ACHD Featured Articles of April 2016

Assessment of Kidney Function in Survivors Following Fontan Palliation.

Sharma S, Ruebner RL, Furth SL, Dodds KM, Rychik J, Goldberg DJ.

Congenit Heart Dis. 2016 Apr 22. doi: 10.1111/chd.12358. [Epub ahead of print]

PMID: 27106111

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Select item 27107132

 

Take Home Points:

  1. In a medium term follow up study (~10 years post Fontan), estimated GFR on average is the same as in controls, but 10% of Fontan patients were found to have decreased renal function, defined as eGFR < 90 ml/min/1.73 m2.
  2. In this study, cystatin C and creatinine both determined similar eGFR, although cystatin C is likely more accurate in this population as it does not depend as much as creatinine on muscle mass, and many Fontan patients have low muscle mass compared to the general population.
  3. PTH levels and presence of proteinuria were higher in Fontan patients than in normal controls.

Kay_William_MD.16.CVaCommentary from Dr. W. Aaron Kay (Indianapolis), section co-editor of ACHD Journal Watch

Little is known about long-term effects of Fontan physiology on renal function.  It stands to reason that the lower cardiac output inherent in the Fontan may affect renal perfusion.  In this study from Children’s Hospital of Philadelphia, all patients in the Single Ventricle Survivorship Program (n=68) had routine evaluation of renal function by laboratory studies of serum creatinine and cystatin C, as well as other markers, including parathyroid hormone and presence of proteinuria.

The authors found no significant difference in estimated GFR between Fontan patients (mean age 13 years) versus controls, but 10% of Fontan patients had an eGFR < 90 ml/min/1.73 m2.  PTH level was much higher in Fontan patients than controls (p < 0.001), and proteinuria was more common in Fontans, but this finding was not statistically significant.  Of note, Fontan patients with a lower eGFR were more likely to be on ACE/ARB (p = 0.03).  Fontan patients with eGFR were also more often on diuretics, although that finding in this study was not statistically significant.

 

Noninvasive cardiac output estimation by inert gas rebreathing in pediatric and congenital heart disease.

Marma AK, Opotowsky AR, Fromm BS, Ubeda-Tikkanen A, Porras D, Rhodes J.

Am Heart J. 2016 Apr;174:80-8. doi: 10.1016/j.ahj.2016.01.006. Epub 2016 Jan 19.

PMID: 26995373

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Select item 26663415

 

Take Home Points:

  1. Inert gas rebreathing (IGR) can provide rapid, real time data, about pulmonary cardiac output (Qp) but is only accurate in patients without a shunt, or with only a right-to-left shunt
  2. This technique can be reliably and reproducibly performed in patients as young as 8 years of age.

 

Commentary from Dr. W. Aaron Kay (Indianapolis), section co-editor of ACHD Journal Watch

Having “real-time” assessment of cardiac output would be very helpful in many clinical circumstances.  Most of our current techniques to accurately measure cardiac output are limited by the need for an invasive procedure or the lack of timeliness of data.  Inert gas rebreathing (IGR) has been used in general heart failure patients to accurately measure cardiac output, but this technique has not been formally studied in pediatric cardiology or ACHD.  In this study, 80 patients with a variety of diagnoses underwent cardiac output measurement by IGR, and results were compared to a standard assessment of cardiac output using either catheterization with indirect Fick or cardiac MRI.

The authors found that IGR fairly accurately correlated with pulmonary flow (Qp) in patients without a shunt, or in patients with only a right-to-left shunt, but IGR was very inaccurate at measuring Qp in patients with a pure left-to-right shunt or a complete mixing lesion.  IGR was feasible to do in patients as young as 8 years of age.  The authors discuss potential uses of this technique, such as to help optimize pacemaker settings in congenital complete heart block, or potential uses of this technique to measure changes with exercise.

 

Trends in the Burden of Adult Congenital Heart Disease in US Emergency Departments.

Agarwal S, Sud K, Khera S, Kolte D, Fonarow GC, Panza JA, Menon V.

