]

PMID: 28678047

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Select item 28672079

 

  1. Evaluating the Performance of Ultrasound Screening for Congenital Heart Disease: A Descriptive Cohort Study.

Froehlich RJ, Maggio L, Has P, Werner EF, Rouse DJ.

Am J Perinatol. 2017 Jul;34(9):905-910. doi: 10.1055/s-0037-1601309. Epub 2017 Mar 16.

PMID: 28301892

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Select item 28264208

 

  1. Cardiopulmonary Exercise Testing in Adult Congenital Heart Disease.

Mantegazza V, Apostolo A, Hager A.

Ann Am Thorac Soc. 2017 Jul;14(Supplement_1):S93-S101. doi: 10.1513/AnnalsATS.201611-876FR.

PMID: 28375677

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Select item 28701619

 

  1. Cognitive dysfunction in adult CHD with different structural complexity.

Tyagi M, Fteropoulli T, Hurt CS, Hirani SP, Rixon L, Davies A, Picaut N, Kennedy F, Deanfield J, Cullen S, Newman SP.

Cardiol Young. 2017 Jul;27(5):851-859. doi: 10.1017/S1047951116001396. Epub 2016 Oct 18.

PMID: 27751192

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Select item 27680401

 

  1. Gerbode defect and multivalvular dysfunction: Complex complications in adult congenital heart disease.

Ruivo C, Guardado J, Montenegro Sá F, Saraiva F, Antunes A, Correia J, Morais J.

Echocardiography. 2017 Jul;34(7):1099-1101. doi: 10.1111/echo.13561. Epub 2017 May 18.

PMID: 28517030

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Select item 28434921

 

  1. Adolescents with congenital heart disease: their opinions about the preparation for transfer to adult care.

Burström Å, Bratt EL, Frenckner B, Nisell M, Hanséus K, Rydberg A, Öjmyr-Joelsson M.

Eur J Pediatr. 2017 Jul;176(7):881-889. doi: 10.1007/s00431-017-2917-9. Epub 2017 May 16.

PMID: 28508990 Free PMC Article

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  1. Complete isolation of right subclavian artery supplied by the thoracic aorta and bilateral patent ductus arteriosus.

Ghasemi A, Serati AR, Emami S, Movahed MR.

Future Cardiol. 2017 Jul;13(4):337-344. doi: 10.2217/fca-2016-0062. Epub 2017 Jun 16.

PMID: 28621552

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Select item 28525297

 

  1. Physical activity in adults with congenital heart disease and associations with functional outcomes.

Müller J, Amberger T, Berg A, Goeder D, Remmele J, Oberhoffer R, Ewert P, Hager A.

Heart. 2017 Jul;103(14):1117-1121. doi: 10.1136/heartjnl-2016-310828. Epub 2017 Mar 8.

PMID: 28274955

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Select item 28183791

 

  1. Arterial stiffness and arterial function in adult cyanotic patients with congenital heart disease.

Trojnarska O, Szczepaniak-Chicheł L, Gabriel M, Bartczak-Rutkowska A, Rupa-Matysek J, Tykarski A, Grajek S.

J Cardiol. 2017 Jul;70(1):62-67. doi: 10.1016/j.jjcc.2016.09.003. Epub 2016 Oct 15.

PMID: 27756510

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Select item 27428818

 

  1. Association Between Depressive Symptoms and Exercise Capacity in Patients With Heart Disease: A META-ANALYSIS.

Papasavvas T, Alhashemi M, Micklewright D.

J Cardiopulm Rehabil Prev. 2017 Jul;37(4):239-249. doi: 10.1097/HCR.0000000000000193.

PMID: 27428818

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Select item 28449285

 

  1. Research Review: Childhood chronic physical illness and adult emotional health – a systematic review and meta-analysis.

Secinti E, Thompson EJ, Richards M, Gaysina D.

J Child Psychol Psychiatry. 2017 Jul;58(7):753-769. doi: 10.1111/jcpp.12727. Epub 2017 Apr 27. Review.

PMID: 28449285

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Select item 28540525

 

  1. Survival in portopulmonary hypertension: Outcomes of the United Kingdom National Pulmonary Arterial Hypertension Registry.

Sithamparanathan S, Nair A, Thirugnanasothy L, Coghlan JG, Condliffe R, Dimopoulos K, Elliot CA, Fisher AJ, Gaine S, Gibbs JSR, Gatzoulis MA, E Handler C, Howard LS, Johnson M, Kiely DG, Lordan JL, Peacock AJ, Pepke-Zaba J, Schreiber BE, Sheares KKK, Wort SJ, Corris PA; National Pulmonary Hypertension Service Research Collaboration of the United Kingdom and Ireland.

J Heart Lung Transplant. 2017 Jul;36(7):770-779. doi: 10.1016/j.healun.2016.12.014. Epub 2016 Dec 31.

PMID: 28190786

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Select item 28140493

 

  1. Long-term survival after the Fontan operation: Twenty years of experience at a single center.

Downing TE, Allen KY, Glatz AC, Rogers LS, Ravishankar C, Rychik J, Faerber JA, Fuller S, Montenegro LM, Steven JM, Spray TL, Nicolson SC, Gaynor JW, Goldberg DJ.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):243-253.e2. doi: 10.1016/j.jtcvs.2017.01.056. Epub 2017 Mar 6.

PMID: 28341469

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Select item 28320512

 

  1. An Overview of Cardiac Computed Tomography in Adults With Congenital Heart Disease.

Suranyi P, Varga-Szemes A, Hlavacek AM.

J Thorac Imaging. 2017 Jul;32(4):258-273. doi: 10.1097/RTI.0000000000000281.

PMID: 28632654

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Select item 28632653

 

  1. Imaging Adults With Congenital Heart Disease Part II: Advanced CMR Techniques.

Sahu A, Slesnick TC.

J Thorac Imaging. 2017 Jul;32(4):245-257. doi: 10.1097/RTI.0000000000000274.

PMID: 28632653

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Select item 28632652

 

  1. Utility of Cardiac Magnetic Resonance Imaging in the Management of Adult Congenital Heart Disease.

Muscogiuri G, Secinaro A, Ciliberti P, Fuqua M, Nutting A.

J Thorac Imaging. 2017 Jul;32(4):233-244. doi: 10.1097/RTI.0000000000000280.

PMID: 28632652

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Select item 28632651

 

  1. Imaging in Adult Congenital Heart Disease.

Gaydos SS, Varga-Szemes A, Judd RN, Suranyi P, Gregg D.

J Thorac Imaging. 2017 Jul;32(4):205-216. doi: 10.1097/RTI.0000000000000282.

PMID: 28632651

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Select item 28632650

 

  1. Advanced Cardiac Imaging in Adults With Congenital Heart Disease: The Great Wave.

Hlavacek AM, Schoepf UJ.

J Thorac Imaging. 2017 Jul;32(4):203-204. doi: 10.1097/RTI.0000000000000283. No abstract available.

PMID: 28632650

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Select item 28549022

 

  1. Aneurysms of the azygos vein.

Kreibich M, Siepe M, Grohmann J, Pache G, Beyersdorf F.

J Vasc Surg Venous Lymphat Disord. 2017 Jul;5(4):576-586. doi: 10.1016/j.jvsv.2016.12.012. Epub 2017 Apr 5. Review.

PMID: 28624000

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Select item 28514670

 

  1. Three-dimensional echocardiography in adult congenital heart disease.

Yang HS.

Korean J Intern Med. 2017 Jul;32(4):577-588. doi: 10.3904/kjim.2016.251. Epub 2017 Jun 30. Review.

PMID: 28704916 Free PMC Article

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Select item 27808411

 

  1. Status and Challenges of Care in Africa for Adults With Congenital Heart Defects.

Edwin F, Zühlke L, Farouk H, Mocumbi AO, Entsua-Mensah K, Delsol-Gyan D, Bode-Thomas F, Brooks A, Cupido B, Tettey M, Aniteye E, Tamatey MM, Gyan KB, Tchoumi JCT, Elgamal MA.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):495-501. doi: 10.1177/2150135117706340.

PMID: 28696875

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Select item 28696873

 

  1. A Rare Case of Embolic ST-Elevation Myocardial Infarction in an Adult Patient With Repaired Hypoplastic Left Heart Syndrome.

Shamoon R, Habib H, Rampal U, Hamdan A, Bikkina M, Shamoon F.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):543-549. doi: 10.1177/2150135116651860. Epub 2016 Jun 13.

PMID: 27297083

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Select item 28697829

 

  1. Intermediate term thrombotic risk in contemporary total cavo-pulmonary connection for single ventricle circulations.

Faircloth JM, Roe O, Alsaied T, Palumbo JS, Vinks A, Veldtman GR.

J Thromb Thrombolysis. 2017 Jul 31. doi: 10.1007/s11239-017-1530-0. [Epub ahead of print]

PMID: 28761995

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Select item 28762167

 

  1. Elevated Myocardial Extracellular Volume Fraction in Duchenne Muscular Dystrophy.

Starc JJ, Moore RA, Rattan MS, Villa CR, Gao Z, Mazur W, Jefferies JL, Taylor MD.

Pediatr Cardiol. 2017 Jul 31. doi: 10.1007/s00246-017-1690-x. [Epub ahead of print]

PMID: 28762167

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Select item 28762166

 

  1. Management of Kawasaki disease in adults.

Denby KJ, Clark DE, Markham LW.

Heart. 2017 Jul 27. pii: heartjnl-2017-311774. doi: 10.1136/heartjnl-2017-311774. [Epub ahead of print] Review.

PMID: 28751537

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Select item 28750632

 

  1. Impact of bileaflet mitral valve prolapse on quantification of mitral regurgitation with cardiac magnetic resonance: a single-center study.

Vincenti G, Masci PG, Rutz T, De Blois J, Prša M, Jeanrenaud X, Schwitter J, Monney P.

J Cardiovasc Magn Reson. 2017 Jul 27;19(1):56. doi: 10.1186/s12968-017-0362-6.

PMID: 28750632 Free PMC Article

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Select item 28749010

 

  1. Exercise Performance and 22q11.2 Deletion Status Affect Quality of Life in Tetralogy of Fallot.

Goldmuntz E, Cassedy A, Mercer-Rosa L, Fogel MA, Paridon SM, Marino BS.

