scholarly journals Congenital Heart Disease Requiring Maintenance of Ductus Arteriosus in Critically Ill Newborns Admitted at A Tertiary Neonatal Intensive Care Unit

2016 ◽  
Vol 2 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Manuela Cucerea ◽  
Marta Simon ◽  
Elena Moldovan ◽  
Marcela Ungureanu ◽  
Raluca Marian ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Pulmonary Circulation ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Prostaglandin E ◽  
Critical Congenital Heart Disease ◽  
The Mean

AbstractIntroduction: Congenital heart diseases (CHD) have been reported to be responsible for 30 to 50% of infant mortality caused by congenital disabilities. In critical cases, survival of newborns with CHD depends on the patency of the ductus arteriosus (PDA), for maintaining the systemic or pulmonary circulation. The aim of the study was to assess the efficacy and side effects of PGE (prostaglandin E) administration in newborns with critical congenital heart disease requiring maintenance of the ductus arteriosus.Material and method: All clinical and paraclinical data of 66 infants admitted to one referral tertiary level academic center and treated with Alprostadil were analyzed. Patients were divided into three groups: Group 1: PDA dependent pulmonary circulation (n=11) Group 2: PDA dependent systemic circulation (n=31) Group 3: PDA depending mixed circulation (n=24)Results: The mean age of starting PGE1 treatment was 2.06 days, 1.91 (+/−1.44) days for PDA depending pulmonary flow, 2.39 (+/−1.62) days for PDA depending systemic flow and 1.71 (+/1.12) for PDA depending mixing circulation. PEG1 initiation was commenced 48 hours after admission for 72%, between 48-72 hours for 6%, and after 72 to 120 hours for 21% of newborns detected with PDA dependent circulation. Before PEG1 initiation the mean initial SpO2 was 77.89 (+/− 9.2)% and mean initial oxygen pressure (PaO2) was 26.96(+/−6.45) mmHg. At the point when stable wide open PDA was achieved their mean SpO2increased to 89.73 (+/−8.4)%, and PaO2 rose to 49 (+/−7.2) mmHg. During PGE1 treatment, eleven infants (16.7%) had apnea attacks, five children (7.5%) had convulsions, 33 (50%) had fever, 47 (71.2%) had leukocytosis, 52 (78.8%) had edema, 25.8% had gastrointestinal intolerance, 45.5% had hypokalemia, and 63.6% had irritability.Conclusions: For those infants with severe cyanosis or shock caused by PDA dependent heart lesions, the initiation and maintenance of PGE1 infusion is imperative. The side effects of this beneficial therapy were transient and treatable.

A retrospective analysis of a pediatric tele-echocardiography service to treat, triage, and reduce trans-Pacific transport

2017 ◽  
Vol 24 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Christopher A Rouse ◽  
Brandon T Woods ◽  
C Becket Mahnke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
The United States ◽  
Critical Congenital Heart Disease ◽  
Medical Centers ◽  
Prompt Diagnosis ◽  
Patent Ductus

Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.

Should we start a nationwide screening program for critical congenital heart disease in Turkey? A pilot study on four centres with different altitudes

2019 ◽  
Vol 29 (4) ◽  
pp. 475-480
Author(s):  
Dilek Dilli ◽  
Vehbi Doğan ◽  
Banu M. Özyurt ◽  
Abdullah Özyurt ◽  
Nilay Hakan ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Screening Program ◽  
Critical Congenital Heart Disease ◽  
Multi Centre Study ◽  
Geographical Regions ◽  
The Mean ◽  
Different Altitudes

AbstractBackground:To investigate the feasibility of critical congenital heart disease (CCHD) screening test by pulse oximetry in four geographical regions of Turkey with different altitudes, before implementation of a nationwide screening program.Methods:It was a prospective multi-centre study performed in four centres, between December, 2015 and May, 2017. Pre- and post-ductal oxygen saturations and perfusion indices (PI) were measured using Masimo Radical-7 at early postnatal days. The results were evaluated according to the algorithm recommended by the American Academy of Pediatrics. Additionally, a PI value <0.7 was accepted to be significant.Results:In 4888 newborns, the mean screening time was 31.5 ± 12.1 hours. At first attempt, the mean values of pre- and post-ductal measurements were: saturation 97.3 ± 1.8%, PI 2.8 ± 2.0, versus saturation 97.7 ± 1.8%, PI 2.3±1.3, respectively. Pre-ductal saturations and PI and post-ductal saturations were the lowest in Centre 4 with the highest altitude. Overall test positivity rate was 0.85% (n = 42). CCHD was detected in six babies (0.12%). Of them, right hand (91 ± 6.3) and foot saturations (92.1 ± 4.3%) were lower compared to ones with non-CCHD and normal variants (p <0.05, for all comparisons). Sensitivity, specificity, positive and negative predictive values, and likelihood ratio of the test were: 83.3%, 99.9%, 11.9%, 99.9%, and 99.2%, respectively.Conclusion:This study concluded that pulse oximetry screening is an effective screening tool for congenital heart disease in newborns at different altitudes. We support the implementation of a national screening program with consideration of altitude differences for our country.

