Implementation of Rapid Genome Sequencing for Infants with Congenital Heart Disease DOI Open Access
Thomas Hays, Rebecca Hernan,

Michele Disco

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2022, Volume and Issue: unknown

Published: Dec. 16, 2022

Abstract Background Rapid genome sequencing (rGS) has been shown to improve the care of critically ill infants. Congenital heart disease (CHD) is a leading cause infant mortality, and often caused by genetic disorders, yet utility rGS not prospectively studied in this population. Methods We conducted prospective evaluation use infants with CHD our cardiac neonatal intensive unit (CNICU). Results In cohort 48 CHD, diagnosed 14 disorders 13 (27%) individuals led changes clinical management eight (62%) cases diagnostic results. These included two whom diagnoses helped avert intensive, futile interventions prior CNICU discharge, as well three eye was treated early childhood. Genetic were associated small for gestational age birth weight. Conclusions Our study provides first knowledge. found that 27% 62% model enabled multidisciplinary coordination between neonatologists, cardiologists, surgeons, geneticists, counselors. findings highlight important role demonstrate need expanded how implement resource broader population CHD.

Language: Английский

Recommendations for centers performing pediatric heart surgery in the United States DOI

Carl L. Backer,

David M. Overman, Joseph A. Dearani

et al.

Journal of Thoracic and Cardiovascular Surgery, Journal Year: 2023, Volume and Issue: 166(6), P. 1782 - 1820

Published: Sept. 29, 2023

Language: Английский

Citations

16
Implementation of Rapid Genome Sequencing for Critically Ill Infants With Complex Congenital Heart Disease DOI Open Access
Thomas Hays, Rebecca Hernan,

Michele Disco

et al.

Circulation Genomic and Precision Medicine, Journal Year: 2023, Volume and Issue: 16(5), P. 415 - 420

Published: July 7, 2023

Rapid genome sequencing (rGS) has been shown to improve care of critically ill infants. Congenital heart disease (CHD) is a leading cause infant mortality and often caused by genetic disorders, yet the utility rGS not prospectively studied in this population.We conducted prospective evaluation infants with complex CHD our cardiac neonatal intensive unit.In cohort 48 CHD, diagnosed 14 disorders 13 (27%) individuals led changes clinical management 8 (62%) cases diagnostic results. These included 2 whom diagnoses helped avert intensive, futile interventions before unit discharge, 3 eye was treated early childhood.Our study provides first for knowledge. We found that 27% 62% Our model depended on coordination between neonatologists, cardiologists, surgeons, geneticists, counselors. findings highlight important role demonstrate need expanded how implement resource broader population CHD.

Language: Английский

Citations

12
Is routine preoperative head ultrasound screening before congenital cardiac surgery mandatory? DOI Creative Commons
Sajid Farooq, Heba Hassan,

Omai Mohammed AlSassi

et al.

The Cardiothoracic Surgeon, Journal Year: 2025, Volume and Issue: 33(1)

Published: Jan. 11, 2025

Abstract Background The practice of routine preoperative head ultrasound (HUS) screening for infants and neonates undergoing surgery congenital heart disease has been widely adopted; however, its usefulness is still unclear. Therefore, this study aimed to determine the prevalence HUS abnormalities in with disease, association postoperative neurological outcomes, sensitivity specificity detecting abnormalities. This retrospective cohort was conducted between 2015 2022 at a tertiary referral center. included 596 children who were scheduled cardiac had HUS. Results 23% ( n = 137). There no differences baseline characteristics patients normal abnormal most common abnormality reported by intraventricular hemorrhage (IVH) 65, 47.45%). Surgery done 417 (78.53%) IVH vs. 50 (76.92%) P 0.766). Mortality statistically not significantly higher (14% 8%; 0.092). Twenty-seven developed new complications (5.78%), difference groups (5.7% 6.1%, 0.893). Preoperative OR : 1.24 (95% CI 1.08–1.41); 0.002) intrauterine growth retardation 5.37 1.61–17.88), 0.006) associated events. compared that MRI 51%, 83%. Conclusions showed high percentage findings disease; these necessarily correlated outcome. do support use disease. Abnormal did impact surgical rates or outcomes.

Language: Английский

Citations

0
Cerebral autoregulation and optimal blood pressure from birth to surgery in neonates with critical congenital heart disease DOI Creative Commons

Angelica M. Vasquez,

Eliza Gentzler, David Bateman

et al.

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 11, 2025

Abstract Objectives Increased time-to-surgery has been correlated with increasing cerebral fractional oxygen extraction without compensatory increase in blood flow neonates critical congenital heart disease (cCHD) suggesting an overwhelmed autoregulation system. Autoregulation analysis can provide precision targets such as optimal pressure but it remains unclear how evolves days preceding surgery. Our hypothesis is that longer wait times between birth and surgery are associated periods of impaired autoregulation. Methods A retrospective observational study evaluating the time spent within (MAPOPT) range identified by full term newborns cCHD awaiting neonatal Results Sixty subjects had a median [IQR (interquartile range)] 5.2 [3.9–7.9] recordings from to Subjects 7.6%, [5.3–13%] Time MAPOPT decreases slightly first ten life when controlling for confounders. mean (+/- standard deviation) 40.8% (± 15.5%) each day (51.3 ± 6.1 mmHg) 28.1% [13.6–45.5] below MAPOPT. Mixed effects regression showed 1.93% less (p = 0.001) over there was no difference Conclusion Full experience variable throughout preoperative period spend time. These changes hemodynamics may be physiologic mechanism previously described association increased white matter injury.

