Social-psychological characteristics of children after radical correction of congenital heart disease

Studying the long-term results of surgical correction of CHD in children is an urgent problem in the modern world, since there are currently no uniform criteria for assessing the long-term results of this type of intervention.Objective. To study the social and psychological characteristics of children with congenital heart disease after surgery to predict possible risks of adaptation disorders in the long term period.Material and Methods. Social and emotional functioning of 116 children with congenital heart disease after surgical treatment was assessed using the Pediatric Quality of Life Questionnaire PEDsQL4.0. Children were divided into two groups: children from families with (group 1) and without unfavorable social and economic factors (group 2).Results and Discussion. Lower indicators of health were observed in group of children with familial history of various unfavorable social and economic factors as well as in children with more complicated defects and comorbidities during threeyear follow-up.Conclusion. Integrated dynamic differentiated observation is essential during the follow-up of patients with congenital heart defects. While creating a rehabilitation program, it is necessary to take into account all components of health, including the psychosocial functioning of the child, and to implement a personalized approach to rehabilitation on this basis.

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Long-Term Follow-up after Radiofrequency Catheter Ablation of Atrial Tachycardias in Patients with Congenital Heart Disease

10.1055/s-0040-1705579 ◽

2020 ◽

Author(s):

S. Klehs ◽

H. Schneider ◽

D. J. Backhoff ◽

M. Müller ◽

T. Paul ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Catheter Ablation ◽

Radiofrequency Catheter Ablation ◽

Congenital Heart ◽

Long Term Follow Up

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Discontinuity of Cardiac Follow‐Up in Young People With Congenital Heart Disease Transitioning to Adulthood: A Systematic Review and Meta‐Analysis

Journal of the American Heart Association ◽

10.1161/jaha.120.019552 ◽

2021 ◽

Author(s):

Philip Moons ◽

Sandra Skogby ◽

Ewa‐Lena Bratt ◽

Liesl Zühlke ◽

Ariane Marelli ◽

...

Keyword(s):

United States ◽

Systematic Review ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Heart Defects ◽

Meta Analysis ◽

Transition Programs ◽

The United States

Background The majority of people born with congenital heart disease require lifelong cardiac follow‐up. However, discontinuity of care is a recognized problem and appears to increase around the transition to adulthood. We performed a systematic review and meta‐analysis to estimate the proportion of adolescents and emerging adults with congenital heart disease discontinuing cardiac follow‐up. In pooled data, we investigated regional differences, disparities by disease complexity, and the impact of transition programs on the discontinuity of care. Methods and Results Searches were performed in PubMed, Embase, Cinahl, and Web of Science. We identified 17 studies, which enrolled 6847 patients. A random effects meta‐analysis of single proportions was performed according to the DerSimonian‐Laird method. Moderator effects were computed to explore sources for heterogeneity. Discontinuity proportions ranged from 3.6% to 62.7%, with a pooled estimated proportion of 26.1% (95% CI, 19.2%–34.6%). A trend toward more discontinuity was observed in simple heart defects (33.7%; 95% CI, 15.6%–58.3%), compared with moderate (25.7%; 95% CI, 15.2%–40.1%) or complex congenital heart disease (22.3%; 95% CI, 16.5%–29.4%) ( P =0.2372). Studies from the United States (34.0%; 95% CI, 24.3%–45.4%), Canada (25.7%; 95% CI, 17.0%–36.7%), and Europe (6.5%; 95% CI, 5.3%–7.9%) differed significantly ( P =0.0004). Transition programs were shown to have the potential to reduce discontinuity of care (12.7%; 95% CI, 2.8%–42.3%) compared with usual care (36.2%; 95% CI, 22.8%–52.2%) ( P =0.1119). Conclusions This meta‐analysis showed that there is a high proportion of discontinuity of care in young people with congenital heart disease. The highest discontinuity proportions were observed in studies from the United States and in patients with simple heart defects. It is suggested that transition programs have a protective effect. Registration URL: www.crd.york.ac.uk/prospero . Unique identifier: CRD42020182413.

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Long‐Term Outcome of Patients With Congenital Heart Disease Undergoing Cardiac Resynchronization Therapy

Journal of the American Heart Association ◽

10.1161/jaha.120.018302 ◽

2021 ◽

Author(s):

Peter Kubuš ◽

Jana Rubáčková Popelová ◽

Jan Kovanda ◽

Kamil Sedláček ◽

Jan Janoušek

Keyword(s):

New York ◽

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Heart Association ◽

Cardiac Resynchronization ◽

New York Heart Association ◽

Crt Response

Background Cardiac resynchronization therapy (CRT) is rarely used in patients with congenital heart disease, and reported follow‐up is short. We sought to evaluate long‐term impact of CRT in a single‐center cohort of patients with congenital heart disease. Methods and Results Thirty‐two consecutive patients with structural congenital heart disease (N=30) or congenital atrioventricular block (N=2), aged median of 12.9 years at CRT with pacing capability device implantation, were followed up for a median of 8.7 years. CRT response was defined as an increase in systemic ventricular ejection fraction or fractional area of change by >10 units and improved or unchanged New York Heart Association class. Freedom from cardiovascular death, heart failure hospitalization, or new transplant listing was 92.6% and 83.2% at 5 and 10 years, respectively. Freedom from CRT complications, leading to surgical system revision (elective generator replacement excluded) or therapy termination, was 82.7% and 72.2% at 5 and 10 years, respectively. The overall probability of an uneventful therapy continuation was 76.3% and 58.8% at 5 and 10 years, respectively. There was a significant increase in ejection fraction/fractional area of change ( P <0.001) mainly attributable to patients with systemic left ventricle ( P =0.002) and decrease in systemic ventricular end‐diastolic dimensions ( P <0.05) after CRT. New York Heart Association functional class improved from a median 2.0 to 1.25 ( P <0.001). Long‐term CRT response was present in 54.8% of patients at last follow‐up and was more frequent in systemic left ventricle ( P <0.001). Conclusions CRT in patients with congenital heart disease was associated with acceptable survival and long‐term response in ≈50% of patients. Probability of an uneventful CRT continuation was modest.

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