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  • Open Access

    ARTICLE

    Long‐term cardiovascular outcome of Williams syndrome

    Seul Gi Cha1, Mi Kyung Song1, Sang Yun Lee1, Gi Beom Kim1, Jae Gun Kwak2, Woong Han Kim2, Eun Jung Bae1

    Congenital Heart Disease, Vol.14, No.5, pp. 684-690, 2019, DOI:10.1111/chd.12810

    Abstract Objective: Cardiovascular lesions are the leading cause of morbidity and mortality in patients with Williams syndrome. Recent studies have rebutted conventional reports about the natural course of cardiovascular anomalies in Williams syndrome.
    Design: Retrospective study.
    Setting: Single tertiary center.
    Patients: Eighty patients with Williams syndrome followed up for more than 5 years.
    Interventions: Not applicable.
    Outcome Measures: Long‐term outcome of cardiovascular lesions, peak velocity change in obstructive cardiovascular lesions over time, post‐interventional courses of disease‐specific intervention, and intervention‐free survival of obstructive cardio‐ vascular lesions.
    Results: The median follow‐up duration was 11.0 (5.1‐28.3) years. Among 80 pa‐ tients, supravalvular aortic stenosis… More >

  • Open Access

    ARTICLE

    Catheter‐associated bloodstream infection incidence and outcomes in congenital cardiac surgery

    Brena Sue Haughey1, Shelby Coral White2, Michael David Seckeler2

    Congenital Heart Disease, Vol.14, No.5, pp. 811-813, 2019, DOI:10.1111/chd.12809

    Abstract Objective: Catheter‐associated bloodstream infections complicate and prolong hos‐ pitalizations. The incidence of catheter‐associated bloodstream infections in children undergoing congenital cardiac surgery has not been reported. This study sought to define the incidence of catheter‐associated bloodstream infections after congenital cardiac surgery in neonates and infants ≤12 months old and compare hospital out‐ comes and costs to those who underwent surgery and did not have a catheter‐associ‐ ated bloodstream infections.
    Design: Retrospective review of hospital admissions between October 2013 and November 2015 for neonates and infants ≤12 months old at admission with ICD‐9 codes for congenital cardiac surgery from discharge data from… More >

  • Open Access

    ARTICLE

    Ancillary referral patterns in infants after initial assessment in a cardiac developmental outcomes clinic

    Sonia A. Monteiro1, Faridis Serrano1, Rocky Tsang1, Eboni Smith Hollier1, Danielle Guffey2, Lisa Noll1, Robert G. Voigt1, Nancy Ghanayem1, Lara Shekerdemian1

    Congenital Heart Disease, Vol.14, No.5, pp. 797-802, 2019, DOI:10.1111/chd.12789

    Abstract Objective: Neurodevelopmental impairment is common after surgery for congeni‐ tal heart disease (CHD) in infancy. While neurodevelopmental follow‐up of high‐risk patients has increased, the referral patterns for ancillary services following initial evaluation have not been reported. The aim of this study is to describe the rates and patterns of referral at the initial visit to our outcomes clinic of patients who under‐ went surgery for CHD during infancy.
    Outcomes Measures: The Cardiac Developmental Outcomes Program clinic at Texas Children’s Hospital provides routine longitudinal follow‐up with developmental pedi‐ atricians and child psychologists for children who required surgery for CHD within the… More >

  • Open Access

    ARTICLE

    Clinic nonattendance is associated with increased emergency department visits in adults with congenital heart disease

    Katherine Awh1,2, Morgan A. Venuti1,2, Lacey P. Gleason1,2, Rachel Rogers3, Srinivas Denduluri1, Yuli Y. Kim1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 726-734, 2019, DOI:10.1111/chd.12784

    Abstract Objective: To determine the prevalence and predictors of nonattendance in an ACHD outpatient clinic, and to examine the relationship between nonattendance and emergency department (ED) visits, hospitalizations, and death.
    Methods: Patients ≥ 18 years who had scheduled appointments at an ACHD outpatient clinic between August 1, 2014 and December 31, 2014 were included. The primary outcome of interest was nonattendance of the first scheduled appointment of the study period, defined as “no-show” or “same-day cancellation.” Secondary outcomes of interest were ED visits, hospitalizations, and death until December 2017.
    Results: Of 527 scheduled visits, 55 (10.4%) were nonattended. Demographic and socioeconomic… More >

  • Open Access

    ARTICLE

    Accuracy of risk prediction scores in pregnant women with congenital heart disease

    Yuli Y. Kim1,2, Leah A. Goldberg2, Katherine Awh2, Tanmay Bhamare1,2, David Drajpuch2, Adi Hirshberg3, Sara L. Partington1,2, Rachel Rogers4, Emily Ruckdeschel1,2, Lynda Tobin1, Morgan Venuti2, Lisa D. Levine3

    Congenital Heart Disease, Vol.14, No.3, pp. 470-478, 2019, DOI:10.1111/chd.12750

    Abstract Objective: To assess performance of risk stratification schemes in predicting adverse cardiac outcomes in pregnant women with congenital heart disease (CHD) and to compare these schemes to clinical factors alone.
    Design: Single‐center retrospective study.
    Setting: Tertiary care academic hospital.
    Patients: Women ≥18 years with International Classification of Diseases, Ninth Revision, Clinical Modification codes indicating CHD who delivered between 1998 and 2014. CARPREG I and ZAHARA risk scores and modified World Health Organization (WHO) criteria were applied to each woman.
    Outcome Measures: The primary outcome was defined by ≥1 of the following: arrhyth‐ mia, heart failure/pulmonary edema, transient ischemic attack, stroke,… More >

