Pediatric Cardiology Featured Articles of May 2017

 

Pediatric Cardiology Reviews of May 2017 Manuscripts

 

Psychiatric Disorders and Function in Adolescents with Tetralogy of Fallot.

Holland JE, Cassidy AR, Stopp C, White MT, Bellinger DC, Rivkin MJ, Newburger JW, DeMaso DR.

J Pediatr. 2017 May 19. pii: S0022-3476(17)30595-4. doi: 10.1016/j.jpeds.2017.04.048. [Epub ahead of print]

PMID: 28533034

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Take Home Points:

 

  • Tetralogy of Fallot (TOF) is one of the common forms of critical congenital heart disease with excellent long-term survival.
  • Adolescents with TOF and associated genetic diagnosis showed an increased prevalence of anxiety disorder (43%) and lower global psychosocial function compared to adolescents with TOF without genetic diagnosis and normal population.
  • Adolescents with TOF without and with a genetic diagnosis had a higher lifetime prevalence of attention deficit hyperactivity disorder (ADHD) compared to normal population.
  • Adolescents with TOF especially those with genetic disorders are at high risk for psychiatric disorder and dysfunction and need screening and surveillance for these abnormalities.

 

Shaji Menon Portrait 12.15.14Commentary from Dr. Shaji Menon (Salt Lake City), section editor of Pediatric Cardiology Journal Watch: In the single center cross-sectional study from Boston Children’s Hospital 91 TOF patients between the ages of 13-16 years and 87 healthy controls completed a clinician-rated structured psychiatric interview, parent-/self-report measures of psychopathology, and brain magnetic resonance imaging.  Patients with TOF and degenerative diagnosis had a high prevalence of anxiety disorder (43%) and lower global psychosocial functioning score (median, 70; IQR, 63-75) compared to adolescence with TOF with our genetic diagnosis (15% and 83; IQR, 79-87, respectively; P = .04 and <.001, respectively) and control subjects (6% and 85; IQR, 76-90, respectively; P = .001 and <.001, respectively). TOF patients with and without associated genetic disorders had a higher lifetime prevalence of attention deficit hyperactivity disorder then the control population (19% and 39%, respectively, vs 5%; P = .04 and .002, respectively). Risk factors for anxiety, ADHD, and lower psychosocial functioning included older age, male sex, and low IQ. Medical variables were not predictive of psychiatric outcomes.

 

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Neuro-developmental outcome in single-ventricle patients: is the Norwood procedure a risk factor?

Rotermann I, Logoteta J, Falta J, Wegner P, Jung O, Dütschke P, Scheewe J, Kramer HH, Hansen JH.

Eur J Cardiothorac Surg. 2017 May 2. doi: 10.1093/ejcts/ezx119. [Epub ahead of print]

PMID: 28472306

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Take Home Points:

 

  • Complex open heart surgeries like Norwood procedure in neonatal period is considered a risk factor for adverse neurodevelopmental outcomes.
  • In this study, neurodevelopmental outcome of preschool Fontan patients was in the normal range.
  • Surprisingly Norwood procedure was not a risk factor for neurodevelopmental impairment. Preoperative and patient specific factors were important determinants of neurodevelopmental outcome.

 

Commentary from Dr. Shaji Menon (Salt Lake City), section editor of Pediatric Cardiology Journal Watch: This study included Fontan patients between 3.5-7 years of age who underwent a Norwood procedure for hypoplastic left heart syndrome or other variants and children with other types of single ventricle anatomy not requiring cardiopulmonary pulmonary bypass in the neonatal period (95 patients; Norwood: n = 69; non-Norwood: n = 26). Verbal, performance and full-scale intelligence quotient (IQ) were evaluated with the Wechsler Preschool and Primary Scale of Intelligence. Cognitive functions were assessed with the German ‘Kognitiver Entwicklungstest fu¨r das Kindergartenalter’ (KET-KID).  On comparing Norwood subject to non-Norwood subjects there was no difference in verbal IQ: 98 (86–105) vs 93 (85–102), P = 0.312; performance IQ: 91 (86–100) vs 96 (86–100), P = 0.932; full-scale IQ: 93(86–101) vs 89 (84–98), P = 0.314; KET-KID non-verbal: 33 (18–62) vs 45 (15–54), P = 0.771; KET-KID global: 42 (14–65) vs 28 (6–63), P = 0.208).  Overall IQ was below 85.720% of Norwood and 35% of non-Norwood cases (p=0.18).  Preoperative factors like small head circumference Z score and complications before neonatal surgery were associated with lower scores.

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Pediatric cardiology May 2017

 

  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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  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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  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

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  1. Stress echocardiography: An overview for use in pediatric and congenital cardiology.

Ermis P.

Congenit Heart Dis. 2017 Jun 5. doi: 10.1111/chd.12495. [Epub ahead of print]

PMID: 28580760

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  1. Right aortic arch with situs solitus frequently heralds a vascular ring.

Evans WN, Acherman RJ, Ciccolo ML, Carrillo SA, Mayman GA, Luna CF, Rollins RC, Castillo WJ, Galindo A, Rothman A, Alexander JA, Kwan TW, Restrepo H.

Congenit Heart Dis. 2017 Jun 5. doi: 10.1111/chd.12487. [Epub ahead of print]

PMID: 28580730

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  1. Kawasaki disease: State of the art.

Newburger JW.

Congenit Heart Dis. 2017 Jun 5. doi: 10.1111/chd.12498. [Epub ahead of print]

PMID: 28580712

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  1. Kawasaki disease: Medical therapies.

Newburger JW.

Congenit Heart Dis. 2017 Jun 5. doi: 10.1111/chd.12502. [Epub ahead of print]

PMID: 28580631

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  1. In vivo efficacy of the AKT inhibitor ARQ 092 in Noonan Syndrome with multiple lentigines-associated hypertrophic cardiomyopathy.

Wang J, Chandrasekhar V, Abbadessa G, Yu Y, Schwartz B, Kontaridis MI.

PLoS One. 2017 Jun 5;12(6):e0178905. doi: 10.1371/journal.pone.0178905. eCollection 2017.

PMID: 28582432 Free Article

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  1. The motor repertoire in 3- to 5-month old infants with Down syndrome.

Herrero D, Einspieler C, Panvequio Aizawa CY, Mutlu A, Yang H, Nogolová A, Pansy J, Nielsen-Saines K, Marschik PB; GenGM Study Group.

Res Dev Disabil. 2017 Jun 3;67:1-8. doi: 10.1016/j.ridd.2017.05.006. [Epub ahead of print]

PMID: 28586709

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10.[Genetics of congenital heart diseases].

Bonnet D.

Presse Med. 2017 Jun 2. pii: S0755-4982(17)30252-X. doi: 10.1016/j.lpm.2017.05.014. [Epub ahead of print] French.

PMID: 28583745

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  1. Pulse oximetry is a feasible method for detecting neonatal critical congenital heart disease.

Hu XJ, Huang GY.

Acta Paediatr. 2017 Jun;106(6):1008. doi: 10.1111/apa.13801. Epub 2017 Mar 21. No abstract available.

PMID: 28235129

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  1. The limitations of pulse oximetry for critical congenital heart disease screening in the neonatal intensive care units.

Fernandes N, Lakshminrusimha S.

Acta Paediatr. 2017 Jun;106(6):1007. doi: 10.1111/apa.13742. Epub 2017 Jan 30. No abstract available.

PMID: 28075515

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  1. Feasibility of exercise stress echocardiography and myocardial response in patients with repaired congenital heart disease.

Hasan BS, Lunze FI, Alvi N, Shafer KM, Rhodes J.

Am Heart J. 2017 Jun;188:1-10. doi: 10.1016/j.ahj.2017.02.029. Epub 2017 Feb 23.

PMID: 28577664

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  1. Interruption of the Aortic Arch.

Combes N, Waldmann V, Heitz F, Bruguiere E, Quedreux JF, Vahdat O, Chambran P, Narayanan K, Marijon E.

Am J Med. 2017 Jun;130(6):e251-e252. doi: 10.1016/j.amjmed.2016.12.041. Epub 2017 Feb 2. No abstract available.

PMID: 28161345

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  1. Recurrence of congenital heart defects among siblings-a nationwide study.

Brodwall K, Greve G, Leirgul E, Tell GS, Vollset SE, Øyen N.

Am J Med Genet A. 2017 Jun;173(6):1575-1585. doi: 10.1002/ajmg.a.38237. Epub 2017 Apr 19.

PMID: 28425218

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  1. Long-Term Outcomes of Children With Trisomy 13 and 18 After Congenital Heart Disease Interventions.

Peterson JK, Kochilas LK, Catton KG, Moller JH, Setty SP.

Ann Thorac Surg. 2017 Jun;103(6):1941-1949. doi: 10.1016/j.athoracsur.2017.02.068. Epub 2017 Apr 26.

PMID: 28456396

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  1. [Mosaic trisomy 18. Series of cases].

Cammarata-Scalisi F, Lacruz-Rengel MA, Araque D, Da Silva G, Avendaño A, Callea M, Stock F, Guerrero Y, Aguilar E, Lacruz MJ, Sulbaran J.

Arch Argent Pediatr. 2017 Jun 1;115(3):e183-e186. doi: http://dx.doi.org/10.5546/aap.2017.e183. Spanish.

PMID: 28504507 Free Article

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  1. Retinovascular findings in newborns with critical congenital heart disease: A case series.

Fettah N, Kabatas EU, Doğan V, Zenciroğlu AL, Dilli D, Özyazıcı E, Koç M, Beken S, Dursun A, Kandemir S.

Arch Argent Pediatr. 2017 Jun 1;115(3):e175-e178. doi: http://dx.doi.org/10.5546/aap.2017.eng.e175. Spanish, English.

PMID: 28504505 Free Article

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  1. Ethnic and socioeconomic variation in incidence of congenital heart defects.

Knowles RL, Ridout D, Crowe S, Bull C, Wray J, Tregay J, Franklin RC, Barron DJ, Cunningham D, Parslow RC, Brown KL.

Arch Dis Child. 2017 Jun;102(6):496-502. doi: 10.1136/archdischild-2016-311143. Epub 2016 Dec 16.

PMID: 27986699 Free Article

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  1. Newborn pulse oximetry screening in practice.

Ismail AQT, Cawsey M, Ewer AK.

Arch Dis Child Educ Pract Ed. 2017 Jun;102(3):155-161. doi: 10.1136/archdischild-2016-311047. Epub 2016 Aug 16.

PMID: 27530240

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  1. Cost of Congenital Heart Disease Hospitalizations in Canada: A Population-Based Study.

Mackie AS, Tran DT, Marelli AJ, Kaul P.

Can J Cardiol. 2017 Jun;33(6):792-798. doi: 10.1016/j.cjca.2017.01.024. Epub 2017 Feb 10.

PMID: 28457736

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  1. Validity of Commercial Activity Trackers in Children With Congenital Heart Disease.

Voss C, Gardner RF, Dean PH, Harris KC.

Can J Cardiol. 2017 Jun;33(6):799-805. doi: 10.1016/j.cjca.2016.11.024. Epub 2016 Dec 18.

PMID: 28347581

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  1. Ebstein Anomaly.

Sherwin ED, Abrams DJ.

Card Electrophysiol Clin. 2017 Jun;9(2):245-254. doi: 10.1016/j.ccep.2017.02.007. Review.

PMID: 28457239

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  1. Use of Clinical Exome Sequencing in Isolated Congenital Heart Disease.

Zahavich L, Bowdin S, Mital S.

Circ Cardiovasc Genet. 2017 Jun;10(3). pii: e001581. doi: 10.1161/CIRCGENETICS.116.001581. No abstract available.

PMID: 28473349

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  1. Genetics of Congenital Heart Disease: Is the Glass Now Half-Full?

Leatherbury L, Berul CI.

Circ Cardiovasc Genet. 2017 Jun;10(3):e001746. doi: 10.1161/CIRCGENETICS.117.001746. No abstract available.

PMID: 28468791

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  1. Prospective ECG-triggering cardiac CT for infants with complex congenital heart disease using low-dose contrast medium, low tube voltage, and adaptive statistical iterative reconstruction.

Wang SY, Gao W, Zhong YM, Sun AM, Wang Q, Hu LW, Qiu HS, Li JY.

Clin Radiol. 2017 Jun;72(6):502-507. doi: 10.1016/j.crad.2017.01.017. Epub 2017 Mar 6.

PMID: 28267987

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  1. Effect of Fontan operation on liver stiffness in children with single ventricle physiology.

DiPaola FW, Schumacher KR, Goldberg CS, Friedland-Little J, Parameswaran A, Dillman JR.

Eur Radiol. 2017 Jun;27(6):2434-2442. doi: 10.1007/s00330-016-4614-x. Epub 2016 Oct 17.

PMID: 27752831

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  1. Incidence and Outcome of Acute Cardiorenal Syndrome in Hospitalized Children.

Athwani V, Bhargava M, Chanchlani R, Mehta AJ.

Indian J Pediatr. 2017 Jun;84(6):420-424. doi: 10.1007/s12098-017-2307-3. Epub 2017 Feb 27.

PMID: 28239760

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  1. Three-Dimensional Mitral Valve Morphology and Age-Related Trends in Children and Young Adults with Structurally Normal Hearts Using Transthoracic Echocardiography.

Jolley MA, Ghelani SJ, Adar A, Harrild DM.

J Am Soc Echocardiogr. 2017 Jun;30(6):561-571. doi: 10.1016/j.echo.2017.01.018. Epub 2017 Apr 6.

PMID: 28391001

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  1. Regression equations for calculation of z scores for echocardiographic measurements of right heart structures in healthy Han Chinese children.

Wang SS, Zhang YQ, Chen SB, Huang GY, Zhang HY, Zhang ZF, Wu LP, Hong WJ, Shen R, Liu YQ, Zhu JX.

J Clin Ultrasound. 2017 Jun;45(5):293-303. doi: 10.1002/jcu.22436. Epub 2017 Jan 25.

PMID: 28121016

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  1. Teaching congenital heart disease: A new era?

Beckerman Z, Mery CM.

J Thorac Cardiovasc Surg. 2017 Jun;153(6):1541. doi: 10.1016/j.jtcvs.2017.02.045. Epub 2017 Mar 9. No abstract available.

PMID: 28359576

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  1. 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 Jun;21(6):1240-1249. doi: 10.1007/s10995-017-2273-4.

PMID: 28092064

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  1. Chromosome 13q deletion syndrome involving 13q31‑qter: A case report.

Wang YP, Wang DJ, Niu ZB, Cui WT.

Mol Med Rep. 2017 Jun;15(6):3658-3664. doi: 10.3892/mmr.2017.6425. Epub 2017 Apr 3.

PMID: 28393221 Free PMC Article

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  1. Impaired Pulmonary Function is an Additional Potential Mechanism for the Reduction of Functional Capacity in Clinically Stable Fontan Patients.

Turquetto ALR, Canêo LF, Agostinho DR, Oliveira PA, Lopes MICS, Trevizan PF, Fernandes FLA, Binotto MA, Liberato G, Tavares GMP, Neirotti RA, Jatene MB.

Pediatr Cardiol. 2017 Jun;38(5):981-990. doi: 10.1007/s00246-017-1606-9. Epub 2017 May 12.

PMID: 28500413

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  1. MicroRNAs Association in the Cardiac Hypertrophy Secondary to Complex Congenital Heart Disease in Children.

Sánchez-Gómez MC, García-Mejía KA, Pérez-Díaz Conti M, Díaz-Rosas G, Palma-Lara I, Sánchez-Urbina R, Klünder-Klünder M, Botello-Flores JA, Balderrábano-Saucedo NA, Contreras-Ramos A.

Pediatr Cardiol. 2017 Jun;38(5):991-1003. doi: 10.1007/s00246-017-1607-8. Epub 2017 Apr 5.

PMID: 28382463

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  1. Trends in National Institutes of Health-Funded Congenital Heart Disease Research from 2005 to 2015.

Burns KM, Pemberton VL, Schramm CA, Pearson GD, Kaltman JR.

Pediatr Cardiol. 2017 Jun;38(5):974-980. doi: 10.1007/s00246-017-1605-x. Epub 2017 Mar 27.

PMID: 28349207

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  1. The Prevalence of Congenital Heart Disease in Nonsyndromic Cleft Lip and/or Palate: A Systematic Review of the Literature.

Munabi NCO, Swanson J, Auslander A, Sanchez-Lara PA, Davidson Ward SL, Magee WP 3rd.

Ann Plast Surg. 2017 May 31. doi: 10.1097/SAP.0000000000001069. [Epub ahead of print]

PMID: 28570447

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  1. Developmentally Supportive Care in Congenital Heart Disease: A Concept Analysis.

Peterson JK, Evangelista LS.

J Pediatr Nurs. 2017 May 31. pii: S0882-5963(16)30173-7. doi: 10.1016/j.pedn.2017.05.007. [Epub ahead of print] Review.

PMID: 28579078

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Select item 28557188

 

  1. Descending aorta to right atrial fistula: Presenting with neonatal collapse.

Ho AB, Magee AG, Hayes N.

Catheter Cardiovasc Interv. 2017 May 30. doi: 10.1002/ccd.27129. [Epub ahead of print]

PMID: 28557188

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Select item 28562391

 

  1. Feasibility of high-pitch spiral dual-source CT angiography in children with complex congenital heart disease compared to retrospective-gated spiral acquisition.

Li T, Zhao S, Liu J, Yang L, Huang Z, Li J, Luo C, Li X.

Clin Radiol. 2017 May 30. pii: S0009-9260(17)30181-2. doi: 10.1016/j.crad.2017.05.005. [Epub ahead of print]

PMID: 28576437

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  1. [Infective endocarditis prophylaxis in congenital heart disease].

