Reoperations for Pediatric and Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database

Jacobs, Jeffrey P.; Mavroudis, Constantine; Quintessenza, James A.; Chai, Paul J.; Pasquali, Sara K.; Hill, Kevin D.; Vricella, Luca A.; Jacobs, Marshall L.; Dearani, Joseph A.; Cameron, Duke E.

doi:10.1053/j.pcsu.2014.01.006

Cited by 74 publications

(59 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While this patient population is relatively small (~600/year in the U.S.), 14, 16 the need is dire because treatment can require multiple surgeries until adulthood to replace degenerated or outgrown valves. 11 Current replacement options for these children include glutaraldehyde-fixed xenografts, as well as decellularized or cryo-preserved homografts. 15, 19 Although there have been some improved preclinical and clinical outcomes, 3, 28 these valve replacement options traditionally have been prone to valve failure due to calcification, structural degeneration, and limited availability.…”

Section: 0 Introductionmentioning

confidence: 99%

Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs

et al. 2016

View full text Add to dashboard Cite

Current pediatric heart valve replacement options are suboptimal because they are incapable of somatic growth. Thus, children typically have multiple surgeries to replace outgrown valves. In this study, we present the in vivo function and growth potential of our tissue-engineered pediatric tubular valve. The valves were fabricated by sewing two decellularized engineered tissue tubes together in a prescribed pattern using degradable sutures and subsequently implanted into the main pulmonary artery of growing lambs. Valve function was monitored using periodic ultrasounds after implantation throughout the duration of the study. The valves functioned well up to eight weeks, four weeks beyond the suture strength half-life, after which their insufficiency index worsened. Histology from the explanted valves revealed extensive host cell invasion occurred within the engineered root and commenced from the leaflet surfaces. These cells expressed multiple phenotypes, including endothelial, and deposited elastin and collagen IV. Although the tubes fused together along the degradable suture line, as designed, the leaflets shortened compared to their original height. This shortening is hypothesized to result from inadequate fusion at the commissures prior to suture degradation. With appropriate commissure reinforcement, this novel heart valve may provide the somatic growth potential desired for a pediatric valve replacement.

show abstract

Section: 0 Introductionmentioning

confidence: 99%

Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Recommendations on the frequency and type of cardiac follow-up can vary by CHD severity. 2 However, the majority of pediatric heart problems are likely congenital 38 and the recommendations on transition process are universal across all types of CHD, regardless of whether they are transitioning to specialized adult CHD center or a general cardiologist. 2 Additionally, we do not know if the child’s special healthcare need is related to his/her heart problem, one of the other 19 conditions defined as comorbidities in this analysis, or another condition not captured in the NSCSHCN.…”

Section: Discussionmentioning

confidence: 99%

Preparing adolescents with heart problems for transition to adult care, 2009-2010 National Survey of Children with Special Health Care Needs

Downing

Oster

Farr

2017

Congenital Heart Disease

View full text Add to dashboard Cite

Objective A substantial percentage of children with congenital heart disease (CHD) fail to transfer to adult care, resulting in increased risk of morbidity and mortality. Transition planning discussions with a provider may increase rates of transfer, yet little is known about frequency and content of these discussions. We assessed prevalence and predictors of transition-related discussions between providers and parents of children with special healthcare needs (CSHCN) and heart problems, including CHD. Design Using parent-reported data on 12- to 17-year-olds from the 2009–2010 National Survey of CSHCN, we calculated adjusted prevalence ratios (aPR) for associations between demographic factors and provider discussions on shift to adult care, future insurance, and adult healthcare needs, weighted to generate population-based estimates. Results Of the 5.3% of adolescents with heart problems in our sample (n =724), 52.8% were female, 65.3% white, 62.2% privately insured, and 37.1% had medical homes. Less than 50% had parents who discussed with providers their child’s future health insurance (26.4%), shift to adult care (22.9%), and adult healthcare needs (49.0%). Transition planning did not differ between children with and without heart problems (aPR range: 1.0–1.1). Among parents of CSHCN with heart problems who did not have discussions, up to 66% desired one. Compared to 1-/13-year-olds, a larger percentage of 16-/17-year-olds had parents who discussed their shift to adult care (aPR 2.1, 95% confidence interval (CI) [1.1, 3.9]), and future insurance (aPR 1.8, 95% CI [1.1, 2.9]). Having a medical home was associated with discussing adult healthcare needs (aPR 1.5, 95% CI [1.2, 1.8]) and future insurance (aPR 1.8, 95% CI [1.3, 2.6]). Conclusions Nationally, less than half of adolescents with heart problems had parents who discussed their child’s transition with providers, which could be contributing to the large percentage of CHD patients who do not successfully transfer to adult care.

show abstract

“…Between August 2011 and October 2013, a total of 193 cases who were operated with the diagnosis of TOF were screened. Patients with previous palliation or reoperation, [9] pulmonary atresia, [10] emergency surgery, hypothyroidism, [11] and thymus hypo/aplasia [12] were excluded, as all might increase peri-and postoperative risk. A total of 51 cases (30 males, 21 females; median age 2 years; 1-3. quartiles 1.19 to 3.65 years) in whom complete repair was performed constituted the study population ( Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Does preoperative neutrophil-lymphocyte ratio indicate postoperative morbidity after repair of tetralogy of Fallot?

Şişli¹

2016

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

Reoperations for Pediatric and Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database

Cited by 74 publications

References 11 publications

Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs

Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs

Preparing adolescents with heart problems for transition to adult care, 2009-2010 National Survey of Children with Special Health Care Needs

Does preoperative neutrophil-lymphocyte ratio indicate postoperative morbidity after repair of tetralogy of Fallot?

Contact Info

Product

Resources

About