P3654Location of the coronary origins in transposition patients following anatomical repair: Implications for invasive coronary angiography and intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A H Constantine ◽  
T Segura ◽  
E Nicol ◽  
A H Kempny ◽  
I Rafiq ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Statistical Significance ◽  
Ct Imaging ◽  
Circular Data ◽  
Control Group ◽  
Complex Anatomy ◽  
Significant Difference ◽  
Coronary Ostia

Abstract Background Surgical repair of transposition of the great arteries (TGA) is most commonly via the arterial switch operation (ASO). This involves translocation of the aorta and pulmonary trunk, typically with anastomosis of the branch pulmonary arteries anteriorly (LeCompte manoeuvre) and re-implantation of the coronary arteries onto the posterior neo-aorta. As such, the position of the coronary ostia may differ from their expected locations. Purpose To use ECG-gated CT angiography to describe the anatomic position of coronary ostia in post-switch TGA patients guiding potential catheter interventions in this population. Methods All post ASO patients who underwent CT imaging between 2008–2018 were identified. Patients with complex anatomy such as double outlet right ventricle were excluded. The positions of the coronary ostia were measured in degrees from vertical on a double-oblique reconstruction in the aortic valve plane. Ostium positions were compared to those of patients with no congenital heart disease via Watson's two-sample test of homogeneity for circular data. Angular dispersion was compared between groups via the Wallraff test. P<0.05 indicated statistical significance. Results Of 206 adult patients with TGA and ASO followed in our adult congenital heart disease centre, 38 (18.4%) had CT imaging available for analysis during the study period (mean age 24±6.8, 75% male). The control group consisted of 15 patients investigated for chest pain (mean age 54±15.1, 73% male). In the control group, the right and left coronary ostia arose at a mean angle of −19 and +125 degrees from vertical (figure 1a). This was significantly different to the mean ASO coronary ostia clustered at mean angles of −70 and +29 degrees from vertical (Watson p<0.001) (figure 1b, with stenosis at the left coronary anastomosis). There was no significant difference in spread of left ostia (Rho 0.9 vs 0.99, p=0.12), but right ostia were significantly more variable in ASO patients than controls (0.71 vs 0.96, p=0.003). Figure 1 Conclusions Coronary ostial positions in the neo-aorta of post-ASO patients differ significantly from those of normal controls, with considerable variability, especially in right coronary position. CT can demonstrate coronary ostia in 3D space and derive appropriate tube angles to guide catheterisation in post-operative congenital cardiac patients, optimise catheter selection, reduce catheterisation tome, radiation and contrast dose.

scholarly journals Evaluation of the school success in children with the diagnosis of congenital heart disease who underwent an intervention

2014 ◽  
Author(s):  
Gülben İrem Kanberoğlu ◽  
Önder Doksöz ◽  
Özlem Bağ ◽  
Serpil Ece Aras Öztürk
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Academic Success ◽  
Patient Group ◽  
Social Life ◽  
Congenital Heart ◽  
School Success ◽  
Control Group ◽  
Significant Difference ◽  
Behavioral Attitudes

OBJECTIVE: Congenital heart disease is one of the most common childhood diseases that affect both the children's and their families social life, quality of life and the children's academic achievement. The aim of this study is to evaluate the school performance of children suffering from congenital heart disease who underwent surgical or catheter based interventions. METHODS: The study group included 50 patients with congenital heart disease underwent surgical or catheter based interventions attending to secondary school (aged 12-15 years old) and 50 healthy controls. The academic success validation from official school grades of lessons Turkish, Mathematics, Science, Social Sciences lessons and behavioral attitudes were obtained from the Ministry of Education ‘’e-school’’ parent information system printouts. The patient group consisted of both cyanotic and acyanotic patients and each groups were compared with controls. RESULTS: Turkish, mathematics, physical education classes and behavioral attitudes note in the patient group was significantly lower than in the control group. The school success in Cyanotic group was significantly lower than the control group in Turkish, mathematics, education lessons and behavioral attitudes grades. Significant difference was not determined in science and social science lessons. CONCLUSION: Cyanotic group's success in mathematic and turkish lessons are lower in children with congenital heart disease especially in cyanotic group. We suggest that providing supportive teaching pragrammes for children with congenital hearth disease are needed in order to maintain academic success.