Clin Cardiol. 2016 Apr 15. doi: 10.1002/clc.22541. [Epub ahead of print]

PMID: 27079279 Free Article

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Select item 26953188

 

Take Home Points:

  1. The ACHD population had increasing utilization of the emergency department over the 7-year study period, which may be related to changes in payor mix or changes in complexity of the patients themselves.
  2. Traditional cardiac risk factors are becoming more common amongst patients with ACHD presenting to the ED.
  3. Despite the increase in ED utilization, and a high percentage of ACHD patients being admitted from the ED, the likelihood of admission is decreasing, possibly due to improvement in the availability of ACHD outpatient care.

Commentary from Dr. W. Aaron Kay (Indianapolis), section co-editor of ACHD Journal Watch:  The authors analyzed data from 2006-2012 using the Nationwide Emergency Department Sample (NEDS) database.  This database incorporates deidentified data from 30 states, and approximates 20% of all US Hospital Emergency Departments (ED), with a representative sample of the whole nation, including academic and nonacademic centers.  There was a significant increase in the number of ACHD patients presenting to the ED over the study.  Although the percentage of patients who were admitted declined over the study, the vast majority of patients (63.4%) arriving to the ED were admitted to the hospital.  The authors extrapolate the findings to note that over the 7 years of this study, on a nationwide basis, there were a projected 324,040 ED visits nationally of ACHD patients.  The most common cardiac reasons for presentation to ED for chest pain (in patients with simple ACHD defects per Bethesda classification) and respiratory problems (in patients with complex ACHD lesions).

Patients in the Northeast United States were more likely to be admitted to the hospital than in other regions of the country.  Although the percentage of patients admitted from the ED declined, there was also a decline in hospital mortality, which might indicate better coordination of care from the ED to outpatient ACHD centers for improved outpatient management of symptoms.  The majority of patients who were transferred from an ED to a different hospital were more likely to have complex rather than simple ACHD (2.1% versus 0.9%, p < 0.001).  The authors note that there was a significant increase in the proportion of Medicaid use amongst the ACHD population during the study period, which may have played a role in increased ED utilization.

The authors noted that there was an increase in coding for traditional cardiac risk factors of hypertension, diabetes, and lipid disorders amongst the ACHD population, and there was also an increase in the number of patients with simple ACHD presenting to the ED with acute myocardial infarction.

achd 1.1

Figure 1B from article, showing significant increase in number of complex ACHD patients presenting to ED from 2006-2012.

 

Emerging Research Directions in Adult Congenital Heart Disease: A Report from an NHLBI/ACHA Working Group.

Gurvitz M, Burns KM, Brindis R, Broberg CS, Daniels CJ, Fuller SM, Honein MA, Khairy P, Kuehl KS, Landzberg MJ, Mahle WT, Mann DL, Marelli A, Newburger JW, Pearson GD, Starling RC, Tringali GR, Valente AM, Wu JC, Califf RM.

J Am Coll Cardiol. 2016 Apr 26;67(16):1956-64. doi: 10.1016/j.jacc.2016.01.062. Review.

PMID: 27102511

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Select item 27129783

 

Take Home Points:

  1. There are numerous areas in ACHD where more research is needed.
  2. Most of our current data in the US is based on small populations from referral-based centers, rather than the community at large.
  3. The United States would greatly benefit from a nationwide registry of all CHD patients.

Commentary from Dr. W. Aaron Kay (Indianapolis), section co-editor of ACHD Journal Watch: This article is a summary of a multidisciplinary NHLBI working group, including experts in ACHD, adult acquired heart failure, cardiac surgery, and many other specialties, focusing on specific high-yield research goals to focus on in the upcoming years.  The main areas of focus were determined to be heart failure (with focus on tetralogy of Fallot, improving indications for mechanical circulatory support / transplantation, and better evaluation for sudden cardiac death), vascular disease  (focusing primarily on coarctation outcomes), and multisystem complications (primarily focusing on single ventricle / Fontan patients, as well as physiological changes of pregnancy in the ACHD population).    The authors note in the paper the lack of a robust epidemiological understanding of the CHD population in the United States and propose goals for a nationwide registry.

 

Imaging of congenital heart disease in adults.

Babu-Narayan SV, Giannakoulas G, Valente AM, Li W, Gatzoulis MA.

Eur Heart J. 2016 Apr 14;37(15):1182-95. doi: 10.1093/eurheartj/ehv519. Epub 2015 Sep 29. Review.