J Pediatr. 2017 Jul 19. pii: S0022-3476(17)30899-5. doi: 10.1016/j.jpeds.2017.06.049. [Epub ahead of print]

PMID: 28734657

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Select item 28724437

 

  1. Non-invasive Evaluation of Right Ventricular Function with Real-Time 3-D Echocardiography.

Chen R, Zhu M, Amacher K, Wu X, Sahn DJ, Ashraf M.

Ultrasound Med Biol. 2017 Jul 14. pii: S0301-5629(17)30202-8. doi: 10.1016/j.ultrasmedbio.2017.05.007. [Epub ahead of print]

PMID: 28716430

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Select item 28707371

 

  1. Cervical artery dissection expands the cardiovascular phenotype in FBN1-related Weill-Marchesani syndrome.

Newell K, Smith W, Ghoshhajra B, Isselbacher E, Lin A, Lindsay ME.

Am J Med Genet A. 2017 Jul 11. doi: 10.1002/ajmg.a.38353. [Epub ahead of print]

PMID: 28696036

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Select item 28696274

 

  1. Editorial commentary: Keeping the congenitally malformed heart in shape.

van den Berg G, Krasemann T, Postma AV.

Trends Cardiovasc Med. 2017 Jul 10. pii: S1050-1738(17)30106-8. doi: 10.1016/j.tcm.2017.06.019. [Epub ahead of print] No abstract available.

PMID: 28735782

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Select item 28691263

 

  1. Clinical implications of eicosapentaenoic acid/arachidonic acid ratio (EPA/AA) in adult patients with congenital heart disease.

Kanoh M, Inai K, Shinohara T, Tomimatsu H, Nakanishi T.

Heart Vessels. 2017 Jul 5. doi: 10.1007/s00380-017-1015-2. [Epub ahead of print]

PMID: 28681101

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Select item 28743382

 

  1. Characterization of micro-RNA Profile in the Blood of Patients with Marfan’s Syndrome.

Abu-Halima M, Ludwig N, Rädle-Hurst T, Keller A, Motsch L, Marsollek I, El Rahman MA, Abdul-Khaliq H, Meese E.

Thorac Cardiovasc Surg. 2017 Jul 5. doi: 10.1055/s-0037-1604083. [Epub ahead of print] No abstract available.

PMID: 28679133

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Select item 28676038

 

  1. Imaging of the pulmonary valve in the adults.

Pignatelli RH, Noel C, Reddy SCB.

Curr Opin Cardiol. 2017 Jul 3. doi: 10.1097/HCO.0000000000000436. [Epub ahead of print]

PMID: 28678047

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Select item 28672079

 

  1. Observations on obesity patterns in tetralogy of Fallot patients from childhood to adulthood.

Briston DA, Sabanayagam A, Zaidi AN.

Cardiol Young. 2017 Jul;27(5):890-894. doi: 10.1017/S1047951116001530. Epub 2016 Sep 22.

PMID: 27655153

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Select item 27640521

 

  1. An Overview of Cardiac Computed Tomography in Adults With Congenital Heart Disease.

Suranyi P, Varga-Szemes A, Hlavacek AM.

J Thorac Imaging. 2017 Jul;32(4):258-273. doi: 10.1097/RTI.0000000000000281.

PMID: 28632654

Similar articles

Select item 28632651

 

  1. Time in therapeutic range as a marker for thrombotic and bleeding outcomes in Fontan patients.

Faircloth JM, Miner KM, Alsaied T, Nelson N, Ciambarella J, Mizuno T, Palumbo JS, Vinks AA, Veldtman GR.

J Thromb Thrombolysis. 2017 Jul;44(1):38-47. doi: 10.1007/s11239-017-1499-8.

PMID: 28429248

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Select item 28624000

 

  1. Challenges of Cardiac Transplantation Following the Fontan Procedure.

Kirklin JK, Pearce FB, Dabal RJ, Carlo WF Jr, Mauchley DC.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):480-486. doi: 10.1177/2150135117714460. No abstract available.

PMID: 28696868

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Pediatric Cardiology Featured Articles of July 2017

Pediatric Cardiology Reviews of July/August 2017 Manuscripts

 

Neurodevelopmental Profiles of Children with Congenital Heart Disease at School Age.

Naef N, Liamlahi R, Beck I, Bernet V, Dave H, Knirsch W, Latal B.

J Pediatr. 2017 Jul 11. pii: S0022-3476(17)30769-2. doi: 10.1016/j.jpeds.2017.05.073. [Epub ahead of print]

PMID: 28709631

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Select item 28695245

 

Take Home Points:

  • This study from Switzerland found that children with congenital heart disease (CHD) in the absence of a genetic syndrome scored mostly within the normal range on neurodevelopmental testing.
  • However, children with CHD in the absence of a genetic syndrome still scored statistically lower than the published norms in median IQ, verbal comprehension, perceptual reasoning, general language scales and motor development.
  • There was no difference in neurodevelopmental scores between children with univentricular compared to biventricular CHD.
  • The strongest independent predictor of cognitive outcomes was found to be social economic status in this study.

 

Abarbanell picture smallCommentary from Dr. Ginnie Abarbanell (St. Louis), section editor of Pediatric Cardiology Journal Watch:  This study from Switzerland evaluated a cohort of children with congenital heart disease (CHD) in regards to neurodevelopmental outcomes.  233 children with history of cardiac surgery with cardiopulmonary bypass were included in the study and underwent neurodevelopmental testing at 6 years of age.  Researchers found that cognitive and motor performance in children with CHD was significantly lower than published norms.  As expected, children with CHD and a genetic syndrome performed worse than those without a genetic syndrome.  Children with CHD in the absence of a genetic syndrome performed well with most of the median scores on the Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III) falling within the normal range.  However overall as a group, children with CHD without a genetic syndrome scored statistically lower than published norms in median IQ, verbal comprehension, perceptual reasoning and general language scales.  See Table II.  The Zurich Neuromotor Assessment (ZNA) was used to evaluate motor performance.  Children with CHD without a genetic syndrome also scored significantly lower than the published norms in all the motor domains tested.  Using multiple linear regression, the strongest independent predictor of cognitive outcomes in children with CHD without a genetic syndrome in this study was social economic status (based on maternal education and paternal occupation).  ICU hospital length of stay and the presence of postoperative seizures were independent predictors of worse motor outcomes.  Among the children with CHD and no genetic disorder there was no difference in IQ or motor performance on the ZNA between children with univentricular compared to biventricular CHD.  These results are similar to previously published studies in regards to neurodevelopmental outcomes.  Interestingly, within the group of children without a genetic disorder the strongest independent predictor of cognitive outcomes was social economic status which may suggest that programs aimed at assisting families and helping to provide neurodevelopmental support may improve the neurodevelopmental outcomes of children with CHD.

July 2017 peds 1

 

Ischemic heart disease in children and young adults with congenital heart disease in Sweden.

Fedchenko M, Mandalenakis Z, Rosengren A, Lappas G, Eriksson P, Skoglund K, Dellborg M.

Int J Cardiol. 2017 Jul 1. pii: S0167-5273(17)32268-4. doi: 10.1016/j.ijcard.2017.06.120. [Epub ahead of print]

PMID: 28705603

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Select item 28668979

 

Take Home Points:

  • This large population study found that adults with a congenital heart disease are at increased risk for ischemic heart disease.
  • Patients with CHD had a 16.5 times higher risk of being hospitalized or dying from ischemic heart disease compared to controls.

 

Commentary from Dr. Ginnie Abarbanell (St. Louis), section editor of Pediatric Cardiology Journal Watch:  This population based study from Sweden would suggest that adults with a history of congenital heart disease are at increased risk for ischemic heart disease.  Researchers used the Swedish National Patient Registry to identify a cohort of 21,982 patients born with congenital heart disease (CHD) between 1970 to 1993.  Controls were matched 10 to 1 by age, sex and county from the general population. Mean follow up was 26.4 years.  Researchers found that patients with CHD had a 16.5 times higher risk of being hospitalized or dying from ischemic heart disease compared to controls. This risk of ischemic heart disease was highest in patients with conotruncal defects, endocardial cushion defects, common ventricle and hypoplastic left heart syndrome. The risk of ischemic heart disease was lowest in those patients with history of a ventricular septal defect or an atrial septal defect.  The overall incidence of ischemic heart disease in both the CHD group and the control group was low (46.8 vs 2.9 cases of ischemic heart disease per 100,000 person-years).  Interestingly, comorbidities such as hypertension and diabetes mellitus were more common in the control group as where the patients with CHD were more likely to have documented heart failure.  Researchers discussed that the etiology of ischemic heart disease among patients with CHD is most likely multifactorial possibly relating to history of previous cardiac surgeries, presence of volume/ pressure overload, increased radiation to the thorax from radiological studies and sedentary lifestyle.  As the authors conclude, these results would suggest that adult patients with history of congenital heart disease may want to be more closely monitored for ischemic heart disease and the threshold for treatment of conventional risk factors may need to be lowered.

July 2017 peds 2

July 2017 peds 3 July 2017 peds 4

 

Effect of congenital heart disease on 4-year neurodevelopment within multiple-gestation births.

Schultz AH, Ittenbach RF, Gerdes M, Jarvik GP, Wernovsky G, Bernbaum J, Solot C, Clancy RR, Nicolson SC, Spray TL, McDonald-McGinn D, Zackai E, Gaynor JW.

 

J Thorac Cardiovasc Surg. 2017 Jul;154(1):273-281.e2. doi: 10.1016/j.jtcvs.2017.02.022. Epub 2017 Feb 21.

PMID: 28320512

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Select item 28292589

 

Take Home Points:

  • This is the 4 year follow up evaluation of neurodevelopmental outcomes in children with congenital heart disease (CHD) compared to their unaffected twin or triplet siblings.
  • At 4 years of age, children with congenital heart disease perform worse than their siblings in cognition and fine motor skills.
  • These findings suggest that other confounding variables besides gestational age, maternal conditions during pregnancy, home environment, social economic status and parental intelligence are contributing to the neurodevelopment of children with CHD.

