Selection of cuffed endotracheal tube for children with congenital heart disease based on an ultrasound-based linear regression formula

Abstract Background Cardiac MR (CMR) is the gold standard for right ventricular (RV) quantification. Three-dimensional echo (3DE) is a relatively new technique which may offer a rapid alternative for the examination of the right heart. The purpose of this study was to investigate the clinical significance and interchangeability of these modalities to evaluate patients with congenital heart disease (CHD) who underwent percutaneous pulmonary valve implantation (PPVI) for RV outflow tract dysfunction. Methods 36 patients who underwent PPVI were evaluated with 3DE and CMR to quantify the RV. RV volumes and ejection fraction (EF) were measured for both imaging techniques with commercially available softwares (Tomtec-Germany for 3DE and Medimatic-Netherlands for CMR data). Paired t-test, Bland-Altman analysis, and Pearson's correlation analysis were used as most appropriate to compare both measured techniques with CMR regarded as the reference standard. Results 86% of the patients (31 patients) had adequate image quality on 3DE and was included in the study. Patients underwent both 3D echo and CMR within a mean of 9 days of each other and at a mean time of 3 years after PPVI. Compared to CMR, 3D echo significantly underestimated volumes in all patients and overestimate RV ejection fraction (EF). Mean RV End-diastolic Volumes (EDV) and End-Systolic Volumes (ESV) were significantly greater when measured by CMR compared to 3D echo (EDV: 99 ml/m2 vs. 85 ml/m2; p<0.01, ESV: 52 ml/m2 vs. 41 ml/m2; p<0.01). Mean RV EF was lower when measured by CMR compared to 3D echo (48% vs 52%; p<0.05). Linear regression analysis showed high correlation coefficients between 3DE and CMR (r=0,68 for EDV, r=0,62 for ESV, and r=0,57 for EF; p<0.001). Bland-Altman analysis demonstrated that for both RV EDV and RV ESV there was a significant and systematic under-estimation of volume by 3D echo compared to CMR. Both 3DE and CMR measurements were found to be highly reproducible in terms of intra-observer variability. Conclusions Statistically significant and clinically meaningful differences in volumetric measurements were observed between 3DE and CMR in the evaluation of RV volumes and function in patients with CHD after PPVI. Despite linear regression and Bland-Altman analysis showed that the two techniques are related and present some degree of agreement, 3D Echocardiography systematically underestimates volumes and overestimates EF and this would have to be considered in the clinical practice.

Download Full-text

Usefulness of ultrasound-guided measurement of minimal transverse diameter of subglottic airway in determining the endotracheal tube size in children with congenital heart disease: A prospective observational study

Annals of Cardiac Anaesthesia ◽

10.4103/aca.aca_220_17 ◽

2018 ◽

Vol 21 (4) ◽

pp. 382 ◽

Cited By ~ 5

Author(s):

Raj Sahajanandan ◽

Rahul Pillai ◽

Suresh Kumaran ◽

L Jeyaseelan ◽

SajanP George

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Observational Study ◽

Endotracheal Tube ◽

Congenital Heart ◽

Prospective Observational Study ◽

Transverse Diameter ◽

Ultrasound Guided ◽

Tube Size ◽

Endotracheal Tube Size

Download Full-text

Selection of the Best of 2017 in Congenital Heart Disease

Revista Española de Cardiología (English Edition) ◽

10.1016/j.rec.2017.12.009 ◽

2018 ◽

Vol 71 (4) ◽

pp. 302-303

Author(s):

Beatriz García-Aranda ◽

Fernando Sarnago ◽

María Teresa Velázquez ◽

Alberto Mendoza ◽

María Jesús López-Gude ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Selection Of

Download Full-text

First person – Jessica Sam

Biology Open ◽

10.1242/bio.054247 ◽

2020 ◽

Vol 9 (6) ◽

pp. bio054247

Keyword(s):

New York ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Cardiac Development ◽

Early Career ◽

First Person ◽

Early Career Researchers ◽

Genetic Mechanisms ◽

Selection Of

ABSTRACTFirst Person is a series of interviews with the first authors of a selection of papers published in Biology Open, helping early-career researchers promote themselves alongside their papers. Jessica Sam is first author on ‘Specificity, redundancy and dosage thresholds among gata4/5/6 genes during zebrafish cardiogenesis’, published in BiO. Jessica is a PhD student in the lab of Todd Evans at the Department of Surgery, Weill Cornell Medicine, New York, USA, investigating the genetic mechanisms underlying cardiac development and congenital heart disease.

Download Full-text

SELECTION OF PATIENTS FOR SURGERY IN CONGENITAL HEART DISEASE

British Medical Bulletin ◽

10.1093/oxfordjournals.bmb.a069486 ◽

1955 ◽

Vol 11 (3) ◽

pp. 178-182 ◽

Cited By ~ 1

Author(s):

MAURICE CAMPBELL

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Selection Of Patients ◽

Selection Of

Download Full-text

Does Previous Cardiac Surgery Predict Impaired Quality of Life in Adults With Congenital Heart Disease?

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135120908185 ◽

2020 ◽

Vol 11 (3) ◽

pp. 304-309 ◽

Cited By ~ 1

Author(s):

Qi Feng Wang ◽

Sarah Rouse ◽

Margaret Hay ◽

Samuel Menahem

Keyword(s):

Quality Of Life ◽

Congenital Heart Disease ◽

Cardiac Surgery ◽

Heart Disease ◽

Linear Regression ◽

Congenital Heart ◽

Anxiety And Depression ◽

History Of ◽

Standard Linear

Background: Improved survival of children with congenital heart disease (CHD) into adult life has led to further study of their quality of life (QoL) and its determinants. The QoL including the symptoms of anxiety and depression of adults with CHD was analyzed to determine the relationship, if any, between prior cardiac surgery and QoL. Methods: Adults with CHD who were recruited from a single community-based cardiology practice completed self-reported questionnaires on their QoL, which included symptoms of anxiety and depression. Standard linear regression analysis was used to determine whether prior cardiac surgery predicted lower QoL scores. Results: One hundred forty-nine adult patients with CHD were sent QoL questionnaires. Completed questionnaires were received from 135 patients: 71 (53%) males and 64 (47%) females, with a mean age of 26.3 years (standard deviation: 7.8, min: 17, max: 49). Respondents were assigned to two groups: those who had (n = 89, 66%) or had not (n = 46, 34%) previously undergone one or more cardiac surgical interventions. Results from standard linear regression analyses revealed no predictive relationship between history of previous cardiac surgery, whether one or more operations, and QoL. Conclusions: Among adult patients with CHD who completed QoL questionnaires, we observed no association between a patient’s history of prior cardiac surgery and self-reported QoL measures. This welcome and important finding may be a reflection of the good functional capacity of both groups (postsurgical and nonsurgical) irrespective of the original CHD diagnosis and need for surgical intervention.

Download Full-text