Congenital heart disease
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Congenital heart disease · Jul 2013
Midterm results of surgery for adults with congenital heart disease centralized to a Swedish cardiothoracic center.
The surgical management of adults with congenital heart disease (ACHD) offers a great challenge, with a large number of anomalies with complex pathophysiology necessitating specific treatments. Pre- and postoperative morbidity has been relatively high, and the influencing factors are not completely identified. We sought to evaluate the incidence and predictors of postoperative complications following surgery for ACHD centralized to a Swedish cardiothoracic center. ⋯ Our present data suggest that surgery in ACHD can be performed in centralized units with an excellent early and midterm survival. The incidence of postoperative complications was relatively low consisting mainly of supraventricular arrhythmias. In our opinion, ACHD surgery should be performed in centralized units with experienced surgeons in a dedicated multidisciplinary team for optimized postoperative management.
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Congenital heart disease · Jul 2013
Comparative StudyCardiovascular magnetic resonance imaging in congenital heart disease as an alternative to diagnostic invasive cardiac catheterization: a single center experience.
The study aims to assess whether the increasing use of cardiovascular magnetic resonance imaging in place of diagnostic cardiac catheterization in the management of pediatric patients with congenital heart disease has had an impact on pediatric cardiac care. ⋯ Replacing catheterization with cardiovascular magnetic resonance imaging has resulted in reduced rates of complication and shorter hospital stays without a significant impact on surgical outcome.
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Congenital heart disease · Jul 2013
Echocardiographic predictors of left ventricular dysfunction after aortic valve surgery in children with chronic aortic regurgitation.
Postoperative left ventricular dysfunction is associated with poor prognosis in adults with severe chronic aortic regurgitation and published practice guidelines aim to minimize this risk. However, only limited information exists in pediatrics. The goal of this study was to define preoperative risk factors for postoperative left ventricular dysfunction in children with chronic aortic regurgitation. ⋯ Lower indices of left ventricular systolic function and severity of dilation identify children at risk for postoperative left ventricular dysfunction after aortic valve surgery. These identifiers are similar to predictors defined in adult patients albeit with different threshold values.
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Congenital heart disease · Jul 2013
Resting energy expenditure at 3 months of age following neonatal surgery for congenital heart disease.
Infants with Congenital Heart Disease (CHD) often exhibit growth failure. This can affect anthropometric and neurodevelopmental outcomes well into childhood. To determine the resting energy expenditure (REE), body composition, and growth in infants with CHD at 3 months of age, with the secondary aim to identify predictors of REE as compared with healthy infants. ⋯ At 3 months of age, there was no difference in REE between postsurgical infants with CHD and healthy infants. Infants with CHD had lower growth z-scores and %FAT. These data demonstrate decreased %FAT contributed to growth failure in the infants with CHD.
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Congenital heart disease · Jul 2013
Facilitators of and barriers to advance care planning in adult congenital heart disease.
Most adults with congenital heart disease (CHD) are interested in discussing matters related to advance care planning (ACP) early in the disease course, yet few such conversations actually occur. We aimed to evaluate factors that impact these discussions between patients and adult CHD providers. ⋯ Despite the fact that challenges to prognostication exist, discussions about ACP should not be reserved for patients with a severely reduced life expectancy. Most patients want these discussions regardless of the complexity of their disease. The trusting and close patient-doctor relationship in adult CHD, often evolving over many years, may provide an excellent platform from which to initiate such discussions.