 

Commentary from Dr. Ginnie Abarbanell (St. Louis), section editor of Pediatric Cardiology Journal Watch:  This is a follow up study to evaluate the neurodevelopmental outcomes of a small cohort of children with congenital heart disease (CHD) compared to their unaffected twin or triplet siblings.  This study design allowed the researchers to uniquely control for differences in gestational age, maternal conditions during pregnancy, home environment, social economic status, and parental intelligence.   This cohort of children initially underwent neurodevelopmental testing at 1 year of age1.  At 1 year of age the children with CHD were shown to have lower scores on the Bayley Scales of Infant Development than their twin or triplet siblings.  This study reports the neurodevelopmental outcomes on this cohort (12 twin sets and 2 triplet sets) at 4 years of age.  At 4 years of age, the children with congenital heart disease continued to have lower scores on neurodevelopmental testing.  In particular, children with CHD had lower scores than their siblings in cognition and fine motor skills.  See figure.  Additionally, the children with CHD were significantly smaller (median weight for age z-score) than their twin/triplet siblings.  There appeared to be the greatest discrepancies between siblings on neurodevelopmental scores in those twins/triplets born at lower gestational ages.  See figures.  This follow up study demonstrates that there continues to be worse neurodevelopmental outcomes in children with CHD compared to their twin/triplet siblings.  These findings suggest that other confounding variables besides gestational age, maternal conditions during pregnancy, home environment, social economic status, and parental intelligence are contributing to the neurodevelopment of children with CHD.

 

  1. Schultz AH, Jarvik GP, Wernovsky G, Bernbaum J, Clancy RR, D’Agostino JA, et al. Effect of congenital heart disease on neurodevelopmental outcomes within multiple-gestation births. J Thorac Cardiovasc Surg. 2005 Dec;130(6):1511–6.

July 2017 peds 5 July 2017 peds 6 July 2017 peds 7

 

The Effect of the Superior Cavopulmonary Anastomosis on Ventricular Remodeling in Infants with Single Ventricle.

Margossian R, Zak V, Shillingford AJ, Hlavacek AM, Cnota JF, Puchalski MD, Levine JC, McCrindle BW, Cohen MS, Altmann K, Barker PC, Hsu DT, Colan SD; Pediatric Heart Network Investigators.

J Am Soc Echocardiogr. 2017 Jul;30(7):699-707.e1. doi: 10.1016/j.echo.2017.03.005. Epub 2017 May 10.

PMID: 28501374

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Select item 27756510

 

Take Home Points:

  • Decreases in ventricular size and mass occur following SCPA with greater effect in those with a single left ventricle
  • Volume unloading may not be enough to prevent progressive right ventricular dysfunction
  • There was no significant effect of enalapril on z-score changes

Hershenson, JaredCommentary from Dr. Jared Hershenson (Greater Washington DC), section editor of Pediatric Cardiology Journal Watch: One of the aims of surgical management in those with single ventricular (SV) physiology is to mitigate the impact of chronic volume overload that can lead to progressive ventricular dilation and ultimately to decreased systolic function. This study was a part of the Infant Single Ventricle trial. Infants with SV physiology were enrolled between 7 and 45 days and followed them for 14 months. Ventricular morphology was characterized as LV dominant or RV dominant, and those with indeterminate morphology were excluded in this astomosis, 28 had a bilateral cavopulmonary anastomosis and 26 had a hemi-Fontanalysis. Detailed echocardiograms were obtained at 2 time points: prior to superior cavopulmonary anastomosis (SCPA) and at 14 months of life. Echo images were obtained from the apical and parasternal short-axis planes. The endocardial border was traced at end-diastole and end-systole and the epicardial border was traced in end-diastole in both planes. End diastolic and end systolic volumes and mass were calculated by a modified Simpson biplane method. EF and mass were calculated via standard formulas. AV valve inflow Doppler and tissue Doppler values were also obtained. 134 patients had a bidirectional cavopulmonary anan. Of those, 156 patients who had complete images at both time-points were compared.  Mean z-scores for EDV, ESV, mass and mass/volume were all > 2 at the pre-SCPA visit, and although ESV and mass remained above 2, all z-scores did decrease significantly at the 14 month visit (table 1) with mean EDV falling below 2. Mass/volume score decrease did not reach significance. No significant difference was found in those on enalapril vs. those not. Greater absolute and relative declines in z-scores were present in single LVs as compared to single RVs (table 2). The median age of SCPA surgery was 5.3 months. When comparing < 5 months, 5-7 months and > 7 months, there was a smaller decrease in z-score at > 7 months until 14 months, but this may have been due to shorter duration of remodeling response. The modified Simpson’s technique has been shown in previous studies to correlate with MRI measurements; however, future MRI data and 3D echo data may better for future comparisons given the known difficulties in measuring single ventricular (especially RV) size and function. Additionally, further studies on strain may shed more light on the changes in structure in function due to known changes and differences in fiber orientation and torsion between single RV and single LVs.

July 2017 peds 8 July 2017 peds 9

 

Health Insurance Coverage among Young Adult Survivors of Pediatric Heart Transplantation.

Tumin D, Li SS, Nandi D, Gajarski RJ, McKee C, Tobias JD, Hayes D Jr.

J Pediatr. 2017 Jul 6. pii: S0022-3476(17)30797-7. doi: 10.1016/j.jpeds.2017.06.014. [Epub ahead of print]

PMID: 28690004

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Select item 28683505

 

Take home points:

  • Change in insurance status (loss of insurance) was a risk for graft failure and mortality in adolescent heart transplant patients followed into adulthood
  • Efforts are needed to protect health care coverage and continuity of treatment in the turbulent transition from adolescence to adulthood

Hershenson, JaredCommentary from Dr. Jared Hershenson (Greater Washington DC), section editor of Pediatric Cardiology Journal Watch: As insurance issues and health care reform are becoming a larger part of the political environment in the US, this interesting study looked at pediatric heart transplant patients and how their insurance status changed over time and whether this impacted outcomes.  Data on insurance coverage was available for 5 years post-transplant, and Medicaid cut-off for children’s coverage availability ends at age 19, so patients aged 15-18 at the time of transplant (all patients at least 20 at the 5-year anniversary) were included in this study. Exclusions included graft loss, death, or loss to follow up before the 5th year. Post-transplant insurance status was compared with insurance status at the time of transplant. Categories included continuous private insurance, continuous public insurance, or change between private and public insurance. Secondary outcomes included patient and graft survival. 366 patients were included in the cohort. 56% had private insurance at transplant and at 5 year follow up, 26% had public insurance at transplant and 5 year follow up, and 18% experienced a change in insurance status (table 1). There were 95 deaths over a median 9 +/- 3 year follow up duration. Univariate regression revealed an increased mortality risk in those with a change in insurance status (HR 2.2) and continuous public coverage (HR 1.6), but multivariate analysis revealed that only change in insurance status increased risk for mortality (HR 1.9) [see figure 1 and table 2]. Analysis of graft failure according to insurance status were nearly identical to mortality. Change in insurance status during the transition from childhood to adulthood is particular relevant for those with illnesses that require extensive monitoring and costly medications. Changes in insurance status influenced mortality and graft failure in this cohort of heart transplant recipients. The authors noted that most of the patients studied reached adulthood at around the time the Affordable Care Act was enacted, which could have supported the continuation of private insurance. Additionally, Medicaid expansion a few years later may have afforded coverage for those who could not obtain private insurance but would not be reflected in this study. Other limitations mentioned included UNOS registry’s discontinuation of insurance coverage data 5 years post-transplant and an inability to determine which patients had a transfer of care from a pediatric to adult center and if this would impact survival. These results, while limited, do suggest that loss of health care coverage impact graft survival and mortality. Continued efforts are needed to protect insurance status and continuity of care and treatment during the turbulent transition from childhood/adolescence to adulthood.

July 2017 peds 10

July 2017 peds 11

July 2017 peds 12

 

 

Evaluating Appropriate Use of Pediatric Echocardiograms for Chest Pain in Outpatient Clinics.

Chamberlain RC, Pelletier JH, Blanchard S, Hornik CP, Hill KD, Campbell MJ.

J Am Soc Echocardiogr. 2017 Jul;30(7):708-713. doi: 10.1016/j.echo.2017.03.008. Epub 2017 May 10.

PMID: 28501373

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Select item 28758063

 

Take Home Points:

  • Echocardiogram use for chest pain meeting the “rarely appropriate” indication of the ACC’s AUC criteria has very little diagnostic utility
  • These “rarely appropriate” echocardiograms lead to significantly increased cost to patients and the health care system

Commentary from Dr. Jared Hershenson (Greater Washington DC), section editor of Pediatric Cardiology Journal Watch: The American College of Cardiology published appropriate use criteria (AUC) in 2014 guiding the performance of echocardiograms for various common outpatient pediatric cardiology issues. This was a study of 539 patients who presented with chest pain in a single clinic over one year with retrospective application of the AUC. Indications for echo were classified as appropriate, maybe appropriate and rarely appropriate as per the AUC guidelines. Table 1 shows the demographics and breakdown by AUC. 380 patients had echocardiograms performed and 19 (5%) were abnormal (see figure 1). 17/19 were classified in the appropriate category, mostly due to a complaint of exertional chest pain. 2/19 were maybe appropriate. Only 1 patient, however, had an abnormal finding that was considered to be possibly contributory to the chest pain (anomalous right coronary from the left). None of the 60 echocardiograms performed for the rarely appropriate group were abnormal (see table 2). Excess cost associated with “non-diagnostic” echocardiograms in the rarely appropriate group, including follow up visits and additional imaging was calculated as $47,578 over the one year study, with the majority of cost coming from the echocardiograms. Physicians with > 20 years of practice were associated with decreased ordering frequency of rarely appropriate echocardiograms. The authors note that the AUC criteria were published during part of their cohort and likely had not fully been put into practice. They also mention that ~ 12% of appropriate and 23.5% with maybe appropriate indications did not have echocardiograms. Overall, this confirms the suspected low diagnostic yield of echocardiograms in the rarely appropriate category and can lead to reduced health care costs.

July 2017 peds 13 July 2017 Peds 14

 

Pediatric cardiology July 2017

 

  1. Accuracy and Specific Value of Cardiovascular 3D-Models in Pediatric CT-Angiography.

Hammon M, Rompel O, Seuss H, Dittrich S, Uder M, Rüffer A, Cesnjevar R, Ehret N, Glöckler M.

Pediatr Cardiol. 2017 Jul 31. doi: 10.1007/s00246-017-1693-7. [Epub ahead of print]

PMID: 28762166

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Select item 28764856

 

  1. Image quality of CT angiography in young children with congenital heart disease: a comparison between the sinogram-affirmed iterative reconstruction (SAFIRE) and advanced modelled iterative reconstruction (ADMIRE) algorithms.

