scholarly journals Evaluation of the school success in children with the diagnosis of congenital heart disease who underwent an intervention

Author(s):  
Gülben İrem Kanberoğlu ◽  
Önder Doksöz ◽  
Özlem Bağ ◽  
Serpil Ece Aras Öztürk

OBJECTIVE: Congenital heart disease is one of the most common childhood diseases that affect both the children's and their families social life, quality of life and the children's academic achievement. The aim of this study is to evaluate the school performance of children suffering from congenital heart disease who underwent surgical or catheter based interventions. METHODS: The study group included 50 patients with congenital heart disease underwent surgical or catheter based interventions attending to secondary school (aged 12-15 years old) and 50 healthy controls. The academic success validation from official school grades of lessons Turkish, Mathematics, Science, Social Sciences lessons and behavioral attitudes were obtained from the Ministry of Education ‘’e-school’’ parent information system printouts. The patient group consisted of both cyanotic and acyanotic patients and each groups were compared with controls. RESULTS: Turkish, mathematics, physical education classes and behavioral attitudes note in the patient group was significantly lower than in the control group. The school success in Cyanotic group was significantly lower than the control group in Turkish, mathematics, education lessons and behavioral attitudes grades. Significant difference was not determined in science and social science lessons. CONCLUSION: Cyanotic group's success in mathematic and turkish lessons are lower in children with congenital heart disease especially in cyanotic group. We suggest that providing supportive teaching pragrammes for children with congenital hearth disease are needed in order to maintain academic success.

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Zhigang Qin ◽  
Younian Xu

In this study, we have investigated feasibility of remifentanil and sufentanil anesthesia in children with congenital heart disease surgery and its effects on cardiac function and serological parameters. For this purpose, a retrospective study was conducted on 120 children with congenital heart disease who underwent repair of ventricular septum or atrial septum in our hospital, specifically from January 2016 to January 2018, and 60 patients in each group were randomly divided into the control and treatment groups, respectively. The control group was anesthetized with sufentanil, and the treatment group was anesthetized with remifentanil. The heart function, serological indexes, and adverse reactions were observed and compared. We have observed that there was no significant difference in HR levels between these groups ( P > 0.05 ), but SDP and DBP values of the two groups were decreased after anesthetic induction ( P < 0.05 ). ACH, cortisol, and lactic acid in the treatment group were significantly lower than those in the control group, and the difference was statistically significant ( P < 0.05 ). The incidence of bradycardia, nausea and vomiting, hypotension, muscle rigidity, and respiratory depression in the treatment group was 16.67% lower than that in the control group ( P < 0.05 ). Remifentanil has less influence on hemodynamics and a better analgesic effect than fentanyl in inhibiting stress response in congenital heart surgery, which provides reference and basis for children congenital heart surgery.


2021 ◽  
Vol 16 (1) ◽  
pp. 150-156
Author(s):  
Henry Wicaksono ◽  
Mahrus A Rahman ◽  
Roedi Irawan ◽  
I Ketut Alit Utamayasa ◽  
Teddy Ontoseno ◽  
...  

Background: The most common complication in acyanotic congenital heart disease (CHD) is heart failure which definitive diagnosis and therapy remain unsatisfactory. Heart failure’s progression is often associated with oxidative stress process. Superoxide dismutase (SOD) is the first line antioxidant of defense against superoxide anion. While Catalase (CAT) breaks down hydrogen peroxide into water and oxygen molecules which complements previous detoxification carried out by SOD. Objective: This study aimed to compare the differences of SOD and CAT levels in acyanotic CHD patients between those with and without heart failure. Methods: A case-control study was conducted on three to ten years old children with a left-to-right shunt acyanotic CHD with and without heart failure in the Pediatric Cardiology outpatient clinic, ward, and emergency room of Dr. Soetomo Hospital Surabaya from April-July 2020. Echocardiography was used to establish the diagnosis of CHD, while Pediatric Heart Failure Score (PHFS) criteria was used to indicate heart failure. T-test was undertaken for analysing the difference between both groups. Results: The total samples were 41 children, consisted of 29 subjects in the case group (CHD with heart failure) and 12 subjects in the control group (without heart failure). The level of SOD in CHD with heart failure was lower (74.670+15.705) than those without it (109.163+3.111) (p<0.05). In contrast, level of CAT in CHD with heart failure was higher (25.895) than those without it (13.976) (p<0.05). Conclusion: There was a significant difference of SOD and CAT levels in acyanotic CHD between those with and without heart failure.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Erin A Fender ◽  
Ammar M Killu ◽  
David O Hodge ◽  
Bryan C Cannon ◽  
Paul A Friedman ◽  
...  

