Risk Factors for Heart Failure and Its Costs Among Children with Complex Congenital Heart Disease in a Medicaid Cohort

2017 ◽  
Vol 38 (8) ◽  
pp. 1672-1679 ◽  
Author(s):  
Deipanjan Nandi ◽  
Joseph W. Rossano ◽  
Yinding Wang ◽  
Jeanette M. Jerrell
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease

Abstract 14610: Renal Dysfunction in Adults With Congenital Heart Disease in Vietnam

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ngoc Thanh Kim ◽  
Thanh Tung Le ◽  
Doan Loi Do ◽  
Thanh Huong Truong
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Renal Dysfunction ◽  
Congenital Heart ◽  
Pulmonary Arterial

Introduction: In Vietnam, knowledge about renal function in adults with congenital heart disease (CHD) is limited. Hypothesis: This study aims to estimate incidence of renal dysfunction in adults with congenital heart disease and risk factors. Methods: This is a cross-sectional study, including 365 CHD patients more than 16 years old. We collected clinical and para-clinical information, estimated glomerular filtration rate (GFR) and calculated the odds ratio (OR) for reduced GFR. Results: Totally, 52.8% patients had GFR < 90 ml/phút/1.73 m 2 . Logistic regression had confirmed the OR for GFR < 90 ml/phút/1.73 m 2 in the group > 60-years-old, the group with atrial fibrillation, the group with heart failure (based on NT-proBNP > 125 pmol/L), and the group with pulmonary arterial hypertension (based on pulmonary artery systolic pressure > 50 mmHg by echocardiography) were 6.46 (95% CI: 1.37 - 30.41), 7.58 (95% CI: 1.66 - 34.56), 2.98 (95% CI: 1.49 - 5.98) and 1.84 (95% CI: 1.02 - 3.33), respectively. Conclusions: Renal dysfunction is common in adults with CHD. Age > 60 years-old, atrial fibrillation, heart failure, and pulmonary arterial hypertension were risk factors for renal dysfunction in adults with CHD.

Sacubitril/valsartan for heart failure in adults with complex congenital heart disease

2020 ◽  
Vol 300 ◽  
pp. 137-140 ◽  
Author(s):  
Susanne J. Maurer ◽  
Claudia Pujol Salvador ◽  
Sandra Schiele ◽  
Alfred Hager ◽  
Peter Ewert ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease

Heart failure admissions in adults with congenital heart disease; risk factors and prognosis

2013 ◽  
Vol 168 (3) ◽  
pp. 2487-2493 ◽  
Author(s):  
A.C. Zomer ◽  
I. Vaartjes ◽  
E.T. van der Velde ◽  
H.M.Y. de Jong ◽  
T.C. Konings ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Disease Risk ◽  
Heart Disease Risk Factors ◽  
Heart Disease Risk

scholarly journals Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When?

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Christine H. Attenhofer Jost ◽  
Dörthe Schmidt ◽  
Michael Huebler ◽  
Christian Balmer ◽  
Georg Noll ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Heart Transplantation ◽  
Lung Transplantation ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
Eisenmenger’S Syndrome ◽  
Number Of Patients ◽  
Increased Risk

Due to impressive improvements in surgical repair options, even patients with complex congenital heart disease (CHD) may survive into adulthood and have a high risk of end-stage heart failure. Thus, the number of patients with CHD needing heart transplantation (HTx) has been increasing in the last decades. This paper summarizes the changing etiology of causes of death in heart failure in CHD. The main reasons, contraindications, and risks of heart transplantation in CHD are discussed and underlined with three case vignettes. Compared to HTx in acquired heart disease, HTx in CHD has an increased risk of perioperative death and rejection. However, outcome of HTx for complex CHD has improved over the past 20 years. Additionally, mechanical support options might decrease the waiting list mortality in the future. The number of patients needing heart-lung transplantation (especially for Eisenmenger’s syndrome) has decreased in the last years. Lung transplantation with intracardiac repair of a cardiac defect is another possibility especially for patients with interatrial shunts. Overall, HTx will remain an important treatment option for CHD in the near future.

Prolonged Candidemia in Infants Following Surgery for Congenital Heart Disease

2003 ◽  
Vol 24 (10) ◽  
pp. 753-757 ◽  
Author(s):  
Chandrama Chakrabarti ◽  
Sunil K. Sood ◽  
Vincent Parnell ◽  
Lorry G. Rubin
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Case Control Study ◽  
Case Control ◽  
Complex Congenital Heart Disease ◽  
Common Source ◽  
Control Study