Di Filippo S.

Presse Med. 2017 May 30. pii: S0755-4982(17)30254-3. doi: 10.1016/j.lpm.2017.05.016. [Epub ahead of print] French.

PMID: 28576635

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  1. A Role for Primary Cilia in Aortic Valve Development and Disease.

Toomer KA, Fulmer D, Guo L, Drohan A, Peterson N, Swanson P, Brooks B, Mukherjee R, Body S, Lipschutz J, Wessels A, Norris RA.

Dev Dyn. 2017 May 27. doi: 10.1002/dvdy.24524. [Epub ahead of print]

PMID: 28556366

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Select item 28551818

 

  1. Pediatric heart disease simulation curriculum: Educating the pediatrician.

Harris TH, Adler M, Unti SM, McBride ME.

Congenit Heart Dis. 2017 May 26. doi: 10.1111/chd.12483. [Epub ahead of print]

PMID: 28547923

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  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 May 24. doi: 10.1007/s10875-017-0403-9. [Epub ahead of print]

PMID: 28540525

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Select item 28543795

 

  1. Pulmonary Hypertension in Infants, Children, and Young Adults.

Hansmann G.

J Am Coll Cardiol. 2017 May 23;69(20):2551-2569. doi: 10.1016/j.jacc.2017.03.575. Review.

PMID: 28521893

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Select item 28536747

 

  1. A Genetic Variant in FIGN Gene Reduces the Risk of Congenital Heart Disease in Han Chinese Populations.

Wang D, Chu M, Wang F, Zhou A, Ruan M, Chen Y.

Pediatr Cardiol. 2017 May 22. doi: 10.1007/s00246-017-1636-3. [Epub ahead of print]

PMID: 28534241

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Select item 28534240

 

  1. An Early Glenn Operation May be Associated with the Later Occurrence of Protein-Losing Enteropathy in Fontan Patients : Association of Early Glenn and Failing Fontan.

Unseld B, Stiller B, Borth-Bruhns T, du Bois F, Kroll J, Grohmann J, Fleck T.

Pediatr Cardiol. 2017 May 22. doi: 10.1007/s00246-017-1632-7. [Epub ahead of print]

PMID: 28534240

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Select item 28534239

 

  1. Transatlantic medical consultation and second opinion in pediatric cardiology has benefit past patient care: A case study in videoconferencing.

Kovacikova L, Zahorec M, Skrak P, Hanna BD, Lee Vogel R.

Congenit Heart Dis. 2017 May 19. doi: 10.1111/chd.12480. [Epub ahead of print]

PMID: 28523862

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Select item 28523857

 

  1. Long-term respiratory outcomes after primary total correction for tetralogy of Fallot and absent pulmonary valve in patient with respiratory symptoms.

Hoashi T, Iwasa T, Kagisaki K, Shimada M, Kurosaki K, Shiraishi I, Ichikawa H.

Congenit Heart Dis. 2017 May 19. doi: 10.1111/chd.12477. [Epub ahead of print]

PMID: 28523732

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Select item 28542743

 

  1. Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease.

Claessens NHP, Kelly CJ, Counsell SJ, Benders MJNL.

Dev Med Child Neurol. 2017 May 19. doi: 10.1111/dmcn.13461. [Epub ahead of print] Review.

PMID: 28542743

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Select item 28544539

 

  1. Psychiatric Disorders and Function in Adolescents with Tetralogy of Fallot.

Holland JE, Cassidy AR, Stopp C, White MT, Bellinger DC, Rivkin MJ, Newburger JW, DeMaso DR.

J Pediatr. 2017 May 19. pii: S0022-3476(17)30595-4. doi: 10.1016/j.jpeds.2017.04.048. [Epub ahead of print]

PMID: 28533034

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Select item 28516823

 

  1. Predictors of health-related quality of life in children with chronic heart disease.

Niemitz M, Gunst DCM, Hövels-Gürich HH, Hofbeck M, Kaulitz R, Galm C, Berger F, Nagdyman N, Stiller B, Borth-Bruhns T, Konzag I, Balmer C, Goldbeck L.

Cardiol Young. 2017 May 18:1-10. doi: 10.1017/S1047951117000440. [Epub ahead of print]

PMID: 28516823

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Select item 28517030

 

  1. Birth weight, length and head circumference: Progression and impact over the outcome of patients with congenital heart disease.

Silveira DB, da Rosa EB, Correia JD, Trevisan P, Fiegenbaum M, Oliveira CA, Grapiglia CG, Nunes MR, Rosa RCM, Zen TD, Zen PRG, Rosa RFM.

Int J Cardiol. 2017 May 18. pii: S0167-5273(17)30305-4. doi: 10.1016/j.ijcard.2017.05.078. [Epub ahead of print]

PMID: 28539208

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Select item 28523472

 

  1. Assessment of coronary artery by prospective ECG-triggered 256 multi-slice CT on children with congenital heart disease.

Yao LP, Zhang L, Li HM, Ding M, Yu LW, Yang X, Li XM, Sun K.

Int J Cardiovasc Imaging. 2017 May 18. doi: 10.1007/s10554-017-1150-y. [Epub ahead of print]

PMID: 28523472

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Select item 28515370

 

  1. HDliveFlow with spatiotemporal image correlation for the diagnosis of congenital heart disease.

Ito M, AboEllail MAM, Yamamoto K, Kanenishi K, Tanaka H, Masaoka H, Hata T.

Ultrasound Obstet Gynecol. 2017 May 16. doi: 10.1002/uog.17519. [Epub ahead of print]

PMID: 28508399

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Select item 28343597

 

  1. Comparison of Echocardiography and 64-Multislice Spiral Computed Tomography for the Diagnosis of Pediatric Congenital Heart Disease.

Li A, Peng Z, Zhang C.

Med Sci Monit. 2017 May 13;23:2258-2266.

PMID: 28500278 Free PMC Article

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Select item 28502187

 

  1. Impaired ventilatory efficiency after closure of atrial or ventricular septal defect.

Heiberg J, Nyboe C, Hjortdal VE.

Scand Cardiovasc J. 2017 May 13:1-7. doi: 10.1080/14017431.2017.1326623. [Epub ahead of print]

PMID: 28502187

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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 May 12. doi: 10.1213/ANE.0000000000002073. [Epub ahead of print]

PMID: 28514318

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Select item 28506578

 

  1. Evaluation of athletes with complex congenital heart disease.

Bates BA, Richards C, Hall M, Kerut EK, Campbell W, McMullan MR.

Echocardiography. 2017 May 12. doi: 10.1111/echo.13562. [Epub ahead of print]

PMID: 28497583

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Select item 28500462

 

  1. Perfusion index and left ventricular output correlation in healthy term infants.

Corsini I, Cecchi A, Coviello C, Dani C.

Eur J Pediatr. 2017 May 12. doi: 10.1007/s00431-017-2920-1. [Epub ahead of print] Erratum in: Eur J Pediatr. 2017 Jun 5;:.

PMID: 28500462

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Select item 28506649

 

  1. Exercise Training In Athletes With Heart Disease.

Fernandez AB, Thompson PD.

Prog Cardiovasc Dis. 2017 May 12. pii: S0033-0620(17)30065-8. doi: 10.1016/j.pcad.2017.05.004. [Epub ahead of print] Review.

PMID: 28502848

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Select item 28583678

 

  1. The effect of an electronic health record-based tool on abnormal pediatric blood pressure recognition.

Twichell SA, Rea CJ, Melvin P, Capraro AJ, Mandel JC, Ferguson MA, Nigrin DJ, Mandl KD, Graham D, Zachariah JP.

Congenit Heart Dis. 2017 May 11. doi: 10.1111/chd.12469. [Epub ahead of print]

PMID: 28493451

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Select item 28493446

 

  1. Family perception of unmet support needs following a diagnosis of congenital coronary anomaly in children: Results of a survey.

Agrawal H, Wright OK, Carberry KE, Sexson Tejtel SK, Mery CM, Molossi S.

Congenit Heart Dis. 2017 May 11. doi: 10.1111/chd.12473. [Epub ahead of print]

PMID: 28493446

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Select item 28498910

 

  1. Physical activity evaluation in children with congenital heart disease.

Voss C, Harris KC.

Heart. 2017 May 10. pii: heartjnl-2017-311340. doi: 10.1136/heartjnl-2017-311340. [Epub ahead of print] Review.

PMID: 28490620

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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 May 10. pii: S0894-7317(17)30183-9. doi: 10.1016/j.echo.2017.03.005. [Epub ahead of print]

PMID: 28501374

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Select item 28490416

 

  1. Left ventricular noncompaction cardiomyopathy in a patient with trisomy 13: A report and review of the literature.

Hayashi A, Kumada T, Nozaki F, Hiejima I, Shibata M, Kusunoki T, Fujii T.

Am J Med Genet A. 2017 May 9. doi: 10.1002/ajmg.a.38270. [Epub ahead of print]

PMID: 28488311

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Select item 28536530

 

  1. Prevalence of Congenital Heart Disease among Infants from 2012 to 2014 in Langfang, China.

Sun PF, Ding GC, Zhang MY, He SN, Gao Y, Wang JH.

Chin Med J (Engl). 2017 May 5;130(9):1069-1073. doi: 10.4103/0366-6999.204923.

PMID: 28469102 Free PMC Article

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Select item 28280240

 

  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 May 5. doi: 10.1007/s10995-017-2295-y. [Epub ahead of print] No abstract available.

PMID: 28477067

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Select item 28472932

 

  1. miR-21 is associated with fibrosis and right ventricular failure.

Reddy S, Hu DQ, Zhao M, Blay E Jr, Sandeep N, Ong SG, Jung G, Kooiker KB, Coronado M, Fajardo G, Bernstein D.

JCI Insight. 2017 May 4;2(9). pii: 91625. doi: 10.1172/jci.insight.91625. [Epub ahead of print]

PMID: 28469078 Free PMC Article

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Select item 28473357

 

  1. A HAND to TBX5 Explains the Link Between Thalidomide and Cardiac Diseases.

Khalil A, Tanos R, El-Hachem N, Kurban M, Bouvagnet P, Bitar F, Nemer G.

Sci Rep. 2017 May 3;7(1):1416. doi: 10.1038/s41598-017-01641-3.

PMID: 28469241 Free PMC Article

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Select item 28302752

 

  1. Lower Circulating Folate Induced by a Fidgetin Intronic Variant Is Associated With Reduced Congenital Heart Disease Susceptibility.

Wang D, Wang F, Shi KH, Tao H, Li Y, Zhao R, Lu H, Duan W, Qiao B, Zhao SM, Wang H, Zhao JY.

Circulation. 2017 May 2;135(18):1733-1748. doi: 10.1161/CIRCULATIONAHA.116.025164. Epub 2017 Mar 16.

PMID: 28302752

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Select item 28464509

 

  1. Neuro-developmental outcome in single-ventricle patients: is the Norwood procedure a risk factor?

Rotermann I, Logoteta J, Falta J, Wegner P, Jung O, Dütschke P, Scheewe J, Kramer HH, Hansen JH.

Eur J Cardiothorac Surg. 2017 May 2. doi: 10.1093/ejcts/ezx119. [Epub ahead of print]

PMID: 28472306

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Select item 28472474

 

  1. Toward evidence-based diagnosis of myocarditis in children and adolescents: Rationale, design, and first baseline data of MYKKE, a multicenter registry and study platform.

Messroghli DR, Pickardt T, Fischer M, Opgen-Rhein B, Papakostas K, Böcker D, Jakob A, Khalil M, Mueller GC, Schmidt F, Kaestner M, Udink Ten Cate FEA, Wagner R, Ruf B, Kiski D, Wiegand G, Degener F, Bauer UMM, Friede T, Schubert S; MYKKE Consortium.

Am Heart J. 2017 May;187:133-144. doi: 10.1016/j.ahj.2017.02.027. Epub 2017 Feb 24.

PMID: 28454797

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Select item 28283176

 

  1. Growth characteristics and endocrine abnormalities in 22q11.2 deletion syndrome.

Levy-Shraga Y, Gothelf D, Goichberg Z, Katz U, Somech R, Pinhas-Hamiel O, Modan-Moses D.

Am J Med Genet A. 2017 May;173(5):1301-1308. doi: 10.1002/ajmg.a.38175. Epub 2017 Feb 16.

PMID: 28421700

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Select item 28371479

 

  1. Oral-facial-digital syndrome type 1 in males: Congenital heart defects are included in its phenotypic spectrum.

Bouman A, Alders M, Oostra RJ, van Leeuwen E, Thuijs N, van der Kevie-Kersemaekers AM, van Maarle M.

Am J Med Genet A. 2017 May;173(5):1383-1389. doi: 10.1002/ajmg.a.38179. Epub 2017 Apr 3.

PMID: 28371265 Free PMC Article

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Select item 28500812

 

  1. Birth prevalence of congenital heart disease: A cross-sectional observational study from North India.

Al-Mendalawi MD.

Ann Pediatr Cardiol. 2017 May-Aug;10(2):220. doi: 10.4103/apc.APC_124_16. No abstract available.

PMID: 28566838 Free PMC Article

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  1. Functional tricuspid stenosis: a rare presentation of suspected rhabdomyoma as congenital cyanotic heart disease.

Nair A, Rajesh GN, Sajeev CG.

Cardiol Young. 2017 May;27(4):808-811. doi: 10.1017/S1047951116002110. Epub 2017 Jan 12.

PMID: 28077182

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Select item 27373527

 

  1. Pulmonary Perfusion Changes Following Extracardiac Lateral Fontan and Bilateral Bidirectional Glenn Shunt in Hypoplastic Right Ventricle With Duplicated Superior Vena Cava.

Salas Fragomeni RA, Turkbey EB, Jones BC, Solnes LB, Rowe SP.

Clin Nucl Med. 2017 May;42(5):377-378. doi: 10.1097/RLU.0000000000001605.

PMID: 28240666

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Select item 28580610

 

  1. Speaking to children and their families about congenital heart disease: Ushering in a new era of healthcare literacy.

Penny DJ.

Congenit Heart Dis. 2017 May;12(3):241. doi: 10.1111/chd.12474. No abstract available.

PMID: 28580609

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Select item 28580608

 

  1. Dysphagia in infants with single ventricle anatomy following stage 1 palliation: Physiologic correlates and response to treatment.

McGrattan KE, McGhee H, DeToma A, Hill EG, Zyblewski SC, Lefton-Greif M, Halstead L, Bradley SM, Martin-Harris B.

Congenit Heart Dis. 2017 May;12(3):382-388. doi: 10.1111/chd.12456. Epub 2017 Feb 28.

PMID: 28244680

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Select item 28225219

 

  1. Educational intervention for improving the appropriateness of transthoracic echocardiograms ordered by pediatric cardiologists.

Sachdeva R, Douglas PS, Kelleman MS, McCracken CE, Lopez L, Stern KWD, Eidem BW, Benavidez OJ, Weiner RB, Welch E, Campbell RM, Lai WW.

Congenit Heart Dis. 2017 May;12(3):373-381. doi: 10.1111/chd.12455. Epub 2017 Feb 22.

PMID: 28225219

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Select item 28225202

 

  1. Cardiac remodeling in preterm infants with prolonged exposure to a patent ductus arteriosus.

de Waal K, Phad N, Collins N, Boyle A.

Congenit Heart Dis. 2017 May;12(3):364-372. doi: 10.1111/chd.12454. Epub 2017 Feb 22.

PMID: 28225202

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Select item 28217850

 

  1. Practice variability in management of infectious issues in heterotaxy: A survey of pediatric cardiologists.

Loomba RS, Geddes G, Shillingford AJ, Hehir DA.

Congenit Heart Dis. 2017 May;12(3):332-339. doi: 10.1111/chd.12448. Epub 2017 Feb 15.

PMID: 28199048

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Select item 28140523

 

  1. Tissue plasminogen activator for neonatal coronary thrombosis presenting with mitral valve regurgitation and impaired ventricular function.

Molkara D, Silva Sepulveda JA, Do T, Davis C, Goldstein GP, Moore JW, El-Said HG.

Congenit Heart Dis. 2017 May;12(3):270-274. doi: 10.1111/chd.12432. Epub 2017 Jan 31.

PMID: 28140523

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Select item 28121380

 

  1. Practice trends over time in the care of infants with hypoplastic left heart syndrome: A report from the National Pediatric Cardiology Quality Improvement Collaborative.

Carlo WF, Cnota JF, Dabal RJ, Anderson JB.

Congenit Heart Dis. 2017 May;12(3):315-321. doi: 10.1111/chd.12442. Epub 2017 Jan 25.

PMID: 28121380

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Select item 28092429

 

  1. Incidence, morphology, and progression of bicuspid aortic valve in pediatric and young adult subjects with coexisting congenital heart defects.

Niaz T, Poterucha JT, Johnson JN, Craviari C, Nienaber T, Palfreeman J, Cetta F, Hagler DJ.

Congenit Heart Dis. 2017 May;12(3):261-269. doi: 10.1111/chd.12429. Epub 2016 Nov 28.

PMID: 27893194

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Select item 27893189

 

  1. Defining pediatric inpatient cardiology care delivery models: A survey of pediatric cardiology programs in the USA and Canada.

Mott AR, Neish SR, Challman M, Feltes TF.

Congenit Heart Dis. 2017 May;12(3):294-300. doi: 10.1111/chd.12438. Epub 2016 Nov 25.

PMID: 27885832

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Select item 27874259

 

  1. Pediatric cardiac readmissions: An opportunity for quality improvement?

Sacks JH, Kelleman M, McCracken C, Glanville M, Oster M.

