Unsupervised free-breathing 3-dimensional imaging of morphology, function and flow in congenital heart disease under 30 minutes: pilot study

Introduction: The most common comorbidities in children with congenital heart disease (CHD) are neurodevelopmental and psychosocial impairments, particularly in areas of executive function, memory, attention, and behavioral control. Limited studies in the adult CHD population suggest similar impairments exist and adults with CHD may be at increased risk for dementia. No studies have screened specifically for mild cognitive impairment and dementia in adult CHD patients. Methods: We performed a prospective cross-sectional study of adult CHD patients, ages 30-65 years, who were coming for routine clinic visits. We administered the Mini-Mental State Exam (MMSE) and scores were compared with population norms adjusted by age and education level. We also evaluated the association of MMSE scores with CHD complexity, demographic and clinical risk factors. Results: A total of 125 patients were recruited (55% male). The median age was 40 years (range 30-65). Almost all participants (97%) had a high school degree and 75% had some college education or advanced degrees. The majority of patients (94%) had moderate or complex CHD. Adjusting for age and education, CHD participants scored significantly lower than the general population (median 1 point lower, p=0.001). The greatest impairments occurred in recall and orientation. Factors associated with lower scores included decreased systemic ventricular function (p=0.028) and having ≥2 cardiac catheterizations (p=0.006). Five percent of the total cohort met the general threshold for mild cognitive impairment (MMSE<24). Clinical factors associated with this degree of cognitive impairment were duration of cyanosis (p=0.005) and decreased systemic ventricular function (p=0.003). Conclusions: Our pilot study showed that, when adjusted for age and education level, adult CHD patients had significantly lower MMSE scores than the general population, with 5% meeting criteria for mild cognitive impairment. These findings suggest that subtle and early neurodevelopmental changes are present in the adult CHD population. Further studies are needed to investigate those changes and evaluate potential disease modifying therapies that might influence long-term outcomes in the adult CHD population.

Download Full-text

Educational DVD for parents of children with congenital heart disease – a pilot study

Journal of Visual Communication in Medicine ◽

10.1080/17453054.2017.1399792 ◽

2017 ◽

Vol 41 (1) ◽

pp. 18-23 ◽

Cited By ~ 1

Author(s):

Derrick H. Z. Ha ◽

Margaret Hay ◽

Samuel Menahem

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Pilot Study ◽

Congenital Heart

Download Full-text

Printing 3D Heart Models From CT Scans Using Materialize: A Congenital Heart Disease Program at the American University of Beirut (AUB)

Volume 3: Biomedical and Biotechnology Engineering ◽

10.1115/imece2017-71522 ◽

2017 ◽

Author(s):

Ramsey F. Hamade ◽

Mohammad Karim Elham ◽

Issam El Rassi ◽

Lamya Atweh ◽

Ziad Bulbul ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Blood Volume ◽

Congenital Heart ◽

3D Models ◽

American University ◽

3 Dimensional ◽

American University Of Beirut ◽

East Region ◽

Value Range

Presented in this work is a detailed methodology of how to properly print 3-dimensional (3D) heart models starting from computed tomography (CT) scan and using the Mimics Innovation Suite (Mimics and 3-matic) software package (from Materialize, Leuven, Belgium). The methodology starts by segmenting the clinical DICOM files to retain masks of gray value range of interest. Specifically, retained is the blood volume contained in the heart. Using Mimics, this is accomplished by creating mask and then editing and refining the relevant mask in order to isolate the blood within a certain range of Hounsfield Units (HU). A second mask is created using different gray value ranges to isolate the tissues of the heart. Both 3D models are transferred to 3-matic where integrated Boolean operations are executed to subtract the geometric entities thus retaining the 3D geometry of the heart (including myocardium, cavities, and arteries) of interest. The retained model geometry consists of the muscle surface of the heart and enclosing the hollowed cavities inside that represent the blood volume. Following further processing in 3-matic, the 3D model is now ready for 3D printing. At the American University of Beirut (AUB), a ProJet 3510 SD (3D Systems) is employed to print the heart models (both sectioned and whole). Printed 3D models are employed within the Program for Congenital Heart Disease at AUB that represents a model for clinical applications, education, and research as the first such initiative in Lebanon and the Middle East region.

Download Full-text

Utility and Access to 3-Dimensional Printing in the Context of Congenital Heart Disease: An International Physician Survey Study

CJC Open ◽

10.1016/j.cjco.2020.01.008 ◽

2020 ◽

Vol 2 (4) ◽

pp. 207-213

Author(s):

Caroline F. Illmann ◽

Martin Hosking ◽

Kevin C. Harris

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Survey Study ◽

Physician Survey ◽

3 Dimensional ◽

Dimensional Printing

Download Full-text

Toward a characterization of language development in children with congenital heart disease: A pilot study

Child Neuropsychology ◽

10.1080/09297049.2019.1617261 ◽

2019 ◽

Vol 26 (1) ◽

pp. 1-14

Author(s):

Giulia Sommariva ◽

Tiziana Zilli ◽

Cristiano Crescentini ◽

Andrea Marini ◽

Chiara Pilotto ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Pilot Study ◽

Language Development ◽

Congenital Heart

Download Full-text

Pulse Oximetry and Congenital Heart Disease Screening: Results of the First Pilot Study in Morocco

International Journal of Neonatal Screening ◽

10.3390/ijns6030053 ◽

2020 ◽

Vol 6 (3) ◽

pp. 53

Author(s):

Nadia El Idrissi Slitine ◽

Fatiha Bennaoui ◽

Craig A. Sable ◽

Gerard R. Martin ◽

Lisa A. Hom ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Pilot Study ◽

Pulse Oximetry ◽

Screening Test ◽

Congenital Heart ◽

False Negative ◽

University Hospital ◽

Critical Congenital Heart Disease ◽

Negative Case

Congenital heart disease (CHD) is the most common congenital malformation. Diagnosis of critical congenital heart disease (CCHD), the most severe type of congenital heart disease, in a newborn may be difficult. The addition of CCHD screening, using pulse oximetry, to clinical assessment significantly improves the rate of detection. We conducted a pilot study in Morocco on screening neonates for critical congenital heart disease. This study was conducted in the maternity ward of Mohammed VI University Hospital of Marrakesh, Morocco, and included asymptomatic newborns delivered between March 2019 and January 2020. The screening of CCHD was performed by pulse oximetry measuring the pre- and post-ductal saturation. Screening was performed on 8013/10,451 (76.7%) asymptomatic newborns. According to the algorithm, 7998 cases passed the screening test (99.82%), including one inconclusive test that was repeated an hour later and was normal. Fifteen newborns failed the screening test (0.18%): five CCHD, five false positives, and five CHD but non-critical. One false negative case was diagnosed at 2 months of age. Our results encourage us to strengthen screening for CCHD by adding pulse oximetry to the routine newborn screening panel.

Download Full-text