AbstractObjectives:To describe a group of infants with complex congenital heart disease (CCHD) who had candidemia postoperatively and to perform a case–control study of risk factors.Design:Descriptive and case–control study.Setting:Tertiary-care medical centers.Patients:Infants with CCHD who underwent cardiac surgery and developed candidemia. Controls were matched for congenital heart disease lesions, age, and postoperative hospital stay.Results:Of 95 infants younger than 6 months with CCHD who underwent cardiac surgery between January 1999 and April 2001, 6 (6.3%) developed candidemia with 5 different species. The candidemia was prolonged (range, 12 to 32 days; median, 17 days). The interval between cardiac surgery and onset of candidemia was 12 to 57 days (median, 24 days). All had a central venous catheter inserted 8 to 50 days prior to the onset of candidemia. The mortality rate was 83%, compared with 13% for the group without candidemia. A univariate analysis of the potential risk factors revealed that duration of total parenteral nutrition (TPN), duration of antibiotics, intraoperative cardiopulmonary bypass time, and documentation of an intravascular thrombus were associated with candidemia. In multivariate analysis, long duration of TPN and documentation of a thrombus were associated with candidemia.Conclusions:Candidemia following cardiac surgery for infants with CCHD was persistent and associated with high mortality. The variety of species indicates that this was not a common-source outbreak. Risk factors associated with candidemia were duration of TPN and documentation of an intravascular thrombus.

scholarly journals Outcomes of the Surgical Management of Atrial Isomerism and Functional Single Ventricle: A Single-Centered Cohort From China

2021 ◽  
Vol 8 ◽  
Author(s):  
Ming-Hui Zou ◽  
Fan Cao ◽  
Li Ma ◽  
Wei-Dan Chen ◽  
Wen-Lei Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Palliative Surgery ◽  
Complex Congenital Heart Disease ◽  
Atrioventricular Valve Regurgitation ◽  
Independent Risk Factors ◽  
Atrial Isomerism ◽  
Anomalous Pulmonary Venous Connection

Objectives: The management of atrial isomerism with complex congenital heart disease remains challenging. Experience has been largely obtained in advanced countries. The clinical diversity is greater in China. We evaluated the early- and medium-term outcomes of surgical treatment of these patients.Methods: We reviewed 86 patients of atrial isomerism with complex congenital heart disease undergoing varied surgeries in our center in 2008–2020. Cox regression models were used to analyze the risk factors for mortality.Results: There were 75 cases of right and 11 of left atrial isomerism. Eighty-three (96.5%) patients underwent single-ventricle staged palliation approach, with 10 early and 7 late deaths. The overall 1-, 5-, and 10-year survival rates were 84.7, 79.3, and 79.3%, respectively. Thirty-six (43.4%) patients completed the Fontan procedure with median age of 48 months and freedom from death or Fontan failure at 1-, 5-, and 8-years were 94.4, 87.4, and 80.7%, respectively. Concomitant total anomalous pulmonary venous connection [hazard ratio (HR): 5.15 (1.95–12.94), p = 0.008], more than moderate atrioventricular valve regurgitation [HR: 4.82 (2.42–6.79), p = 0.003], and the need for first-stage palliative surgery [HR: 4.58 (1.64–10.76), p = 0.015] were independent risk factors for mortality.Conclusions: Despite even greater clinical diversity, the surgical outcomes of atrial isomerism with complex congenital heart disease are improving in China. The early and intermediate outcomes are comparable to many previous reports. Concomitant total anomalous pulmonary venous connection, moderate or severe atrioventricular valve regurgitation, and the need for a first-stage palliative surgery are still independent risk factors for mortality.

scholarly journals Predicting Outcomes Using the Heart Failure Survival Score in Adults with Moderate or Complex Congenital Heart Disease

2014 ◽  
Vol 10 (5) ◽  
pp. 387-395 ◽  
Author(s):  
Elaine Y. Lin ◽  
Hillel W. Cohen ◽  
Ami B. Bhatt ◽  
Ada Stefanescu ◽  
David Dudzinski ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
Survival Score

scholarly journals Heart failure in single right ventricle congenital heart disease: physiological and molecular considerations

2020 ◽  
Vol 318 (4) ◽  
pp. H947-H965 ◽  
Author(s):  
Anastacia M. Garcia ◽  
Jonathan-Thomas Beatty ◽  
Stephanie J. Nakano
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricle ◽  
Congenital Heart ◽  
Molecular Mechanisms ◽  
Therapeutic Interventions ◽  
Anatomy And Physiology ◽  
Molecular Alterations

Because of remarkable surgical and medical advances over the past several decades, there are growing numbers of infants and children living with single ventricle congenital heart disease (SV), where there is only one functional cardiac pumping chamber. Nevertheless, cardiac dysfunction (and ultimately heart failure) is a common complication in the SV population, and pharmacological heart failure therapies have largely been ineffective in mitigating the need for heart transplantation. Given that there are several inherent risk factors for ventricular dysfunction in the setting of SV in addition to probable differences in molecular adaptations to heart failure between children and adults, it is perhaps not surprising that extrapolated adult heart failure medications have had limited benefit in children with SV heart failure. Further investigations into the molecular mechanisms involved in pediatric SV heart failure may assist with risk stratification as well as development of targeted, efficacious therapies specific to this patient population. In this review, we present a brief overview of SV anatomy and physiology, with a focus on patients with a single morphological right ventricle requiring staged surgical palliation. Additionally, we discuss outcomes in the current era, risk factors associated with the progression to heart failure, present state of knowledge regarding molecular alterations in end-stage SV heart failure, and current therapeutic interventions. Potential avenues for improving SV outcomes, including identification of biomarkers of heart failure progression, implications of personalized medicine and stem cell-derived therapies, and applications of novel models of SV disease, are proposed as future directions.

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