Congenit Heart Dis. 2017 May;12(3):282-288. doi: 10.1111/chd.12436. Epub 2016 Nov 22.

PMID: 27874252

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Select item 27865060

 

  1. Reducing variation in feeding newborns with congenital heart disease.

Simsic JM, Carpenito KR, Kirchner K, Peters S, Miller-Tate H, Joy B, Galantowicz M.

Congenit Heart Dis. 2017 May;12(3):275-281. doi: 10.1111/chd.12435. Epub 2016 Nov 16.

PMID: 27865060

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Select item 28374180

 

  1. Coronary Artery Anomalies: When You Need to Worry.

Kochar A, Kiefer T.

Curr Cardiol Rep. 2017 May;19(5):39. doi: 10.1007/s11886-017-0854-x. Review.

PMID: 28374180

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Select item 28345243

 

  1. Myocardial fibrosis in congenital and pediatric heart disease.

Tian J, An X, Niu L.

Exp Ther Med. 2017 May;13(5):1660-1664. doi: 10.3892/etm.2017.4224. Epub 2017 Mar 10.

PMID: 28565750 Free PMC Article

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  1. Development of an Online, Evidence-Based Patient Information Portal for Congenital Heart Disease: A Pilot Study.

Etnel JRG, van Dijk APJ, Kluin J, Bertels RA, Utens EMWJ, van Galen E; Regina The, Bogers AJJC, Takkenberg JJM.

Front Cardiovasc Med. 2017 May 1;4:25. doi: 10.3389/fcvm.2017.00025. eCollection 2017.

PMID: 28507990 Free PMC Article

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Select item 28346832

 

  1. Association of airway abnormalities with 22q11.2 deletion syndrome.

Sacca R, Zur KB, Crowley TB, Zackai EH, Valverde KD, McDonald-McGinn DM.

Int J Pediatr Otorhinolaryngol. 2017 May;96:11-14. doi: 10.1016/j.ijporl.2017.02.012. Epub 2017 Feb 21.

PMID: 28390597

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Select item 27784831

 

  1. N-Terminal Pro-B-Type Natriuretic Peptide and Phonocardiography in Differentiating Innocent Cardiac Murmurs from Congenital Cardiac Anomalies in Asymptomatic Puppies.

Marinus SM, van Engelen H, Szatmári V.

J Vet Intern Med. 2017 May;31(3):661-667. doi: 10.1111/jvim.14667. Epub 2017 Mar 18.

PMID: 28316101 Free PMC Article

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Select item 26616137

 

  1. A Rare Cause of Shock in an Infant: Cor Triatriatum.

Vayngortin T, Rosenfeld H, Mansour K.

Pediatr Emerg Care. 2017 May 1. doi: 10.1097/PEC.0000000000001162. [Epub ahead of print]

PMID: 28463946

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Select item 28403058

 

  1. Multiorgan Involvement Confounding the Diagnosis of Bartonella henselae Infective Endocarditis in Children With Congenital Heart Disease.

Ouellette CP, Joshi S, Texter K, Jaggi P.

Pediatr Infect Dis J. 2017 May;36(5):516-520. doi: 10.1097/INF.0000000000001510.

PMID: 28403058

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Select item 28403044

 

  1. Comparing First- and Second-year Palivizumab Prophylaxis in Patients With Hemodynamically Significant Congenital Heart Disease in the CARESS Database (2005-2015).

Li A, Wang DY, Lanctôt KL, Mitchell I, Paes BA; CARESS Investigators.

Pediatr Infect Dis J. 2017 May;36(5):445-450. doi: 10.1097/INF.0000000000001357.

PMID: 28403044

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Select item 28258649

 

  1. Cardiac manifestations of inherited metabolic disease in children.

Lloyd DF, Vara R, Mathur S.

Pediatr Int. 2017 May;59(5):525-529. doi: 10.1111/ped.13272. Review.

PMID: 28258649

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Select item 27289364

 

  1. Risk factors for pulmonary arterial hypertension in children and young adults.

Naumburg E, Söderström L, Huber D, Axelsson I.

Pediatr Pulmonol. 2017 May;52(5):636-641. doi: 10.1002/ppul.23633. Epub 2016 Nov 1.

PMID: 27801982

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Select item 28243677

 

  1. [Sports in children with congenital heart diseases].

Bosser G, Moulin-Zinsch A, Fischer-Atalla R.

Presse Med. 2017 May;46(5):509-522. doi: 10.1016/j.lpm.2017.03.005. Epub 2017 Apr 21. French.

PMID: 28434627

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Select item 28314442

 

  1. [Congenital heart disease: Recent technical advances in three-dimensional echocardiography].

Karsenty C, Hadeed K, Acar P.

Presse Med. 2017 May;46(5):482-489. doi: 10.1016/j.lpm.2016.11.016. Epub 2017 Jan 4. French.

PMID: 28063755

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Select item 28038838

 

  1. Double Aortic Arch With a Retroaortic Innominate Vein: A Rare Association Diagnosed Using Cardiac Magnetic Resonance Imaging.

Walsh R, Cracchiolo V.

World J Pediatr Congenit Heart Surg. 2017 May;8(3):394-395. doi: 10.1177/2150135117690097. No abstract available.

PMID: 28520543

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Select item 28520541

 

  1. Congenital pseudoaneurysm of the mitral-aortic intervalvular fibrosa: a case report.

Harrington JK, Glickstein J, Shah A.

Cardiol Young. 2017 May 29:1-4. doi: 10.1017/S1047951117000890. [Epub ahead of print]

PMID: 28552080

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Select item 28552079

 

  1. Association between vascular rings and learning performance: A cross-sectional study.

Chen FL, Liaw YP, Hsu SY, Nfor ON.

J Clin Ultrasound. 2017 May 29. doi: 10.1002/jcu.22502. [Epub ahead of print]

PMID: 28555926

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Select item 28553678

 

  1. Major Aortopulmonary Collateral Arteries With Anatomy Other Than Pulmonary Atresia/Ventricular Septal Defect.

Patrick WL, Mainwaring RD, Reinhartz O, Punn R, Tacy T, Hanley FL.

Ann Thorac Surg. 2017 May 17. pii: S0003-4975(17)30291-6. doi: 10.1016/j.athoracsur.2017.02.029. [Epub ahead of print]

PMID: 28527961

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Select item 28515113

 

  1. Mid-term Risk for Subclinical Atherosclerosis and Chronic Myocarditis in Children with Kawasaki Disease and Transient Coronary Abnormalities.

Parihar M, Singh S, Vignesh P, Gupta A, Rohit M.

Pediatr Cardiol. 2017 May 17. doi: 10.1007/s00246-017-1626-5. [Epub ahead of print]

PMID: 28512721

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Select item 28512720

 

  1. Comparison of two-dimensional and three-dimensional echocardiographic strain in children with CHD.

Wisotzkey BL, Soriano BD, Buddhe S.

Cardiol Young. 2017 May 15:1-9. doi: 10.1017/S1047951117000762. [Epub ahead of print]

PMID: 28502268

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Select item 28284501

 

  1. Sudden death in a pediatric heart transplant recipient with peripheral eosinophilia and eosinophilic myocardial infiltrates.

McEachern W, Godown J, Dodd DA, Dipchand AI, Conway JL, Wilson GJ, Hoffman RD.

Pediatr Transplant. 2017 May 14. doi: 10.1111/petr.12937. [Epub ahead of print]

PMID: 28504342

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Select item 28511801

 

  1. Mitral arcade: A rare case presenting with fatigue and cough.

Aydın Sahin D, Ceylan O.

Echocardiography. 2017 May 12. doi: 10.1111/echo.13554. [Epub ahead of print]

PMID: 28497556

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Select item 28583678

 

  1. Pediatric out-of-hospital cardiac arrest caused by left coronary-artery agenesis with primary shockable rhythm. A brief report.

Weigeldt M, Lahmann S, Krieger K, Buttenberg S, Stephan V, Stiller B, Stengel D.

Am J Emerg Med. 2017 May 11. pii: S0735-6757(17)30375-3. doi: 10.1016/j.ajem.2017.05.011. [Epub ahead of print]

PMID: 28549578

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Select item 28493591

 

  1. Bacterial infections after pediatric heart transplantation: Epidemiology, risk factors and outcomes.

Rostad CA, Wehrheim K, Kirklin JK, Naftel D, Pruitt E, Hoffman TM, L’Ecuyer T, Berkowitz K, Mahle WT, Scheel JN.

J Heart Lung Transplant. 2017 May 11. pii: S1053-2498(17)31790-4. doi: 10.1016/j.healun.2017.05.009. [Epub ahead of print]

PMID: 28583371

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Select item 28498231

 

  1. Reduced cortical volume and thickness and their relationship to medical and operative features in post-Fontan children and adolescents.

Watson CG, Stopp C, Wypij D, Newburger JW, Rivkin MJ.

Pediatr Res. 2017 May 3. doi: 10.1038/pr.2017.30. [Epub ahead of print]

PMID: 28157834

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Select item 28460651

 

  1. Recessive TAF1A mutations reveal ribosomopathy in siblings with end-stage pediatric dilated cardiomyopathy.

Long PA, Theis JL, Shih YH, Maleszewski JJ, Abell Aleff PC, Evans JM, Xu X, Olson TM.

Hum Mol Genet. 2017 May 2. doi: 10.1093/hmg/ddx169. [Epub ahead of print]

PMID: 28472305

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Select item 28562282

 

  1. Aspirin Dose and Prevention of Coronary Abnormalities in Kawasaki Disease.

Dallaire F, Fortier-Morissette Z, Blais S, Dhanrajani A, Basodan D, Renaud C, Mathew M, De Souza AM, Dionne A, Blanchard J, Saulnier H, Kaspy K, Rached-d’Astous S, Dahdah N, McCrindle BW, Human DG, Scuccimarri R.

Pediatrics. 2017 May 2. pii: e20170098. doi: 10.1542/peds.2017-0098. [Epub ahead of print]

PMID: 28562282

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Select item 28454797

 

  1. Relation of Right Atrial Volume, Systemic Venous Dimensions, and Flow Patterns to Right Atrial Pressure in Infants and Children.

Patel SG, Woolman P, Li L, Craft M, Danford DA, Kutty S.

Am J Cardiol. 2017 May 1;119(9):1473-1478. doi: 10.1016/j.amjcard.2017.01.013. Epub 2017 Feb 10.

PMID: 28256251

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Select item 28332295

 

  1. Advanced cardiovascular imaging in Williams syndrome: Abnormalities, usefulness, and strategy for use.

Hills JA, Zarate YA, Danylchuk NR, Lepard T, Chen JC, Collins RT 2nd.

Am J Med Genet A. 2017 May;173(5):1194-1199. doi: 10.1002/ajmg.a.38138. Epub 2017 Mar 22.

PMID: 28332295

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Select item 28213406

 

  1. Correlation of electrocardiogram parameters and hemodynamic outcomes in patients with isolated secundum atrial septal defects.

Refaei M, Islam S, Mackie AS, Atallah J.

Ann Pediatr Cardiol. 2017 May-Aug;10(2):152-157. doi: 10.4103/0974-2069.205139.

PMID: 28566823 Free PMC Article

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Select item 28566822

 

  1. .A case of biatrial drainage of the right superior vena cava.

Iwata Y, Kojima A, Nakayama Y, Omoya K, Kuwahara T, Takeuchi T.

Asian Cardiovasc Thorac Ann. 2017 May;25(4):292-295. doi: 10.1177/0218492316641535. Epub 2016 Mar 27.

PMID: 27022086

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Select item 28317142

 

  1. Variability of antithrombotics use in patients with hypoplastic left heart syndrome and its variants following first- and second-stage palliation surgery: a national report using the National Pediatric Cardiology Quality Improvement Collaborative registry.

Ramachandran P, King E, Nebbia A, Beekman RH, Anderson JB.

Cardiol Young. 2017 May;27(4):731-738. doi: 10.1017/S1047951116001189. Epub 2016 Aug 30.

PMID: 27981915

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Select item 27869054

 

  1. A rare cause of cardiomyopathy in an infant: middle aortic syndrome.

Mir A, Stam B, Sperrazza C.

Cardiol Young. 2017 May;27(4):794-796. doi: 10.1017/S1047951116002018. Epub 2016 Nov 14.

PMID: 27839529

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Select item 27751193

 

  1. Factors influencing bacteraemia in patients with isomerism and CHD: the effects of functional splenic status and antibiotic prophylaxis.

Loomba RS, Pelech AN, Anderson RH.

Cardiol Young. 2017 May;27(4):639-647. doi: 10.1017/S1047951116000962. Epub 2016 Sep 29.

PMID: 27679871

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Select item 27645708

 

  1. Cholelithiasis in children with CHD: is it a problem?

Kargl S, Gitter R, Pumberger W.

Cardiol Young. 2017 May;27(4):630-633. doi: 10.1017/S1047951116000846. Epub 2016 Jun 20.

PMID: 27322515

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Select item 28258658

 

  1. De Novo Migraine With Aura After Surgical Repair of Aortic Coarctation.

Kato Y, Hayashi T, Kobayashi T, Masuoka A, Abe T, Hasebe T, Tanahashi N, Takao M.

Headache. 2017 May;57(5):792-795. doi: 10.1111/head.12995. Epub 2016 Dec 2.

PMID: 27910096

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Select item 28213054

 

  1. Influence of apical position on the left ventricular outflow tract obstruction in congenitally corrected transposition.

Lee ML, Chiu IS.

J Cardiol. 2017 May;69(5):785-789. doi: 10.1016/j.jjcc.2016.07.019. Epub 2016 Nov 11.

PMID: 27842759

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Select item 27554048

 

 

 

 

 

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Fetal Cardiology Featured Articles of May 2017

Fetal Cardiology Reviews of May 2017 Manuscripts

 

Usefulness of the Prenatal Echocardiogram in Fetuses with Isolated Transposition of the Great Arteries to Predict the Need for Balloon Atrial Septostomy.

Vigneswaran TV, Zidere V, Miller OI, Simpson JM, Sharland GK.

Am J Cardiol. 2017 May 1;119(9):1463-1467. doi: 10.1016/j.amjcard.2017.01.017. Epub 2017 Feb 9.

PMID: 28283176

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Select item 28262200

 

Take Home Points:

 

  • Following prenatal diagnosis of isolated d-transposition (D-TGA) of great arteries, prediction of fetuses requiring postnatal balloon atrial septostomy (BAS) remains challenging.
  • Restrictive atrial septum associated hypoxia continues to be a significant cause of morbidity in patients with a restrictive atrial septum.
  • To evaluate the usefulness of prenatal echocardiogram in predicting need for postnatal BAS, third trimester fetal echocardiographic characteristics including arterial valves, arterial duct, total septal length (TSL), and foramen ovale (FO) length were made, in addition to a subjective assessment of the atrial septum were evaluated in the study.
  • The foramen ovale (FO): total septal length (TSL) <0.5 had 99% sensitivity in identifying fetuses requiring balloon atrial septostomy in isolated D-TGA. FO: TSL was significantly smaller in those who required a BAS with good predictive value (area under the receiver operating characteristics curve: 0.80).
  • Restrictive movement of the atrial septum and smaller ovale length (6.8 ±2.8 mm vs. 8.8±1.7mm) is associated with higher likelihood of postnatal BAS.
  • Hypermobile and aneurysmal atrial septum was not associated with higher likelihood of postnatal BAS.

 

Shaji Menon Portrait 12.15.14Commentary from Dr. Shaji Menon (Salt Lake City), section editor of Pediatric Cardiology Journal Watch: This retrospective study from London, third trimester fetal echocardiograms of 40 cases of isolated TGA when compared to gestation matched control.  The factors evaluated in the prenatal echocardiogram included arterial valves, arterial duct, total septal length (TSL), and foramen ovale (FO) length were made, in addition to a subjective assessment of the atrial septum.  In emergency postnatal BAS was required and 12 out of 40 cases.  All 3 cases with limited movement of the atrial septum required emergency balloon atrial septostomy. The FO length in normal fetuses was not significantly different from those with TGA who did not require an emergency BAS but was significantly smaller in fetuses with TGA who required an emergency BAS (p < 0.01). The FO: TSL was significantly smaller in those who required an emergency BAS with good predictive value (area under the receiver operating characteristics curve: 0.80). The sensitivity for FO: TSL <0.5 was 99%. Hypermobile atrial septum was not associated with emergency BAS.

May fetal 1

May Fetal 2

May fetal 3

 

 

 

First-Trimester Fetal Echocardiography: Identification of Cardiac Structures for Screening from 6 to 13 Weeks’ Gestational Age.

Hutchinson D, McBrien A, Howley L, Yamamoto Y, Sekar P, Motan T, Jain V, Savard W, Hornberger LK.

J Am Soc Echocardiogr. 2017 May 13. pii: S0894-7317(17)30217-1. doi: 10.1016/j.echo.2017.03.017. [Epub ahead of print]

PMID: 28511860

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Select item 28511801

 

Take Home Points:

 

  • Development of the fetal heart is generally complete by 7-8 weeks of gestation.
  • With advances in ultrasound technology fetal echocardiograms performed early in the gestation, 12-16 weeks, has been shown to be effective in identifying structural heart disease.
  • This study shows that very early fetal echocardiogram, as early as 8 weeks can be used to assess cardiac structure and color Doppler imaging enhances the diagnostic yield of fetal echocardiograms.
  • The best time for a complete early fetal echocardiogram excluding pulmonary veins appear to be around 11 weeks of gestation.