PMID: 26424866

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Select item 27091396

 

Commentary from Dr. W. Aaron Kay (Indianapolis), section co-editor of ACHD Journal Watch

This is a very nice review of specific indications for various ACHD lesions, with numerous high-quality images showing examples of several different imaging modalities.  This paper is a tremendous resource for cardiology fellows in training and other cardiologists interested in ACHD.

 

  1. Pregnancy in women with complete transposition of the great arteries following the atrial switch procedure. A study from 3 the largest Adult Congenital Heart Disease centers in Poland.

Lipczyńska M, Szymański P, Trojnarska O, Tomkiewicz-Pająk L, Pietrzak B, Klisiewicz A, Kumor M, Podolec P, Hoffman P.

J Matern Fetal Neonatal Med. 2016 Apr 12:1-18. [Epub ahead of print]

PMID: 27072884

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Select item 27059600

 

Take Home Points:

  1. Pregnancy in women with Mustard/Senning atrial baffle procedures may be better tolerated than previously thought
  2. This study suggests that there may be little reason to discourage pregnancy in Mustard/Senning women with normal functional status and mild systemic AV valve regurgitation.

 

Moe_Tabitha-WEBCommentary from Dr. Tabitha Moe (Phoenix), section co-editor of ACHD Journal Watch: 

This Polish study reviews women with d-TGA who underwent Mustard and Senning atrial baffle procedures and who had pregnancies.  The study evaluated women at the 3 largest ACHD centers in Poland.  59 women were identified, and they had a total of 24 pregnancies.  Although premature labor and delivery was a frequent complication of the pregnancies, no women developed peripartum cardiomyopathy however there was one episode of sudden cardiac death likely arrhythmic. This study is unique in that the follow up period was greater than 25 years in both the pregnant women and the nulliparous controls.  2 women deteriorated from NYHA I to II, and only one women deteriorated from NYHA I to III after her fourth pregnancy and this same woman had significant worsening of her systemic AV valve regurgitation from mild to moderate plus. This study is in stark contrast to previously reported studies in that no patients developed significant arrhythmias, and a comparable number of pregnant women as nulliparous controls developed clinical worsening of their NYHA status.  This small study suggests that in women with good functional status, and limited or mild systemic AV valve regurgitation pregnancy may be well-tolerated albeit with an increased risk of maternal complications. A larger study with higher volumes across multiple centers may help us to better understand these risks.

 

  1. Fertility and pregnancy in the Fontan population.

Zentner D, Kotevski A, King I, Grigg L, d’Udekem Y.

Int J Cardiol. 2016 Apr 1;208:97-101. doi: 10.1016/j.ijcard.2016.01.180. Epub 2016 Jan 13.

PMID: 26836494

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Select item 27049664

 

Take Home Points:

  1. Pregnancy is reasonably well-tolerated in well-compensated Fontans.
  2. The long-term effects of pregnancy on single-ventricle circulations remain unknown.
  3. Prematurity and small for dates deliveries must be acknowledged and anticipated as well.

 

Commentary from Dr. Tabitha Moe (Phoenix), section co-editor of ACHD Journal Watch: D’Udekem et al describe 40 pregnancies in 156 female patients aged 16-45 enrolled in the Australia and New Zealand (ANZ) Fontan Registry. They evaluated menstrual history, contraceptive use, medication and anti-coagulation use as well as reported medical advice regarding pregnancy.  A Fontan circulation is considered a WHO Class III risk stratification defined as significantly increased risk of maternal mortality or severe morbidity. From a fertility perspective, age at menarche in a population of women with congenital heart disease is delayed in concert with increasing cyanosis and CHD complexity.  Current data would suggest a 50% pregnancy completion rate in this population.  Of the 156 women who were surveyed only one carried a diagnosis of HLHS. 40 pregnancies in 20 women were reported. 14 of these pregnancies involved the use of either aspirin, warfarin, or lovenox for anti-thrombotic effects. 40% of the women were able to take their infants home at the end of the delivery hospitalization. These data are encouraging in that women who are well-compensated at the time of pregnancy seem to do well during the peripartum period. What remains unknown is the long-term outcomes of pregnancy on ventricular function, NYHA classification, AV valve regurgitation, and occurrence of arrhythmias.

 

  1. A cohort study of women with a Fontan circulation undergoing preconception counselling.

Cauldwell M, Von Klemperer K, Uebing A, Swan L, Steer PJ, Babu-Narayan SV, Gatzoulis MA, Johnson MR.