scholarly journals Echocardiography-computed tomography fusion imaging: a new approach for congenital heart disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Fournier ◽  
C Batteux ◽  
M Mostefa-Kara ◽  
S Cohen ◽  
I Van Aerschot ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fusion Imaging ◽  
Fusion Process ◽  
Complex Congenital Heart Disease ◽  
Complex Anatomy ◽  
Significant Difference ◽  
Time Required

Abstract Introduction Diagnosis, management and surgical decision making in children and adults with congenital heart disease are based on echocardiography. One of the most recent developments in cardiac imaging is “fusion” of different imaging modalities. Our objective was to evaluate the feasibility of imaging fusion between computed tomography (CT) and 3D trans-thoracic echocardiography (TTE) in children and adults with congenital heart disease. Methods Fourteen patients with congenital heart disease who had a CT and a 3D TTE (9.5 years [2.7–15.7], 57% male, BSA 0.9 m2 [0.6–1.7]) were prospectively included for their usual monitoring in our center. Congenital heart disease was classified as simple (n=4, 29%), moderate (n=4, 29%) or complex (n=6, 42%). A full-volume 3D heart acquisition on three cycles was performed using a VividTM E95 GE. Image fusion between CT and TTE was done using General Electrics (GE) Fusion Software. Steps required for images importation, for fusion process (alignment, landmarks, superposition), navigation and analysis were described. Results Fusion imaging between 3D TTE and CT was successful for all patients and superposition was good with a median scored at 8.5/10. Median total time required to complete the fusion process was 735 seconds [628–1163], without significant difference according to the degree of complexity of the cardiopathy. Landmarks were significantly placed differently from the reference landmarks in complex congenital heart disease. For complex cardiopathy, navigation into the heart at the same time with multiple modalities demonstrate its interest, for diagnosis or for planning surgery. Conclusion We have investigated the feasibility and the accuracy of imaging fusion between 3D TTE and CT in a varied population of patients with congenital heart disease, from children to adult. These advances allow simultaneous visualization of intracardiac structures and may help in understanding the complex anatomy of congenital heart disease, without limitations in terms of age, weight or type of congenital heart disease. FUNDunding Acknowledgement Type of funding sources: None. Validation of fusion imaging Navigation in fusion imaging

scholarly journals Effects of Remifentanil and Sufentanil Anesthesia on Cardiac Function and Serological Parameters in Congenital Heart Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zhigang Qin ◽  
Younian Xu
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Treatment Group ◽  
Cardiac Function ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Control Group ◽  
Muscle Rigidity ◽  
Significant Difference

In this study, we have investigated feasibility of remifentanil and sufentanil anesthesia in children with congenital heart disease surgery and its effects on cardiac function and serological parameters. For this purpose, a retrospective study was conducted on 120 children with congenital heart disease who underwent repair of ventricular septum or atrial septum in our hospital, specifically from January 2016 to January 2018, and 60 patients in each group were randomly divided into the control and treatment groups, respectively. The control group was anesthetized with sufentanil, and the treatment group was anesthetized with remifentanil. The heart function, serological indexes, and adverse reactions were observed and compared. We have observed that there was no significant difference in HR levels between these groups ( P > 0.05 ), but SDP and DBP values of the two groups were decreased after anesthetic induction ( P < 0.05 ). ACH, cortisol, and lactic acid in the treatment group were significantly lower than those in the control group, and the difference was statistically significant ( P < 0.05 ). The incidence of bradycardia, nausea and vomiting, hypotension, muscle rigidity, and respiratory depression in the treatment group was 16.67% lower than that in the control group ( P < 0.05 ). Remifentanil has less influence on hemodynamics and a better analgesic effect than fentanyl in inhibiting stress response in congenital heart surgery, which provides reference and basis for children congenital heart surgery.