Introduction: Patients with congenital heart disease (CHD) frequently require implantable cardiac devices. Device infection or malfunction may necessitate lead extraction. Extraction may be challenging due to long lead dwell times, anatomic abnormalities, and prior cardiac surgery. Little is known about extraction outcomes in the CHD population. Methods and Results: This retrospective study included 41 CHD patients and 82 age and gender matched controls that underwent lead extractions at two centers between 2001-2014. Only patients with leads older than 12 months were included. There were 79 leads in CHD patients and 150 in controls. Patients with CHD had a mean age of 39±17 years at extraction and on average their leads had been implanted for 81±84 months, this was not significantly different from the control group. Eighty eight percent of CHD patients had 1 or more cardiac surgeries as compared to only 22% of controls (p<0.001). The number of abandoned leads was also significantly different with 16 abandoned leads in the CHD group and 3 in controls (p<0.001). There was no statistically significant difference in extraction techniques between the groups. Complete extraction was achieved in 94% of patients in both groups. There were no CHD group complications. Control group complications included 3 SVC lacerations requiring sternotomy (one was fatal), and 1 ventricular perforations with tamponade requiring sternotomy. None of these patients had a history of cardiac surgery. The average age of leads in patients with a complication was 15.3 years which was older than the mean lead age seen in the CHD and control populations which was 6.75 and 4.6 years respectively. Conclusions: Lead extraction can be safely performed in patients with CHD. Despite anatomic abnormalities and previous cardiac surgery, the outcome of lead extraction in patients with CHD is comparable to controls. Prior cardiac surgery may lower the risk for extraction complications.


2020 ◽  
Vol 10 (2) ◽  
pp. e14-e14
Author(s):  
Hossein Emad Momtaz ◽  
Asadolah Tanasan ◽  
Majid Godini

Introduction: Nephropathy as a consequence of congenital heart disease (CHD), especially cyanotic heart disease, has been detected since past decades. However, lack of a diagnostic method at early stages of the disease, caused patients referring when nephropathy is established and also complicated with severe proteinuria and renal failure. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is known as one of the newest biomarkers for early detection of renal parenchymal damage. In this study, we attempted to evaluate the role of urinary NGAL level in early detection of nephropathy in pediatrics with CHD. Objectives: The aim of this study was to evaluate urinary NGAL as a potential biomarker for the early detection of renal involvement in children with CHD. Patients and Methods: In this case–control study, urinary NGAL levels of 42 children with CHD (case group) and 42 healthy children (control group) with the matched ages were measured. Afterward, we compared mean urinary NGAL levels between these two groups to find a possible significant difference. Results: In this study, mean urinary NGAL level in patients with CHD and healthy children was 3.83 μg/mL and 1.87 μg/mL, respectively. Although the mean urine NGAL level was higher in children with CHD compared to healthy children, this difference was not statistically significant. Conclusion: in this study, it can be concluded that, urinary NGAL level cannot be used as an early diagnostic test of nephropathy in children with CHD.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A H Constantine ◽  
T Segura ◽  
E Nicol ◽  
A H Kempny ◽  
I Rafiq ◽  
...  