 

Commentary from Dr. Shaji Menon (Salt Lake City), section editor of Pediatric Cardiology Journal Watch: This is a single central prospective study evaluating the ability of fetal echocardiogram to visualize cardiac structure in the first trimester from as early as 6 weeks of gestation.  The study included a total of 261 early fetal echocardiographic examinations in 202 individual pregnancies, including 166 singletons, 33 sets of twins, and three sets of triplets.  All subjects underwent transabdominal scan.  Transvaginal scanning was used in addition to transabdominal scan in subjects less than 11 weeks of gestation.  Four chambers could be identified in 52% of patients in the eighth week (n = 12 of 23), improving to 80% (n = 36 of 45) in the 10th week and 98% (n = 57 of 58) by the 11th week. The inferior vena cava was seen by 2D imaging in only 4% (n = 1 of 23) in the eighth week, increasing to 13% (n = 6 of 45) by the 10th week and 80% (n = 25 of 31) by the 13th week.  Pulmonary veins could be assessed only after the 11th week.  Outflow tracts could be visualized by 2D imaging in 16% from 8-10 week and an 80% from 11-14 weeks.  Color Doppler imaging significantly improves the visualization of outflow tracts.

May Fetal 4

May fetal 5

May fetal 6

 

 

Fetal cardiology May 2017

 

  1. Fetal Cardiac US: Techniques and Normal Anatomy Correlated with Adult CT and MR Imaging.

Patel N, Narasimhan E, Kennedy A.

Radiographics. 2017 Jun 2:160126. doi: 10.1148/rg.2017160126. [Epub ahead of print]

PMID: 28574808

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  1. Phenotyping cardiac and structural birth defects in fetal and newborn mice.

Liu X, Kim AJ, Reynolds W, Wu Y, Lo CW.

Birth Defects Res. 2017 Jun 1;109(10):778-790. doi: 10.1002/bdr2.1048. Epub 2017 May 22. Review.

PMID: 28544620

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  1. A Targeted, Next-Generation Genetic Sequencing Study on Tetralogy of Fallot, Combined With Cleft Lip and Palate.

Liu L, Bu H, Yang Y, Tan Z, Zhang F, Hu S, Zhao T.

J Craniofac Surg. 2017 Jun;28(4):e351-e355. doi: 10.1097/SCS.0000000000003598.

PMID: 28230599

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  1. Role of HDLive in Imaging the Fetal Heart.

Lakshmy SR, Jain B, Rose N.

J Ultrasound Med. 2017 Jun;36(6):1267-1278. doi: 10.7863/ultra.16.05071. Epub 2017 Mar 11.

PMID: 28295440

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  1. Developmental Changes in Aortic Mechanical Properties in Normal Fetuses and Fetuses with Cardiovascular Disease.

Taketazu M, Sugimoto M, Saiki H, Ishido H, Masutani S, Senzaki H.

Pediatr Neonatol. 2017 Jun;58(3):245-250. doi: 10.1016/j.pedneo.2016.05.004. Epub 2016 Sep 28.

PMID: 27816335 Free Article

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  1. Neonatal outcomes in fetuses with cardiac anomalies and the impact of delivery route.

Parikh LI, Grantz KL, Iqbal SN, Huang CC, Landy HJ, Fries MH, Reddy UM.

Am J Obstet Gynecol. 2017 May 31. pii: S0002-9378(17)30678-6. doi: 10.1016/j.ajog.2017.05.049. [Epub ahead of print]

PMID: 28578168

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  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 May 22. doi: 10.1038/ng.3870. [Epub ahead of print]

PMID: 28530678

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Select item 28534241

 

  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 May 19. doi: 10.1089/gtmb.2016.0369. [Epub ahead of print]

PMID: 28525297

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  1. Epidemiology of Live Born Infants with Nonimmune Hydrops Fetalis-Insights from a Population-Based Dataset.

Steurer MA, Peyvandi S, Baer RJ, MacKenzie T, Li BC, Norton ME, Jelliffe-Pawlowski LL, Moon-Grady AJ.

J Pediatr. 2017 May 19. pii: S0022-3476(17)30508-5. doi: 10.1016/j.jpeds.2017.04.025. [Epub ahead of print]

PMID: 28533037

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  1. Induced pluripotent stem cell modelling of HLHS underlines the contribution of dysfunctional NOTCH signalling to impaired cardiogenesis.

Yang C, Xu Y, Yu M, Lee D, Alharti S, Hellen N, Ahmad Shaik N, Banaganapalli B, Sheikh HAM, Ramu E, Przyborski S, Tenin G, Williams S, O’Sullivan J, Al-Radi OO, Atta J, Harding SE, Keavney B, Lako M, Armstrong L.

Hum Mol Genet. 2017 May 17. doi: 10.1093/hmg/ddx140. [Epub ahead of print]

PMID: 28521042

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Select item 28515113

 

  1. First-Trimester Fetal Echocardiography: Identification of Cardiac Structures for Screening from 6 to 13 Weeks’ Gestational Age.

Hutchinson D, McBrien A, Howley L, Yamamoto Y, Sekar P, Motan T, Jain V, Savard W, Hornberger LK.

J Am Soc Echocardiogr. 2017 May 13. pii: S0894-7317(17)30217-1. doi: 10.1016/j.echo.2017.03.017. [Epub ahead of print]

PMID: 28511860

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Select item 28511801

 

  1. Chromosome microarray analysis in the investigation of children with congenital heart disease.

Wu XL, Li R, Fu F, Pan M, Han J, Yang X, Zhang YL, Li FT, Liao C.

BMC Pediatr. 2017 May 4;17(1):117. doi: 10.1186/s12887-017-0863-3.

PMID: 28472932 Free PMC Article

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Select item 28471087

 

  1. An antenatal marker of neurodevelopmental outcomes in infants with congenital heart disease.

Siddiqui S, Fifer WP, Ordonez-Retamar M, Nugent JD, Williams IA.

J Perinatol. 2017 May 4. doi: 10.1038/jp.2017.59. [Epub ahead of print]

PMID: 28471442

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  1. Usefulness of the Prenatal Echocardiogram in Fetuses With Isolated Transposition of the Great Arteries to Predict the Need for Balloon Atrial Septostomy.

Vigneswaran TV, Zidere V, Miller OI, Simpson JM, Sharland GK.

Am J Cardiol. 2017 May 1;119(9):1463-1467. doi: 10.1016/j.amjcard.2017.01.017. Epub 2017 Feb 9.

PMID: 28283176

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  1. Association of genetic polymorphisms of de novo nucleotide biosynthesis with increased CHD susceptibility in the northern Chinese population.

Jiang YC, Kuang LL, Sun SN, Duan WY, Qiao B, Wang HY.

Clin Genet. 2017 May;91(5):748-755. doi: 10.1111/cge.12874. Epub 2016 Dec 12.

PMID: 27659940

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  1. Increased regurgitant flow causes endocardial cushion defects in an avian embryonic model of congenital heart disease.

Ford SM, McPheeters MT, Wang YT, Ma P, Gu S, Strainic J, Snyder C, Rollins AM, Watanabe M, Jenkins MW.

Congenit Heart Dis. 2017 May;12(3):322-331. doi: 10.1111/chd.12443. Epub 2017 Feb 17.

PMID: 28211263

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  1. TCF21 rs12190287 Polymorphisms Are Associated with Ventricular Septal Defects in a Chinese Population.

Yang L, Gao X, Luo H, Huang Q, Su D, Tan X, Lu C.

Genet Test Mol Biomarkers. 2017 May;21(5):312-315. doi: 10.1089/gtmb.2016.0324. Epub 2017 Mar 27.

PMID: 28346832

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  1. Placental Characteristics of Fetuses With Congenital Heart Disease.

Albalawi A, Brancusi F, Askin F, Ehsanipoor R, Wang J, Burd I, Sekar P.

J Ultrasound Med. 2017 May;36(5):965-972. doi: 10.7863/ultra.16.04023. Epub 2017 Mar 4.

PMID: 28258617

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  1. Prenatal Diagnosis of a Retroesophageal Left Brachiocephalic Vein: Two Case Reports.

Cheng YKY, Law KM, Chak PK, To KF, Chan YM, Leung TY.

J Ultrasound Med. 2017 May;36(5):1065-1069. doi: 10.7863/ultra.16.05003. Epub 2017 Mar 4.

PMID: 28258609

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  1. Associations of GATA4 genetic mutations with the risk of congenital heart disease: A meta-analysis.

Zhang Y, Ai F, Zheng J, Peng B.

Medicine (Baltimore). 2017 May;96(18):e6857. doi: 10.1097/MD.0000000000006857.

PMID: 28471988 Free PMC Article

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  1. Exome sequencing reveals novel IRXI mutation in congenital heart disease.

Guo C, Wang Q, Wang Y, Yang L, Luo H, Cao XF, An L, Qiu Y, Du M, Ma X, Li H, Lu C.

Mol Med Rep. 2017 May;15(5):3193-3197. doi: 10.3892/mmr.2017.6410. Epub 2017 Mar 30.

PMID: 28358424

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  1. MicroRNA-1 upregulation promotes myocardiocyte proliferation and suppresses apoptosis during heart development.

Liu L, Yuan Y, He X, Xia X, Mo X.

Mol Med Rep. 2017 May;15(5):2837-2842. doi: 10.3892/mmr.2017.6282. Epub 2017 Mar 3.

PMID: 28260051

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  1. Myocardial deformation in fetuses with coarctation of the aorta: a case-control study.

Miranda JO, Hunter L, Tibby S, Sharland G, Miller O, Simpson JM.

Ultrasound Obstet Gynecol. 2017 May;49(5):623-629. doi: 10.1002/uog.15939.

PMID: 27072120

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  1. Abnormal Fetal Findings Associated With a Global Sphericity Index of the 4-Chamber View Below the 5th Centile.

DeVore GR, Satou G, Sklansky M.

J Ultrasound Med. 2017 May 30. doi: 10.1002/jum.14261. [Epub ahead of print]

PMID: 28556937

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  1. Antenatal diagnosis of double-outlet left atrium.

Vaksmann G, Bouzguenda I, Houyel L.

Cardiol Young. 2017 May;27(4):816-818. doi: 10.1017/S104795111600250X. Epub 2017 Jan 12.

PMID: 28077186

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  1. Prenatal diagnosis of absent pulmonary valve syndrome from first trimester onwards: novel insights into pathophysiology, associated conditions and outcome.

Gottschalk I, Jehle C, Herberg U, Breuer J, Brockmeier K, Bennink G, Hellmund A, Strizek B, Gembruch U, Geipel A, Berg C.

Ultrasound Obstet Gynecol. 2017 May;49(5):637-642. doi: 10.1002/uog.15977. Epub 2017 Apr 5.

PMID: 27240926

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Congenital EP Featured Articles of April 2017

 

Pediatric Cardiac and EP Reviews of April 2017 Manuscripts

 

Pacemaker and Defibrillator Implantation in Patients with Transposition of the Great Arteries

Grubb AF, Shah G, Aziz PF, Krasuski RA

The Journal of Innovations in Cardiac Rhythm Management, 8 (2017), 2658-2664

 

Take Home Points:

 

  • Cardiac implantable device implantation in TGA substrates presents unique challenges both at implant and throughout follow-up.
  • This study does not apply to arterial switch patients.
  • Despite differences in indications for implantable devices and age at device implant between d- and l-TGA patients, both TGA groups unfortunately appear to have similar progressions in the development of heart failure with its associated morbidity and mortality.
  • Utilization of current published guidelines for primary prevention ICD implantation has shortcomings when applied to TGA substrates and would benefit from updated evidence and experience with ICDs in TGA patients to guide and individualize this treatment option in this unique patient population.

 

chang-philip-1780821827Commentary from Dr. Philip Chang (Los Angeles), section editor of Congenital Heart Surgery Journal Watch: Article summary:

Grubb et al presented a retrospective review of their single-center experience with cardiac implantable electronic devices (CIEDs) in d- and l-TGA patients with systemic RVs.  The study looked at all TGA patients with CIEDs cared for at their institution over an 18-year period.  All patients had systemic right ventricles and all patients had undergone biventricular repair approaches, with single-ventricle variants and those with repairs to restore systemic morphologic left ventricular circulation excluded from analysis.  In total, 63 patients were identified (34 d-TGA, 29 l-TGA).  The authors performed detailed chart review for each subject to determine initial device implant timing/age, development of heart failure, and variables associated with ICD follow-up including defibrillation thresholds and shocks.

 

EP1

 

EP3

 

EP4

 

Study limitations include single-center inclusivity and retrospective design.  The authors did not provide more in-depth detail pertaining to implant approaches, CIED pocket site (left vs. right chest for transvenous devices, which could have implications in ICD defibrillation function), or CIED-related complications.   Several patients reportedly had CRT devices, but no detail was provided in terms of the indications for CRT or implant approach.

 

Reviewer perspective and thoughts for pediatric/CHD EP:

While it is commonly recognized and even expected that TGA patients will require CIED implantation, primarily for pacing indications, it has been quite some time since the topic of CIED utilization and benefit in TGA patients has been studied.  As such, the authors are commended for reviewing their data and presenting their experience, which is quite valuable for our community.  The study definitely highlights the importance of considering multi-institutional pooling of data and experience.  Furthermore, while the growth of the atrial switched d-TGA population is diminishing, there is still a considerable population of these patients, along with a growing number of adult l-TGA patients that should motivate greater awareness of the use of CIEDs in these very unique ACHD subgroups.

There is little debate in the indications for and benefits of pacing in TGA substrates and the authors’ findings of more predominant pacing for sinus node disease in d-TGA and AV block in l-TGA isn’t novel.  It remains unclear as to the role of CRT for wide QRS, heart block, or dyssynchrony in TGA, and more specifically its feasibility and effectiveness in primary systemic RV resynchronization.  With the advent of and interest in His-bundle pacing, the feasibility of this method of pacing in d- vs. l-TGA would be interesting to explore in terms of technical considerations and long-term benefit.  The finding that no primary prevention ICD patients received appropriate shocks was interesting, but not entirely surprising.  This certainly raises the question of the appropriateness of applying standard guidelines for ICD implantation to the TGA population and while some published data exists for risk stratification in d-TGA, greater evidence is needed to guide ICD therapy, particularly for primary prevention indications, in these patients.   Finally, with the subcutaneous ICD as a contemporary implant option, it will also be interesting to see how the balance between implant indication and “ease” of device implant will change.

 

It is sobering to see that both d- and l-TGA patients with systemic RVs progress in very similar fashions to develop heart failure and its associated clinical sequelae and mortality.  This shared finding between d- and l-TGA patients highlights the unique and highly complex substrate in which CIEDs are being applied, as well as the multifactorial process involved in the near-universal fate of the systemic RV in these TGA patients.

 

 

 

Lone Pediatric Atrial Fibrillation in the United States: Analysis of Over 1500 Cases

El-Assaad I, Al-Kindi SG, Saarel EV, Aziz PF

Pediatr Cardiol April 2017 (DOI: 10.1007/s00246-017-1608-7)

 

Take home points:

  • Lone atrial fibrillation is a rare arrhythmia condition among pediatric patients.
  • Increasing age and obesity appear associated with higher incidence of lone atrial fibrillation though evidence indicating direct causality is lacking.
  • While complications such as thromboembolic events are rare in pediatric lone atrial fibrillation, their incidence is not ignorable. However, treatment recommendations and practice patterns are inconsistent.

 

Commentary from Dr. Philip Chang (Los Angeles, CA) section editor of Congenital Heart Surgery Journal WatchThere has been much recent interest in atrial fibrillation in pediatric and young adult patients, particularly as it pertains to risk factors for its development as well as treatment in patients with significant or symptomatic recurrences and in the setting of CHD.  Despite this interest, studies with large sample sizes are lacking in order to better understand its incidence, clinical sequelae, treatment options and response, and long-term outcomes, particularly in otherwise healthy individuals.  The current study from El-Assaad et al provides a descriptive analysis of the largest cohort of young patients with lone atrial fibrillation in the United States.

The authors sought to evaluate risk factors and short-term outcomes of pediatric lone atrial fibrillation, simply defined as atrial fibrillation occurring in the absence of cardiac and systemic diseases.  They utilized a privately managed national healthcare database, Explorys, from which they were able to query and determine an incidence of pediatric lone atrial fibrillation, other variables that may be associated with its diagnosis, and clinical sequelae over a 17-year period (1999-2016).  The database was created from de-identified data provided by 360 hospitals in all 50 US states and over 300,000 providers.

Results of querying the Explorys database yielded nearly 8 million children, with 1910 children linked to an atrial fibrillation diagnosis.  Of these patients, 1750 children met the definition of lone atrial fibrillation.  This resulted in a calculated pediatric lone AF incidence of 7.5 in 100,000 persons at risk.  Nearly 10% of these patients also had concomitant diagnosis of SVT but further characterization of this could not be determined from the dataset variables.  The authors found relatively low percentages of antiarrhythmic use (5%), aspirin or warfarin for anticoagulation (7% and 5%, respectively), and electrical cardioversion (3%).  Older patients tended to be prescribed aspirin or warfarin more frequently compared to younger aged cohorts.

EP5

Multivariate analysis showed increasing age, male gender, and obesity to be associated with risk of lone AF.  Increasing age was also associated with increased risk of AF recurrence within 1 month of initial episode.  Interestingly, among patients 15-19 years of age, nearly 20% experienced AF recurrence.  The authors also found that 2% of patients experienced a stroke within 1 year of lone AF diagnosis.  Following exclusion of other concomitant diagnoses including sepsis, hypertension, hypertensive crisis, drug abuse, stimulant use, cancer, renal impairment, sleep apena, respiratory failure, and bone marrow transplant, a total of 1580 patient remained.  Among these patients, a male predominance was noted (61%), and most episodes of lone AF occurred in the 15-19 years age group (58%).  Those in the oldest age cohort had recurrence rates spanning 15-22% from 1 month up to 1 year after the initial event.  In this lone AF subset, 1% of patients had a stroke within 1 year of lone AF diagnosis.

