Congenital Heart Disease and Its Impact on the Development of Anastomotic Strictures after Reconstruction of Esophageal Atresia

Background. The aim was to explore if severe congenital heart disease (CHD) influenced the need for dilatation of anastomotic strictures (AS) after the repair of esophageal atresia (EA). Methods. A retrospective case-control study was conducted examining AS in children with EA and Gross type C. The spectra of CHD and cardiac interventions were reviewed. The frequency of dilatations of AS during the first year following EA reconstruction was compared between children with and without severe CHD requiring cardiac surgery during their first year of life. Endoscopic signs of stricture were an indication for dilatation. Results. Included in the follow-up for AS were 94 patients who had EA reconstructions, of whom 10 (11%) children had severe CHD requiring surgery during the first year including 19 different cardiac interventions. In total, 38 patients needed dilatation of esophageal AS, distributed as six (60%) with severe CHD and 32 (38%) without severe CHD (p=0.31). Conclusion. Severe CHD was present in 11% of children with EA. Esophageal AS developed in 60% children with concomitant CHD, but although high, it did not reach statistical difference from children without CHD (38%).

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Parental experience of the neuromotor development of children with congenital heart disease: an exploratory qualitative study

BMC Pediatrics ◽

10.1186/s12887-021-02808-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elena Mitteregger ◽

Martina Wehrli ◽

Manuela Theiler ◽

Jana Logoteta ◽

Irina Nast ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Qualitative Study ◽

Motor Development ◽

Congenital Heart ◽

Healthcare Professionals ◽

Qualitative Content Analysis ◽

First Year ◽

First Year Of Life ◽

Neuromotor Development

Abstract Background Children with severe congenital heart disease (CHD) are a group of children at risk for neurodevelopmental impairments. Motor development is the first domain to show a delay during the first year of life and may significantly contribute to parental concerns, stress, and difficulties in early child-parent attachment. Thus, the aim of the study was to better understand the wishes and concerns of parents of children with CHD and explore their experience of their children’s neuromotor development in the first year of life. Methods In this qualitative study, fourteen families were recruited. Their children were aged 1–3 years and had undergone open heart surgery within the first 6 months of life. Semi-structured interviews were audio-recorded and transcribed. The data was explored within an expert group, and a qualitative content analysis was conducted using VERBI MAXQDA software 2020. The study was conducted in accordance with the COREQ checklist. Results Parents of children with CHD reported several burdens and needs. Parental burdens concerned the child’s motor development, their own physical and psychological strain, and difficulties in communication with healthcare professionals. The needs, parents reported included supporting their child’s motor development, a medical coordinator, and better communication between healthcare professionals and parents. During the first phase of their children’s illness, parents underwent a dynamic transitional phase and expressed the need to rely on themselves, to trust their children’s abilities, and to regain self-determination in order to strengthen their self-confidence. Conclusions It is essential to involve parents of children with CHD at an early stage of decision-making. Parents are experts in their children and appreciate medical information provided by healthcare professionals. Interprofessional teamwork, partnering with parents, and continuous support are crucial to providing the best possible care for children and their families. Family-centred early motor intervention for CHD children might counteract the effect of parental overprotection and improve children’s motor development and thus strengthen child-parent interaction. In future work, we aim to evaluate a family-centred early motor intervention for children with CHD developed on the basis of this qualitative study. Trial registration Not applicable.

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Survival of Patients with High-Risk Pulmonary Arterial Hypertension Associated with Congenital Heart Disease

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.06.12404 ◽

2021 ◽

Vol 104 (6) ◽

pp. 895-901

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

High Risk ◽

Congenital Heart ◽

First Year ◽

Pulmonary Arterial ◽

Group 3 ◽

Group 2 ◽

Group 1

Background: Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease (CHD) with uncorrected left-to-right shunts. Currently, no consensus guideline exists on the management of PAH-CHD in children, especially those who do not meet operability criteria. Objective: To compare survival between three groups of high-risk PAH-CHD, group 1: total correction including both surgical and percutaneous intervention, group 2: palliative treatment, and group 3: conservative with medical treatment group. Materials and Methods: All pediatric patients with PAH-CHD that underwent cardiac catheterization between January 1, 2008 and December 31, 2017 were retrospectively reviewed. Inclusion criteria were high risk PAH-CHD patients who had pulmonary vascular resistance (PVR) greater than 6 Wood unit·m² and PVR-to-SVR ratio greater than 0.3 evaluated in room air. Exclusion criteria were younger than three months of age, severe left side heart disease with pulmonary capillary wedge pressure greater than 15 mmHg, obstructive total pulmonary venous return, and single ventricle physiology. The Kaplan-Meier analysis was performed from the date of PAH diagnosis to the date of all-cause mortality or to censored date at last follow-up. Results: Seventy-six patients with a median age at diagnosis of 27.5 months (IQR 14.5 to 69.0 months) were included in this study. The patients were divided into three subgroups and included 38 patients (50.0%) in group 1, six patients (7.9%) in group 2, and 32 patients (42.1%) in group 3. The median follow-up time was 554 days (IQR 103 to 2,133 days). The overall mortality was 21.7%. One-year survival in patients with simple lesion in group 1 and 3 were 79.5% and 87.5% and patients with complex lesions in group 1, 2, and 3 were 93.8%, 83.3%, and 73.1%, respectively. The results showed that most mortalities occurred in the first year. There were no statistically significant differences in survival among difference types of treatment (log rank test, p=0.522). Conclusion: The mortality of high-risk PAH-CHD patients were not different among those who underwent corrective surgery, palliative, or conservative treatment. The mortality was high in the first year after PAH diagnosis and remain stable afterward. Management decision for an individual with high-risk PAH-CHD patients requires comprehensive clinical assessment to balance the risks and benefits before making individualized clinical judgment. Keywords: Pulmonary hypertension; Congenital heart disease; High-risk patients

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Infants with congenital heart disease in the first year of life

Fetal Cardiology - Series in Maternal-Fetal Medicine ◽

10.3109/9781439807989.045 ◽

2008 ◽

pp. 691-704

Author(s):

Andrew J Parry ◽

Frank L Hanley

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

First Year ◽

First Year Of Life

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Updates in Congenital Heart Disease: Can Outcomes Improve?

American Journal of Perinatology ◽

10.1055/s-0039-1691773 ◽

2019 ◽

Vol 36 (S 02) ◽

pp. S22-S28

Author(s):

Gerard R. Martin ◽

Russell R. Cross ◽

Lisa A. Hom ◽

Darren Klugman

Keyword(s):

Intensive Care Unit ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Malformations ◽

Congenital Heart ◽

First Year ◽

Cardiac Intensive Care Unit ◽

Cardiac Intensive Care ◽

First Year Of Life ◽

Pulse Oximetry Screening

AbstractDespite numerous advances in medical and surgical management, congenital heart disease (CHD) remains the number one cause of death in the first year of life from congenital malformations. The current strategies used to approach improving outcomes in CHD are varied. This article will discuss the recent impact of pulse oximetry screening for critical CHD, describe the contributions of advanced cardiac imaging in the neonate with CHD, and highlight the growing importance of quality improvement and safety programs in the cardiac intensive care unit.

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