Abstract Background Surgical repair of transposition of the great arteries (TGA) is most commonly via the arterial switch operation (ASO). This involves translocation of the aorta and pulmonary trunk, typically with anastomosis of the branch pulmonary arteries anteriorly (LeCompte manoeuvre) and re-implantation of the coronary arteries onto the posterior neo-aorta. As such, the position of the coronary ostia may differ from their expected locations. Purpose To use ECG-gated CT angiography to describe the anatomic position of coronary ostia in post-switch TGA patients guiding potential catheter interventions in this population. Methods All post ASO patients who underwent CT imaging between 2008–2018 were identified. Patients with complex anatomy such as double outlet right ventricle were excluded. The positions of the coronary ostia were measured in degrees from vertical on a double-oblique reconstruction in the aortic valve plane. Ostium positions were compared to those of patients with no congenital heart disease via Watson's two-sample test of homogeneity for circular data. Angular dispersion was compared between groups via the Wallraff test. P<0.05 indicated statistical significance. Results Of 206 adult patients with TGA and ASO followed in our adult congenital heart disease centre, 38 (18.4%) had CT imaging available for analysis during the study period (mean age 24±6.8, 75% male). The control group consisted of 15 patients investigated for chest pain (mean age 54±15.1, 73% male). In the control group, the right and left coronary ostia arose at a mean angle of −19 and +125 degrees from vertical (figure 1a). This was significantly different to the mean ASO coronary ostia clustered at mean angles of −70 and +29 degrees from vertical (Watson p<0.001) (figure 1b, with stenosis at the left coronary anastomosis). There was no significant difference in spread of left ostia (Rho 0.9 vs 0.99, p=0.12), but right ostia were significantly more variable in ASO patients than controls (0.71 vs 0.96, p=0.003). Figure 1 Conclusions Coronary ostial positions in the neo-aorta of post-ASO patients differ significantly from those of normal controls, with considerable variability, especially in right coronary position. CT can demonstrate coronary ostia in 3D space and derive appropriate tube angles to guide catheterisation in post-operative congenital cardiac patients, optimise catheter selection, reduce catheterisation tome, radiation and contrast dose.


2019 ◽  
Vol 03 (01) ◽  
pp. 17-23
Author(s):  
Manoj Kumar Sahu ◽  
Chalattil Bipin ◽  
Harsha Vardhan Niraghatam ◽  
Ameya Karanjkar ◽  
Sarvesh Pal Singh ◽  
...  

Abstract Background Data from many studies suggest that patients with congenital heart disease are vitamin D (vitD) deficient. Following cardiac surgery as a result of intraoperative institution of cardiopulmonary bypass (CPB), serum vitD levels become even low. This may affect postoperative convalescence in terms of mechanical ventilation, inotropic support, infection, and so forth. Objective We intended to study the prevalence of vitD deficiency pre and post cardiac surgery and the effect of vitD supplementation (stoss therapy) on postoperative convalescence of the children with tetralogy of Fallot (TOF) undergoing intracardiac repair (ICR). Methodology In this randomized controlled trial (RCT), 60 children younger than 18 years with TOF and serum vitD levels < 20ng/dL were randomized into two groups. The study group received vitD supplementation as “stoss therapy” at 10,000 units/kg body weight. All these children underwent ICR with CPB. Demographic data, preoperative, intraoperative, and postoperative variables were compared between the study and the control groups. Results Prevalence of severe vitD deficiency was 93.1%. When compared with the control group, study group showed higher serum vitD levels in the immediate preoperative period (p = 0.001), postoperative period following CPB (p = 0.012), and on the first postoperative day (p = 0.003). No statistically significant difference was observed in postoperative mechanical ventilation (p = 0.35), intensive care unit (ICU) stay (p = 0.15), and inotropic duration (p = 0.19). Conclusion Children with TOF are highly deficient of vitD, its level falls further after CPB, and supplementing vitD preoperatively does not influence postoperative recovery pattern. Supplementation of vitD as “stoss therapy” was useful in raising the serum levels before and after cardiac surgery.


2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anna L Harbison ◽  
Jodie K Votava-Smith ◽  
Sylvia Del Castillo ◽  
S Ram Kumar ◽  
Vincent K Lee ◽  
...  