Heart. 2016 Apr 1;102(7):534-40. doi: 10.1136/heartjnl-2015-308788. Epub 2016 Jan 19.

PMID: 26786817

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Select item 26762240

 

Take Home Points:

  1. ~70% of Fontan pregnancies result in preterm birth.
  2. ~25 % of noncyanotic Fontan pregnancies result in small for gestational age birth.

 

Commentary from Dr. Tabitha Moe (Phoenix), section co-editor of ACHD Journal Watch: This is a nice study by the group from the UK evaluating the efforts of educating women with a Fontan circulation regarding pregnancy risks.  They offered pre-conception counseling as a team effort with an OB/GYN and a Cardiologist to impart the risks of pregnancy.  Despite appropriate counseling the number of women who elected to consider pregnancy was unaffected by the correlated risk stratification.  The authors surmise that there are a number of other factors that may play an even more significant role in the decision-making process of pregnancy including financial stability, independence, a supportive partner, etc. This series reaffirms the suspected risk of preterm delivery occurring in 71% of births.  They also confirmed the previously reported risk of 25% of SGA delivery which increased to 40% in patients with cyanosis.  They identified 58 women aged 16-45 with Fontan circulations. Of the women who completed pre-conception counseling 19 determined to pursue pregnancy, and 14 succeeded with a total of 43 reported pregnancies. 5 women who desired pregnancy were unable to conceive or bring a pregnancy to viability. 15 opted against conception, and 14 opted to delay pregnancy after pre-conception counseling.

achd 2.1

 

  1. Tailored circulatory intervention in adults with pulmonary hypertension due to congenital heart disease.

Couperus LE, Henkens IR, Jongbloed MR, Hazekamp MG, Schalij MJ, Vliegen HW.

Neth Heart J. 2016 Apr 20. [Epub ahead of print]

PMID: 27098530

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Select item 27099973

 

Take Home Points:

  1. More increasingly complex patients with ACHD-related comorbidities are surviving to adulthood than ever before.
  2. Experienced multidisciplinary approaches to the evaluation and management of PAH-CHD patients are required now more than ever.

 

Commentary from Dr. Tabitha Moe (Phoenix), section co-editor of ACHD Journal Watch: Adults with PAH-CHD often are left with residual shunts.  Repeated invasive interventions aim to protect the pulmonary vascular bed, and prevent long-term RV failure. Increasingly complex PAH-CHD patients are reaching adult care, and with them an increase in CHD-related comorbidities including PAH.  Disease targeted medical managements includes phosphodiesterase inhibitors, endothelin receptor antagonists, prostacyclins, and guanylyl cyclase inhibitors. It has been suggested the targeted therapy and the reduction in PVR may cause an increase in pulmonary shunt flow and result in progression of pulmonary endothelial damage.  Irreversibly high PVR is considered a contraindication for shunt closure when a predominantly left-to-right shunt exists at rest.  PVR <6 Woods units is thought to be feasible for shunt intervention. If the PVR exceeds 6 WU but is <2/3 SVR then intervention could still be considered.  They present a case series of 4 cases that were reviewed in a multi-disciplinary ACHD conference and individualized management was developed for each case including a balloon atrial septostomy, a hybrid approach with replacement of a pulmonary valve and branch PA stenting, stenting of the aorta to tamponade off a recanalized Potts shunt, and a staged surgical intervention with closure of a VSD, and tricuspid ring annuloplasty. Of these four cases three clinically continue to do well. These cases need to be carefully and thoughtfully considered in a multidisciplinary approach by experienced ACHD physicians.

achd 2.2

 

ACHD April 2016

  1. Transition of care for adolescents from paediatric services to adult health services.

Campbell F, Biggs K, Aldiss SK, O’Neill PM, Clowes M, McDonagh J, While A, Gibson F.

Cochrane Database Syst Rev. 2016 Apr 29;4:CD009794. doi: 10.1002/14651858.CD009794.pub2. Review.

PMID: 27128768

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  1. Is maternal smoking during pregnancy associated with an increased risk of congenital heart defects among offspring? A systematic review and meta-analysis of observational studies.

Zhang D, Cui H, Zhang L, Huang Y, Zhu J, Li X.

