scholarly journals Ultraprotective Ventilation during CPB Protects the Alveolar-Capillary Barrier in Pulmonary Normotensive Congenital Heart Patients

2017 ◽  
Vol 20 (2) ◽  
pp. 045
Author(s):  
Ugur Gocen ◽  
Atakan Atalay
Keyword(s):  
Congenital Heart ◽  
Heart Defects ◽  
Membrane Damage ◽  
Protective Effects ◽  
Capillary Barrier ◽  
Heart Patients ◽  
Significant Difference ◽  
Alveolar Capillary ◽  
Ultraprotective Ventilation ◽  
Ventilated Patients

Background: Alveolar-capillary membrane damage develops as a result of the inflammatory effect of cardiopulmonary bypass (CPB). In the presence of a healthy alveolar-capillary barrier, there is little or no surfactant in the blood. The aim of this study was to evaluate the protective effects of ultraprotective ventilation during CPB by measuring serum and bronchoalveolar lavage (BAL) surfactant protein B (SPB) values in congenital heart surgery.Methods: This prospective study was designed for 46 patients with congenital heart defects. Patients were classified into two groups: group 1 comprising pulmonary normotensive patients and group 2 consisting of pulmonary hypertensive (PH) patients. Each group was divided into two sub-groups: (a) those who received ultraprotective ventilation during CPB and (b) those who did not receive ultraprotective ventilation during CPB. Serum SPB (S-SPB) values were measured preoperatively (ST1); at the fourth hour postop (ST2); and at the 24th hour postop (ST3). BAL SPB values were measured preoperatively (BT1); and at the fourth hour postop (BT2). Results: ST1, ST2, and ST3 values of group 1a (pulmonary normotensive ventilated patients) and group 1b (pulmonary normotensive non-ventilated patients) were much lower than those of group 2a (pulmonary hypertensive ventilated patients) and group 2b (pulmonary hypertensive non-ventilated patients) (P < .05). The evaluation of ST1, ST2, and ST3 values between groups 1a and 1b did not show statistically significant differences. When comparing ST1 to ST3, a decrease in value was observed in group 1a (32.28 ± 13.27 ng/mL to 19.38 ± 7.6 ng/mL) (P = .006). In Group 1b, values increased between ST1 and ST2 before decreasing from ST2 to ST3; however, the ST3 values were still higher than their ST1 counterparts. It was recorded that there was no statistically significant difference between the ST1, ST2, and ST3 values of group 2a and group 2b. A comparison of the BT1 and BT2 values in groups also yielded no statistically significant differences. Conclusion: Although pulmonary hypertension is known to result in lung injury, this study is important as it shows that ultraprotective ventilation protects the alveolar-capillary barrier in pulmonary normotensive congenital heart patients. 

scholarly journals A randomized control trial: Effects of teach back method on self-efficacy among mothers of children with congenital heart defects

2018 ◽  
Vol 8 (7) ◽  
pp. 106
Author(s):  
Azza A. Ghoneim ◽  
Aml AbdElrazk Fathalla
Keyword(s):  
Congenital Heart Defects ◽  
Self Efficacy ◽  
Congenital Heart ◽  
Heart Defects ◽  
Nursing Intervention ◽  
University Hospital ◽  
Health Concern ◽  
Discharge Instructions ◽  
Significant Difference ◽  
Randomized Control

Background/Objective: Congenital Heart Defects (CHD) remain a major health concern all over the world particularly Egypt where the prevalence of CHD is 1.0 per 1,000. Nurses are instrumental in supplying information. The teach-back method is a technique used for improving patient understanding and outcomes. This study aimed to evaluate the effect of teach back method on self-efficacy and satisfaction among mothers of children with congenital heart defects.Methods: The design of this study was randomized control trail. A sample of 60 children with congenital heart defects and their mothers participated in this study. It conducted at Menofia University hospital. Tools of this study included Self Efficacy Scale; Teach back Discharge Education Audit and Satisfaction Assessment.Results: The current study revealed that the majority of nurses were unfamiliar with teach-back method and there was significant difference between mothers in the experimental and control groups regarding their self-efficacy.Conclusions: This study concluded that mothers who received discharge instructions through teach back method had increased self-efficacy and high level of satisfaction. Therefore, pediatric nurses should integrate teach back method as a routine nursing intervention in the discharge plan for children with congenital heart defects.