Objectives: Term congenital heart disease (CHD) neonates demonstrate pre-operative (op) abnormal brain metabolism (reduced N-acetylaspartate (NAA), elevated lactate) on long echo MR spectroscopy (MRS). We sought to delineate associations between serial brain metabolism and patient and perioperative clinical factors in term neonates with CHD using short echo MRS. We measured NAA and lactate as well as other metabolites important for brain connectivity such as neurotransmitters glutamate/glutamine and GABA. Methods: Subjects were prospectively enrolled to undergo pre and post-op 3T short echo single voxel MRS of parietal white matter with absolute quantitation of 15 metabolites using LCModel. Neurodevelopment (ND) was assessed via 18 month Battelle Developmental Inventory. Linear and logistic regression with false discovery rate correction was used for statistical analysis. Results: Eighty subjects were enrolled 2009-2015 and 21 term CHD infants underwent both pre and post-op MRS. Eight infants had at least one MRS and ND. NAA and glutamate were significantly decreased post-op compared to pre-op (p<0.0001), with no significant difference in other metabolites. Pre-op factors including lower Apgar score, birth weight, head circumference and PaO2 and higher arterial pH and serum lactate were associated with lower NAA (p<0.002). Single ventricle anatomy was associated with low NAA, high myo-inositol and low glutamine/glutamate compared to two ventricles (p<0.01). Longer cardipulmonary bypass time, but not deep hypothermic circulatory arrest, was associated with reduced NAA (p<0.001). Post-op, global alteration in multiple serial brain metabolites (NAA, lactate, glutamate/glutamine, GABA, myo-inostol) were associated with longer ICU and hospital stay (p<0.03). In those with ND testing, high GABA correlated with low cognitive domain score, while high glutamine correlated with low motor score (p<0.03). Conclusion: In term CHD neonates, serial brain metabolism by MRS demonstrates alterations beyond NAA, including neurotransmitters GABA and glutamate/glutamine. These abnormalities are associated with multiple clinical pre and post-op factors and also predict prolonged hospital stay and 18 month ND.


Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Joshua R Thomas ◽  
Ricky T Munoz ◽  
Mark D Fox ◽  
Angela T Yetman

Background: Cardiovascular risk factors (CRFs) are poorly defined among the population of adults with congenital heart disease. In particular, the prevalence of pre-hypertension (pre-HTN) and hypertension (HTN) are currently unknown. Objective: To determine the prevalence of pre-HTN and HTN among adults with congenital heart disease; and to assess HTN control rates among different clinic types. Methods: A retrospective analysis of a cohort of adults with congenital heart disease (CHD) was conducted. Data regarding CHD patients' blood pressure (BP), medications, and provider specialty were analyzed. Results: The cohort consisted of 971 patients. The mean age was 30.4 years (SD = 10.4), with 51% male. Thirty-two percent had HTN (n = 304). There was no statistically significant difference in the prevalence of Pre-HTN and HTN by clinic type (i.e. specialty vs. non-specialty)( p = .225, p= .633 respectively). However, a statistically significant association exists between clinic type and HTN control rates χ 2 (1) = 3.185, p = .07 (Table 1). Those receiving care from a specialty clinic are 1.6 times more likely to have controlled HTN. Conclusions: Pre-HTN and HTN are common among adults with congenital heart disease. These CRFs are better managed in specialty clinics devoted to this population.


Author(s):  
Qi-Liang Zhang ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hua Cao ◽  
Qiang Chen

Abstract Background The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease surgery after discharge. Methods A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with congenital heart disease surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. Results One month after discharge, the SAS and SDS scores of parents in the intervention group were significantly lower than those in the control group (P&lt;0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at one month after discharge (P&lt;0.05), while the scores of parents in the control group were similar at one month after discharge (P&gt;0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P&gt;0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents’ educational levels were, the higher their SAS and SDS scores were (P&lt;0.05). One month after discharge, in the control group, the lower the parents’ education levels were, the higher their SAS and SDS scores (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the WHOQOL-BREF scale showed that the scores of the physiological, psychological, social and environmental fields at one month after discharge in the intervention group were significantly higher than those in the control group (P&lt;0.05). Conclusion Providing health education and medical support to the parents of infants with congenital heart disease surgery after discharge via telemedicine can effectively relieve the parents’ anxiety and depression and improve their quality of life.


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