J Matern Fetal Neonatal Med. 2016 Apr 29:1-36. [Epub ahead of print]

PMID: 27126055

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Select item 27128381

 

  1. Adult patients with Fontan circulation: What we know and how to manage adults with Fontan circulation?

Ohuchi H.

J Cardiol. 2016 Apr 28. pii: S0914-5087(16)30038-7. doi: 10.1016/j.jjcc.2016.04.001. [Epub ahead of print] Review.

PMID: 27134136

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Select item 27126593

 

  1. Cardiac Contractility Modulation in a Model of Repaired Tetralogy of Fallot: A Sheep Model.

Roubertie F, Eschalier R, Zemmoura A, Thambo JB, Rooryck C, Labrousse L, Ploux S, Ritter P, Haïssaguerre M, Dos Santos P, Bordachar P.

Pediatr Cardiol. 2016 Apr 28. [Epub ahead of print]

PMID: 27126593

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Select item 27121304

 

  1. Postoperative residua and sequelae in adults with repaired tetralogy of Fallot.

Masuda M.

Gen Thorac Cardiovasc Surg. 2016 Apr 26. [Epub ahead of print] Review.

PMID: 27116601

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Select item 27102511

 

  1. Emerging Research Directions in Adult Congenital Heart Disease: A Report From an NHLBI/ACHA Working Group.

Gurvitz M, Burns KM, Brindis R, Broberg CS, Daniels CJ, Fuller SM, Honein MA, Khairy P, Kuehl KS, Landzberg MJ, Mahle WT, Mann DL, Marelli A, Newburger JW, Pearson GD, Starling RC, Tringali GR, Valente AM, Wu JC, Califf RM.

J Am Coll Cardiol. 2016 Apr 26;67(16):1956-64. doi: 10.1016/j.jacc.2016.01.062. Review.

PMID: 27102511

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Select item 27129783

 

  1. The Challenges of Transfer and Transition in Congenital Heart Disease.

Learn CP, Jefferies JL.

Circ J. 2016 Apr 25;80(5):1108-9. doi: 10.1253/circj.CJ-16-0290. Epub 2016 Apr 8. No abstract available.

PMID: 27063296 Free Article

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Select item 27039842

 

  1. Nationwide Survey of the Transfer of Adults With Congenital Heart Disease From Pediatric Cardiology Departments to Adult Congenital Heart Disease Centers in Japan.

Ochiai R, Kato H, Akiyama N, Ichida F, Yao A, Inuzuka R, Niwa K, Shiraishi I, Nakanishi T.

Circ J. 2016 Apr 25;80(5):1242-50. doi: 10.1253/circj.CJ-15-0937. Epub 2016 Mar 31.

PMID: 27039842 Free Article

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Select item 27017367

 

  1. Assessment of Kidney Function in Survivors Following Fontan Palliation.

Sharma S, Ruebner RL, Furth SL, Dodds KM, Rychik J, Goldberg DJ.

Congenit Heart Dis. 2016 Apr 22. doi: 10.1111/chd.12358. [Epub ahead of print]

PMID: 27106111

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Select item 27107132

 

  1. Familial noncompaction on cardiac computed tomography.

Finsterer J, Stöllberger C.

Int J Cardiol. 2016 Apr 21;215:307-308. doi: 10.1016/j.ijcard.2016.04.152. [Epub ahead of print] No abstract available.

PMID: 27128552

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Select item 27131401

 

  1. Tailored circulatory intervention in adults with pulmonary hypertension due to congenital heart disease.

Couperus LE, Henkens IR, Jongbloed MR, Hazekamp MG, Schalij MJ, Vliegen HW.

Neth Heart J. 2016 Apr 20. [Epub ahead of print]

PMID: 27098530

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Select item 27099973

 

  1. Trends in the Burden of Adult Congenital Heart Disease in US Emergency Departments.

Agarwal S, Sud K, Khera S, Kolte D, Fonarow GC, Panza JA, Menon V.

Clin Cardiol. 2016 Apr 15. doi: 10.1002/clc.22541. [Epub ahead of print]

PMID: 27079279 Free Article

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Select item 26953188

 

  1. Fontan circulation causes early, severe liver damage. Should we offer patients a tailored strategy?

Agnoletti G, Ferraro G, Bordese R, Marini D, Gala S, Bergamasco L, Ferroni F, Calvo PL, Barletti C, Cisarò F, Longo F, Pace Napoleone C.

