scholarly journals Impact of hepatopathy in pediatric patients after surgery for complex congenital heart disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248776
Author(s):  
Torben Kehl ◽  
Daniel Biermann ◽  
Andrea Briem-Richter ◽  
Gerhard Schoen ◽  
Jakob Olfe ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Organ Dysfunction ◽  
Congenital Heart ◽  
Heart Rhythm ◽  
Complex Congenital Heart Disease ◽  
Control Group ◽  
Heart Rhythm Disorders ◽  
The Impact

Patients undergoing complex pediatric cardiac surgery in early infancy are at risk of postoperative secondary end-organ dysfunction. The aim of this study was to determine specific risk factors promoting the development of peri- and postoperative hepatopathy after surgery for congenital heart disease. In this retrospective study, we identified 20 consecutive patients operated between 2011 and 2019 from our institutional cohort who developed significant postsurgical hepatic dysfunction. These patients were compared to a control group of 30 patients with comparable initial cardiac conditions and STS-EACTS risk score. Patients who developed hepatopathy in the intensive care unit have chronic cholestasis and decreased liver synthesis. The impact of postoperative hepatopathy on morbidity was marked. In six patients (30%), liver transplantation was executed as ultima ratio, and two (10%) were listed for liver transplantation. The overall mortality related to postoperative hepatopathy is high: We found nine patients (45%) having severe hepatopathy and mostly multiple organ dysfunction who died in the postoperative course. According to risk analysis, postoperative right and left heart dysfunction in combination with a postoperative anatomical residuum needing a re-operation or re-intervention in the postoperative period is associated with a high risk for the development of cardiac hepatopathy. Furthermore, postoperative complications (pleural effusion, heart rhythm disorders, etc.), postoperative infections, and the need for parenteral nutrition also raise the risk for cardiac hepatopathy. Further investigations are needed to reduce hepatic complications and improve the general prognosis of such complex patients.

scholarly journals LEVELS OF ESSENTIAL AND CONDITIONALLY ESSENTIAL NUTRIENTS IN THE INTRAOPERATIVE BIOPSY SPECIMENS OF CHILDREN WITH CONGENITAL HEART DISEASE AND HEART RHYTHM DISORDERS

2018 ◽  
Vol 7 (2) ◽  
pp. 112-120 ◽  
Author(s):  
A. V. Dubovaya ◽  
G. E. Sukhareva
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Strong Correlation ◽  
Congenital Heart ◽  
Heart Rhythm ◽  
Mineral Nutrients ◽  
Emission Spectrometry ◽  
Essential Nutrients ◽  
Biopsy Specimens ◽  
Heart Rhythm Disorders

Background. Despite recent numerous studies, etiopathogenesis, treatment and rehabilitation of children with heart rhythm disorders haven’t been studied well. We paid attention to the significant impact of mineral nutrients on cardiac activity, while addressing to the viable solutions. Aim. To measure the levels of essential and conditionally essential mineral nutrients and to determine any relationships between their concentrations in hair and in the intraoperative biopsy specimens obtained from children with congenital heart disease and heart rhythm disorders. Methods 55 children (34 boys and 21 girls) aged 6 to 17 years with different heart rhythm disorders and congenital heart disease were included in the study. Levels of 15 essential mineral nutrients (calcium, potassium, magnesium, sodium, phosphorus, sulfur, chromium, copper, iron, iodine, cobalt, manganese, molybdenum, selenium, zinc) and 3 conditionally essential nutrients (boron, silicon, vanadium) were measured in hair and in the intraoperative biopsy specimens obtained from children with congenital heart disease using inductively coupled plasma atomic emission spectrometry and electrothermal atomization atomic absorption spectrometry. The results of the study were processed using variational and alternative statistic methods with the commercially available software “MedStat”. Results The lack of essential nutrients (K, Mn, Se, Cr, P, Co, S, Cu, Na, Mo) and conditionally essential mineral, Si, in the intraoperative biopsy specimens of the heart and great arteries has been found. The direct strong correlation between the levels of essential (K, Mn, Se, Cr, Co) and conditionally essential (Si) minerals in hair and heart tissues of children with congenital heart disease and heart rhythm disorders has been determined. Conclusion The deficit of essential (potassium, manganese, selenium, chromium, phosphorus, cobalt, sulfur, copper, sodium, molybdenum) and conditionally essential (silicon) mineral nutrients, and the direct strong correlation between their levels in hair and heart tissues of children with congenital heart disease and heart rhythm disorders allows using hair as a biosubstrate, which is highly informative for the measurement of nutrients in the human body. 

scholarly journals The Impact of Prenatal Diagnosis of Complex Congenital Heart Disease on Neonatal Outcomes

2010 ◽  
Vol 31 (5) ◽  
pp. 587-597 ◽  
Author(s):  
Allison Levey ◽  
Julie S. Glickstein ◽  
Charles S. Kleinman ◽  
Stephanie M. Levasseur ◽  
Jonathan Chen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Prenatal Diagnosis ◽  
Congenital Heart ◽  
Neonatal Outcomes ◽  
Complex Congenital Heart Disease ◽  
The Impact