Nam SB, Jeong DW, Choo KS, Nam KJ, Hwang JY, Lee JW, Kim JY, Lim SJ.

Clin Radiol. 2017 Jul 29. pii: S0009-9260(17)30364-1. doi: 10.1016/j.crad.2017.07.006. [Epub ahead of print]

PMID: 28764856

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Select item 28760477

 

  1. Ventricular function and vascular dimensions after Norwood and hybrid palliation of hypoplastic left heart syndrome.

Latus H, Nassar MS, Wong J, Hachmann P, Bellsham-Revell H, Hussain T, Apitz C, Salih C, Austin C, Anderson D, Yerebakan C, Akintuerk H, Bauer J, Razavi R, Schranz D, Greil G.

Heart. 2017 Jul 28. pii: heartjnl-2017-311532. doi: 10.1136/heartjnl-2017-311532. [Epub ahead of print]

PMID: 28754809

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Select item 28753691

 

  1. Experimental Study of Anisotropic Stress/Strain Relationships of Aortic and Pulmonary Artery Homografts and Synthetic Vascular Grafts.

Jia Y, Qiao Y, Argueta-Morales IR, Maung A, Norfleet J, Bai Y, Divo E, Kassab AJ, DeCampli W.

J Biomech Eng. 2017 Jul 28. doi: 10.1115/1.4037400. [Epub ahead of print]

PMID: 28753691

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Select item 28753627

 

  1. Coronary anatomy in children with bicuspid aortic valves and associated congenital heart disease.

Koenraadt WMC, Bartelings MM, Bökenkamp R, Gittenberger-de Groot AC, DeRuiter MC, Schalij MJ, Jongbloed MR.

Heart. 2017 Jul 27. pii: heartjnl-2017-311178. doi: 10.1136/heartjnl-2017-311178. [Epub ahead of print]

PMID: 28751538

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Select item 28749481

 

  1. Evaluation of critical congenital heart defects screening using pulse oximetry in the neonatal intensive care unit.

Van Naarden Braun K, Grazel R, Koppel R, Lakshminrusimha S, Lohr J, Kumar P, Govindaswami B, Giuliano M, Cohen M, Spillane N, Jegatheesan P, McClure D, Hassinger D, Fofah O, Chandra S, Allen D, Axelrod R, Blau J, Hudome S, Assing E, Garg LF.

J Perinatol. 2017 Jul 27. doi: 10.1038/jp.2017.105. [Epub ahead of print]

PMID: 28749481

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Select item 28746973

 

  1. Building a comprehensive team for the longitudinal care of single ventricle heart defects: Building blocks and initial results.

Texter K, Davis JAM, Phelps C, Cheatham S, Cheatham J, Galantowicz M, Feltes TF.

Congenit Heart Dis. 2017 Jul 26. doi: 10.1111/chd.12459. [Epub ahead of print]

PMID: 28744980

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Select item 28747048

 

  1. Development of quality metrics for ambulatory pediatric cardiology: Infection prevention.

Johnson JN, Barrett CS, Franklin WH, Graham EM, Halnon NJ, Hattendorf BA, Krawczeski CD, McGovern JJ, O’Connor MJ, Schultz AH, Vinocur JM, Chowdhury D, Anderson JB.

Congenit Heart Dis. 2017 Jul 25. doi: 10.1111/chd.12519. [Epub ahead of print]

PMID: 28741863

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Select item 28693354

 

  1. Perinatal outcomes of congenital heart disease after emergent neonatal cardiac procedures.

Wolter A, Holtmann H, Kawecki A, Degenhardt J, Enzensberger C, Graupner O, Akintürk H, Yerebakan C, Khalil M, Schranz D, Axt-Fliedner R.

J Matern Fetal Neonatal Med. 2017 Jul 25:1-8. doi: 10.1080/14767058.2017.1353970. [Epub ahead of print]

PMID: 28693354

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Select item 28746169

 

  1. Traditional Long-Term Central Venous Catheters Versus Transhepatic Venous Catheters in Infants and Young Children.

Marshall AM, Danford DA, Curzon CL, Anderson V, Delaney JW.

Pediatr Crit Care Med. 2017 Jul 25. doi: 10.1097/PCC.0000000000001276. [Epub ahead of print]

PMID: 28746169

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Select item 28738792

 

  1. Sildenafil in Infants and Children.

Simonca L, Tulloh R.

Children (Basel). 2017 Jul 24;4(7). pii: E60. doi: 10.3390/children4070060. Review.

PMID: 28737730 Free Article

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Select item 28737022

 

  1. Anatomic types of anomalous aortic origin of a coronary artery: A pictorial summary.

Agrawal H, Mery CM, Krishnamurthy R, Molossi S.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12518. [Epub ahead of print]

PMID: 28737022

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Select item 28736987

 

  1. Cardiac stress MRI evaluation of anomalous aortic origin of a coronary artery.

Noel C.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12501. [Epub ahead of print]

PMID: 28736987

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Select item 28736983

 

  1. Forgotten knowledge of the coronary-cameral connections and the rediscovery of their dynamic nature in development: The result of a misnomer, ambiguous use of nomenclature, and varied evaluation methods.

Snodgrass B, Chilakala A.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12522. [Epub ahead of print] No abstract available.

PMID: 28736983

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Select item 28736841

 

  1. Exercise capacity is not decreased in children who have undergone lung resection early in life for congenital thoracic malformations compared to healthy age-matched children.

Dunn A, Pearce K, Callister R, Collison A, Morten M, Mandaliya P, Platt L, Dascombe B, Kumar R, Selvadurai H, Robinson PD, Mattes J.

Pediatr Pulmonol. 2017 Jul 24. doi: 10.1002/ppul.23772. [Epub ahead of print]

PMID: 28737279

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Select item 28742724

 

  1. Epidemiology of Noninvasive Ventilation in Pediatric Cardiac ICUs.

Romans RA, Schwartz SM, Costello JM, Chanani NK, Prodhan P, Gazit AZ, Smith AH, Cooper DS, Alten J, Mistry KP, Zhang W, Donohue JE, Gaies M.

Pediatr Crit Care Med. 2017 Jul 22. doi: 10.1097/PCC.0000000000001282. [Epub ahead of print]

PMID: 28742724

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Select item 28733782

 

  1. Strengths, Limitations, and Geographical Discrepancies in the Eligibility Criteria for Sport Participation in Young Patients With Congenital Heart Disease.

Cantinotti M, Giordano R, Assanta N, Murzi B, Melo M, Franchi E, Crocetti M, Iervasi G, Kutty S.

Clin J Sport Med. 2017 Jul 21. doi: 10.1097/JSM.0000000000000474. [Epub ahead of print]

PMID: 28742603

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Select item 28730319

  1. Survival, by Birth Weight and Gestational Age, in Individuals With Congenital Heart Disease: A Population-Based Study.

Best KE, Tennant PWG, Rankin J.

J Am Heart Assoc. 2017 Jul 21;6(7). pii: e005213. doi: 10.1161/JAHA.116.005213.

PMID: 28733436 Free Article

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Select item 28731912

 

  1. Assessing infant and maternal readiness for newborn discharge.

Jing L, Bethancourt CN, McDonagh T.

Curr Opin Pediatr. 2017 Jul 20. doi: 10.1097/MOP.0000000000000526. [Epub ahead of print]

PMID: 28731912

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Select item 28169218

 

  1. Exercise Performance and 22q11.2 Deletion Status Affect Quality of Life in Tetralogy of Fallot.

Goldmuntz E, Cassedy A, Mercer-Rosa L, Fogel MA, Paridon SM, Marino BS.

J Pediatr. 2017 Jul 19. pii: S0022-3476(17)30899-5. doi: 10.1016/j.jpeds.2017.06.049. [Epub ahead of print]

PMID: 28734657

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Select item 28746916

 

  1. Genetic Testing Protocol Reduces Costs and Increases Rate of Genetic Diagnosis in Infants with Congenital Heart Disease.

Geddes GC, Basel D, Frommelt P, Kinney A, Earing M.

Pediatr Cardiol. 2017 Jul 19. doi: 10.1007/s00246-017-1685-7. [Epub ahead of print]

PMID: 28725922

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Select item 28719142

 

  1. Changing prevalence of severe congenital heart disease: Results from the National Register for Congenital Heart Defects in Germany.

Pfitzer C, Helm PC, Ferentzi H, Rosenthal LM, Bauer UMM, Berger F, Schmitt KRL.

Congenit Heart Dis. 2017 Jul 18. doi: 10.1111/chd.12515. [Epub ahead of print]

PMID: 28719142

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Select item 28719069

 

  1. Altered Carnitine Homeostasis in Children With Increased Pulmonary Blood Flow Due to Ventricular Septal Defects.

Black SM, Field-Ridley A, Sharma S, Kumar S, Keller RL, Kameny R, Maltepe E, Datar SA, Fineman JR.

Pediatr Crit Care Med. 2017 Jul 18. doi: 10.1097/PCC.0000000000001275. [Epub ahead of print]

PMID: 28723882

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Select item 28720027

 

  1. Physical Activity in Pediatric Pulmonary Arterial Hypertension Measured by Accelerometry. A Candidate Clinical Endpoint.

Zijlstra WMH, Ploegstra MJ, Vissia-Kazemier T, Roofthooft MTR, Sarvaas GDM, Bartelds B, Rackowitz A, van den Heuvel F, Hillege HL, Plasqui G, Berger RMF.

Am J Respir Crit Care Med. 2017 Jul 15;196(2):220-227. doi: 10.1164/rccm.201608-1576OC.

PMID: 28178426

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Select item 28743483

 

  1. Transfer of Neonates with Critical Congenital Heart Disease Within a Regionalized Network.

Swartz MF, Cholette JM, Orie JM, Jacobs ML, Jacobs JP, Alfieris GM.

Pediatr Cardiol. 2017 Jul 15. doi: 10.1007/s00246-017-1668-8. [Epub ahead of print]

PMID: 28711963

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Select item 28707350

 

  1. Genetic contribution to neurodevelopmental outcomes in congenital heart disease: are some patients predetermined to have developmental delay?

Rollins CK, Newburger JW, Roberts AE.

Curr Opin Pediatr. 2017 Jul 14. doi: 10.1097/MOP.0000000000000530. [Epub ahead of print]

PMID: 28719389

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Select item 28716702

 

  1. Single-Center Experience Using Selexipag in a Pediatric Population.

Gallotti R, Drogalis-Kim DE, Satou G, Alejos J.