Int J Cardiol. 2016 Apr 15;209:60-5. doi: 10.1016/j.ijcard.2016.02.041. Epub 2016 Feb 3.

PMID: 26882184

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Select item 27091581

 

  1. Imaging of congenital heart disease in adults.

Babu-Narayan SV, Giannakoulas G, Valente AM, Li W, Gatzoulis MA.

Eur Heart J. 2016 Apr 14;37(15):1182-95. doi: 10.1093/eurheartj/ehv519. Epub 2015 Sep 29. Review.

PMID: 26424866

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Select item 27091396

 

  1. Pregnancy in women with complete transposition of the great arteries following the atrial switch procedure. A study from 3 the largest Adult Congenital Heart Disease centers in Poland.

Lipczyńska M, Szymański P, Trojnarska O, Tomkiewicz-Pająk L, Pietrzak B, Klisiewicz A, Kumor M, Podolec P, Hoffman P.

J Matern Fetal Neonatal Med. 2016 Apr 12:1-18. [Epub ahead of print]

PMID: 27072884

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Select item 27059600

 

  1. Lifestyle Habits among Adult Congenital Heart Disease Patients in Malta.

Caruana M, Grech V.

Congenit Heart Dis. 2016 Apr 8. doi: 10.1111/chd.12366. [Epub ahead of print]

PMID: 27060997

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Select item 27060888

 

  1. Loeys Dietz Syndrome and pregnancy: A case report with literature review and a proposed focused management protocol.

Cauldwell M, Patel RR, Uebing A, Gatzoulis MA, Swan L.

Int J Cardiol. 2016 Apr 7;214:491-492. doi: 10.1016/j.ijcard.2016.04.025. [Epub ahead of print] No abstract available.

PMID: 27100340

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Select item 27063805

 

  1. Cardiac adaption during pregnancy in women with congenital heart disease and healthy women.

Kampman MA, Valente MA, van Melle JP, Balci A, Roos-Hesselink JW, Mulder BJ, van Dijk AP, Oudijk MA, Jongbloed MR, van Veldhuisen DJ, Pieper PG; ZAHARA II investigators.

Heart. 2016 Apr 5. pii: heartjnl-2015-308946. doi: 10.1136/heartjnl-2015-308946. [Epub ahead of print]

PMID: 27048772

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Select item 27045011

 

  1. Healthcare needs of adolescents with congenital heart disease transitioning into adulthood: a Delphi survey of patients, parents, and healthcare providers.

Chen CW, Su WJ, Chiang YT, Shu YM, Moons P.

Eur J Cardiovasc Nurs. 2016 Apr 4. pii: 1474515116643622. [Epub ahead of print]

PMID: 27045011

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Select item 26902528

 

  1. Noninvasive cardiac output estimation by inert gas rebreathing in pediatric and congenital heart disease.

Marma AK, Opotowsky AR, Fromm BS, Ubeda-Tikkanen A, Porras D, Rhodes J.

Am Heart J. 2016 Apr;174:80-8. doi: 10.1016/j.ahj.2016.01.006. Epub 2016 Jan 19.

PMID: 26995373

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Select item 26663415

 

  1. Risks and Benefits of Exercise Training in Adults With Congenital Heart Disease.

Chaix MA, Marcotte F, Dore A, Mongeon FP, Mondésert B, Mercier LA, Khairy P.

Can J Cardiol. 2016 Apr;32(4):459-66. doi: 10.1016/j.cjca.2015.12.007. Epub 2015 Dec 18. Review.

PMID: 26868839

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Select item 26777265

 

  1. Habitual Physical Activity in Adults With Congenital Heart Disease Compared With Age- and Sex-Matched Controls.

Sandberg C, Pomeroy J, Thilén U, Gradmark A, Wadell K, Johansson B.

Can J Cardiol. 2016 Apr;32(4):547-53. doi: 10.1016/j.cjca.2015.08.021. Epub 2015 Aug 28.

PMID: 26777265

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Select item 26690295

 

  1. Common long-term complications of adult congenital heart disease: avoid falling in a H.E.A.P.

Ministeri M, Alonso-Gonzalez R, Swan L, Dimopoulos K.