scholarly journals Microalbuminuria among children with congenital heart disease seen in Sokoto, North-Western Nigeria

2021 ◽  
Vol 8 (3) ◽  
pp. 414
Author(s):  
Khadijat O. Isezuo ◽  
Usman M. Sani ◽  
Usman M. Waziri ◽  
Bilkisu G. Ilah ◽  
Fatima B. Jiya ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Elisa Technique ◽  
Weak Negative Correlation

Background: Congenital heart disease (CHD) especially cyanotic CHD has been associated with microalbuminuria which is an early marker of glomerular nephropathy but this has hardly been studied in African children. The aim of this study was to compare mean microalbuminuria levels and associations among children with acyanotic CHD, cyanotic CHD and normal controls.Methods: Forty-one (41) children comprising 19 acyanotic CHD, 14 cyanotic CHD and 8 without CHD aged 1 to 15 years were recruited in a cross-sectional study. Quantitative urinary microalbuminuria was measured by ELISA technique. Positive result was microalbuminuria of 30-300 mcg/mgCr. Mean levels were compared by student t-test and analysis of variance (ANOVA). Statistical significance was taken at p<0.05.Results: There were 22 (53.7%) females and 19 (46.3%) males. Mean level of microalbuminuria was highest in those with cyanotic CHD at 147.7±78.8 mcg/mgCr, followed by those with acyanotic CHD at 111.8±61.5 mcg/mgCr and lowest in those without CHD at 67.3±31.6 mcg/mgCr. There was significant difference between the groups with CHD and those without CHD (F=4.1, p=0.03) and microalbuminuria had a significant but weak negative correlation with oxygen saturation implying that microalbuminuria increased with worsening cyanosis.Conclusions: Microalbuminuria was high among the patients with CHD, though higher in cyanotic patients warranting closer follow up of these patients.

scholarly journals The level of superoxide dismutase and catalase in acyanotic congenital heart disease children with heart failur

2021 ◽  
Vol 16 (1) ◽  
pp. 150-156
Author(s):  
Henry Wicaksono ◽  
Mahrus A Rahman ◽  
Roedi Irawan ◽  
I Ketut Alit Utamayasa ◽  
Teddy Ontoseno ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Superoxide Dismutase ◽  
Heart Disease ◽  
Congenital Heart ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
The Difference ◽  
Acyanotic Congenital Heart Disease

Background: The most common complication in acyanotic congenital heart disease (CHD) is heart failure which definitive diagnosis and therapy remain unsatisfactory. Heart failure’s progression is often associated with oxidative stress process. Superoxide dismutase (SOD) is the first line antioxidant of defense against superoxide anion. While Catalase (CAT) breaks down hydrogen peroxide into water and oxygen molecules which complements previous detoxification carried out by SOD. Objective: This study aimed to compare the differences of SOD and CAT levels in acyanotic CHD patients between those with and without heart failure. Methods: A case-control study was conducted on three to ten years old children with a left-to-right shunt acyanotic CHD with and without heart failure in the Pediatric Cardiology outpatient clinic, ward, and emergency room of Dr. Soetomo Hospital Surabaya from April-July 2020. Echocardiography was used to establish the diagnosis of CHD, while Pediatric Heart Failure Score (PHFS) criteria was used to indicate heart failure. T-test was undertaken for analysing the difference between both groups. Results: The total samples were 41 children, consisted of 29 subjects in the case group (CHD with heart failure) and 12 subjects in the control group (without heart failure). The level of SOD in CHD with heart failure was lower (74.670+15.705) than those without it (109.163+3.111) (p<0.05). In contrast, level of CAT in CHD with heart failure was higher (25.895) than those without it (13.976) (p<0.05). Conclusion: There was a significant difference of SOD and CAT levels in acyanotic CHD between those with and without heart failure.