Pediatr Cardiol. 2017 Jul 13. doi: 10.1007/s00246-017-1677-7. [Epub ahead of print]

PMID: 28702718

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Select item 28706270

 

  1. [Congenital heart disease mortality in Spain during a 10 year period (2003-2012)].

Pérez-Lescure Picarzo J, Mosquera González M, Latasa Zamalloa P, Crespo Marcos D.

An Pediatr (Barc). 2017 Jul 12. pii: S1695-4033(17)30221-7. doi: 10.1016/j.anpedi.2017.06.002. [Epub ahead of print] Spanish.

PMID: 28711428 Free Article

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Select item 28709760

 

  1. Clinical and pathologic implications of extending the spectrum of maternal autoantibodies reactive with ribonucleoproteins associated with cutaneous and now cardiac neonatal lupus from SSA/Ro and SSB/La to U1RNP.

Izmirly PM, Halushka MK, Rosenberg AZ, Whelton S, Rais-Bahrami K, Nath DS, Parton H, Clancy RM, Rasmussen S, Saxena A, Buyon JP.

Autoimmun Rev. 2017 Jul 12. pii: S1568-9972(17)30184-2. doi: 10.1016/j.autrev.2017.07.013. [Epub ahead of print] Review.

PMID: 28709760

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Select item 28699323

 

  1. Initial Validation of A Healthcare Needs Scale for Youth With Congenital Heart Disease.

Chen CW, Ho CL, Su WJ, Wang JK, Chung HT, Lee PC, Lu CW, Hwang BT.

J Adv Nurs. 2017 Jul 12. doi: 10.1111/jan.13390. [Epub ahead of print]

PMID: 28702947

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Select item 28702717

 

  1. Mindfulness-Based Stress Reduction and Group Support Decrease Stress in Adolescents with Cardiac Diagnoses: A Randomized Two-Group Study.

Freedenberg VA, Hinds PS, Friedmann E.

Pediatr Cardiol. 2017 Jul 12. doi: 10.1007/s00246-017-1679-5. [Epub ahead of print]

PMID: 28702717

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Select item 28702716

 

  1. Neurodevelopmental Profiles of Children with Congenital Heart Disease at School Age.

Naef N, Liamlahi R, Beck I, Bernet V, Dave H, Knirsch W, Latal B.

J Pediatr. 2017 Jul 11. pii: S0022-3476(17)30769-2. doi: 10.1016/j.jpeds.2017.05.073. [Epub ahead of print]

PMID: 28709631

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Select item 28695245

 

  1. A multinational and multidisciplinary approach to treat CHD in paediatric age in Angola: initial experience of a medical-surgical centre for children with heart disease in Angola.

Nunes MAS, Magalhães MP, Uva MS, Heitor P, Henriques A, Manuel V, Miguel G, Júnior AF.

Cardiol Young. 2017 Jul 10:1-9. doi: 10.1017/S1047951117001202. [Epub ahead of print]

PMID: 28689504

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Select item 28716477

 

  1. 2017 AHA/ACC Key Data Elements and Definitions for Ambulatory Electronic Health Records in Pediatric and Congenital Cardiology: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards.

Writing Committee Members, Boris JR, Béland MJ, Bergensen LJ, Colan SD, Dangel J, Daniels CJ, Davis C, Everett AD, Franklin R, Gaynor JW, Gray DT, Hirsch-Romano JC, Jacobs JP, Jacobs M, Jeffries H, Krogmann ON, Lomotan EA, Lopez L, Marelli A, Martin GR, Matherne GP, Mavroudis C, McCardle K, Pearson GD, Rosenthal G, Scott JS, Serwer GA, Seslar SS, Shaddy R, Slesnick T, Vener DF, Walters HL 3rd, Weinberg PM.

J Am Coll Cardiol. 2017 Jul 10. pii: S0735-1097(17)37850-6. doi: 10.1016/j.jacc.2017.06.027. [Epub ahead of print] No abstract available.

PMID: 28716477

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Select item 28693530

 

  1. Analysis of circulating microRNAs in patients with repaired Tetralogy of Fallot with and without heart failure.

Abu-Halima M, Meese E, Keller A, Abdul-Khaliq H, Rädle-Hurst T.

J Transl Med. 2017 Jul 10;15(1):156. doi: 10.1186/s12967-017-1255-z.

PMID: 28693530 Free PMC Article

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Select item 28624383

 

  1. Abnormal right atrial performance in repaired tetralogy of Fallot: A CMR feature tracking analysis.

Kutty S, Shang Q, Joseph N, Kowallick JT, Schuster A, Steinmetz M, Danford DA, Beerbaum P, Sarikouch S.

Int J Cardiol. 2017 Jul 8. pii: S0167-5273(17)30593-4. doi: 10.1016/j.ijcard.2017.06.121. [Epub ahead of print]

PMID: 28712562

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Select item 28182287

 

  1. Transthoracic echocardiography study of congenitally corrected transposition of the great arteries.

Singh A, Singh G, Dhaliwal TS, Singh M.

J Clin Ultrasound. 2017 Jul 8;45(6):375-379. doi: 10.1002/jcu.22450. Epub 2017 Feb 9.

PMID: 28182287

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Select item 28698113

 

  1. Image Quality of Coronary Arteries on Non-electrocardiography-gated High-Pitch Dual-Source Computed Tomography in Children with Congenital Heart Disease.

Kanie Y, Sato S, Tada A, Kanazawa S.

Pediatr Cardiol. 2017 Jul 8. doi: 10.1007/s00246-017-1675-9. [Epub ahead of print]

PMID: 28689328

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Select item 28689327

 

  1. Chromosome 21-Encoded microRNAs (mRNAs): Impact on Down’s Syndrome and Trisomy-21 Linked Disease.

Alexandrov PN, Percy ME, Lukiw WJ.

Cell Mol Neurobiol. 2017 Jul 7. doi: 10.1007/s10571-017-0514-0. [Epub ahead of print]

PMID: 28687876

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Select item 28687711

 

  1. A case of complete double aortic arch visualized by transthoracic echocardiography.

Saito N, Kato S, Saito N, Nakachi T, Fukui K, Iwasawa T, Kosuge M, Kimura K.

Echocardiography. 2017 Jul 6. doi: 10.1111/echo.13568. [Epub ahead of print]

PMID: 28681466

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Select item 28681451

 

  1. Hemodynamic Evaluation of Children with Persistent or Recurrent Pulmonary Arterial Hypertension Following Complete Repair of Congenital Heart Disease.

Latus H, Wagner I, Ostermayer S, Kerst G, Kreuder J, Schranz D, Apitz C.

Pediatr Cardiol. 2017 Jul 5. doi: 10.1007/s00246-017-1667-9. [Epub ahead of print]

PMID: 28681131

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Select item 28677508

 

  1. Current practices are variable in the evaluation and management of patients with anomalous aortic origin of a coronary artery: Results of a survey.

Agrawal H, Mery CM, Day PE, Sexson Tejtel SK, McKenzie ED, Fraser CD Jr, Qureshi AM, Molossi S.

Congenit Heart Dis. 2017 Jul 2. doi: 10.1111/chd.12511. [Epub ahead of print]

PMID: 28670826

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Select item 28763186

 

  1. Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry.

Guillory C, Gong A, Livingston J, Creel L, Ocampo E, McKee-Garrett T.

Am J Perinatol. 2017 Jul;34(9):856-860. doi: 10.1055/s-0037-1599214. Epub 2017 Mar 6.

PMID: 28264208

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Select item 28212589

 

  1. A rare case of acyanotic congenital heart disease, large patent ductus arteriosus with pre-ductal coarctation of descending thoracic aorta with patent ductus arteriosus closure and extra anatomical bypass grafting.

Wani Z, Tiwari D, Gehlot R, Kumar D, Chhabra S, Sharma M.

Ann Card Anaesth. 2017 Jul-Sep;20(3):365-368. doi: 10.4103/aca.ACA_46_17.

PMID: 28701609 Free Article

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Select item 28701597

 

  1. Cardiac haemangioma associated with a duct-dependent congenital heart disease in a newborn infant.

Djordjevic SA, Glumac S, Kalanj J.

Cardiol Young. 2017 Jul;27(5):990-992. doi: 10.1017/S1047951116002699. Epub 2017 Jan 12.

PMID: 28077189

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Select item 27751196

 

  1. An interactive tool for rapid biventricular analysis of congenital heart disease.

Gilbert K, Lam HI, Pontré B, Cowan BR, Occleshaw CJ, Liu JY, Young AA.

Clin Physiol Funct Imaging. 2017 Jul;37(4):413-420. doi: 10.1111/cpf.12319. Epub 2015 Nov 17.

PMID: 26577068 Free PMC Article

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Select item 28719706

 

  1. Bilateral second branchial cleft fistulae in a boy with congenital heart disease.

Lee YF, Shiau EL.

Ear Nose Throat J. 2017 Jul;96(7):243-244. No abstract available.

PMID: 28719706

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Select item 28646501

 

  1. Progressive aortic root dilatation in pediatric heart transplant recipients.

Sachdeva S, Zhang L, Simpson P, Frommelt PC.

Echocardiography. 2017 Jul;34(7):1035-1039. doi: 10.1111/echo.13570. Epub 2017 Jun 23.

PMID: 28646501

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Select item 28517030

 

  1. Identification of a novel and functional mutation in the TBX5 gene in a patient by screening from 354 patients with isolated ventricular septal defect.

Chen HX, Zhang X, Hou HT, Wang J, Yang Q, Wang XL, He GW.

Eur J Med Genet. 2017 Jul;60(7):385-390. doi: 10.1016/j.ejmg.2017.04.011. Epub 2017 Apr 18.

PMID: 28434921

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Select item 28508990

 

  1. Association Analysis of Nonsyndromic Congenital Heart Disease and Tag Single Nucleotide Polymorphisms of TBX20 and Genes in the Ras-MAPK Pathway.

Luo Z, Shen Y, Chen W, Ma X, Liu L, Huang X, Yang Z, Sun H.

Genet Test Mol Biomarkers. 2017 Jul;21(7):440-444. doi: 10.1089/gtmb.2016.0369. Epub 2017 May 19.

PMID: 28525297

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Select item 28274955

 

  1. Ischemic heart disease in children and young adults with congenital heart disease in Sweden.

Fedchenko M, Mandalenakis Z, Rosengren A, Lappas G, Eriksson P, Skoglund K, Dellborg M.