scholarly journals High prevalence of congenital heart disease at high altitudes in Tibet

2018 ◽  
Vol 26 (7) ◽  
pp. 756-759 ◽  
Author(s):  
Hua Chun ◽  
Yan Yue ◽  
Yibin Wang ◽  
Zhaxi Dawa ◽  
Pu Zhen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Patent Ductus Arteriosus ◽  
High Altitude ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Congenital Heart Diseases ◽  
Patent Ductus

Background Previous small sample studies suggested that elevated altitudes might be associated with the incidence of cardiovascular diseases. However, it remains uncertain whether high altitudes (over 3000 m above sea level) are related to congenital heart disease. We therefore explored the prevalence of congenital heart disease in a large cohort of students in the world's largest prefecture-level city with the highest altitude. Methods This cross-sectional study included 84,302 student participants (boys 52.12%, girls 47.88%, with an average age of 10.62 ± 3.33 years). Data were extracted from the screening results among different altitude area schools in Nagqu from June 2016 to August 2017. Students were first screened by performing a physical examination consisting of cardiac auscultations and clinical manifestation screenings. An echocardiography was performed to confirm and identify the subtype of congenital heart disease. Results The prevalence of congenital heart disease among students in Nagqu, Tibet, was 5.21‰ (439 cases). The most common congenital heart disease type was patent ductus arteriosus, representing 66.3% of congenital heart diseases diagnosed in this study, followed by atrial septal defect and ventricular septal defect, representing 20.3% and 9.1% of congenital heart diseases, respectively. Students living in higher altitudes were significantly more prone to have congenital heart disease than students in locations with lower altitudes. The prevalence of congenital heart disease in girls was found to be higher than that of boys. Conclusions The correlation between congenital heart disease and increased altitude is noteworthy. This study's results are the first big data epidemiological investigation to confirm that high altitude is a significant environmental risk factor for congenital heart disease, especially patent ductus arteriosus. Furthermore, the results provide additional support to make a diagnostic and treatment plan to prevent congenital heart disease in high altitude areas.

scholarly journals Side effects of therapy with prostaglandin E1 in infants with critical congenital heart disease.

Circulation ◽  
1981 ◽  
Vol 64 (5) ◽  
pp. 893-898 ◽  
Author(s):  
A B Lewis ◽  
M D Freed ◽  
M A Heymann ◽  
S L Roehl ◽  
R C Kensey
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Congenital Heart ◽  
Prostaglandin E1 ◽  
Critical Congenital Heart Disease

scholarly journals High-definition mapping of the atria using a novel multipolar mapping catheter in patients with complex adult congenital heart disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohammad Paymard ◽  
Santabhanu Chakrabarti
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Catheter Ablation ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Atrial Arrhythmias ◽  
Grid Mapping ◽  
The Mean ◽  
Activation Mapping ◽  
Mapping Catheter

Abstract Background The Advisor™ HD Grid Mapping Catheter (Abbott Technologies, Minneapolis, MN) has been recently introduced. Although the clinical use of HD Grid mapping catheter is well described in adults with no congenital heart disease, there is limited data on the feasibility of using the HD Grid multipolar catheter to create voltage and activation mapping in adults with congenital heart disease. The purpose of this study was to evaluate the safety and technical feasibility of using the Advisor™ HD Grid mapping catheter during the catheter ablation of atrial arrhythmias in adults with congenital heart disease. We included 6 consecutive adults with congenital heart disease suffering from atrial arrhythmias in our study. The HD Grid mapping catheter was used to perform voltage and activation mapping. Results Six patients with congenital heart diseases (d-TGA n = 1, Tricuspid atresia n = 1, atrioventricular defect repair n = 1, secundum atrial septal defect n = 1, double-inlet single-ventricle n = 1, Tetralogy of Fallot = 1); majority (84%) male, with the mean age was 35 ± 10 years included in our series. The mean ablation duration and the fluoroscopy time were 789 ± 433 and 502 ± 355 s, respectively. The mean radiation dose was 7.52 ± 9 milliGy/cm2. The HD Grid mapping catheter was used successfully for entire arrhythmia mapping in 5 out of 6 cases. During one procedure, HD Grid mapping catheter could not be used for the entire mapping due to suboptimal reach through baffle puncture. The acute success rate of ablation was 100% with no immediate complications. Conclusions The use of HD Grid mapping catheter is a safe and valuable adjunct to accurately create voltage and activation mapping in ACHD patients undergoing radiofrequency catheter ablation. However, a contact force-sensing ablation catheter should be considered in conjunction to supplement data acquisition in challenging anatomy and substrates.