Abstract 10903: Extraction Outcomes in Patients With Congenital Heart Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Erin A Fender ◽  
Ammar M Killu ◽  
David O Hodge ◽  
Bryan C Cannon ◽  
Paul A Friedman ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Lead Extraction ◽  
Control Group ◽  
Cardiac Devices ◽  
Device Infection ◽  
Significant Difference ◽  
And Gender

Introduction: Patients with congenital heart disease (CHD) frequently require implantable cardiac devices. Device infection or malfunction may necessitate lead extraction. Extraction may be challenging due to long lead dwell times, anatomic abnormalities, and prior cardiac surgery. Little is known about extraction outcomes in the CHD population. Methods and Results: This retrospective study included 41 CHD patients and 82 age and gender matched controls that underwent lead extractions at two centers between 2001-2014. Only patients with leads older than 12 months were included. There were 79 leads in CHD patients and 150 in controls. Patients with CHD had a mean age of 39±17 years at extraction and on average their leads had been implanted for 81±84 months, this was not significantly different from the control group. Eighty eight percent of CHD patients had 1 or more cardiac surgeries as compared to only 22% of controls (p<0.001). The number of abandoned leads was also significantly different with 16 abandoned leads in the CHD group and 3 in controls (p<0.001). There was no statistically significant difference in extraction techniques between the groups. Complete extraction was achieved in 94% of patients in both groups. There were no CHD group complications. Control group complications included 3 SVC lacerations requiring sternotomy (one was fatal), and 1 ventricular perforations with tamponade requiring sternotomy. None of these patients had a history of cardiac surgery. The average age of leads in patients with a complication was 15.3 years which was older than the mean lead age seen in the CHD and control populations which was 6.75 and 4.6 years respectively. Conclusions: Lead extraction can be safely performed in patients with CHD. Despite anatomic abnormalities and previous cardiac surgery, the outcome of lead extraction in patients with CHD is comparable to controls. Prior cardiac surgery may lower the risk for extraction complications.

scholarly journals Evaluation of urinary NGAL level in children with congenital heart disease as a possible early indicator of nephropathy

2020 ◽  
Vol 10 (2) ◽  
pp. e14-e14
Author(s):  
Hossein Emad Momtaz ◽  
Asadolah Tanasan ◽  
Majid Godini
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Detection ◽  
Congenital Heart ◽  
Control Group ◽  
Healthy Children ◽  
Urinary Ngal ◽  
Ngal Level ◽  
Potential Biomarker ◽  
Significant Difference

Introduction: Nephropathy as a consequence of congenital heart disease (CHD), especially cyanotic heart disease, has been detected since past decades. However, lack of a diagnostic method at early stages of the disease, caused patients referring when nephropathy is established and also complicated with severe proteinuria and renal failure. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is known as one of the newest biomarkers for early detection of renal parenchymal damage. In this study, we attempted to evaluate the role of urinary NGAL level in early detection of nephropathy in pediatrics with CHD. Objectives: The aim of this study was to evaluate urinary NGAL as a potential biomarker for the early detection of renal involvement in children with CHD. Patients and Methods: In this case–control study, urinary NGAL levels of 42 children with CHD (case group) and 42 healthy children (control group) with the matched ages were measured. Afterward, we compared mean urinary NGAL levels between these two groups to find a possible significant difference. Results: In this study, mean urinary NGAL level in patients with CHD and healthy children was 3.83 μg/mL and 1.87 μg/mL, respectively. Although the mean urine NGAL level was higher in children with CHD compared to healthy children, this difference was not statistically significant. Conclusion: in this study, it can be concluded that, urinary NGAL level cannot be used as an early diagnostic test of nephropathy in children with CHD.

scholarly journals Vitamin D Deficiency and Its Response to Supplementation as “Stoss Therapy” in Children with Cyanotic Congenital Heart Disease Undergoing Open Heart Surgery

2019 ◽  
Vol 03 (01) ◽  
pp. 17-23
Author(s):  
Manoj Kumar Sahu ◽  
Chalattil Bipin ◽  
Harsha Vardhan Niraghatam ◽  
Ameya Karanjkar ◽  
Sarvesh Pal Singh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
Postoperative Convalescence