scholarly journals Prevalence of Congenital Heart Defects in Neonates of Drug Abusing Mothers

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohammad Radgoodarzi ◽  
Elahe Norouzi ◽  
Zahra Vahedi ◽  
Mitra Salavati ◽  
Ameneh Yaghoubi ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart Defect ◽  
Congenital Heart ◽  
Heart Defects ◽  
Normal Population ◽  
Color Doppler ◽  
Newborn Infants ◽  
Teaching Hospitals ◽  
Heart Defect ◽  
Significant Difference

Background: Congenital heart defects (CHDs) are the most common congenital malformations at birth. Substance abuse has increased dramatically over the past two decades. It also can affect neonates of drug-abusing mothers. Objectives: This study aimed to elucidate the possible association of maternal drug abuse with CHDs in their newborn infants. Patients and Methods: In this study, 72 neonates who were born during 6 years in three teaching hospitals are studied. Echocardiography was performed by a single pediatric cardiologist using two-dimensional and color Doppler echocardiography. The data were analyzed using descriptive statistics. Results: 1) Of 72 included cases, 38 (52.78%) had abnormal echocardiographic findings; 2) from 38 abnormal echocardiography, 35 (48.61% of total and 92.11% of abnormal echoes) had mild congenital heart defect (CHD), and 3 had complex CHD; 3) There was no significant difference in the prevalence of neonatal congenital heart defect with the type of misused drugs (opiates or methamphetamines). Conclusions: In our study, the prevalence of CHD in newborns of drug abuser mothers was significantly higher than the normal population of infants. Hence, echocardiographic screening of these newborns seems to be logical.

scholarly journals The incidence of congenital heart defects in the world regarding the severity of the defect

2016 ◽  
Vol 73 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Vesna Miranovic
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Methodological Approach ◽  
Live Births ◽  
Significant Difference ◽  
The World

Bacground/Aim. Congenital heart defects (CHDs) are structural or functional abnormalities of the heart present at birth even if they are detected much later. Their importance lies in the fact that, depending on the severity, they change the quality of life, and may be life threating. In addition, we should not ignore the high costs of treating people with congenital heart disease. The aim of this study was to analyze the incidence of congenital heart disease in relation to the severity in the world based on the available literature. Methods. All the available literature on the incidence of CHD cases regarding the severity of CHD published from 1955 to 2012 was analyzed. The researcher was able to read the titles and abstracts of 128 papers on the subject. Due to methodological inconsistency, 117 of the papers were rejected. Based on the criteria of reliability, availability and comparability, our analysis included 11 studies testing CHD incidence regarding the severity of the defect conducted all over the world. The Yates' ?2-test was used to compare the observed incidences. Results. The frequency of severe congenital heart defects, ranged from 0.414 to 2.3/1,000 live births, the incidence of moderate congenital heart defects from 0.43 to 2.6/1,000 live births while in the group of minor congenital heart defects the incidence ranged from 0.99 to 10.3/1000 live births. There were no statistically significant differences in the incidence of mild, moderate and severe CHDs. Conclusion. The results obtained studying of the available data suggest that no statistically significant difference in the incidence of mild, moderate and severe congenital heart defects. A universal methodological approach to the incidence of CHD is essential.

Abstract P040: Muscle Metaboreflex Regulation of Arterial Blood Pressure in Children with Congenital Heart Defects

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Corey R Tomczak ◽  
Stephanie Fusnik ◽  
Elizabeth Hogeweide ◽  
Mark J Haykowsky ◽  
Michael K Stickland ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Flow Control ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Free Flow ◽  
Post Exercise ◽  
Muscle Metaboreflex ◽  
Arterial Blood ◽  
Significant Difference