  • Open Access

    ARTICLE

    Comprehensive comparative outcomes in children with congenital heart disease: The rationale for the Congenital Catheterization Research Collaborative

    Christopher J. Petit1, Athar M. Qureshi2, Andrew C. Glatz3, Courtney E. McCracken1, Michael Kelleman1, George T. Nicholson4, Jeffery J. Meadows5, Shabana Shahanavaz6, Jeffrey D. Zampi7, Mark A. Law8, Joelle A. Pettus1, Bryan H. Goldstein9

    Congenital Heart Disease, Vol.14, No.3, pp. 341-349, 2019, DOI:10.1111/chd.12737

    Abstract Clinical research in the treatment of patients with congenital heart disease (CHD) is limited by the wide variety of CHD manifestations and therapeutic options as well as the generally low incidence of CHD. The availability of comprehensive, contemporary outcomes studies is therefore limited. This inadequacy may result in a lack of data‐driven medical decision making. In 2013, clinician scientists at two centers begana researchcollaboration,the Congenital Catheterization Research Collaborative (CCRC). Over time, the CCRC has grown to include nine cardiac centers from across the United States, with a common data coordinating center. The CCRC seeks to generate high‐quality, contemporary, statistically robust,… More >

  • Open Access

    ARTICLE

    Vasopressor magnitude predicts poor outcome in adults with congenital heart disease after cardiac surgery

    Joseph T. Poterucha1, Saraschandra Vallabhajosyula2, Alexander C. Egbe2, Joseph S. Krien3, Devon O. Aganga4, Kimberly Holst5, Adele W. Golden6, Joseph A. Dearani5, Sheri S. Crow4

    Congenital Heart Disease, Vol.14, No.2, pp. 193-200, 2019, DOI:10.1111/chd.12717

    Abstract Background: High levels of vasoactive inotrope support (VIS) after congenital heart surgery are predictive of morbidity in pediatric patients. We sought to discern if this relationship applies to adults with congenital heart disease (ACHD).
    Methods: We retrospectively studied adult patients (≥18 years old) admitted to the intensive care unit after cardiac surgery for congenital heart disease from 2002 to 2013 at Mayo Clinic. Vasoactive medication dose values within 96 hours of admis‐ sion were examined to determine the relationship between VIS score and poor out‐ come of early mortality, early morbidity, or complication related morbidity.
    Results: Overall, 1040 ACHD patients… More >

  • Open Access

    ARTICLE

    The long‐term functional outcome in Mustard patients study: Another decade of follow‐up

    Nayan T. Srivastava1,2, Roger Hurwitz3, W. Aaron Kay4, George J. Eckert5, Alisha Kuhlenhoelter6, Nicole DeGrave2, Eric S. Ebenroth2,6

    Congenital Heart Disease, Vol.14, No.2, pp. 176-184, 2019, DOI:10.1111/chd.12698

    Abstract Objective: For over 20 years, we have followed a cohort of patients who underwent the Mustard procedure for d‐transposition of the great arteries. The current study follows the same cohort from our last study in 2007 to reassess their functional ca‐ pacity and quality of life.
    Participants: Of the original 45 patients, six patients have required cardiac transplant and 10 patients have died, including two of the transplanted patients. Twenty‐five of the remaining patients agreed to participate in this current study.
    Design: Patients underwent comparable testing to the previous studies when possi‐ ble including exercise stress testing, echocardiography, MRI or… More >

  • Open Access

    ARTICLE

    The utility of cardiac magnetic resonance imaging in postFontan surveillance

    Neil C. Zaki1,2, Michael S. Kelleman1, W. James Parks1,3, Timothy C. Slesnick1,3, Michael E. McConnell1,3, Matthew E. Oster1,3

    Congenital Heart Disease, Vol.14, No.2, pp. 140-146, 2019, DOI:10.1111/chd.12692

    Abstract Objective: Gated cardiac MRI offers the most detailed and accurate noninvasive method of assessing cardiac anatomy, particularly in patients with complex congenital heart disease. The proposed benefits of using cMRI as a routine screening tool in the Fontan population include early recognition of asymptomatic, postoperative anatomic and physiologic changes. In 2011, we therefore instituted at our center a recommended practice of cMRI screening in patients with Fontan physiology at 3 and 8 years postFontan operation. The purpose of this study was to determine the impact of this standardized practice of cMRI screening on the clinical management of a Fontan population.
    More >

  • Open Access

    REVIEW

    Frontiers in Fontan failure: Innovation and improving outcomes: A conference summary

    Georges Ephrem1, Camden Hebson2, Anitha John3, Estella Moore4, Maan Jokhadar4, Ryan Ford5, Gruschen Veldtman6, Yoav Dori7, Michelle Gurvitz8,9, Brian Kogon10, Adrienne Kovacs11, Meghan Roswick, Michael McConnell12, Wendy M. Book4, Fred Rodriguez III4,12

    Congenital Heart Disease, Vol.14, No.2, pp. 128-137, 2019, DOI:10.1111/chd.12685

    Abstract The initial “Frontiers in Fontan Failure” conference in 2015 in Atlanta, Georgia, provided an opportunity for experts in the field of pediatric cardiology and adult congenital heart disease to focus on the etiology, physiology, and potential interventions for patients with “Failing Fontan” physiology. Four types of “Fontan Failure” were described and then published by Dr Book et al. The acknowledgment that even Dr Fontan himself realized that the Fontan proce‐ dure “imposed a gradually declining functional capacity and premature late death after an initial period of often excellent palliation.” The purpose of the second “Frontiers in Fontan Failure” was to… More >

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