Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 4: Congenital Heart Disease

Hare, George F. Van; Ackerman, Michael J.; Evangelista, Juli Anne K.; Kovacs, Richard J.; Myerburg, Robert J.; Shafer, Keri M.; Warnes, Carole A.; Washington, Reginald L.

doi:10.1161/cir.0000000000000240

Cited by 162 publications

(91 citation statements)

References 54 publications

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“…Alike, three out of five patients in our cohort with L-ACAOS were treated conservatively, based on the absence of (typical) complaints and negative FFR. Despite AHA/ ACC guideline and AATS expert consensus guidelines advise offering surgery in L-ACAOS [9,13]. The majority of the R-ACAOS patients presented without symptoms or with atypical complaints.…”

Section: Discussionmentioning

confidence: 99%

“…In literature, most authors suggest a liberal decision making for intervention [8,10] in L-ACAOS, while for the right variant conflicting reports have been published. Some authors suggest conservative treatment for R-ACAOS in certain cases [11][12][13]. Other authors suggest performing unroofing on all ACAOS with an intramural course [14,15] or slitlike aspect of the orifice [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Anomalous coronary artery originating from the opposite sinus of Valsalva (ACAOS), fractional flow reserve‐ and intravascular ultrasound‐guided management in adult patients

Driesen

Warmerdam

Sieswerda

et al. 2018

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anomalous coronary artery originating from the opposite sinus of Valsalva (ACAOS), fractional flow reserve‐ and intravascular ultrasound‐guided management in adult patients

Driesen

Warmerdam

Sieswerda

et al. 2018

Cathet Cardio Intervent

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show abstract

“…The 2015 ACC guidelines recommend restriction of athletic sports in such patients prior to repair. 10 Asymptomatic patients with ARCA and a negative exercise stress test or without slit-like origin on CCTA may be watched conservatively (Class IIa, LOE C).…”

Section: Discussionmentioning

confidence: 99%

Stress test to STEMI: Utility of coronary CTA in the diagnosis and management of anomalous right coronary artery from the left coronary cusp

2017

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A 42-year-old woman presented to the emergency department with chest pain. Acute coronary syndrome was ruled out. During dobutamine stress echocardiography (DSE), she developed chest pain and inferior ST elevation. Emergent coronary angiography revealed no culprit lesions but did show an anomalous right coronary artery (RCA). Coronary CT angiography (CCTA) confirmed an anomalous RCA arising from the left coronary cusp with a slit-like ostium and interarterial course (ARCA-LCC-IA). Herein, we review the extant literature on ARCA-LCC-IA, its clinical presentation, the vital role of CTA and MRI in its diagnosis, as well as challenges and controversies surrounding management.

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“…There is a wide variation in the capacity of these individuals to participate to individual and even group sporting activities, with some being able to function at levels that are surprising for patients bearing only one functional ventricle. The American Heart Association has recently lifted a ban on exercise for these patients [96]. It has now been demonstrated that resistance exercise training is actually beneficial for these patients [97].…”

Section: Exercise Capacitymentioning

confidence: 99%

Current Therapy for Hypoplastic Left Heart Syndrome and Related Single Ventricle Lesions

2016

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Universally fatal only four decades ago, the progress in the three-stage palliation of hypoplastic left heart syndrome and related single right ventricular lesions has drastically improved the outlook for these patients. While the stage II operation (hemi-Fontan or bidirectional Glenn) and stage III Fontan procedure have evolved into relatively low risk operations, the stage I Norwood procedure remains one of the highest risk and costliest common operations performed in congenital heart surgery. Yet, despite this fact, experienced centers now report hospital survivals in excess of 90% for the Norwood. This traditional three-stage surgical palliation has seen several innovations in the past decade aimed at improving outcomes, particularly for the Norwood procedure. One significant change is a renewed interest in the right ventricle-to-pulmonary artery shunt as the source of pulmonary blood flow, rather than the modified Blalock-Taussig shunt for the Norwood. The multi-institutional Single Ventricle Reconstruction trial randomized 555 patients to one or the other shunt, and these subjects continue to be followed closely as they now approach 10 years post-randomization. In addition to modifications to the Norwood procedure, the “hybrid procedure,” a combined catheter-based and surgical approach, avoids the Norwood procedure in the newborn period entirely. The initial hybrid procedure is then followed by a “comprehensive” stage II, that combines components of both the Norwood and the traditional stage II, and later completion of the Fontan. Proponents of this approach hope to not only improve short-term survival, but potentially longer-term outcomes, such as neurodevelopment, as well. Regardless of the approach, traditional surgical staged palliation or the hybrid procedure, survivals have vastly improved, and large numbers of these patients are surviving not only through their Fontan in early childhood, but into adolescence and young adulthood. As this population grows, it becomes increasingly important to understand the longer-term outcomes of these Fontan patients, not only in terms of survival, but also burden of disease, neurodevelopmental outcomes, psychosocial development and quality of life.

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Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 4: Congenital Heart Disease

Cited by 162 publications

References 54 publications

Anomalous coronary artery originating from the opposite sinus of Valsalva (ACAOS), fractional flow reserve‐ and intravascular ultrasound‐guided management in adult patients

Anomalous coronary artery originating from the opposite sinus of Valsalva (ACAOS), fractional flow reserve‐ and intravascular ultrasound‐guided management in adult patients

Stress test to STEMI: Utility of coronary CTA in the diagnosis and management of anomalous right coronary artery from the left coronary cusp

Current Therapy for Hypoplastic Left Heart Syndrome and Related Single Ventricle Lesions

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