scholarly journals Burden of congenital heart diseases in a tertiary cardiac care institute of high altitude area

2019 ◽  
Vol 7 (5) ◽  
pp. 1441
Author(s):  
Zubair Mushtaq Tramboo ◽  
Aamir Rashid Patigaroo ◽  
Nazir Ahmad
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Indian Subcontinent ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Mortality And Morbidity

Background: Congenital heart disease is one of the major causes of mortality and morbidity in the paediatric population of both the developing and developed countries. Variability in incidence and prevalence of CHD from various countries of Indian subcontinent and rest of the world could be because of genetic, cultural, and environmental factors.  The objective of the study was to find the prevalence and pattern of CHD in a tertiary care hospital in Kashmir (Jammu and Kashmir).Methods: All children admitted at territary care hospital with age 0-15 years were screened for congenital heart disease. The study was conducted for period of one year to ascertain the prevalence and spectrum of CHDs.Results: A total of 232 patients out of 23000, were found having CHDs measuring a prevalence of 10.5/1000. About 170 (73%) were the acyanotics, and 62 (27%) were cyanotic heart patients. Among the acyanotic heart diseases ventricular septal defect was the most frequent lesion seen in 54 (23%), followed by patent ductus arteriosus in 50 (22%) children. Among the cyanotic heart diseases tetralogy of Fallot was the most frequent cyanotic heart disease seen in 15 (6.4%) patients.Conclusions: Authors observed high prevalence of CHD in our population. The pattern and spectrum of CHD were comparable to national and international data.

scholarly journals Attention Deficit Hyperactivity Disorder (ADHD) in Patients With Congenital Heart Disease (CHD)

2021 ◽  
Author(s):  
Hassan Mottaghi Moghaddam Shahri ◽  
Mahboubeh Eslamzadeh ◽  
Aazam Sadat Heydari Yazdi
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Attention Deficit ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Developmental Problems ◽  
Hyperactivity Disorder ◽  
Increased Risk ◽  
The Mean

Abstract BackgroundIt is established that children with congenital heart disease (CHD) are more susceptible for suffering deficiencies in intellectual functioning, developmental problems, and academic performance difficulties. Neurodevelopmental disabilities, particularly executive function impairments, are currently the most prevalent long-term morbidity in the population with CHD. The aim of this study was to investigate the frequency of Attention deficit hyperactivity disorder (ADHD) in children with CHD. MethodsThis was a retrospective cohort study, which was performed between 2002-2018 in patients with CHD referred to Imam Reza hospital, Mashhad, Iran. Using the census method, all files for which ADHD diagnosis has been made according to DSM-IV or DSM-V criteria should be included in the study. Diagnosis of CHD was performed clinically and using an echocardiographic machine by an experienced pediatric cardiologist. Heart diseases were divided into two important (major) and non-important (minor) categories based on the need for follow-up and intervention. Demographic, clinical and para-clinical data of patients as well as the type of heart intervention were collected and analyzed.Results136 patients were enrolled in the study. The mean age of participants in the study was 59.12± 45.84 months at the time of diagnosis. Abnormal electroencephalogram (EEG) was reported in three cases (2.2%). There was significant correlation between prematurity and developmental delay (P=0.01). The mean of age was significantly different in patients with minor rather than patients with major cardiac disorders (P<0.05). The prevalence of ADHD in CHD population was high (31.6%).ConclusionThis study demonstrated that children born with CHD are at increased risk of suffering from ADHD.

Palliative Therapies for Congenital Heart Disease with Ductus Dependent Pulmonary Circulation

2017 ◽  
Vol 221 (06) ◽  
pp. 272-275
Author(s):  
Shi-Min Yuan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Circulation ◽  
Congenital Heart ◽  
Prostaglandin E ◽  
Blalock Taussig Shunt

AbstractIn neonates, the management of ductus dependent pulmonary circulation is challenging. There have been three palliative therapies for this lesion: the modified Blalock-Taussig shunt, ductal stenting and prostaglandin E infusions, for maintaining the ductal patency before definite operations. Debates remain with regard to the indications and disadvantages of three palliative therapies. The aim of this article is to give a brief review of these three palliative therapies.

Sign in / Sign up

Export Citation Format

Share Document