EP6

EP7

Study limitations include limited available variables in the database and inability to control for the quality and accuracy of the data provided.  For example, the authors noted that they were unable to review ECGs to confirm AF diagnosis or echocardiograms to evaluate chamber size and that some patients could have been misclassified as having AF in the first place.  Recurrence rates could have been overestimated if a single AF diagnosis reappeared on more than 1 occasion.  They also noted that the dataset itself has not been directly validated for pediatric studies, though adult studies have demonstrated its validity.  It is unclear as to why nearly 10% of the originally classified “lone AF” patients were excluded given other systemic diseases to come to the subgroup of 1580 patients that were further analyzed for lone AF incidence and recurrence.  By the authors’ definition, these patients would not have met a pure lone AF diagnosis given these concomitant conditions, many of which can certainly increase the risk of arrhythmias (AF being one of them).  If the subgroup patients were used to calculate incidence, the lone AF incidence would be even lower.  Finally, the authors did not have further details relating to concomitant SVT in the 10% of patients identified and there was no long-term data regarding treatment efficacy (antiarrhythmics or catheter ablation), prognosis, and outcomes.

 

Reviewer perspective and thoughts for pediatric/CHD EP:

This study is an excellent example of the use of large scale databases to evaluate otherwise rare conditions.  As such, it provides a faster, and perhaps more accurate, assessment of pediatric lone AF incidence, as well as general approaches to management, complications, and recurrence.  The study is obviously limited by the quality and accuracy of data entered into the database itself.

This study’s finding of the association between lone AF and obesity, male gender, and increasing age is helpful and consistent with previous publications noting these potential associations that had substantially smaller patient cohorts.  The association with obesity is likely multifactorial.  Obesity is frequently associated with other cardiovascular conditions including hypertension, diastolic dysfunction, and left atrial distension and pressure loading, though interestingly, the association between obesity and lone AF was apparently made in the study after excluding for these other systemic diseases.  It is possible that these other systemic diseases were under-reported in the dataset and echo data was not available to assess for evidence of diastolic dysfunction or left atrial abnormalities.  Obesity is also frequently associated with obstructive sleep apnea, which is increasingly recognized as having a strong association with arrhythmia risk including AF (though again, the study largely excluded patients with concomitant diagnoses of AF and sleep apnea).  The authors noted familial lone AF as a possible important contributor, and the genetics of AF remains an important area of ongoing research.

Several important findings from this study that are important for the pediatric EP community to be aware of is the low incidence of pediatric lone AF that is found and which is likely more reflective of its true incidence in the general pediatric population.  Furthermore, based on the study’s results, there appears to be a fairly high recurrence rate (up to 20% in the oldest age cohort) as well as a low but very concerning incidence of stroke.  Both of these appeared to be present in the setting of low utilization of antiarrhythmic agents and anticoagulation.  In fact, the stroke incidence that was noted in this study corresponded to an equivalent CHADS2VASc score that would qualify patients to receive anticoagulation with either warfarin or NOACs.  This study’s findings show that pediatric lone AF may not be as benign of a condition as some may think and that these patients require aggressive and close follow-up to address or prevent recurrences and to reduce AF-related complications.

CHD EP April 2017

 

  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 Apr 24. doi: 10.1111/pace.13101. [Epub ahead of print]

PMID: 28436549

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  1. Percutaneous Ventricular Assist Device for Circulatory Support During Ablation of Atrial Tachycardias in Patients With Fontan Circulation.

Hendriks A, De Vries L, Witsenburg M, Yap SC, Van Mieghem N, Szili-Torok T.

Rev Esp Cardiol (Engl Ed). 2017 Apr 18. pii: S1885-5857(17)30170-6. doi: 10.1016/j.rec.2017.03.010. [Epub ahead of print] English, Spanish. No abstract available.

PMID: 28431884

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  1. The electrical heart axis and ST events in fetal monitoring: A post-hoc analysis following a multicentre randomised controlled trial.

Vullings R, Verdurmen KMJ, Hulsenboom ADJ, Scheffer S, de Lau H, Kwee A, Wijn PFF, Amer-Wåhlin I, van Laar JOEH, Oei SG.

PLoS One. 2017 Apr 14;12(4):e0175823. doi: 10.1371/journal.pone.0175823. eCollection 2017.

PMID: 28410419 Free PMC Article

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  1. Sudden cardiac death in adults with congenital heart disease: does QRS-complex fragmentation discriminate in structurally abnormal hearts?

Vehmeijer JT, Koyak Z, Bokma JP, Budts W, Harris L, Mulder BJ, de Groot JR.

Europace. 2017 Apr 10. doi: 10.1093/europace/eux044. [Epub ahead of print]

PMID: 28402450

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  1. Post mortem therapy from a subcutaneous ICD: What is the mechanism?

Wiles BM, Fitzsimmons SJ, Roberts PR.

Pacing Clin Electrophysiol. 2017 Apr 4. doi: 10.1111/pace.13089. [Epub ahead of print] No abstract available.

PMID: 28374449

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  1. Lone Pediatric Atrial Fibrillation in the United States: Analysis of Over 1500 Cases.

El-Assaad I, Al-Kindi SG, Saarel EV, Aziz PF.

Pediatr Cardiol. 2017 Apr 3. doi: 10.1007/s00246-017-1608-7. [Epub ahead of print]

PMID: 28374048

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  1. [Clinical features and outcomes of radiofrequency catheter ablation of atrial flutter in children].

Jiang H, Li XM, Zhang Y, Liu HJ, Li MT, Ge HY.

Zhonghua Er Ke Za Zhi. 2017 Apr 2;55(4):267-271. doi: 10.3760/cma.j.issn.0578-1310.2017.04.007. Chinese.

PMID: 28441822

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Select item 28441821

 

  1. [Brief interpretation of “the Pediatric and Congenital Electrophysiology Society (PACES)and the Heart Rhythm Society (HRS) expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease].

Wu JJ, Li F.

Zhonghua Er Ke Za Zhi. 2017 Apr 2;55(4):256-259. doi: 10.3760/cma.j.issn.0578-1310.2017.04.004. Chinese. No abstract available.

PMID: 28441820

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Select item 28441817

 

  1. Non-fluoroscopic cardiac ablation of neonates with CHD.

Bigelow AM, Arnold BS, Padrutt GC, Clark JM.

Cardiol Young. 2017 Apr;27(3):592-596. doi: 10.1017/S1047951116001554. Epub 2016 Oct 21.

PMID: 27766996

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  1. What Is the Best Age for Diagnostic Prediction of Pediatric Long-QT Syndrome With a Borderline QT Interval?

Miyazaki A, Doi H.

Circ Arrhythm Electrophysiol. 2017 Apr;10(4). pii: e005119. doi: 10.1161/CIRCEP.117.005119. No abstract available.

PMID: 28356308

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Select item 28408709

 

  1. Left ventricular dysfunction is associated with frequent premature ventricular complexes and asymptomatic ventricular tachycardia in children.

Bertels RA, Harteveld LM, Filippini LH, Clur SA, Blom NA.

Europace. 2017 Apr 1;19(4):617-621. doi: 10.1093/europace/euw075.

PMID: 28431063

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Select item 28293976

 

  1. Outcomes of lead extraction in young adults.

El-Chami MF, Sayegh MN, Patel A, El-Khalil J, Desai Y, Leon AR, Merchant FM.

Heart Rhythm. 2017 Apr;14(4):537-540. doi: 10.1016/j.hrthm.2017.01.030. Epub 2017 Feb 16.

PMID: 28189822

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  1. Avoiding sports-related sudden cardiac death in children with congenital channelopathy : Recommendations for sports activities.

Lang CN, Steinfurt J, Odening KE.

Herz. 2017 Apr;42(2):162-170. doi: 10.1007/s00059-017-4549-2.

PMID: 28233036

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Select item 28032672

 

  1. Corrigendum to ‘Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology’ [Int. J. Cardiol. 220 (2016) 131-136].

Ertekin E, van Hagen IM, Salam AM, Ruys TP, Johnson MR, Popelova J, Parsonage WA, Ashour Z, Shotan A, Oliver JM, Veldtman GR, Hall R, Roos-Hesselink JW.

Int J Cardiol. 2017 Apr 1;232:348. doi: 10.1016/j.ijcard.2017.01.077. Epub 2017 Jan 27. No abstract available.

PMID: 28139301 Free Article

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Select item 28093463

 

  1. Utility and safety of the SafeSept™ transseptal guidewire for electrophysiology studies with catheter ablation in pediatric and congenital heart disease.

Knadler JJ, Anderson JB, Chaouki AS, Czosek RJ, Connor C, Knilans TK, Spar DS.

J Interv Card Electrophysiol. 2017 Apr;48(3):369-374. doi: 10.1007/s10840-017-0224-z. Epub 2017 Jan 14.

PMID: 28091832

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Select item 28211168

 

  1. Evaluation of Prolonged QT Interval: Structural Heart Disease Mimicking Long QT Syndrome.

Weissler-Snir A, Gollob MH, Chauhan V, Care M, Spears DA.

Pacing Clin Electrophysiol. 2017 Apr;40(4):417-424. doi: 10.1111/pace.13040. Epub 2017 Mar 16.

PMID: 28155223

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Select item 27987225

 

  1. Arrhythmias in Adults with Congenital Heart Disease: What Are Risk Factors for Specific Arrhythmias?

Loomba RS, Buelow MW, Aggarwal S, Arora RR, Kovach J, Ginde S.

Pacing Clin Electrophysiol. 2017 Apr;40(4):353-361. doi: 10.1111/pace.12983. Epub 2017 Feb 27.

PMID: 27987225

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Select item 28300357

 

  1. Clinical Application of the QRS-T Angle for the Prediction of Ventricular Arrhythmias in Patients with the Fontan Palliation.

Tran TV, Cortez D.

Pediatr Cardiol. 2017 Apr 29. doi: 10.1007/s00246-017-1618-5. [Epub ahead of print]

PMID: 28456831

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Select item 28456830

 

  1. Fetal cardiac time intervals in healthy pregnancies – an observational study by fetal ECG (Monica Healthcare System).

Wacker-Gussmann A, Plankl C, Sewald M, Schneider KM, Oberhoffer R, Lobmaier SM.

J Perinat Med. 2017 Apr 28. pii: /j/jpme.ahead-of-print/jpm-2017-0003/jpm-2017-0003.xml. doi: 10.1515/jpm-2017-0003. [Epub ahead of print]

PMID: 28453441

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Select item 28453909

 

  1. Electrophysiological effects of anthracyclines in adult survivors of pediatric malignancy.

Markman TM, Ruble K, Loeb D, Chen A, Zhang Y, Beasley GS, Thompson WR, Nazarian S.

Pediatr Blood Cancer. 2017 Apr 28. doi: 10.1002/pbc.26556. [Epub ahead of print]

PMID: 28453898

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Select item 28450351

 

  1. Prospective Study of Adenosine on Atrioventricular Nodal Conduction in Pediatric and Young Adult Patients After Heart Transplant.

Flyer JN, Zuckerman WA, Richmond ME, Anderson BR, Mendelsberg TG, McAllister JM, Liberman L, Addonizio LJ, Silver ES.

Circulation. 2017 Apr 27. pii: CIRCULATIONAHA.117.028087. doi: 10.1161/CIRCULATIONAHA.117.028087. [Epub ahead of print]

PMID: 28450351

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Select item 28450553

 

  1. Mid-Term Follow-up of School-Aged Children With Borderline Long QT Interval.

Miyazaki A, Sakaguchi H, Matsumura Y, Hayama Y, Noritake K, Negishi J, Tsuda E, Miyamoto Y, Aiba T, Shimizu W, Kusano K, Shiraishi I, Ohuchi H.

Circ J. 2017 Apr 25;81(5):726-732. doi: 10.1253/circj.CJ-16-0991. Epub 2017 Feb 18.

PMID: 28216547 Free Article

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Select item 28444501

 

  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 Apr 24. doi: 10.1111/pace.13100. [Epub ahead of print]

PMID: 28436586

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Select item 28436179

 

  1. The role of echocardiography in fetal tachyarrhythmia diagnosis. A burden for the pediatric cardiologist and a review of the literature.

Gozar L, Marginean C, Toganel R, Muntean I.

Med Ultrason. 2017 Apr 22;19(2):232-235. doi: 10.11152/mu-892.

PMID: 28440361 Free Article

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Select item 28429460

 

  1. Automated T-wave analysis can differentiate acquired QT prolongation from congenital long QT syndrome.

Sugrue A, Noseworthy PA, Kremen V, Bos JM, Qiang B, Rohatgi RK, Sapir Y, Attia ZI, Brady P, Caraballo PJ, Asirvatham SJ, Friedman PA, Ackerman MJ.

Ann Noninvasive Electrocardiol. 2017 Apr 21. doi: 10.1111/anec.12455. [Epub ahead of print]

PMID: 28429460

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Select item 28437292

 

  1. Cardiac Transplantation in Children and Adolescents with Long QT Syndrome.

Kelle AM, Bos JM, Etheridge SP, Cannon BC, Bryant RM, Johnson JN, Ackerman MJ.

Heart Rhythm. 2017 Apr 14. pii: S1547-5271(17)30451-4. doi: 10.1016/j.hrthm.2017.04.023. [Epub ahead of print]

PMID: 28416468

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Select item 28410386

 

  1. Lidocaine Attenuation Testing: An In Vivo Investigation of Putative LQT3-Associated Variants in the SCN5A-Encoded Sodium Channel.

Heather N Anderson MD, Bos JM, Kapplinger JD, Meskill JM, Ye D, Ackerman MJ.

Heart Rhythm. 2017 Apr 12. pii: S1547-5271(17)30448-4. doi: 10.1016/j.hrthm.2017.04.020. [Epub ahead of print]

PMID: 28412158

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Select item 28433559

 

  1. The KCNH2-IVS9-28A/G mutation causes aberrant isoform expression and hERG trafficking defect in cardiomyocytes derived from patients affected by Long QT Syndrome type 2.

Mura M, Mehta A, Ramachandra CJ, Zappatore R, Pisano F, Ciuffreda MC, Barbaccia V, Crotti L, Schwartz PJ, Shim W, Gnecchi M.

Int J Cardiol. 2017 Apr 12. pii: S0167-5273(17)30298-X. doi: 10.1016/j.ijcard.2017.04.038. [Epub ahead of print]

PMID: 28433559

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Select item 28411949

 

  1. Evaluation of QTc in Rett syndrome: Correlation with age, severity, and genotype.

Crosson J, Srivastava S, Bibat GM, Gupta S, Kantipuly A, Smith-Hicks C, Myers SM, Sanyal A, Yenokyan G, Brenner J, Naidu SR.

Am J Med Genet A. 2017 Apr 10. doi: 10.1002/ajmg.a.38191. [Epub ahead of print]

PMID: 28394409

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Select item 28393750

 

  1. Noninvasive predictors of perioperative atrial arrhythmias in patients with tetralogy of Fallot undergoing pulmonary valve replacement.

Cortez D, Barham W, Ruckdeschel E, Sharma N, McCanta AC, von Alvensleben J, Sauer WH, Collins KK, Kay J, Patel S, Nguyen DT.

Clin Cardiol. 2017 Apr 10. doi: 10.1002/clc.22707. [Epub ahead of print]

PMID: 28394443 Free Article

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Select item 28394251

 

  1. Tachycardia cycle and atrioventricular nodal conduction properties in children with supraventricular tachycardia.

Mills M, Dubin AM, Motonaga KS, Ceresnak SR.

Pacing Clin Electrophysiol. 2017 Apr 6. doi: 10.1111/pace.13083. [Epub ahead of print] No abstract available.

PMID: 28383202

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Select item 28390986

 

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

Kean AC, Rodefeld M.

Heart Rhythm. 2017 Apr 5. pii: S1547-5271(17)30314-4. doi: 10.1016/j.hrthm.2017.03.021. [Epub ahead of print] No abstract available.

PMID: 28389305

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Select item 28378434

 

  1. Interpreting Incidentally Identified Variants in Genes Associated With Catecholaminergic Polymorphic Ventricular Tachycardia in a Large Cohort of Clinical Whole-Exome Genetic Test Referrals.

Landstrom AP, Dailey-Schwartz AL, Rosenfeld JA, Yang Y, McLean MJ, Miyake CY, Valdes SO, Fan Y, Allen HD, Penny DJ, Kim JJ.

Circ Arrhythm Electrophysiol. 2017 Apr;10(4). pii: e004742. doi: 10.1161/CIRCEP.116.004742.

PMID: 28404607

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Select item 28356306

 

  1. Effect of Age and Sex on the QTc Interval in Children and Adolescents With Type 1 and 2 Long-QT Syndrome.

Vink AS, Clur SB, Geskus RB, Blank AC, De Kezel CC, Yoshinaga M, Hofman N, Wilde AA, Blom NA.

Circ Arrhythm Electrophysiol. 2017 Apr;10(4). pii: e004645. doi: 10.1161/CIRCEP.116.004645.

PMID: 28356306

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Select item 28408715

 

  1. J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge.

Antzelevitch C, Yan GX, Ackerman MJ, Borggrefe M, Corrado D, Guo J, Gussak I, Hasdemir C, Horie M, Huikuri H, Ma C, Morita H, Nam GB, Sacher F, Shimizu W, Viskin S, Wilde AAM.

Europace. 2017 Apr 1;19(4):665-694. doi: 10.1093/europace/euw235. No abstract available.