Int J Cardiol. 2017 Jul 1. pii: S0167-5273(17)32268-4. doi: 10.1016/j.ijcard.2017.06.120. [Epub ahead of print]

PMID: 28705603

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Select item 28668979

 

  1. Comparison of systemic right ventricular function in transposition of the great arteries after atrial switch and congenitally corrected transposition of the great arteries.

Morcos M, Kilner PJ, Sahn DJ, Litt HI, Valsangiacomo-Buechel ER, Sheehan FH.

Int J Cardiovasc Imaging. 2017 Jul 1. doi: 10.1007/s10554-017-1201-4. [Epub ahead of print]

PMID: 28668979

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Select item 28600095

 

  1. Holt-Oram Syndrome: A Rare Variant.

Shankar B, Bhutia E, Kumar D, Kishore S, Das SP.

Iran J Med Sci. 2017 Jul;42(4):416-419.

PMID: 28761211 Free PMC Article

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Select item 28501374

 

  1. The Effect of the Superior Cavopulmonary Anastomosis on Ventricular Remodeling in Infants with Single Ventricle.

Margossian R, Zak V, Shillingford AJ, Hlavacek AM, Cnota JF, Puchalski MD, Levine JC, McCrindle BW, Cohen MS, Altmann K, Barker PC, Hsu DT, Colan SD; Pediatric Heart Network Investigators.

J Am Soc Echocardiogr. 2017 Jul;30(7):699-707.e1. doi: 10.1016/j.echo.2017.03.005. Epub 2017 May 10.

PMID: 28501374

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Select item 27756510

 

  1. Identification of 22q11.2 Deletion Syndrome via Newborn Screening for Severe Combined Immunodeficiency.

Barry JC, Crowley TB, Jyonouchi S, Heimall J, Zackai EH, Sullivan KE, McDonald-McGinn DM.

J Clin Immunol. 2017 Jul;37(5):476-485. doi: 10.1007/s10875-017-0403-9. Epub 2017 May 24.

PMID: 28540525

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Select item 28450386

 

  1. Update on congenital heart disease and sudden infant/perinatal death: from history to future trends.

Ottaviani G, Buja LM.

J Clin Pathol. 2017 Jul;70(7):555-562. doi: 10.1136/jclinpath-2017-204326. Epub 2017 Apr 27. Review.

PMID: 28450386

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Select item 28190786

 

  1. The Use of Dexmedetomidine in Pediatric Palliative Care: A Preliminary Study.

Burns J, Jackson K, Sheehy KA, Finkel JC, Quezado ZM.

J Palliat Med. 2017 Jul;20(7):779-783. doi: 10.1089/jpm.2016.0419. Epub 2017 Feb 10.

PMID: 28186850

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Select item 28457522

 

  1. Investigating the causes of neurodevelopmental deficits in congenital heart disease through multiple gestations.

Davies RR.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):282-283. doi: 10.1016/j.jtcvs.2017.03.026. Epub 2017 Mar 19. No abstract available.

PMID: 28526506

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Select item 28341469

 

  1. Effect of congenital heart disease on 4-year neurodevelopment within multiple-gestation births.

Schultz AH, Ittenbach RF, Gerdes M, Jarvik GP, Wernovsky G, Bernbaum J, Solot C, Clancy RR, Nicolson SC, Spray TL, McDonald-McGinn D, Zackai E, Gaynor JW.

J Thorac Cardiovasc Surg. 2017 Jul;154(1):273-281.e2. doi: 10.1016/j.jtcvs.2017.02.022. Epub 2017 Feb 21.

PMID: 28320512

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Select item 28292589

 

  1. Erratum to: Critical Congenital Heart Disease Newborn Screening Implementation: Lessons Learned.

McClain MR, Hokanson JS, Grazel R, Van Naarden Braun K, Garg LF, Morris MR, Moline K, Urquhart K, Nance A, Randall H, Sontag MK.

Matern Child Health J. 2017 Jul;21(7):1590. doi: 10.1007/s10995-017-2295-y. No abstract available.

PMID: 28477067

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Select item 28624838

 

  1. Dental management of pediatric patients affected by pulmonary atresia with ventricular septal defect: A scoping review.

Garrocho-Rangel A, Echavarría-García AC, Rosales-Bérber MA, Flores-Velázquez J, Pozos-Guillén A.

Med Oral Patol Oral Cir Bucal. 2017 Jul 1;22(4):e458-e466.

PMID: 28624838 Free Article

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Select item 28396253

 

  1. Moderate therapeutic hypothermia induces multimodal protective effects in oxygen-glucose deprivation/reperfusion injured cardiomyocytes.

Krech J, Tong G, Wowro S, Walker C, Rosenthal LM, Berger F, Schmitt KRL.

Mitochondrion. 2017 Jul;35:1-10. doi: 10.1016/j.mito.2017.04.001. Epub 2017 Apr 8.

PMID: 28396253

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Select item 28530678

 

  1. The complex genetics of hypoplastic left heart syndrome.

Liu X, Yagi H, Saeed S, Bais AS, Gabriel GC, Chen Z, Peterson KA, Li Y, Schwartz MC, Reynolds WT, Saydmohammed M, Gibbs B, Wu Y, Devine W, Chatterjee B, Klena NT, Kostka D, de Mesy Bentley KL, Ganapathiraju MK, Dexheimer P, Leatherbury L, Khalifa O, Bhagat A, Zahid M, Pu W, Watkins S, Grossfeld P, Murray SA, Porter GA Jr, Tsang M, Martin LJ, Benson DW, Aronow BJ, Lo CW.

Nat Genet. 2017 Jul;49(7):1152-1159. doi: 10.1038/ng.3870. Epub 2017 May 22.

PMID: 28530678

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Select item 28436549

 

  1. Congenital Heart Defects and Measures of Prenatal Brain Growth: A Systematic Review.

Hansen T, Henriksen TB, Bach CC, Matthiesen NB.

Pediatr Neurol. 2017 Jul;72:7-18.e1. doi: 10.1016/j.pediatrneurol.2017.03.014. Epub 2017 Apr 1. Review.

PMID: 28549654

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Select item 28435986

 

  1. Asian consortium on radiation dose of pediatric cardiac CT (ASCI-REDCARD).

Hui PKT, Goo HW, Du J, Ip JJK, Kanzaki S, Kim YJ, Kritsaneepaiboon S, Lilyasari O, Siripornpitak S.

Pediatr Radiol. 2017 Jul;47(8):899-910. doi: 10.1007/s00247-017-3847-4. Epub 2017 Apr 24.

PMID: 28435986

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Select item 28432402

 

  1. Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance.

Lu JC, Lowery R, Yu S, Ghadimi Mahani M, Agarwal PP, Dorfman AL.

Pediatr Radiol. 2017 Jul;47(8):911-916. doi: 10.1007/s00247-017-3851-8. Epub 2017 Apr 21.

PMID: 28432402

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Select item 28607205

 

  1. Brain Injury and Neurodevelopmental Outcome in Congenital Heart Disease: A Systematic Review.

Mebius MJ, Kooi EMW, Bilardo CM, Bos AF.

Pediatrics. 2017 Jul;140(1). pii: e20164055. doi: 10.1542/peds.2016-4055. Epub 2017 Jun 13. Review.

PMID: 28607205

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Select item 28110616

 

  1. Parkes Weber syndrome-Diagnostic and management paradigms: A systematic review.

Banzic I, Brankovic M, Maksimović Ž, Davidović L, Marković M, Rančić Z.

Phlebology. 2017 Jul;32(6):371-383. doi: 10.1177/0268355516664212. Epub 2016 Aug 9.

PMID: 27511883

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Select item 28412186

 

  1. Cyanotic Congenital Heart Disease: Essential Primer for the Practicing Radiologist.

Zucker EJ, Koning JL, Lee EY.

Radiol Clin North Am. 2017 Jul;55(4):693-716. doi: 10.1016/j.rcl.2017.02.009. Epub 2017 Apr 6. Review.

PMID: 28601176

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Select item 28422570

 

  1. [Co-occurrence of Carpenter syndrome and double outlet right ventricle].

Güvenç O, Çimen D, Arslan D, Güler İ.

Turk Kardiyol Dern Ars. 2017 Jul;45(5):454-457. doi: 10.5543/tkda.2016.16040. Turkish.

PMID: 28694400 Free Article

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Select item 28696882

 

  1. [Risk factors for congenital heart disease in Chinese neonates: a Meta analysis].

Liu Y, Zhu B, Zhuo L, He MY, Xu Y, Wang TT, Cai QQ, Hu B, Xu JC, Zhang WH.

Zhongguo Dang Dai Er Ke Za Zhi. 2017 Jul;19(7):754-758. Chinese.

PMID: 28697826 Free Article

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Select item 28697825

 

  1. [Screening and follow-up for congenital heart disease in children aged 0-3 years in rural areas of Chongqing, China].

Zhang L, An MY, Zhu B, Shen WD, Tan SJ, Ji XJ, Tian J, Liu XY.

Zhongguo Dang Dai Er Ke Za Zhi. 2017 Jul;19(7):748-753. Chinese.

PMID: 28697825 Free Article

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  1. Accuracy and Specific Value of Cardiovascular 3D-Models in Pediatric CT-Angiography.

Hammon M, Rompel O, Seuss H, Dittrich S, Uder M, Rüffer A, Cesnjevar R, Ehret N, Glöckler M.

Pediatr Cardiol. 2017 Jul 31. doi: 10.1007/s00246-017-1693-7. [Epub ahead of print]

PMID: 28762166

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Select item 28762165

 

  1. Portopulmonary hypertension in children: a rare but potentially lethal and under-recognized disease.

Tingo J, Rosenzweig EB, Lobritto S, Krishnan US.

Pulm Circ. 2017 Jul 31:2045893217723594. doi: 10.1177/2045893217723594. [Epub ahead of print]

PMID: 28704131

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Select item 28760475

 

  1. Excessive Maternal Orange Intake – A Reversible Etiology of Fetal Premature Ductus Arteriosus Constriction: A Case Report.

Rakha S.

Fetal Diagn Ther. 2017 Jul 27. doi: 10.1159/000453063. [Epub ahead of print]

PMID: 28746929

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Select item 28749475

 

  1. Effect of unconjugated hyperbilirubinemia on neonatal autonomic functions: evaluation by heart rate variability.

Özdemir R, Olukman Ö, Karadeniz C, Çelik K, Katipoğlu N, Muhtar Yılmazer M, Çalkavur Ş, Meşe T, Arslanoğlu S.