Abstract Background Data from many studies suggest that patients with congenital heart disease are vitamin D (vitD) deficient. Following cardiac surgery as a result of intraoperative institution of cardiopulmonary bypass (CPB), serum vitD levels become even low. This may affect postoperative convalescence in terms of mechanical ventilation, inotropic support, infection, and so forth. Objective We intended to study the prevalence of vitD deficiency pre and post cardiac surgery and the effect of vitD supplementation (stoss therapy) on postoperative convalescence of the children with tetralogy of Fallot (TOF) undergoing intracardiac repair (ICR). Methodology In this randomized controlled trial (RCT), 60 children younger than 18 years with TOF and serum vitD levels < 20ng/dL were randomized into two groups. The study group received vitD supplementation as “stoss therapy” at 10,000 units/kg body weight. All these children underwent ICR with CPB. Demographic data, preoperative, intraoperative, and postoperative variables were compared between the study and the control groups. Results Prevalence of severe vitD deficiency was 93.1%. When compared with the control group, study group showed higher serum vitD levels in the immediate preoperative period (p = 0.001), postoperative period following CPB (p = 0.012), and on the first postoperative day (p = 0.003). No statistically significant difference was observed in postoperative mechanical ventilation (p = 0.35), intensive care unit (ICU) stay (p = 0.15), and inotropic duration (p = 0.19). Conclusion Children with TOF are highly deficient of vitD, its level falls further after CPB, and supplementing vitD preoperatively does not influence postoperative recovery pattern. Supplementation of vitD as “stoss therapy” was useful in raising the serum levels before and after cardiac surgery.

scholarly journals Cyanotic congenital heart disease: Impact on growth and endocrine functions.

2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Tertiary Care ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.

Pulmonary vasodilator therapy is associated with greater survival in Eisenmenger syndrome

Heart ◽  
2017 ◽  
Vol 104 (9) ◽  
pp. 732-737 ◽  
Author(s):  
Clare Arnott ◽  
Geoff Strange ◽  
Andrew Bullock ◽  
Adrienne C Kirby ◽  
Clare O’Donnell ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Single Agent ◽  
Eisenmenger Syndrome ◽  
Vasodilator Therapy ◽  
Risk Of Death ◽  
Complex Anatomy ◽  
Pulmonary Vasodilator

ObjectiveEisenmenger syndrome (ES) is a severe form of pulmonary hypertension in adults with congenital heart disease (CHD) and has a poor prognosis. We aimed to understand factors associated with survival in ES and particularly to assess the potential benefits of advanced pulmonary vasodilator therapy (AT).MethodsFrom January 2004, when AT became generally available for patients with ES, we followed 253 ES adults from 12 adult congenital heart disease centres across Australia and New Zealand. Demographic, medical and outcome data were collected and analysed prospectively and retrospectively.ResultsThe patients with ES were predominantly female (60%), aged 31 (SD 12) years. At diagnosis of ES, 64% were WHO functional class ≥3. The most common underlying lesion was ventricular septal defect (33%) with 21% having ‘complex’ anatomy. Over a median follow-up time of 9.1 years, the majority (72%) had been prescribed at least one AT (49% single agent), mostly bosentan (66%, 168 patients). The mean time on AT was 6 (SD 3.6) years. Those on AT were more functionally impaired at presentation (69% WHO ≥3 vs 51%, p=0.007) and more likely to have been prescribed anticoagulation (47% vs 27%, p=0.003). The risk of death/transplant was 4.8 %/year in AT exposed versus 8.4% in those never exposed. On multivariable analysis, exposure to AT was independently associated with greater survival (survival HR 2.27, 95% CI 1.49 to 3.45; p<0.001). WHO ≥3 at presentation was associated with a worse prognosis (mortality HR 1.82, 95% CI 1.19 to 2.78; p=0.006).ConclusionTreatment with AT was independently associated with greater survival in patients with ES, even though they were comparatively sicker prior to treatment.

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