Expert Rev Cardiovasc Ther. 2016 Apr;14(4):445-62. doi: 10.1586/14779072.2016.1133294. Epub 2016 Jan 25.

PMID: 26678842

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Select item 26786817

 

  1. A cohort study of women with a Fontan circulation undergoing preconception counselling.

Cauldwell M, Von Klemperer K, Uebing A, Swan L, Steer PJ, Babu-Narayan SV, Gatzoulis MA, Johnson MR.

Heart. 2016 Apr 1;102(7):534-40. doi: 10.1136/heartjnl-2015-308788. Epub 2016 Jan 19.

PMID: 26786817

Similar articles

Select item 26762240

 

  1. Right ventricular longitudinal strain for risk stratification in low-flow, low-gradient aortic stenosis with low ejection fraction.

Dahou A, Clavel MA, Capoulade R, Bartko PE, Magne J, Mundigler G, Bergler-Klein J, Burwash I, Mascherbauer J, Ribeiro HB, O’Connor K, Baumgartner H, Sénéchal M, Dumesnil JG, Rosenhek R, Mathieu P, Larose E, Rodés-Cabau J, Pibarot P.

Heart. 2016 Apr 1;102(7):548-54. doi: 10.1136/heartjnl-2015-308309. Epub 2016 Jan 13.

PMID: 26762240

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Select item 26541676

 

  1. Dextrocardia in Adults with Congenital Heart Disease.

Offen S, Jackson D, Canniffe C, Choudhary P, Celermajer DS.

Heart Lung Circ. 2016 Apr;25(4):352-7. doi: 10.1016/j.hlc.2015.09.003. Epub 2015 Oct 9.

PMID: 26541676

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Select item 26899159

 

  1. Clinical course and potential complications of small ventricular septal defects in adulthood: Late development of left ventricular dysfunction justifies lifelong care.

Karonis T, Scognamiglio G, Babu-Narayan SV, Montanaro C, Uebing A, Diller GP, Alonso-Gonzalez R, Swan L, Dimopoulos K, Gatzoulis MA, Li W.

Int J Cardiol. 2016 Apr 1;208:102-6. doi: 10.1016/j.ijcard.2016.01.208. Epub 2016 Jan 23.

PMID: 26844920

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Select item 26836494

 

  1. Fertility and pregnancy in the Fontan population.

Zentner D, Kotevski A, King I, Grigg L, d’Udekem Y.

Int J Cardiol. 2016 Apr 1;208:97-101. doi: 10.1016/j.ijcard.2016.01.180. Epub 2016 Jan 13.

PMID: 26836494

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Select item 27049664

 

  1. Whole-heart coronary MR angiography using image-based navigation for the detection of coronary anomalies in adult patients with congenital heart disease.

Henningsson M, Hussain T, Vieira MS, Greil GF, Smink J, Ensbergen GV, Beck G, Botnar RM.

J Magn Reson Imaging. 2016 Apr;43(4):947-55. doi: 10.1002/jmri.25058. Epub 2015 Oct 9.

PMID: 26451972

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Select item 25902399

 

  1. “FISHed” out the diagnosis: A case of DiGeorge syndrome.

Bajaj S, Thombare TS, Tullu MS, Agrawal M.

J Postgrad Med. 2016 Apr-Jun;62(2):118-23. doi: 10.4103/0022-3859.167730.

PMID: 26489877 Free Article

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Select item 27053898

 

  1. 3D Printing to Guide Ventricular Assist Device Placement in Adults With CongenitalHeartDisease and Heart Failure.

Farooqi KM, Saeed O, Zaidi A, Sanz J, Nielsen JC, Hsu DT, Jorde UP.

JACC Heart Fail. 2016 Apr;4(4):301-11. doi: 10.1016/j.jchf.2016.01.012. Review.

PMID: 27033018

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Select item 26820980

 

  1. Massive Gastrointestinal Bleed as Presentation for Previously Undiagnosed Coarctation of Aorta.

Neubrand T, Mistry R, Lefort R.

Pediatr Emerg Care. 2016 Apr;32(4):240-2. doi: 10.1097/PEC.0000000000000767.

PMID: 27028942

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Select item 26256999

 

  1. Invited Commentary: The specialty of adult congenital heart disease.

Cedars AM.

Proc (Bayl Univ Med Cent). 2016 Apr;29(2):174-5. No abstract available.