J Matern Fetal Neonatal Med. 2017 Jul 25:1-7. doi: 10.1080/14767058.2017.1355901. [Epub ahead of print]

PMID: 28707558

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Select item 28693354

 

  1. Cardiac stress MRI evaluation of anomalous aortic origin of a coronary artery.

Noel C.

Congenit Heart Dis. 2017 Jul 24. doi: 10.1111/chd.12501. [Epub ahead of print]

PMID: 28736987

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Select item 28736822

 

  1. The role of bioelectrical impedance analysis, NT-ProBNP and inferior vena cava sonography in the assessment of body fluid volume in children with nephrotic syndrome.

Nalcacioglu H, Ozkaya O, Baysal K, Kafali HC, Avci B, Tekcan D, Genc G.

Nefrologia. 2017 Jul 24. pii: S0211-6995(17)30104-2. doi: 10.1016/j.nefro.2017.04.003. [Epub ahead of print] English, Spanish.

PMID: 28751054 Free Article

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Select item 28741094

 

  1. Systolic Function of Right Ventricular Outflow Tract is a Better Predictor to Exercise Performance After Pulmonary Valve Replacement in Tetralogy of Fallot.

Li J, Luo S, Liu F, An Q.

Pediatr Cardiol. 2017 Jul 24. doi: 10.1007/s00246-017-1695-5. [Epub ahead of print]

PMID: 28741094

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Select item 28741093

 

  1. Exercise physiology with a left ventricular assist device: Analysis of heart-pump interaction with a computational simulator.

Fresiello L, Rademakers F, Claus P, Ferrari G, Di Molfetta A, Meyns B.

PLoS One. 2017 Jul 24;12(7):e0181879. doi: 10.1371/journal.pone.0181879. eCollection 2017.

PMID: 28738087 Free Article

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Select item 28740077

 

  1. Double aortic arch anomalies in children: A systematic 20-year single center study.

Kaldararova M, Simkova I, Varga I, Tittel P, Kardos M, Ondriska M, Vrsanska V, Masura J.

Clin Anat. 2017 Jul 20. doi: 10.1002/ca.22955. [Epub ahead of print]

PMID: 28726262

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Select item 28736119

 

  1. Pediatric dilated cardiomyopathy hearts display a unique gene expression profile.

Tatman PD, Woulfe KC, Karimpour-Fard A, Jeffrey DA, Jaggers J, Cleveland JC, Nunley K, Taylor MR, Miyamoto SD, Stauffer BL, Sucharov CC.

JCI Insight. 2017 Jul 20;2(14). pii: 94249. doi: 10.1172/jci.insight.94249. [Epub ahead of print]

PMID: 28724804 Free PMC Article

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Select item 28724792

 

  1. Pediatric and adult dilated cardiomyopathy represent distinct pathological entities.

Patel MD, Mohan J, Schneider C, Bajpai G, Purevjav E, Canter CE, Towbin J, Bredemeyer A, Lavine KJ.

JCI Insight. 2017 Jul 20;2(14). pii: 94382. doi: 10.1172/jci.insight.94382. [Epub ahead of print]

PMID: 28724792 Free PMC Article

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Select item 28727227

 

  1. Long-term outcomes of simultaneous heart and kidney transplantation in pediatric recipients.

Weng PL, Alejos JC, Halnon N, Zhang Q, Reed EF, Tsai Chambers E.

Pediatr Transplant. 2017 Jul 20. doi: 10.1111/petr.13023. [Epub ahead of print]

PMID: 28727227

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Select item 28720014

 

  1. Genetic Testing Protocol Reduces Costs and Increases Rate of Genetic Diagnosis in Infants with Congenital Heart Disease.

Geddes GC, Basel D, Frommelt P, Kinney A, Earing M.

Pediatr Cardiol. 2017 Jul 19. doi: 10.1007/s00246-017-1685-7. [Epub ahead of print]

PMID: 28725922

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Select item 28716837

 

  1. Isolated drainage of right superior vena cava into left atrium: A rare etiology of childhood central cyanosis.

Rakha S, Abuelkheir MM, Elgamal MF.

Echocardiography. 2017 Jul 18. doi: 10.1111/echo.13625. [Epub ahead of print]

PMID: 28722763

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Select item 28721692

 

  1. Accelerometry: Improving Objective Assessments of Therapeutic Impact in Pediatric Pulmonary Arterial Hypertension.

Austin ED, Feinstein JA.

Am J Respir Crit Care Med. 2017 Jul 15;196(2):127-129. doi: 10.1164/rccm.201702-0409ED. No abstract available.

PMID: 28707968

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Select item 28178426

 

  1. Acute rheumatic fever and isolated myocarditis.

Ceylan O, Sahin DA.

Int J Cardiol. 2017 Jul 15;239:13. doi: 10.1016/j.ijcard.2017.01.099. No abstract available.

PMID: 28560960

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Select item 27810299

 

  1. Left ventricular hypertrophy in children with previous repair of coarctation of the aorta.

Pamukcu O, Narin N.

Int J Cardiol. 2017 Jul 15;239:4. doi: 10.1016/j.ijcard.2016.10.044. Epub 2016 Oct 27. No abstract available.

PMID: 27810299

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Select item 28711967

 

  1. Single-Center Experience Using Selexipag in a Pediatric Population.

Gallotti R, Drogalis-Kim DE, Satou G, Alejos J.

Pediatr Cardiol. 2017 Jul 13. doi: 10.1007/s00246-017-1677-7. [Epub ahead of print]

PMID: 28702718

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Select item 28699323

 

  1. Influence of platelet count, platelet mass index, and platelet function on the spontaneous closure of ductus arteriosus in the prematurity.

Kahvecioglu D, Erdeve O, Akduman H, Ucar T, Alan S, Çakır U, Yıldız D, Atasay B, Arsan S, Atalay S.

Pediatr Neonatol. 2017 Jul 11. pii: S1875-9572(17)30411-4. doi: 10.1016/j.pedneo.2017.01.006. [Epub ahead of print]

PMID: 28739214 Free Article

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Select item 28693511

 

  1. 2017 AHA/ACC Key Data Elements and Definitions for Ambulatory Electronic Health Records in Pediatricand Congenital Cardiology: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards.

Writing Committee Members, Boris JR, Béland MJ, Bergensen LJ, Colan SD, Dangel J, Daniels CJ, Davis C, Everett AD, Franklin R, Gaynor JW, Gray DT, Hirsch-Romano JC, Jacobs JP, Jacobs M, Jeffries H, Krogmann ON, Lomotan EA, Lopez L, Marelli A, Martin GR, Matherne GP, Mavroudis C, McCardle K, Pearson GD, Rosenthal G, Scott JS, Serwer GA, Seslar SS, Shaddy R, Slesnick T, Vener DF, Walters HL 3rd, Weinberg PM.

J Am Coll Cardiol. 2017 Jul 10. pii: S0735-1097(17)37850-6. doi: 10.1016/j.jacc.2017.06.027. [Epub ahead of print] No abstract available.

PMID: 28716477

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Select item 28693530

 

  1. Analysis of circulating microRNAs in patients with repaired Tetralogy of Fallot with and without heart failure.

Abu-Halima M, Meese E, Keller A, Abdul-Khaliq H, Rädle-Hurst T.

J Transl Med. 2017 Jul 10;15(1):156. doi: 10.1186/s12967-017-1255-z.

PMID: 28693530 Free PMC Article

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Select item 28695637

 

  1. Image Quality of Coronary Arteries on Non-electrocardiography-gated High-Pitch Dual-Source Computed Tomography in Children with Congenital Heart Disease.

Kanie Y, Sato S, Tada A, Kanazawa S.

Pediatr Cardiol. 2017 Jul 8. doi: 10.1007/s00246-017-1675-9. [Epub ahead of print]

PMID: 28689328

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Select item 28689327

 

  1. Normal Reference Ranges for Pulmonary Artery Diameters in Preterm Infants.

Abushaban L, Vel MT, Rathinasamy J, Sharma PN.

Pediatr Cardiol. 2017 Jul 7. doi: 10.1007/s00246-017-1673-y. [Epub ahead of print]

PMID: 28687889

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Select item 28683835

 

  1. Reduced HDL function in children and young adults with type 1 diabetes.

Heier M, Borja MS, Brunborg C, Seljeflot I, Margeirsdottir HD, Hanssen KF, Dahl-Jørgensen K, Oda MN.

Cardiovasc Diabetol. 2017 Jul 6;16(1):85. doi: 10.1186/s12933-017-0570-2.

PMID: 28683835 Free PMC Article

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Select item 28684531

 

  1. Cardiomyocyte Regeneration: A Consensus Statement.

Eschenhagen T, Bolli R, Braun T, Field LJ, Fleischmann BK, Frisén J, Giacca M, Hare JM, Houser SR, Lee RT, Marbán E, Martin JF, Molkentin JD, Murry CE, Riley PR, Ruiz-Lozano P, Sadek HA, Sussman MA, Hill JA.

Circulation. 2017 Jul 6. pii: CIRCULATIONAHA.117.029343. doi: 10.1161/CIRCULATIONAHA.117.029343. [Epub ahead of print]

PMID: 28684531

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Select item 28685376

 

  1. Health Insurance Coverage among Young Adult Survivors of Pediatric Heart Transplantation.

Tumin D, Li SS, Nandi D, Gajarski RJ, McKee C, Tobias JD, Hayes D Jr.

J Pediatr. 2017 Jul 6. pii: S0022-3476(17)30797-7. doi: 10.1016/j.jpeds.2017.06.014. [Epub ahead of print]

PMID: 28690004

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Select item 28683505

 

  1. Preoperative echocardiographic measures of left ventricular mechanics are associated with postoperative vasoactive support in preterm infants undergoing patent ductus arteriosus ligation.

Gray MA, Graham EM, Atz AM, Bradley SM, Kavarana MN, Chowdhury SM.

J Thorac Cardiovasc Surg. 2017 Jul 5. pii: S0022-5223(17)31370-3. doi: 10.1016/j.jtcvs.2017.06.051. [Epub ahead of print]

PMID: 28743382

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Select item 28688952

 

  1. Left-ventricular mechanics in children with hypertrophic cardiomyopathy. CMR study.

Mazurkiewicz Ł, Ziółkowska L, Petryka J, Śpiewak M, Małek Ł, Kubik A, Marczak M, Misko J, Brzezińska-Rajszys G.