Language: Английский

Citations

0
Recommendations for Centers Performing Pediatric Heart Surgery in the United States DOI

Carl L. Backer,

David M. Overman, Joseph A. Dearani

et al.

World Journal for Pediatric and Congenital Heart Surgery, Journal Year: 2023, Volume and Issue: 14(5), P. 642 - 679

Published: Sept. 1, 2023

Care and outcomes for the more than 40,000 patients undergoing pediatric congenital heart surgery in United States annually are known to vary widely. While consensus recommendations have been published across numerous fields as one mechanism promote a high level of care delivery centers, it has two decades since last were States. More recent guidance is lacking, collaborative efforts involving many disciplines engaged caring these children not undertaken date. The present initiative brings together professional societies spanning domains cardiac surgeons, cardiologists, nursing, other healthcare professionals from diverse programs around country develop centers. focus this initial work on surgery, recommended that future detail adult population. We describe background, rationale, methodology related effort, put forth Essential Centers (essential services necessary any program), Comprehensive (services optimize comprehensive high-complexity care), encompassing structure, process, outcome metrics 14 domains.

Language: Английский

Citations

9
Outcomes of Neonatal Cardiac Surgery: a European Congenital Heart Surgeons Association Study DOI

Claudia Cattapan,

Jeffrey P. Jacobs, Mark S. Bleiweis

et al.

The Annals of Thoracic Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 1, 2024

Language: Английский

Citations

2
Recommendations for Centers Performing Pediatric Heart Surgery in the United States DOI

Carl L. Backer,

David M. Overman, Joseph A. Dearani

et al.

The Annals of Thoracic Surgery, Journal Year: 2023, Volume and Issue: 116(5), P. 871 - 907

Published: Sept. 29, 2023

Language: Английский

Citations

3
Surgical repair of neonatal total anomalous pulmonary venous connection: A single institutional experience with 241 cases DOI Creative Commons
Jin Shentu, Guocheng Shi, Qian Zhang

et al.

JTCVS Open, Journal Year: 2023, Volume and Issue: 16, P. 739 - 754

Published: Aug. 9, 2023

Challenges persist in surgery for neonatal total anomalous pulmonary venous connection (neoTAPVC), with the high mortality risk not mitigated over time.

Language: Английский

Citations

2
Double Jeopardy: A Distinct Mortality Pattern Among Preterm Infants with Congenital Heart Disease DOI Creative Commons

Brennan V. Higgins,

Philip T. Levy, Molly K. Ball

et al.

Pediatric Cardiology, Journal Year: 2024, Volume and Issue: unknown

Published: June 12, 2024

Contemporary United States (US) data on the survival of preterm infants with congenital heart disease (CHD) are unavailable despite over-representation CHD and improving surgical outcomes in population. The aim this study is to use population-based compare 1-year early mortality (< 3 days) by gestational age (GA) between without cyanotic (CCHD) US. This national retrospective cohort included all liveborn, 21 36 weeks GA a birth certificate indicating presence or absence CCHD (n = 2,654,253) born 2014 2019 Data were provided US Center for Disease Control database linking death certificates. Of liveborn infants, 0.13% 3619) had CCHD. was significantly lower 23-36 compared those without. greatest gap occurred 28 31 (28 adjusted risk difference 37.5%; 95% CI 28.4, 46.5; 37.9%; 30.5, 45.3). Early accounted more than half deaths among 23-31 (23 weeks-68%, 46.7, 83.7; weeks-63.9%, 52.9, 73.6). Survival trends demonstrated worsened 35-36 over period. pattern distinct from significant very population notably high rate calls renewed attention neonatal intensive care dually affected

Language: Английский

Citations

0
Risk Factors and Outcomes of Perioperative Extracorporeal Membrane Oxygenation in Neonates and Infants Undergoing Truncus Arteriosus Repair DOI
Lily Suh, Jason R. Buckley, Jessica E. Hook

et al.

World Journal for Pediatric and Congenital Heart Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 25, 2024

Background: Despite surgical advances, neonatal truncus arteriosus repair remains high risk and approximately 10% of patients receive perioperative extracorporeal membrane oxygenation (ECMO). We aimed to assess factors outcomes associated with the use ECMO in infants undergoing repair. Methods: conducted a retrospective cohort study who underwent between 2004 2019, using administrative data from Pediatric Health Information System database. Results: identified 1,645 neonates at 49 centers, which 141 (8.6%) received ECMO. Prematurity (adjusted odds ratio [aOR], 2.06; 95% CI, 1.38-3.06; P < .001), truncal valve intervention (aOR, 4.69; 2.56-8.59; interrupted aortic arch 1.80; 0.96-3.38; = .07) were Hospital mortality occurred 87 (62%) compared 77/1504 (5.1%) did not require ECMO(aOR, 13.39; 8.70-20.61; .001). In 1,481 survived hospital discharge, was higher rates postoperative length stay >30 days (63% [34/54] vs 28% [400/1427]; aOR 2.65; 1.24-5.64, .012) readmission within 90 (61% [33/54 [ 33% [474/1427] [; aOR, 2.66; 1.47-4.82; Conclusions: Prematurity, intervention, are important that could help predict Extracorporeal utilization is strongly greater mortality, prolonged stay, surviving patients.

Language: Английский

Citations

0