PMID: 28431071

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Select item 28431063

 

  1. Corrigendum to ‘Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology‘ [Int. J. Cardiol. 220 (2016) 131-136].

Ertekin E, van Hagen IM, Salam AM, Ruys TP, Johnson MR, Popelova J, Parsonage WA, Ashour Z, Shotan A, Oliver JM, Veldtman GR, Hall R, Roos-Hesselink JW.

Int J Cardiol. 2017 Apr 1;232:348. doi: 10.1016/j.ijcard.2017.01.077. Epub 2017 Jan 27. No abstract available.

PMID: 28139301 Free Article

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Select item 28108573

 

  1. Precision Cardiovascular Medicine: State of Genetic Testing.

Giudicessi JR, Kullo IJ, Ackerman MJ.

Mayo Clin Proc. 2017 Apr;92(4):642-662. doi: 10.1016/j.mayocp.2017.01.015. Review.

PMID: 28385198

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Select item 27827522

 

  1. Early Repolarization in Normal Adolescents is Common.

Ahmed H, Czosek RJ, Spar DS, Knilans TK, Anderson JB.

Pediatr Cardiol. 2017 Apr;38(4):864-872. doi: 10.1007/s00246-017-1594-9. Epub 2017 Apr 3.

PMID: 28367598

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Select item 28361263

 

  1. Arrhythmias After Fontan Operation with Intra-atrial Lateral Tunnel Versus Extra-cardiac Conduit: A Systematic Review and Meta-analysis.

Li D, Fan Q, Hirata Y, Ono M, An Q.

Pediatr Cardiol. 2017 Apr;38(4):873-880. doi: 10.1007/s00246-017-1595-8. Epub 2017 Mar 7.

PMID: 28271152

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Select item 28239753

 

  1. Lateral Atrial Tunnel Fontan Operation Predisposes to the Junctional Rhythm.

Januszewska K, Schuh A, Lehner A, Dalla-Pozza R, Malec E.

Pediatr Cardiol. 2017 Apr;38(4):712-718. doi: 10.1007/s00246-017-1571-3. Epub 2017 Feb 10.

PMID: 28184977

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Select item 28184976

 

  1. Effects of Triple Cryoenergy Application on Lesion Formation and Coronary Arteries in the Developing Myocardium.

Krause U, Abreu da Cunha FD, Backhoff D, Jacobshagen C, Klehs S, Schneider HE, Paul T.

Pediatr Cardiol. 2017 Apr;38(4):663-668. doi: 10.1007/s00246-016-1564-7. Epub 2017 Jan 11.

PMID: 28078383

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Select item 28212163

 

  1. ECGs in the ED.

Tanel RE.

Pediatr Emerg Care. 2017 Apr;33(4):309-310. doi: 10.1097/PEC.0000000000001149. No abstract available.

PMID: 28353534

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Select item 27055169

 

  1. [Our experience in the diagnosis and treatment of postural orthostatic tachycardia syndrome, vasovagal syncope, and inappropriate sinus tachycardia in children].

Ugan Atik S, Dedeoğlu R, Koka A, Öztunç F.

Turk Kardiyol Dern Ars. 2017 Apr;45(3):227-234. doi: 10.5543/tkda.2017.36517. Turkish.

PMID: 28429690 Free Article

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Select item 26085459

 

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CHD Surgery Featured Articles of April 2017

Congenital Heart Surgery Reviews of April 2017 Manuscripts

 

The effects of postoperative hematocrit on shunt occlusion for neonates undergoing single ventricle palliation.

Anderson BR, Blancha VL, Duchon JM, Chai PJ, Kalfa D, Bacha EA, Krishnamurthy G, Ratner V.

J Thorac Cardiovasc Surg. 2017 Apr;153(4):947-955. doi: 10.1016/j.jtcvs.2016.09.085. Epub 2016 Nov 14.

PMID: 27938905

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Select item 28350727

 

 

Take Home Points:

  • In patients undergoing placement of a systemic-to-pulmonary artery shunt, increased hematocrit levels may be associated with early shunt occlusion but not mortality.
  • The optimal anticoagulation strategy following shunt procedures (e.g., aspirin and/or systemic heparin) remains undetermined.

 

jeremy-herrmannCommentary from Dr. Jeremy Herrmann (Indianapolis), section editor of Congenital Heart Surgery Journal Watch:  Defining an optimal range of hematocrit values following cardiac surgery in pediatric patients remains a challenge, particularly for cyanotic patients undergoing placement of a systemic-to-pulmonary artery shunt. The Columbia group reports results of a retrospective analysis of their experience with these shunts from 2010-2015. Eighty neonates were included: 28 with Norwood with modified BT shunt; 39 with modified BT shunt; and 12 with a central shunt. The first postoperative hematocrit values were analyzed in comparison with shunt occlusion and 30-day mortality. Their standard postoperative anticoagulation regimen included aspirin but no systemic heparin. There were 12 instances of shunt occlusion, 5 within the first 24 hours (“early” shunt occlusions). Notably, none of these patients who developed early shunt occlusion died during the study period. There were 6 deaths in the series, 2 of which occurred after late shunt occlusion on postoperative days 12 and 18. On univariable analysis, the two factors associated with increased risk of early shunt occlusion were the first postoperative hematocrit level and later operative era (after July 1, 2014). Interestingly, the first postoperative hematocrit levels were higher in the later operative era, and for each additional 5 additional percentage points of hematocrit value, the risk of early shunt occlusion more than doubled (odds ratio [OR], 2.70; p=0.009). In terms of mortality, increased inotrope score and first postoperative PaO2 were associated with increased mortality in univariable analysis. Increased postoperative hematocrit was also associated with increased inotrope use and higher postoperative PRBC transfusion volumes were associated with increased risk of mortality, but no association between the first postoperative hematocrit and mortality was seen. The authors conclude that lower postoperative hematocrit values may be better for patients undergoing systemic-to-pulmonary artery shunt procedures, though the ideal range remains undetermined. They describe their practice of not transfusing PRBC for levels above 55%. With these results and those from other previous studies that do not strongly support or refute the routine use of systemic heparinization following shunt procedures, the authors continue to routinely use only aspirin in the postoperative period. The results of the present study are compelling regarding the avoidance of high hematocrit levels in the early postoperative period after shunt procedures. However, the question of how best to manage anticoagulation in these patients remains unanswered and may be beyond what a single institution, retrospective study can determine.

 

 


 

  1. Peritoneal Dialysis vs Furosemide for Prevention of Fluid Overload in Infants After Cardiac Surgery: A Randomized Clinical Trial.

Kwiatkowski DM, Goldstein SL, Cooper DS, Nelson DP, Morales DL, Krawczeski CD.

JAMA Pediatr. 2017 Apr 1;171(4):357-364. doi: 10.1001/jamapediatrics.2016.4538.

PMID: 28241247

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Select item 28385198

 

 

Take Home Points:

  • Peritoneal dialysis for postoperative oliguria in infants undergoing cardiac surgery is safe and may offer improved fluid balances, inotropic requirements, electrolyte levels, and less prolonged duration of mechanical ventilation compared to intravenous furosemide therapy.

 

Commentary from Dr. Jeremy Herrmann (Indianapolis), section editor of Congenital Heart Surgery Journal Watch:  Fluid management of neonates following cardiac surgery can be challenging, and fluid overload can be difficult to avoid. In this study, the Cincinnati group conducted a prospective, randomized study comparing the use of intravenous furosemide or peritoneal dialysis (PD) for neonates with postoperative oliguria (urine output <1 ml/kg/hr over a 4-hour period in the first 24 hours). PD catheter placement was planned preoperatively for high-risk patients (age <3 mo undergoing cardiopulmonary bypass, age <4 mo undergoing tetralogy of Fallot or double outlet right ventricle repair, or age <6 mo undergoing heart transplantation) and selectively for other moderate-risk patients. The surgeon was blinded to initial group assignment. Patients were excluded if they had preexisting kidney disease, did not undergo cardiopulmonary bypass during surgery, did not have a PD catheter placed as planned, died during the study period, or required ECMO support or reoperation. Seventy-three patients were included, 32 patients in the furosemide group and 41 in the PD group. The authors observed no difference in the proportion of patients with a negative fluid balance on by the first postoperative day between groups, the but patients in furosemide group were more likely to develop a 10% fluid overload (odds ratio [OR] 3.0, 95% CI 1.3 to 6.9) and require prolonged intubation of more than 72 hours (OR 3.1, 95% CI 1.2 to 8.2). Patients in the PD group demonstrated better fluid balances on postoperative days 1-3, required less inotropic support, and exhibited fewer electrolyte abnormalities compared to the furosemide group. There were 2 adverse events related to PD catheters involving bloody drainage in one patient and a hydrocele in the other, neither of which required intervention. Pleuro-peritoneal communications were identified in 9 patients in the PD group based on drainage of dialysate from the chest tubes, and these patients did not undergo PD as assigned. No difference in mortality was observed.

 

The authors conclude that PD is safe and offers better clinical performance compared to furosemide therapy in oliguric, postoperative infants based on more favorable inotrope use, electrolyte levels, rate of prolonged intubation, and avoidance of fluid overload. However, they also conclude that their study was underpowered to evaluate other clinical outcomes parameters (e.g., length of ICU stay). Given the prospective, randomized nature of this study, these findings are worthy of consideration. Of further interest would be a cost comparison study of PD and furosemide treatment pathways and related clinical outcomes.

CHD Surgery April 2017

 

  1. Resource Utilization Associated with Extracardiac Co-morbid Conditions Following Congenital Heart Surgery in Infancy.

Tuomela KE, Gordon JB, Cassidy LD, Johaningsmeir S, Ghanayem NS.

Pediatr Cardiol. 2017 Apr 29. doi: 10.1007/s00246-017-1620-y. [Epub ahead of print]

PMID: 28456828

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Select item 28455631

 

  1. Lung Transplantation for FLNA-Associated Progressive Lung Disease.

Burrage LC, Guillerman RP, Das S, Singh S, Schady DA, Morris SA, Walkiewicz M, Schecter MG, Heinle JS, Lotze TE, Lalani SR, Mallory GB.

J Pediatr. 2017 Apr 28. pii: S0022-3476(17)30457-2. doi: 10.1016/j.jpeds.2017.03.045. [Epub ahead of print]

PMID: 28457522

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Select item 28457478

 

  1. Mechanical Concepts Applied in Congenital Heart Disease and Cardiac Surgery.

Gerrah R, Haller SJ, George I.

Ann Thorac Surg. 2017 Apr 27. pii: S0003-4975(17)30178-9. doi: 10.1016/j.athoracsur.2017.01.068. [Epub ahead of print] Review.

PMID: 28457478

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Select item 28450553

 

  1. Outcomes of Totally Endoscopic Atrial Septal Defect Closure Using a Glutaraldehyde-Treated Autologous Pericardial Patch.

Nishida H, Nakatsuka D, Kawano Y, Hiraiwa N, Takanashi S, Tabata M.

Circ J. 2017 Apr 25;81(5):689-693. doi: 10.1253/circj.CJ-16-0888. Epub 2017 Feb 8.

PMID: 28179595 Free Article

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Select item 28427582

 

  1. Hospital costs and cost implications of co-morbid conditions for patients with single ventricle in the period through to Fontan completion.

Huang L, Dalziel KM, Schilling C, Celermajer DS, McNeil JJ, Winlaw D, Gentles T, Radford DJ, Cheung M, Bullock A, Wheaton GR, Justo RN, Selbie LA, Forsdick V, Du Plessis K, d’Udekem Y.

Int J Cardiol. 2017 Apr 20. pii: S0167-5273(17)30509-0. doi: 10.1016/j.ijcard.2017.04.056. [Epub ahead of print]

PMID: 28456482

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Select item 28426680

 

  1. Corrigendum to: “Glial fibrillary acidic protein plasma levels are correlated with degree of hypothermia during cardiopulmonary bypass in congenital heart disease surgery” [Interact CardioVasc Thorac Surg 2017]†.

Vedovelli L, Padalino M, D’Aronco S, Stellin G, Ori C, Carnielli VP, Simonato M, Cogo P.

Interact Cardiovasc Thorac Surg. 2017 Apr 17. doi: 10.1093/icvts/ivx072. [Epub ahead of print] No abstract available.

PMID: 28431165

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Select item 28427867

 

  1. New Regenerative Vascular Grafts for Hemodialysis Access: Evaluation of a Preclinical Animal Model.

Valencia Rivero KT, Jaramillo Escobar J, Galvis Forero SD, Miranda Saldaña MC, López Panqueva RDP, Sandoval Reyes NF, Briceño Triana JC.

J Invest Surg. 2017 Apr 17:1-9. doi: 10.1080/08941939.2017.1303100. [Epub ahead of print]

PMID: 28414565

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Select item 28419616

 

  1. The provision of pediatric cardiac anesthesia services in Germany: current status of structural and personnel organization.

Baehner T, Dewald O, Heinze I, Mueller M, Schindler E, Schirmer U, Baumgarten G, Hoeft A, Ellerkmann RK.

Paediatr Anaesth. 2017 Apr 17. doi: 10.1111/pan.13153. [Epub ahead of print]

PMID: 28419616

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Select item 28419229

 

  1. Non-invasive assessment of cerebral oxygen metabolism following surgery of congenital heart disease.

Neunhoeffer F, Sandner K, Wiest M, Haller C, Renk H, Kumpf M, Schlensak C, Hofbeck M.

Interact Cardiovasc Thorac Surg. 2017 Apr 16. doi: 10.1093/icvts/ivx080. [Epub ahead of print]

PMID: 28419229

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Select item 28233535

 

  1. Meta-Analysis of the Effectiveness of Heart Transplantation in Patients With a Failing Fontan.

Tabarsi N, Guan M, Simmonds J, Toma M, Kiess M, Tsang V, Ruygrok P, Konstantinov I, Shi W, Grewal J.

Am J Cardiol. 2017 Apr 15;119(8):1269-1274. doi: 10.1016/j.amjcard.2017.01.001. Epub 2017 Jan 25.

PMID: 28233535

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Select item 28320148

 

  1. Impact of International Quality Improvement Collaborative on Congenital Heart Surgery in Pakistan.

Khan A, Abdullah A, Ahmad H, Rizvi A, Batool S, Jenkins KJ, Gauvreau K, Amanullah M, Haq A, Aslam N, Minai F, Hasan B.

Heart. 2017 Apr 13. pii: heartjnl-2016-310533. doi: 10.1136/heartjnl-2016-310533. [Epub ahead of print]

PMID: 28408415

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Select item 28412186

 

  1. Cardiac surgery in patients with congenital heart disease is associated with acute kidney injury and the risk of chronic kidney disease.

Madsen NL, Goldstein SL, Frøslev T, Christiansen CF, Olsen M.

Kidney Int. 2017 Apr 12. pii: S0085-2538(17)30155-2. doi: 10.1016/j.kint.2017.02.021. [Epub ahead of print]

PMID: 28412020

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Select item 28411047

 

  1. Immunodepression after CPB: Cytokine dynamics and clinics after pediatric cardiac surgery – A prospective trial.

Justus G, Walker C, Rosenthal LM, Berger F, Miera O, Schmitt KRL.

Cytokine. 2017 Apr 11. pii: S1043-4666(17)30085-6. doi: 10.1016/j.cyto.2017.03.017. [Epub ahead of print]

PMID: 28411047

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Select item 28407053

 

  1. Early postoperative physical therapy for improving short-term gross motor outcome in infants with cyanotic and acyanotic congenital heart disease.

Haseba S, Sakakima H, Nakao S, Ohira M, Yanagi S, Imoto Y, Yoshida A, Shimodozono M.

Disabil Rehabil. 2017 Apr 7:1-8. doi: 10.1080/09638288.2017.1309582. [Epub ahead of print]

PMID: 28385091

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Select item 28386957

 

  1. Tetralogy of Fallot Surgical Repair: Shunt Configurations, Ductus Arteriosus and the Circle of Willis.

Piskin S, Unal G, Arnaz A, Sarioglu T, Pekkan K.

Cardiovasc Eng Technol. 2017 Apr 5. doi: 10.1007/s13239-017-0302-5. [Epub ahead of print]

PMID: 28382440

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Select item 28382463

 

  1. Anesthetic Management of a Tracheoesophageal Fistula in a Patient With a Large Uncorrected Aortopulmonary Window: A Case Report.

Adler AC, Steven JM, Jolley MA.

A A Case Rep. 2017 Apr 1;8(7):172-174. doi: 10.1213/XAA.0000000000000460.

PMID: 27941485

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Select item 28029179

 

  1. Transient cortical blindness following intracardiac repair of congenital heart disease in an 11-year-old boy.

Bharati S, Sharma MK, Chattopadhay A, Das D.

Ann Card Anaesth. 2017 Apr-Jun;20(2):256-258. doi: 10.4103/aca.ACA_159_16.

PMID: 28393793 Free Article

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Select item 28393785

 

  1. Modifying risks to improve outcome in cardiac surgery: An anesthesiologist’s perspective.

Chakravarthy M.

Ann Card Anaesth. 2017 Apr-Jun;20(2):226-233. doi: 10.4103/aca.ACA_20_17. Review.

PMID: 28393785 Free Article

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Select item 28393783

 

  1. Coagulopathies in cyanotic cardiac patients: An analysis with three point – of – care testing devices (Thromboelastography, rotational thromboelastometry, and sonoclot analyzer).

Bhardwaj V, Malhotra P, Hasija S, Chowdury UK, Pangasa N.

Ann Card Anaesth. 2017 Apr-Jun;20(2):212-218. doi: 10.4103/aca.ACA_4_17.