Abstract 18813: Outcomes of Patients with Congenital Heart Disease following Heart Transplantation: the Impact of Disease Type, Prior Thoracic Surgeries and End-Organ Dysfunction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Matthew J Lewis ◽  
Jonathan Ginns ◽  
P. C Schulze ◽  
Matt Lippel ◽  
Paul Chai ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Heart Transplantation ◽  
Organ Dysfunction ◽  
Congenital Heart ◽  
Fontan Operation ◽  
Pulmonary Atresia ◽  
Patient Specific ◽  
Increased Risk ◽  
The Impact

Introduction: Adults with congenital heart disease (ACHD) are at increased risk for early adverse outcomes following heart transplantation (Htx). Despite the need for improved risk stratification, small cohorts have constrained identification of patient-specific factors associated with poor prognosis. We hypothesized that type of CHD, number of sternotomies and prior end-organ dysfunction would be associated with an increased risk for mortality post-HTx. Methods: We performed a retrospective, observational cohort study of all patients with ACHD who underwent HTx at our institution from 1/1997 to 1/2014. The primary endpoint was death. Exposures of interest included type of CHD, number of sternotomies and hepatic dysfunction secondary to passive congestion, measured as high Models for End-Stage Liver Disease Excluding INR (MELD-XI) score. Results: 48 ACHD patients were followed (mean age at HTx: 36±1.7 years). Diagnoses included: Tetralogy of Fallot (TOF)/pulmonary atresia/double outlet right ventricle in 15 (31%), D-transposition of the great arteries in 10 (21 %), tricuspid atresia/double inlet left ventricle in 9 (19%), VSD/ASD in 4 (8%), heterotaxy in 3 (6%), congenitally corrected transposition of the great arteries in 2 (4%), and 5 (10%) with other diagnoses. Pre-transplant cardiac surgeries included: Fontan operation in 12 (25%), Mustard/Senning repair in 9 (19%), TOF repair in 5 (11%), Rastelli repair in 5 (11%), VSD/ASD closures in 3 (6%), other another congenital heart surgery in 8 (17%) and no prior cardiac surgery in 5 (11%). Over a median follow-up time of 3.9 years, 14 patients died (29%) and 10 (71%) deaths occurred within 30 days of HTx. Survival at 1 and 5 years was 77%. Deaths within 30 days of surgery were secondary to hemorrhage in 4 (40%), graft failure in 3 (30%) and multi-system organ failure in 3 (30%). By multivariate analysis, ≥3 sternotomies (HR 8.5, p=0.02), MELD-XI score >18 (HR 6.2, p=0.009) and heterotaxy (HR 9.8, p=0.01), were significant predictors of mortality. Conclusion: In our cohort of patients with CHD undergoing Htx, ≥3 sternotomies, MELD-XI score >18 and heterotaxy syndrome were significantly associated with death. These findings may be important in patient selection and timing of Htx in this population.

The adaptation process of mothers raising a child with complex congenital heart disease

2018 ◽  
Vol 22 (4) ◽  
pp. 520-531 ◽  
Author(s):  
Jeong-Ah Ahn ◽  
Sunhee Lee
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Health Care Providers ◽  
Congenital Heart ◽  
Child Rearing ◽  
Complex Congenital Heart Disease ◽  
Adaptation Process ◽  
Care Providers ◽  
Impact Phase ◽  
The Impact

Mothers of children with congenital heart disease (CHD) tend to be concerned about their child’s normal life. The majority of these mothers tend to experience negative psychological problems. In this study, the adaptation process of mothers raising a child with complex CHD was investigated based on the sociocultural context of Korea. The data collection was conducted by in-depth interviews and theoretical sampling was performed until the data were saturated. The collected data were analyzed using continuous theoretical comparisons. The results of the present study showed that the core category in the mothers’ adaptation process was ‘anxiety regarding the future’, and the mothers’ adaptation process consisted of the impact phase, standing against phase, and accepting phase. In the impact phase, the participants emotionally fluctuated between ‘feelings of abandonment’ and ‘entertaining hope’. In the standing against phase, participants tended to dedicate everything to child-rearing while being affected by ‘being encouraged by support’ and ‘being frustrated by tasks beyond their limits’. In the accepting phase, the subjects attempted to ‘accept the child as is’, ‘resist hard feelings’, and ‘share hope’. Health-care providers need to develop programs that include information regarding CHD, how to care for a child with CHD, and effective child-rearing behaviors.

New Insights into the Impact of Genome-Wide Copy Number Variations on Complex Congenital Heart Disease in Saudi Arabia

2020 ◽  
Vol 24 (1) ◽  
pp. 16-28 ◽  
Author(s):  
Majed J. Dasouki ◽  
Salma M. Wakil ◽  
Olfat Al-Harazi ◽  
Maarab Alkorashy ◽  
Nzioka P. Muiya ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Saudi Arabia ◽  
Heart Disease ◽  
Copy Number ◽  
Congenital Heart ◽  
Copy Number Variations ◽  
Complex Congenital Heart Disease ◽  
Genome Wide ◽  
The Impact
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