Magn Reson Imaging. 2017 Jul 5;43:56-65. doi: 10.1016/j.mri.2017.07.003. [Epub ahead of print]

PMID: 28688952

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Select item 28681132

 

  1. Hemodynamic Evaluation of Children with Persistent or Recurrent Pulmonary Arterial Hypertension Following Complete Repair of Congenital Heart Disease.

Latus H, Wagner I, Ostermayer S, Kerst G, Kreuder J, Schranz D, Apitz C.

Pediatr Cardiol. 2017 Jul 5. doi: 10.1007/s00246-017-1667-9. [Epub ahead of print]

PMID: 28681131

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Select item 28679133

 

  1. Efficacy and safety of oral sildenafil in children with Down syndrome and pulmonary hypertension.

Beghetti M, Rudzinski A, Zhang M.

BMC Cardiovasc Disord. 2017 Jul 4;17(1):177. doi: 10.1186/s12872-017-0569-3.

PMID: 28676038 Free PMC Article

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Select item 28705465

 

  1. Aortopulmonary Septal Defect.

Law M, Bhimji S.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017 Jun-.

2017 Jul 2.

PMID: 28723032 Free Books & Documents

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Select item 28670826

 

  1. Neonatal Marfan syndrome: Report of two cases.

Jurko T, Jurko A Jr, Minarik M, Micieta V, Tonhajzerova I, Kolarovszka H, Zibolen M.

Neuro Endocrinol Lett. 2017 Jul 2;38(3):138-140. [Epub ahead of print]

PMID: 28759179

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Select item 28728260

 

  1. Statin Use and the Risk of Type 2 Diabetes Mellitus in Children and Adolescents.

Joyce NR, Zachariah JP, Eaton CB, Trivedi AN, Wellenius GA.

Acad Pediatr. 2017 Jul;17(5):515-522. doi: 10.1016/j.acap.2017.02.006. Epub 2017 Feb 21.

PMID: 28232259

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Select item 28370347

 

  1. Aortic Diameter Growth in Children With a Bicuspid Aortic Valve.

Merkx R, Duijnhouwer AL, Vink E, Roos-Hesselink JW, Schokking M.

Am J Cardiol. 2017 Jul 1;120(1):131-136. doi: 10.1016/j.amjcard.2017.03.245. Epub 2017 Apr 12.

PMID: 28483205 Free Article

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Select item 28264208

 

  1. Evidence of Early Pulmonary Hypertension Is Associated with Increased Mortality in Very Low Birth Weight Infants.

Berenz A, Vergales JE, Swanson JR, Sinkin RA.

Am J Perinatol. 2017 Jul;34(8):801-807. doi: 10.1055/s-0037-1598246. Epub 2017 Feb 15.

PMID: 28201824

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Select item 28680013

 

  1. Evaluation of vitamin D levels in patients with acute rheumatic fever.

Onan SH, Demirbilek H, Aldudak B, Bilici M, Demir F, Yılmazer MM.

Anatol J Cardiol. 2017 Jul;18(1):75-76. doi: 10.14744/AnatolJCardiol.2017.7720. No abstract available.

PMID: 28680013 Free PMC Article

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Select item 28375677

 

  1. Unusual variant of pulmonary venous atresia.

Chellappan S, Sathe YC, Sahu B.

Asian Cardiovasc Thorac Ann. 2017 Jul;25(6):474-475. doi: 10.1177/0218492316652993. Epub 2016 May 25. No abstract available.

PMID: 27225398

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Select item 27072865

 

  1. Unusual presentation of total anomalous systemic venous connection.

Vaidyanathan S, Kothandam S, Kumar R, Pradhan PM, Agarwal R.

Asian Cardiovasc Thorac Ann. 2017 Jul;25(6):453-456. doi: 10.1177/0218492316644355. Epub 2016 Apr 11.

PMID: 27072865

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Select item 28390986

 

  1. The independence of the infundibular building blocks in the setting of double-outlet right ventricle.

Aiello VD, Spicer DE, Anderson RH, Brown NA, Mohun TJ.

Cardiol Young. 2017 Jul;27(5):825-836. doi: 10.1017/S1047951117000452.

PMID: 28555539

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Select item 28460649

 

  1. Congenital left ventricular diverticulum.

Morales-Quispe JA, Aguilar C, Ganiku-Furujen M.

Cardiol Young. 2017 Jul;27(5):973-974. doi: 10.1017/S1047951117000245. Epub 2017 May 2.

PMID: 28460649

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Select item 28088921

 

  1. Red flags: a case series of clinician-family communication challenges in the context of CHD.

Sekar P, Marcus KL, Williams EP, Boss RD.

Cardiol Young. 2017 Jul;27(5):1000-1003. doi: 10.1017/S1047951116002730. Epub 2017 Jan 16.

PMID: 28088921

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Select item 27839523

 

  1. Importance of anatomical dominance in the evaluation of coronary dilatation in Kawasaki disease.

Dionne A, Hanna B, Trinh Tan F, Desjardins L, Lapierre C, Déry J, Fournier A, Dahdah N.

Cardiol Young. 2017 Jul;27(5):877-883. doi: 10.1017/S1047951116001426. Epub 2016 Sep 19.

PMID: 27640521

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Select item 27448024

 

  1. Mitral arcade: A rare case presenting with fatigue and cough.

Aydın Sahin D, Ceylan O.

Echocardiography. 2017 Jul;34(7):1105-1106. doi: 10.1111/echo.13554. Epub 2017 May 12.

PMID: 28497556

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Select item 28508990

 

  1. Evaluating Appropriate Use of Pediatric Echocardiograms for Chest Pain in Outpatient Clinics.

Chamberlain RC, Pelletier JH, Blanchard S, Hornik CP, Hill KD, Campbell MJ.

J Am Soc Echocardiogr. 2017 Jul;30(7):708-713. doi: 10.1016/j.echo.2017.03.008. Epub 2017 May 10.

PMID: 28501373

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Select item 28758063

 

  1. Acquired Systemic-to-pulmonary Venous Shunt or Persistent Left Superior Vena Cava? A Rare Right-to-left Shunt Case-based Discussion.

Gamet A, Raud-Raynier P, Kerforne T, Velasco S, Christiaens L.

J Cardiovasc Echogr. 2017 Jul-Sep;27(3):104-106. doi: 10.4103/jcecho.jcecho_42_16.

PMID: 28758063 Free PMC Article

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Select item 28675482

 

  1. Commentary on: Rérolle C, Faisant M, Lefrancq T, Saint-Martin P. Sudden death due to undiagnosed rheumatic heart disease in a child. J Forensic Sci 2016;61(3):848-50.

Pamukcu O, Narin N.

J Forensic Sci. 2017 Jul;62(4):1118. doi: 10.1111/1556-4029.13548. No abstract available.

PMID: 28675482

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Select item 28562442

 

  1. Pulse wave reflection in children: amplification through the lifecourse.

Zachariah JP.

J Hypertens. 2017 Jul;35(7):1363-1365. doi: 10.1097/HJH.0000000000001357. No abstract available.

PMID: 28562442

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Select item 27494450

 

  1. To evaluate the prevalence of symptomatic and non-symptomatic ductus arteriosus and accuracy of physical signs in diagnosing PDA in preterm infants using blinded comparison of clinical and echocardiographic findings during the first week of life: a prospective observational study from Iran.

Pourarian S, Sharma D, Farahbakhsh N, Cheriki S, Bijanzadeh F.

J Matern Fetal Neonatal Med. 2017 Jul;30(14):1666-1670. doi: 10.1080/14767058.2016.1220532. Epub 2016 Sep 21.

PMID: 27494450

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Select item 28616802

 

  1. Anomalous origin of circumflex coronary artery from right pulmonary artery associated with atrial septal defect.

Al-Muhaya MA, Syed A, Najjar AHA, Mofeed M, Al-Mutairi M.

J Saudi Heart Assoc. 2017 Jul;29(3):219-222. doi: 10.1016/j.jsha.2017.02.001. Epub 2017 Feb 23.

PMID: 28652677 Free PMC Article

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Select item 28652674

 

  1. Long-Term Outcome of Kawasaki Disease Complicated by a Large Coronary Aneurysm.

Jung JW.

Korean Circ J. 2017 Jul;47(4):444-445. doi: 10.4070/kcj.2017.0135. Epub 2017 Jul 20. No abstract available.

PMID: 28765734 Free PMC Article

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Select item 28723748

 

  1. Prenatal Exposure to Snus Alters Heart Rate Variability in the Infant.

Nordenstam F, Lundell B, Cohen G, Tessma MK, Raaschou P, Wickström R.

Nicotine Tob Res. 2017 Jul 1;19(7):797-803. doi: 10.1093/ntr/ntx035.

PMID: 28186551

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Select item 28436586

 

  1. Editorial commentary: Nomograms in pediatric cardiology: where are we?

Valverde I.

Trends Cardiovasc Med. 2017 Jul;27(5):350-351. doi: 10.1016/j.tcm.2017.01.010. Epub 2017 Jan 30. No abstract available.

PMID: 28258793

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Select item 28214110

  1. Pediatric echocardiographic nomograms: What has been done and what still needs to be done.

Cantinotti M, Kutty S, Franchi E, Paterni M, Scalese M, Iervasi G, Koestenberger M.

Trends Cardiovasc Med. 2017 Jul;27(5):336-349. doi: 10.1016/j.tcm.2017.01.006. Epub 2017 Jan 19. Review.

PMID: 28214110

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Select item 28694400

 

  1. Anomalous Aortic Origin of a Coronary Artery: Symptoms Do Not Correlate With Intramural Length or Ostial Diameter.

Balasubramanya S, Mongé MC, Eltayeb OM, Sarwark AE, Costello JM, Rigsby CK, Popescu AR, Backer CL.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):445-452. doi: 10.1177/2150135117710926.

PMID: 28696872

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Select item 28696868

 

  1. Is Interarterial Course a Requisite for Ischemia in Anomalous Origin of Coronary Arteries?

Madan N, Lorber R, Nento D, Mumtaz M, Singh HR.

World J Pediatr Congenit Heart Surg. 2017 Jul;8(4):533-536. doi: 10.1177/2150135116644698. Epub 2016 May 12.

PMID: 27257015

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Select item 27198525

 

 

 

 

 

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