PMID: 28393783 Free Article

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Select item 27865477

 

  1. Tracheostomy Among Infants With Hypoplastic Left Heart Syndrome Undergoing Cardiac Operations: A Multicenter Analysis.

Prodhan P, Agarwal A, ElHassan NO, Bolin EH, Beam B, Garcia X, Gaies M, Tang X.

Ann Thorac Surg. 2017 Apr;103(4):1308-1314. doi: 10.1016/j.athoracsur.2016.09.016. Epub 2016 Nov 16.

PMID: 27865477

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Select item 27863728

 

  1. Fontan Patient Survival After Pediatric Heart Transplantation Has Improved in the Current Era.

Simpson KE, Pruitt E, Kirklin JK, Naftel DC, Singh RK, Edens RE, Barnes AP, Canter CE.

Ann Thorac Surg. 2017 Apr;103(4):1315-1320. doi: 10.1016/j.athoracsur.2016.08.110. Epub 2016 Nov 15.

PMID: 27863728

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Select item 28065447

 

  1. Postoperative Infection in Developing World Congenital Heart Surgery Programs: Data From the International Quality Improvement Collaborative.

Sen AC, Morrow DF, Balachandran R, Du X, Gauvreau K, Jagannath BR, Kumar RK, Kupiec JK, Melgar ML, Chau NT, Potter-Bynoe G, Tamariz-Cruz O, Jenkins KJ.

Circ Cardiovasc Qual Outcomes. 2017 Apr;10(4). pii: e002935. doi: 10.1161/CIRCOUTCOMES.116.002935.

PMID: 28408715

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Select item 27356630

 

  1. Comparison of paracorporeal and continuous flow ventricular assist devices in children: preliminary results.

Nassar MS, Hasan A, Chila T, Schueler S, Pergolizzi C, Reinhardt Z, Lord S, De Rita F, Ferguson L, Smith J, Haynes S, O’Sullivan J, Murtuza B.

Eur J Cardiothorac Surg. 2017 Apr 1;51(4):709-714. doi: 10.1093/ejcts/ezx006.

PMID: 28329112

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Select item 28204298

 

  1. Five-year experience with immediate extubation after arterial switch operations for transposition of great arteries.

Varghese J, Kutty S, Bisselou Moukagna KS, Craft M, Abdullah I, Hammel JM.

Eur J Cardiothorac Surg. 2017 Apr 1;51(4):728-734. doi: 10.1093/ejcts/ezw424.

PMID: 28199509

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Select item 28040675

 

  1. The problematic of polytetrafluoroethylene membranes for valvular repair.

Tasoglu I, Avci T, Collaku A, Paç M.

Eur J Cardiothorac Surg. 2017 Apr 1;51(4):805. doi: 10.1093/ejcts/ezw396. No abstract available.

PMID: 28040675

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Select item 28013288

 

  1. Total endoscopic repair of unroofed coronary sinus syndrome via right mini-thoracotomy.

Zaikokuji K, Sawazaki M, Tomari S, Imaeda Y.

Gen Thorac Cardiovasc Surg. 2017 Apr;65(4):206-208. doi: 10.1007/s11748-015-0601-4. Epub 2015 Nov 16.

PMID: 26572766

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Select item 27876287

 

  1. Mid-term Outcomes of Common Congenital Heart Defects Corrected Through a Right Subaxillary Thoracotomy.

An G, Zhang H, Zheng S, Wang W, Ma L.

Heart Lung Circ. 2017 Apr;26(4):376-382. doi: 10.1016/j.hlc.2015.05.028. Epub 2016 Feb 17.

PMID: 27876287

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Select item 28189822

 

  1. Bidirectional cavopulmonary anastomosis with additional pulmonary blood flow: good or bad pre-Fontan strategy†.

Nichay NR, Gorbatykh YN, Kornilov IA, Soynov IA, Ivantsov SM, Gorbatykh AV, Ponomarev DN, Bogachev-Prokophiev AV, Karaskov AM.

Interact Cardiovasc Thorac Surg. 2017 Apr 1;24(4):582-589. doi: 10.1093/icvts/ivw429.

PMID: 28093463

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Select item 28077509

 

  1. The “basic” approach: a single-centre experience with a cost-reducing model for paediatric cardiac extracorporeal membrane oxygenation.

Padalino MA, Tessari C, Guariento A, Frigo AC, Vida VL, Marcolongo A, Zanella F, Harvey MJ, Thiagarajan RR, Stellin G.

Interact Cardiovasc Thorac Surg. 2017 Apr 1;24(4):590-597. doi: 10.1093/icvts/ivw381.

PMID: 28077509

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Select item 28040751

 

  1. Lung ultrasound profile after cardiopulmonary bypass in paediatric cardiac surgery: first experience in a simple cohort†.

Vitale V, Ricci Z, Gaddi S, Testa G, Toma P, Cogo P.

Interact Cardiovasc Thorac Surg. 2017 Apr 1;24(4):598-602. doi: 10.1093/icvts/ivw357.

PMID: 28040749

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Select item 28145049

 

  1. The impact of liver disorders on perioperative management of reoperative cardiac surgery: a retrospective study in adult congenital heart disease patients.

Adachi K, Toyama H, Kaiho Y, Adachi O, Hudeta H, Yamauchi M.

J Anesth. 2017 Apr;31(2):170-177. doi: 10.1007/s00540-017-2308-4. Epub 2017 Jan 16.

PMID: 28091794

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Select item 28092290

 

  1. Preclinical study of patient-specific cell-free nanofiber tissue-engineered vascular grafts using 3-dimensional printing in a sheep model.

Fukunishi T, Best CA, Sugiura T, Opfermann J, Ong CS, Shinoka T, Breuer CK, Krieger A, Johnson J, Hibino N.

J Thorac Cardiovasc Surg. 2017 Apr;153(4):924-932. doi: 10.1016/j.jtcvs.2016.10.066. Epub 2016 Nov 14.

PMID: 27938900

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Select item 27913078

 

  1. Pilot randomized controlled trial on early and late remote ischemic preconditioning prior to complex cardiac surgery in young infants.

Guerra GG, Joffe AR, Seal R, Phillipos E, Wong M, Moez EK, Dinu IA, Duff JP, Ross D, Rebeyka I, Robertson CM.

Paediatr Anaesth. 2017 Apr;27(4):433-441. doi: 10.1111/pan.13125.

PMID: 28300357

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Select item 28239753

 

  1. Increased Atrial β-Adrenergic Receptors and GRK-2 Gene Expression Can Play a Fundamental Role in Heart Failure After Repair of Congenital Heart Disease with Cardiopulmonary Bypass.

Oliveira MS, Carmona F, Vicente WVA, Manso PH, Mata KM, Celes MR, Campos EC, Ramos SG.

Pediatr Cardiol. 2017 Apr;38(4):734-745. doi: 10.1007/s00246-017-1573-1. Epub 2017 Feb 18.

PMID: 28214967

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Select item 28184978

 

  1. Effect of Fenestration on Early Postoperative Outcome in Extracardiac Fontan Patients with Different Risk Levels.

Fan F, Liu Z, Li S, Yi T, Yan J, Yan F, Wang X, Wang Q.

Pediatr Cardiol. 2017 Apr;38(4):643-649. doi: 10.1007/s00246-016-1561-x. Epub 2017 Jan 23.

PMID: 28116475

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Select item 28108756

 

  1. Pediatric airway surgery.

Maeda K.

Pediatr Surg Int. 2017 Apr;33(4):435-443. doi: 10.1007/s00383-016-4050-7. Epub 2017 Jan 28. Review.

PMID: 28132084

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Select item 28025781

 

  1. Cardiac Biomarkers of Low Cardiac Output Syndrome in the Postoperative Period After Congenital Heart Disease Surgery in Children.

Pérez-Navero JL, de la Torre-Aguilar MJ, Ibarra de la Rosa I, Gil-Campos M, Gómez-Guzmán E, Merino-Cejas C, Muñoz-Villanueva MC, Llorente-Cantarero FJ.

Rev Esp Cardiol (Engl Ed). 2017 Apr;70(4):267-274. doi: 10.1016/j.rec.2016.09.011. Epub 2016 Oct 27. English, Spanish.

PMID: 28137395

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Select item 27515125

 

  1. Equine Cardiovascular Therapeutics.

Sleeper MM.

Vet Clin North Am Equine Pract. 2017 Apr;33(1):163-179. doi: 10.1016/j.cveq.2016.11.005. Review.

PMID: 28325177

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Select item 28101777

 

  1. [Association between fluid overload and acute renal injury after congenital heart disease surgery in infants].

Luo DQ, Chen ZL, Dai W, Chen F.

Zhongguo Dang Dai Er Ke Za Zhi. 2017 Apr;19(4):376-380. Chinese.

PMID: 28407819 Free Article

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  1. Cardioprotective Effects of Wharton Jelly Derived Mesenchymal Stem Cell Transplantation in a Rodent Model of Myocardial Injury.

Gaafar T, Attia W, Mahmoud S, Sabry D, Aziz OA, Rasheed D, Hamza H.

Int J Stem Cells. 2017 Apr 30. doi: 10.15283/ijsc16063. [Epub ahead of print]

PMID: 28446005 Free Article

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Select item 28456833

 

  1. The Evolution of a Pediatric Ventricular Assist Device Program: The Boston Children’s Hospital Experience.

Hawkins B, Fynn-Thompson F, Daly KP, Corf M, Blume E, Connor J, Porter C, Almond C, VanderPluym C.

Pediatr Cardiol. 2017 Apr 29. doi: 10.1007/s00246-017-1615-8. [Epub ahead of print]

PMID: 28456829

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Select item 28456828

 

  1. Three-Dimensional Modeling in Congenital and Structural Heart Perioperative Care and Education: A Path in Evolution.

Sarris GE, Polimenakos AC.

Pediatr Cardiol. 2017 Apr 29. doi: 10.1007/s00246-017-1614-9. [Epub ahead of print] No abstract available.

PMID: 28456827

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Select item 28455909

 

  1. Emergency department utilization in pediatric heart transplant recipients.

Wittlieb-Weber CA, Rossano JW, Weber DR, Lin KY, Ravishankar C, Mascio CE, Shaddy RE, O’Connor MJ.

Pediatr Transplant. 2017 Apr 29. doi: 10.1111/petr.12936. [Epub ahead of print]

PMID: 28455909

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Select item 28455631

 

  1. Impact of Surgery in Ebstein’s Anomaly Using Current Surgical Criteria.

Ávila-Vanzzini N, Fritche-Salazar JF, Herrera-Bello H, Espinola-Zavaleta N, Kuri Alfaro J, Rodriguez-Zanella H, Álvarez Bran MV, Cossio Aranda J, Gaxiola Macias MBA, Curi-Curi P.

Circ J. 2017 Apr 26. doi: 10.1253/circj.CJ-17-0062. [Epub ahead of print]

PMID: 28450668 Free Article

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Select item 28216547

 

  1. Heart Transplantation in a Toddler with Cardiac Kawasaki Disease.

Tirilomis T, Steinmetz M, Grossmann M, Bräuer A, Paul T, Ruschewski W, Schöndube FA.

Front Surg. 2017 Apr 20;4:21. doi: 10.3389/fsurg.2017.00021. eCollection 2017.

PMID: 28473974

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Select item 28438441

 

  1. Immunodepression after CPB: Cytokine dynamics and clinics after pediatric cardiac surgery – A prospective trial.

Justus G, Walker C, Rosenthal LM, Berger F, Miera O, Schmitt KRL.

Cytokine. 2017 Apr 11. pii: S1043-4666(17)30085-6. doi: 10.1016/j.cyto.2017.03.017. [Epub ahead of print]

PMID: 28411047

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Select item 28402400

 

  1. Unplanned cardiac reoperations and interventions during long-term follow-up after the Norwood procedure†.

Sames-Dolzer E, Gierlinger G, Kreuzer M, Schrempf J, Gitter R, Prandstetter C, Tulzer G, Mair R.

Eur J Cardiothorac Surg. 2017 Apr 11. doi: 10.1093/ejcts/ezx038. [Epub ahead of print]

PMID: 28402400

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Select item 28457561

 

  1. Complicated Postoperative Course after Pulmonary Artery Sling Repair and Slide Tracheoplasty.

Weber A, Donner B, Perez MH, Di Bernardo S, Trachsel D, Sandu K, Sekarski N.

Front Pediatr. 2017 Apr 10;5:67. doi: 10.3389/fped.2017.00067. eCollection 2017.

PMID: 28443268 Free PMC Article

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Select item 28394184

 

  1. Neonatal repair of left atrial diverticulum with gigantic thrombus without cardiopulmonary bypass.

Higashida A, Hoashi T, Sakaguchi H, Ichikawa H.

Gen Thorac Cardiovasc Surg. 2017 Apr 8. doi: 10.1007/s11748-017-0775-z. [Epub ahead of print]

PMID: 28391520

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Select item 28389745

 

  1. Cancer recurrence and mortality after pediatric heart transplantation for anthracycline cardiomyopathy: A report from the Pediatric Heart Transplant Study (PHTS) group.

Bock MJ, Pahl E, Rusconi PG, Boyle GJ, Parent JJ, Twist CJ, Kirklin JK, Pruitt E, Bernstein D.

Pediatr Transplant. 2017 Apr 4. doi: 10.1111/petr.12923. [Epub ahead of print]

PMID: 28378408

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Select item 28367761

 

  1. Twin-to-Twin Heart Transplantation: A Unique Event With a 25-Year Follow-Up.

Blitzer D, Yedlicka G, Manghelli J, Dentel J, Caldwell R, Brown JW.

Ann Thorac Surg. 2017 Apr;103(4):e341-e342. doi: 10.1016/j.athoracsur.2016.09.060.

PMID: 28359493

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Select item 28274521

 

  1. Cavopulmonary Anastomosis During Same Hospitalization as Stage 1 Norwood/Hybrid Palliative Surgery.

Tadphale SD, Tang X, ElHassan NO, Beam B, Prodhan P.

Ann Thorac Surg. 2017 Apr;103(4):1285-1291. doi: 10.1016/j.athoracsur.2017.01.013. Epub 2017 Mar 6.

PMID: 28274521

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Select item 27865477

 

  1. Allograft Heart Valves: Current Aspects and Future Applications.

Lisy M, Kalender G, Schenke-Layland K, Brockbank KG, Biermann A, Stock UA.

Biopreserv Biobank. 2017 Apr;15(2):148-157. doi: 10.1089/bio.2016.0070. Epub 2017 Feb 2. Review.

PMID: 28151005

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Select item 28067869

 

  1. Dissecting aneurysm of the interventricular septum due to rupture of the sinus of Valsalva.

Atiq M, Ali F, Hasan SB.

Cardiol Young. 2017 Apr;27(3):609-612. doi: 10.1017/S1047951116001621. Epub 2016 Nov 22.

PMID: 27873570

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Select item 27817752

 

  1. Successful replacement of the systemic tricuspid valve with a mechanical valve in a 3-month-old boy with congenitally corrected transposition of the great arteries having a dysplastic tricuspid valve.

Asada D, Ikeda K, Yamagishi M.

Cardiol Young. 2017 Apr;27(3):597-599. doi: 10.1017/S1047951116001578. Epub 2016 Sep 29.

PMID: 27680744

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Select item 27680574

 

  1. Impact of age on incidence and prevalence of moderate-to-severe cellular rejection detected by routine surveillance biopsy in pediatric heart transplantation.

Zinn MD, Wallendorf MJ, Simpson KE, Osborne AD, Kirklin JK, Canter CE.

J Heart Lung Transplant. 2017 Apr;36(4):451-456. doi: 10.1016/j.healun.2016.09.017. Epub 2016 Oct 7.

PMID: 27865735

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Select item 27865734

 

  1. Vascular endothelial growth factor A is associated with the subsequent development of moderate or severe cardiac allograft vasculopathy in pediatric heart transplant recipients.

Daly KP, Stack M, Eisenga MF, Keane JF, Zurakowski D, Blume ED, Briscoe DM.

J Heart Lung Transplant. 2017 Apr;36(4):434-442. doi: 10.1016/j.healun.2016.09.013. Epub 2016 Oct 3.

PMID: 27865734

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Select item 28248910

 

  1. The effects of postoperative hematocrit on shunt occlusion for neonates undergoing single ventricle palliation.

Anderson BR, Blancha VL, Duchon JM, Chai PJ, Kalfa D, Bacha EA, Krishnamurthy G, Ratner V.

J Thorac Cardiovasc Surg. 2017 Apr;153(4):947-955. doi: 10.1016/j.jtcvs.2016.09.085. Epub 2016 Nov 14.

PMID: 27938905

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Select item 28350727

 

  1. Peritoneal Dialysis vs Furosemide for Prevention of Fluid Overload in Infants After Cardiac Surgery: A Randomized Clinical Trial.

Kwiatkowski DM, Goldstein SL, Cooper DS, Nelson DP, Morales DL, Krawczeski CD.

JAMA Pediatr. 2017 Apr 1;171(4):357-364. doi: 10.1001/jamapediatrics.2016.4538.

PMID: 28241247

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Select item 28385198

 

  1. Veno-Venous ECMO in Europe: are we all speaking the same language?

Pappalardo F, Montisci A, Scandroglio A, Belliato M, Malfertheiner M, Broman M, David P, Lorusso R, Taccone F, Broccati F, DI Nardo M.

Minerva Anestesiol. 2017 Apr;83(4):424-425. doi: 10.23736/S0375-9393.16.11766-3. Epub 2016 Nov 9. No abstract available.

PMID: 27827522

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Select item 27807125

 

  1. Routine Application of Bloodless Priming in Neonatal Cardiopulmonary Bypass: A 3-Year Experience.

Boettcher W, Sinzobahamvya N, Miera O, Redlin M, Dehmel F, Cho MY, Murin P, Berger F, Photiadis J.