Introduction: Metabolically sensitive afferent fibers in skeletal muscle can signal an increase the sympathetic control of arterial blood pressure during exercise. This process, called the muscle metaboreflex, is augmented in adults with cardiovascular disease and contributes to exercise intolerance. The role of the muscle metaboreflex on blood pressure control in children with congenital heart defects (CHD) is not known. Hypothesis: We tested the hypothesis that the mean arterial pressure (MAP) response to the muscle metaboreflex would be augmented in children with CHD compared to healthy controls. Methods: Twenty-six children with CHD (11±2 years; males=14; females=12) and 21 age- and sex-matched controls (11±3 years; males=10; females=11) were studied. CHD diagnoses included Tetralogy of Fallot (n=7), pulmonary or aortic stenosis (n=3), hypoplastic left or right heart syndrome (n=5), Ebstien’s anomaly (n=1), atrial or ventricular septal defect (n=5), transposition of the great arteries (n=2), double inlet left ventricle (n=1), heart transplantation (n=2), tricuspid or pulmonary atresia (n=2), coarctation of the aorta (n=2), and dilated cardiomyopathy (n=1). Testing included a 3 min rest period followed by isometric handgrip exercise at 30% of maximal voluntary contraction for 2 min. Exercise was followed by 3 min of either a free flow control condition or circulatory occlusion to isolate the muscle metaboreflex. Beat-by-beat MAP was recorded using finger plethysmography. Analyses were completed using mixed designs factorial ANOVA with P < 0.05 as the level of significance. Data are mean ± SD. Results: During the free flow control condition, there was no significant difference in resting MAP (75±9 mmHg vs. 78±9 mmHg), exercise MAP (86±14 mmHg vs. 87±12 mmHg), or free flow MAP (72±10 mmHg vs. 78±9 mmHg) between children with CHD vs. controls, respectively ( P > 0.05). MAP significantly increased from rest to exercise and returned to resting levels during the free flow control condition for both groups. For the circulatory occlusion condition, there was no significant difference in resting MAP (73±11 mmHg vs. 74±8 mmHg), exercise MAP (84±15 mmHg vs. 81±11 mmHg), or circulatory occlusion MAP (79±13 mmHg vs. 79±13 mmHg) between children with CHD vs. controls, respectively ( P > 0.05). MAP significantly increased from rest to exercise and MAP remained elevated above resting levels during circulatory occlusion for both children with CHD and controls ( P < 0.001 for all). Conclusions: Post-exercise circulatory occlusion significantly increases MAP in children with CHD and healthy children, with no significant difference in the magnitude of the MAP response between groups. We conclude that children with CHD demonstrate a normal muscle metaboreflex during post-exercise circulatory occlusion.

Increased susceptibility to gingival colonization by specific HACEK microbes in children with congenital heart disease

2001 ◽  
Vol 25 (1) ◽  
pp. 91-94 ◽  
Author(s):  
Robert Steelman ◽  
Stanley Einzig ◽  
Arpy Balian ◽  
John Thomas ◽  
David Rosen ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Defects ◽  
Control Group ◽  
Healthy Children ◽  
Normal Children ◽  
Exact Test ◽  
Inflammatory Index ◽  
Significant Difference ◽  
Experimental Group ◽  
Increased Susceptibility

It is well established that infective endocarditis (IE) involving the HACEK (Hemophilus, Actinobaccillus, Cardiobacter, Eikenella, Kingella) group of microbes occurs in patients with congenital heart defects (CHD) and in those with prosthetic grafts. Dental caries and gingival disease have been presumed to be the focus of microbial shedding. The purpose of this study was to determine if children with CHD had a more severe gingival inflammatory condition and harbored the HACEK group of microbes to a greater extent than normal children. Two groups of 12 age and sex matched children were selected for this study. The experimental group consisted of twelve children with CHD, 1-1/2 to 8 years of age. The control group consisted of 12 healthy children 2 to 8 years of age. Each child had a gingival index score recorded as described by Massler. Subgingival cultures were obtained. Gingival samples were cultured for HACEK microbes and total Streptococcus (spp) using standard techniques. Fisher's exact test was performed with significance defined at P&lt;0.05. Children with CHD had more severe gingival inflammatory index than the control group (P&lt;0.05). 8/12 CHD patient had Actinobacillus actinomycetemcomitans (A.a.) as compared with 2/12 controls (P&lt;0.05). Furthermore, all cyanotic CHD patients (4/4) had A.a. whereas, only 2/12 controls did (P&lt;0.05). 4/12 CHD patients harbored Eikenella corrodens (E.c.) compared to 1/12 controls (N.S.). There was no significant difference in colonization with E.c. or A.a. between cyanotic and acyanotic patients. No significant difference in total Streptococcus (spp) was found between the two groups. This study suggests that children with CHD have a more severe gingival inflammatory index and are colonized with specific HACEK microbes more so than normal children.