PMID: 27034559 Free PMC Article

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  1. Normal Pregnancy and Birth Despite Ruptured Sinus of Valsalva Aneurysm: Another Case for the Record.

Chen X, Yang W, Zhang W, Zhu H.

Tex Heart Inst J. 2016 Apr 1;43(2):158-60. doi: 10.14503/THIJ-14-4897. eCollection 2016 Apr.

PMID: 27127434 Free PMC Article

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  1. Twin pregnancy in a Fontan-palliated patient.

Nair A, Radhakrishnan S, Iyer KS.

Cardiol Young. 2016 Apr 29:1-4. [Epub ahead of print]

PMID: 27125813

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  1. Current attitudes and clinical practice towards the care of pregnant women with underlying CHD: a paediatric cardiology perspective.

Cribbs MG, Briston DA, Zaidi AN.

Cardiol Young. 2016 Apr 11:1-7. [Epub ahead of print]

PMID: 27064196

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  1. Giant Blood Cyst of the Mitral Valve in a Disseminated Tuberculosis Patient.

Ahmad F, Barbant S, Levy T.

Echocardiography. 2016 Apr 5. doi: 10.1111/echo.13224. [Epub ahead of print]

PMID: 27060351

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  1. ACUTE EMBOLIC MYOCARDIAL INFARCTION AND HEART FAILURE IN A FONTAN PATIENT: RECOVERY WITH IMPELLA DEVICE AND SUCCESSFUL TRANSPLANTATION.

Deshpande SR, Dalal A, Kim DW, Babaliaros V, Jokhadar M.

ASAIO J. 2016 Apr 4. [Epub ahead of print] No abstract available.

PMID: 27045968

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  1. Aortic Stiffness in Youth with Hypertrophic Cardiomyopathy Genotype.

Zachariah JP, Johnson PK, Colan SD.

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

PMID: 27041097

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  1. A 74-year-old unoperated univentricular heart: the oldest reported survival.

Gesuete V, Fabi M, Bonvicini M.

Cardiol Young. 2016 Apr;26(4):805-7. doi: 10.1017/S1047951115001973. Epub 2015 Oct 28.

PMID: 26508431

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  1. Bileaflet Mitral Valve Prolapse and Risk of Ventricular Dysrhythmias and Death.

Nordhues BD, Siontis KC, Scott CG, Nkomo VT, Ackerman MJ, Asirvatham SJ, Noseworthy PA.

J Cardiovasc Electrophysiol. 2016 Apr;27(4):463-8. doi: 10.1111/jce.12914. Epub 2016 Feb 12.

PMID: 26749260

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  1. Evaluation of the Mayo Clinic Phenotype-Based Genotype Predictor Score in Patients with Clinically Diagnosed Hypertrophic Cardiomyopathy.

Murphy SL, Anderson JH, Kapplinger JD, Kruisselbrink TM, Gersh BJ, Ommen SR, Ackerman MJ, Bos JM.

J Cardiovasc Transl Res. 2016 Apr;9(2):153-61. doi: 10.1007/s12265-016-9681-5. Epub 2016 Feb 25.

PMID: 26914223

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  1. Altered Cholesterol Metabolism and Hypocholesterolemia in Patients with Single Ventricle following Fontan Palliation.

Whiteside W, Tan M, Ostlund RE Jr, Yu S, Ma L, Rocchini A.

J Pediatr. 2016 Apr;171:73-7. doi: 10.1016/j.jpeds.2015.12.038. Epub 2016 Jan 21.

PMID: 26806364

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  1. Variability in Treatment of Post-coarctectomy Hypertension: A Multicenter Study.

Moffett BS, Penny DJ.

Pediatr Cardiol. 2016 Apr;37(4):772-7. doi: 10.1007/s00246-016-1349-z. Epub 2016 Feb 20.

PMID: 26897371

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  1. Long-Term Serial Follow-Up of Pulmonary Artery Size and Wall Shear Stress in Fontan Patients.

Bossers SS, Cibis M, Kapusta L, Potters WV, Snoeren MM, Wentzel JJ, Moelker A, Helbing WA.

Pediatr Cardiol. 2016 Apr;37(4):637-45. doi: 10.1007/s00246-015-1326-y. Epub 2016 Jan 12.

PMID: 26757738 Free PMC Article

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