Pediatr Cardiol. 2017 Apr;38(4):807-812. doi: 10.1007/s00246-017-1585-x. Epub 2017 Feb 14.

PMID: 28197644

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Select item 28190141

 

  1. Predicting Fluid Responsiveness in Children Undergoing Cardiac Surgery After Cardiopulmonary Bypass.

Favia I, Romagnoli S, Di Chiara L, Ricci Z.

Pediatr Cardiol. 2017 Apr;38(4):787-793. doi: 10.1007/s00246-017-1582-0. Epub 2017 Feb 11.

PMID: 28190141

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Select item 28184979

 

  1. Association Between Hematologic and Inflammatory Markers and 31 Thrombotic and Hemorrhagic Events in Berlin Heart Excor Patients.

Iyengar A, Hung ML, Asanad K, Kwon OJ, Jackson NJ, Reemtsen BL, Federman MD, Biniwale RM.

Pediatr Cardiol. 2017 Apr;38(4):770-777. doi: 10.1007/s00246-017-1578-9. Epub 2017 Feb 10.

PMID: 28184979

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Select item 28184978

 

  1. Alteration of Cardiac Deformation in Acute Rejection in Pediatric Heart Transplant Recipients.

Chanana N, Van Dorn CS, Everitt MD, Weng HY, Miller DV, Menon SC.

Pediatr Cardiol. 2017 Apr;38(4):691-699. doi: 10.1007/s00246-016-1567-4. Epub 2017 Feb 4.

PMID: 28161809

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Select item 28154913

 

 

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ACHD Featured Articles of April 2017

Adult Congenital Heart Reviews of April 2017 Manuscripts, sponsored by the International Society for Adult Congenital Heart Disease

 

  1. Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease. Hayward RM, Foster E, Tseng ZH. JAMA Cardiol. 2017 Apr 12. doi: 10.1001/jamacardio.2017.0283. [Epub ahead of print] PMID: 28403428 Similar articles Select item 28412020

 

Take Home Points:

  • California delivery hospitals demonstrated an association with congenital heart disease, and congestive heart failure admissions, atrial arrhythmias, and fetal growth restriction.
  • Maternal complex congenital heart disease is associated with ventricular arrhythmias and maternal in hospital mortality, though rare.
  • Increased monitoring at the time of delivery may be recommended as a result.
  • Post delivery there is an increased likelihood of readmission that is markedly increased when compared to pregnant women without CHD.

 

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

This investigation from January 1st 2005 to December 31st, 2011 reviewed more than 3 million deliveries in the state of California with its diverse population, and a variety of centers.  Of those 3 million deliveries, 3189 women had noncomplex congenital heart disease and 262 had complex congenital heart disease. Women with CHD were more likely to undergo Caesarian delivery (39%), compared with women without CHD (32%). Interestingly 54.9% of the women in this cohort who had  Tetralogy of Fallot underwent C-section. This marked increase above baseline C-section rates clashes with the maternal indications for C-section, suggesting that the number of C-sections performed on women with TOF is out of proportion with those that are considered necessary by WHO risk stratification criteria. Complex congenital heart disease was associated with greater adjusted odds of serious ventricular arrhythmias and maternal in hospital mortality. Both simple and complex congenital heart disease women were at higher risk for readmission, atrial arrhythmias, heart failure, and fetal growth restriction as compared with the women without congenital heart disease.

This study expertly molds a large publicly available dataset from the HCUP data at UCSF allowing the authors to investigate an important question relating to outcomes associated with pregnancy in CHD.  Though valuable overall, this large database is limited by the specificity of coding classifications, and the transition from ICD 9 to ICD 10 in recent years, which occurred following the data collected in this paper.  Complex CHD included endocardial cushion defects, hypoplastic left heart syndrome, tetralogy of Fallot, transposition of the great arteries, truncus arteriosus, and univentricular heart defects.  All other defects were classified as noncomplex.

ACHD1 v2

The figure above alludes to the increasing likelihood of readmissions for patients with congenital heart disease over the course of the 6 years following delivery. Though this data does not differentiate non pregnancy related complications from overall cardiac complications, it does suggest that pregnancy may present an important milestone determining later outcomes. However, no comparative non-pregnant data is presented, making proper interpretation of such data somewhat speculative

This is nevertheless an important study as it demonstrates an overall decrease in maternal comorbidities compared with the previously reported data by Siu et al. More study as well as collaboration is certainly needed.

 

 

NT-proBNP predicts mortality in adults with transposition of the great arteries late after Mustard or Senning correction.

Popelová JR, Tomková M, Tomek J.

Congenit Heart Dis. 2017 Apr 17. doi: 10.1111/chd.12466. [Epub ahead of print]

PMID: 28419713

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Select item 28417257

 

 

Take Home Points:

 

  • Patients with a Mustard or Senning operation are at risk of unexpected deaths due to heart failure and arrhythmias
  • NT-proBNP was the most useful independent predictor of mortality (HR 281.39), using univariate Cox Regression. A value of 1000 pg/mL had a 88% sensitivity and 95% specificity for the prediction of mortality.
  • Surprisingly, mitral E velocity of 0.68 m/s or greater was associated with improved survival i.e. in the subpulmonary ventricle.

 

Blanche CupidoCommentary from Dr Blanche Cupido (Cape Town, South Africa), section editor of ACHD Journal Watch: Mustard and Senning corrections for transposition of the great arteries have largely been replaced by the arterial switch operation. However a number of such operations continue to be performed in the developing world for simple transposition of the great arteries. Although most patients remain asymptomatic for many years, they may die unexpectedly, usually as a result of heart failure of arrhythmias.  As risk factors for mortality, especially sudden cardiac death remain elusive, the authors of this study sought to investigate the predictors for mortality in adult patients with Mustard or Senning repairs.

 

Eighty-seven patients (39 Senning and 48 Mustard) were followed in an outpatient setting over a 10 years (2005-2015).  They underwent serial clinical [all], echocardiographic [all] and NT-proBNP measurements. CMR data was available in 18% and VO2max measurements in 44%.

 

The majority of patients were male (n=64, 74%). Those with a Mustard correction were significantly older (age 30 vs 21, p<0.0001) and had higher NT-proBNP levels (287 vs 144, p=0.00058) when compared to Senning patients.

 

The overall mortality was 9% (n=8) with no significant differences between the two groups. One of the patients died of early rejection post transplantation, the rest were due to heart failure.

ACHD2

 

NT-proBNP and the mitral E velocity were the only two independent predictors for death that emerged on multivariable analysis (NT-proBNP HR 281.39 (CI 13.06-6063, p=0.00048; and mitral E velocity HR 0.95 (CI 0.90-0.99, p=0.01815).

ACHD3

 

An NT-proBNP level of <1000 pg/mL correlated with improved survival.

ACHD4

 

A baseline mitral E velocity of >0.68m/s was associated with improved survival. Further validation is required. NYHA class and doppler and tissue doppler parameters relating to the systemic RV, surprisingly, did not show significant differences.

The findings of this study need verification however in larger datasets. Because of the relatively small numbers in this particular study, and the small number of outcomes, multivariable time dependent analysis was not possible.

 

Epidemiological changes in Eisenmenger syndrome in the Nordic region in 1977-2012.

Heart. 2017 Apr 27. pii: heartjnl-2016-310979. doi: 10.1136/heartjnl-2016-310979. [Epub ahead of print]

Hjortshøj CS1Jensen AS1Sørensen K2Nagy E3Johansson B4Kronvall T5Dellborg M6Estensen ME7Holmstrøm H8Turanlahti M9Thilén U10Søndergaard L1.

PMID: 28450553

Take Home Points:
• During the last 4 decades, the incidence and prevalence of Eisenmenger syndrome in the Nordic region has decreased.
• During the last 4 decades, the age of death increased, which may not necessarily reflect improved survival, but is more likely the result of decreased incidence and shifting of age distribution.
• Median survival of Eisenmenger syndrome patients is significantly lower than the background population.
• Down syndrome patients with Eisenmenger syndrome appear to have worse survival.

jokhadar-maanCommentary from Dr. Maan Jokhadar (Atlanta), section editor of ACHD Journal Watch: Eisenmenger syndrome (ES) is a late complication of unrepaired large systemic to pulmonary shunt that is characterized by increased pulmonary vascular resistance, pulmonary hypertension, and cyanosis with its associated features of digital clubbing and exertional dyspnea. ES was more common before modern diagnostic methods and surgical correction became available.
Though several studies report ES survival rates, the results are often influenced by so-called “immortal time bias” also known as survivor bias. Because recruit starts at time of diagnosis of start of late follow-up, there is an inherent bias toward survivors as earlier events such as mortality are not normally capture in such analyses. ES late survival is therefore likely to be overestimated when age is used as the time scale variable for Kaplan-Meier survival analyses without accounting for all events that have happened from the time of birth, which for most studies is not feasible.
Therefore, the time from diagnosis to start of follow-up should be removed from the analysis, by accounting for the age at entry to the study.
With this in mind, Dr. Hjortshøj and colleagues from Denmark, Sweden, Norway, and Finland performed a retrospective population based analysis through an extensive search of national registries and found 714 patients with ES between 1977 and 2012. It should be noted that patients with surgically corrected shunts but with persistent pulmonary hypertension were not included in the study.
The results were as follows:
ES incidence decreased from 2.5 to 0.23/million inhabitants/year.
ES prevalence decreased from 24.6 to 12.0/million inhabitants.
The mean age of the study population increased from about 19.9 in 1977 to 40.4 in 2012. The rate of deaths per million inhabitants increased as well. The absolute number of children with ES decreased throughout the study period.
The annual mortality rate was about 2.3%
The median survival was about 38.4 years, which is lower than the median survival of 81.6 years for the matched background control population.
Patients with simple shunts appear to survive longer than patients with complex lesions.
Down syndrome patients appeared to have worse mortality, particularly after factoring in the high preoperative mortality following shunt corrective surgery.
The mean age of death was 27.7 during the first era of the study (1977 to 1992), which was 38.8 during the second era (1993 to 2006), and was 46.3 during the last era (2006 to 2012). Though the study showed an increase in the age of death throughout the study, this may not represent improved longevity, but rather the result of decreasing incidence on age distribution that leads to an older study population.
The results of this study suggest that a reduced incidence of ES is due to earlier detection and treatment of patients with congenital heart disease. However, there will likely remain a small subset of patients with complex lesions who are unsuitable for surgical correction and will go on to develop ES. These findings in this Nordic population are likely similar to other developed countries, but quite different from developing countries where early access to diagnosis and treatment is less common.
Long-term outcomes of pulmonary arterial hypertension under specific drug therapy in Eisenmenger syndrome.

Hascoët S1, Baruteau AE2, Humbert M3, Simonneau G3, Jais X3, Petit J2, Laux D2, Sitbon O3, Lambert V4, Capderou A5.

J Heart Lung Transplant. 2017 Apr;36(4):386-398. doi: 10.1016/j.healun.2016.10.006. Epub 2016 Oct 15.

 

 

Take Home Points:

 

  • There is little long-term data in usefulness of PAH-specific drug therapy (PAH-SDT) in Eisenmenger syndrome
  • In this study, 69 patients with Eisenmenger syndrome were followed over 20 years using a structured follow-up including thorough hemodynamics (with measured VO2) and clinical status
  • PAH-SDT resulted in improvement in measured hemodynamics in 68.0% of patients; however after a median of 4.9 years, changes in hemodynamic measures were no longer significant
  • Even with PAH-SDT, there was a high event rate (death, heart-lung transplantation, or listing for transplantation), with a 15-year cumulative event rate of 49.2%
  • Independent predictors of events were superior vena cava oxygen saturation and hemodynamic reponse to PAH-SDT

 

Kay_William_MD.16.CVaCommentary from Dr. W. Aaron Kay (Indianapolis), section editor of ACHD Journal Watch: This study from France quite thoroughly evaluated a cohort of 69 patients with Eisenmenger syndrome who were treated with PAH-specific drug therapy (PAH-SDT).  All patients underwent thorough invasive hemodynamics, including a measured, rather than calculated, VO2, as well as 6-minute walk distance and WHO functional status.    All patients had measurement of indexed pulmonary output (Qpi), pulmonary vascular index (PVRi), and superior vena cava oxygen saturation.  All patients had an initial PVRi > 8 Woods units * m2 at the start of the study, and all patients were on PAH-SDT (i.e. there was no control group).

Measured hemodynamics improved in the majority of patients, 68.0% of the sample. The hemodynamic response and clinical response was generally initially good.  Overall increase in Qpi was 0.4 LPM/m2.  Overall increase in 6MW distane was +49 m.   Changes in hemodynamics and 6MW distance were assessed after each change in treatment (i.e. intensification or addition of a 2nd or 3rd drug).  The treatment effect was found not to be sustained over long-term follow-up, with changes no longer being significant after a median of 4.9 years.

Events were common; 33.3% of patients met the composite endpoint of death, heart-lung transplant, or listing for transplantation after a median of 7.2 years.  The 15-year cumulative event rate was 49.2%.  Median time to event was 8.1 years.  Patients with events had worse hemodynamics at baseline.  On univariate analysis, predictors of events were a PVRi > 30 Woods Units * m2, right atrial pressure > 4 mmHg, and SVC saturation < 65%, and pulmonary artery saturation < 70%.  On multivariate analysis,  SVC saturation was found to correlate with event rate.  Each 1% decrease in SVC saturation was associated with a 9.8% increase in hazard ratio for events.  SVC saturation in Eisenmenger syndrome reflects both arterial saturation as well as systemic cardiac output.

This study showed some evidence that patients with pretricuspid shunts may have more benefit from PAH-SDT than those with posttricuspid shunts; however the authors caution this may be artifact from “immortal survival bias.”  Atrial septal defects were the most common underlying CHD in this cohort (n=43, 62.3%).

The authors conclude that PAH-SDT can be helpful in Eisenmenger syndrome, but the regimen may need to be individualized base on hemodynamic changes for each patient.

ACHD5

 

 

Figure 4 Kaplan-Meier cumulative event curves in the sub-group (E),aortic oxygen saturation, (F) SVC oxygen saturation, (G),and pattern of hemodynamic change under PAH-SDT(H).

 

 

 

Is the presence of end-diastolic forward flow specific for restrictive right ventricular physiology in repaired tetralogy of Fallot?

 

Mori Y, Murakami T, Inoue N, Kaneko S, Nakashima Y, Koide M.

Int J Cardiol. 2017 Apr 11. pii: S0167-5273(16)34242-5. doi: 10.1016/j.ijcard.2017.04.021. [Epub ahead of print]

PMID

 

Take Home Points:

 

  • From past publications, end diastolic forward flow (EDFF) in repaired tetralogy of Fallot [TOF] has been considered to be synonymous with restrictive right ventricular (RV) physiology.
  • In the present study patients with EDFF have different hemodynamics as compared to those without: higher RA pressure, higher RA to PA pressures gradient, and had higher ANP levels
  • Not all patients who demonstrate EDFF, have restrictive RV physiology when taking invasive hemodynamics into account
  • Patients with a small RV and EDFF demonstrate restrictive RV physiology, and demonstrate associated invasive hemodynamics
  • Patients with large RV and EDFF do not demonstrate restrictive RV physiology. Instead, they may have very low pulmonary diastolic pressure, which is lower than right atrial pressure, resulting in EDFF during RA contraction.

 

Leong Ming ChernCommentary from Dr. M.C. Leong (Kuala Lumpur), section editor of ACHD Journal Watch:  The presence of end diastolic forward flow (EDFF) in the pulmonary arteries on echocardiography or cardiac magnetic resonance has been regarded as the hallmark echocardiopgraphic feature of restrictive right ventricular (RV) physiology in repaired Tetralogy of Fallot. However not all such patients have good late outcomes. A recent study found that TOF patients with EDFF have good effort tolerance only if associated with small right ventricles. The authors of the current study therefore sought to demonstrate that not all patients with EDFF on echocardiography have higher right ventricular filling pressures via cardiac catheterizations.

 

62 patients with repaired TOF were retrospectively reviewed. They were aged 15.7 ± 11.6 years, and underwent cardiac catheterization. Patients were then divided into Group 1 (n=23) with and Group 2 (n=39) without EDFF; Group A (n=53) with small RVs (<150ml/m2) and Group B (n=9) with larger RV (≥150ml/m2). Group 1 had a higher right atrial pressure, pressure gradient between the right atrium and pulmonary diastolic pressure and atrial natriuretic peptide levels. Group A had better RV and left ventricular ejection fraction and smaller LV size.

 

However, on further subgroup analysis, patients with EDFF and smaller RV (Group 1A) had higher right atrial pressure and less pulmonary regurgitation than the rest of the groups. Patients with large RV and EDFF (Group 1B) had right atrial pressure and RV end diastolic pressure similar to those without EDFF. This group of patients had higher pressure gradient between the right atrium and pulmonary diastolic pressure compared to patients without EDFF.

ACHD6ACHD7-1

 

The authors hence postulate that patients in Group 1A corresponds to “true” restrictive RV physiology. However, patients in Group 1B may not have true restrictive RV physiology, despite EDFF. Instead, they may have severe pulmonary regurgitation which results in very low pulmonary diastolic pressure, which created a high gradient between the right atrium and pulmonary diastolic pressure and hence EDFF.

    

 

ACHD April 2017

 

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Hjortshøj CS, Jensen AS, Sørensen K, Nagy E, Johansson B, Kronvall T, Dellborg M, Estensen ME, Holmstrøm H, Turanlahti M, Thilén U, Søndergaard L.

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PMID: 28450553

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