scholarly journals Congenital Anomalies of the Kidney and Urinary Tract in Children with Congenital Heart Defects

2020 ◽  
Vol 45 (2) ◽  
pp. 307-313
Author(s):  
Dapeng Jiang ◽  
Qi Wang ◽  
Zhengzhou Shi ◽  
Jie Sun
Keyword(s):  
Urinary Tract ◽  
Congenital Heart Defects ◽  
Congenital Anomalies ◽  
Congenital Heart ◽  
Medical Center ◽  
Heart Defects ◽  
Clinical Manifestations ◽  
Number Of Patients ◽  
Significant Difference ◽  
History Of

Background/Aims: To investigate the incidence and clinical characteristics of congenital anomalies of the kidney and urinary tract (CAKUT) in children with congenital heart defects (CHD). Methods: We retrospectively analyzed the clinical data of children with CHD with CAKUT admitted to the Shanghai Children’s Medical Center affiliated with the Shanghai Jiao Tong University School of Medicine between September 2018 and March 2019. Patients underwent routine examinations for liver, kidney, and coagulation function, and urinary tract ultrasonography, and we summarized patients’ clinical manifestations and imaging abnormalities. Results: A total of 1,410 children with CHD were diagnosed and treated in our hospital. The total number of patients with abnormal urogenital systems was 104, and hydronephrosis was the most common abnormality, followed by vesicoureteral reflux and duplication of the kidney and ureter. The overall prevalence of CAKUT was 7.4%. There was no statistically significant difference for maternal age, sex, parity, gestational age, and history of medication during pregnancy between the patients with CAKUT and those without CAKUT. Conclusion: The incidence of CAKUT in our patients with CHD was significantly higher than that in the general population. We recommend urinary ultrasonography as a routine examination for children with CHD for early detection of CAKUT, to avoid missed diagnoses, and to initiate appropriate treatment.

scholarly journals The effect of pre-hospital discharge care program on mothers’ knowledge and reported practice for children with congenital heart surgery

2018 ◽  
Vol 8 (9) ◽  
pp. 122
Author(s):  
Fatma Ahmed Elsobky ◽  
Samah Abdalha Mohamed Amer ◽  
Ahlam Elahmady Mohamed Sarhan
Keyword(s):  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Heart Defects ◽  
Care Program ◽  
Congenital Heart Surgery ◽  
Care Practice ◽  
Discharge Care ◽  
Significant Difference

Heart surgery in children is done to repair heart defects for a child born with congenital heart defects and heart diseases. The aim of the study was to evaluate the effect of pre-hospital discharge care program on mothers’ knowledge and reported practice regarding discharge care of children with congenital heart surgery. The study was conducted in the Heart Surgery Department at Abo-EL Riesh University Children Hospital. The sample included 30 mothers and their children that were available during the period of data collection. Three tools were used to collect data including: Tool I: Interviewing questioner sheet of the participants categorized into two parts. Part I and part II: Personal characteristics of the children and their mothers. Tool II: Assessment of mothers’ knowledge regarding care of children after congenital heart surgery. Tool III: Mother’s reported care practice checklist. Results: The results of the present study revealed that there was a highly significant difference in all items of care knowledge (activity, food, medication and follow-up) before, after immediately and after one month from discharge program with highly significant statistically (p < .001). Discharge program improve mothers’ knowledge and practice regarding care of their children after congenital heart surgery. Recommendations: Comprehensive, multidisciplinary discharge planning should deign early and should include the mothers and children contain education regarding congenital heart surgery care.

scholarly journals Long-term experience with the one-and-a-half ventricle repair for simple and complex congenital heart defects

2020 ◽  
Vol 59 (1) ◽  
pp. 244-252
Author(s):  
Giulio Cabrelle ◽  
Biagio Castaldi ◽  
Luca Vedovelli ◽  
Dario Gregori ◽  
Vladimiro L Vida ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Defects ◽  
Stress Test ◽  
Complex Congenital Heart Disease ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
The One ◽  
Clinical Records

Abstract OBJECTIVES The one-and-a-half ventricle repair (1.5VR) is a surgical alternative to Fontan circulation or high-risk biventricular repair in patients with complex congenital heart disease (CHD) with a hypoplastic right ventricle (RV). We report our 25 years of experience to evaluate whether the degree of anatomical complexity of the CHD can affect long-term outcomes. METHODS This is a retrospective study including patients undergoing 1.5VR between 1994 and 2018. Clinical records and operative reports were reviewed. Follow-up data were collected from all survivors at the last evaluation or by phone contact. RESULTS Twenty-nine patients underwent 1.5VR [median age: 3.5 years, interquartile range (IQR) 0.8–7.8]. Fifteen patients had ‘simple’ (i.e. confined to right heart lesions) anatomical characteristics (48.3%); the median tricuspid valve annulus z-score was −3.5 (IQR −6.2 to +3.6). There were no operative deaths. The median hospital stay was 21 days (IQR 10–33), with postoperative complications in 21 patients (75.8%). At a median follow-up of 13.2 years (IQR 3.2–25.6 years; completeness 96.6%), there were 3 late deaths. There was no significant difference in survival and in freedom from adverse events between simple and complex anatomy groups. However, stress test findings showed a tendency towards a higher maximum oxygen uptake in the simple group (P = 0.055). CONCLUSIONS The 1.5VR strategy is an effective low-risk surgical option for patients with CHD with hypoplastic RV. When it is planned from birth, late outcomes can be satisfactory. In our experience, the presence of associated major cardiac anomalies was not associated with either worse early or long-term outcomes and functional status.

Association of MTHFR A1298C polymorphism with conotruncal heart disease

2014 ◽  
Vol 25 (7) ◽  
pp. 1326-1331 ◽  
Author(s):  
Beyza D. Sayin Kocakap ◽  
Cihat Sanli ◽  
Feryal Cabuk ◽  
Murat Koc ◽  
Ali Kutsal
Keyword(s):  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
Control Group ◽  
Genotype Distribution ◽  
Mthfr A1298c ◽  
Wide Range ◽  
Significant Difference ◽  
A1298c Polymorphism

AbstractCongenital heart diseases are common congenital anomalies with 1% prevalence worldwide and are associated with significant childhood morbidity and mortality. Among a wide range of aetiologically heterogeneous conditions, conotruncal anomalies account for approximately one-third of all congenital heart defects. The aetiology of conotruncal heart diseases is complex, with both environmental and genetic causes. Hyperhomocysteinaemia, which is often accompanied by the defects of folic acid metabolism, is known to cause conotruncal heart anomalies. In this study, we have evaluated three polymorphisms in the following two hyperhomocysteinaemia-related genes: methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) and nicotinamide N-methyl transferase (NNMT rs694539) in 79 children with conotruncal heart disease and 99 children without conotruncal heart disease. Genotype distribution of the MTHFR A1298C polymorphism showed a statistically significant difference between the two groups. In the case group, AC and CC genotypes were higher than the control group (p<0.05). We have found that MTHFR A1298C polymorphism is associated with conotruncal heart disease; C allele (p=0.028), AC (OR[95% CI]=2.48[1.24–4.95], p=0.010), CC (OR[95% CI]=3.01[1.16–7.83], p=0.023), and AC+CC (OR[95% CI]=2.60[1.36–4.99], p=0.004) genotypes are more frequent in the patient group. Genotype distributions of the MTHFR C677T and NNMT rs694539 polymorphisms were similar in the two groups when evaluated separately and also according to the dominant genetic model (p>0.05). Our results suggest that MTHFR 1298C allele is a risk factor for conotruncal heart disease.

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