Abstract:
OBJECTIVES:To investigate survival and freedom from reintervention after aortic coarctation repair in Maltese patients and to compare cardiovascular mortality in coarctation repair survivors with that in the general population. DESIGN:All 72 aortic coarctation patients with any type of repair, born by end-1997 and logged in the local database were included. Trends in timing and type of repair were determined by comparing patients born before and after 1985. Kaplan-Meier analyses of survival and reintervention-free survival were performed on the 59 repair survivors with complete follow-up data (mean follow-up 26.13 ± 9.62 (range 1.05-44.55 years). Cardiovascular mortality in repair survivors was compared with that in 438 age- and sex-matched general Maltese controls. RESULTS:Patients born after 1985 underwent repair at a younger age (median age 0.18 vs 13.96 years; P < .001), with less patch aortoplasties in favor of end-to-end anastomosis or transcatheter stenting. Among the 59 long-term follow-up patients, there were 7 cardiovascular deaths and 10 patients needed reintervention. Estimated mean survival was 40.33 years (95% CI 37.71, 42.95) with a survival rate of 67.5% at 40 years from repair. Estimated mean reintervention-free survival was 38.13 years (95% CI 34.52, 41.75) with freedom from reintervention rate of 77% at 30 years. Patients repaired aged <10 years required earlier reintervention (estimated mean reintervention-free survival 35.12 years (95% CI 29.54, 40.71) vs 40.80 years (95% CI 37.16, 44.37); P = .04). There was an excess of cardiovascular deaths among repaired coarctation subjects compared to the general population (11.9% vs 1.4%; P < .001) and survival in coarctation patients was significantly lower (67.90 years (95% CI 60.28, 75.52) vs 85.78 years (95% CI 83.12, 88.44); P < .001). CONCLUSIONS:Despite earlier diagnosis and repair, contemporary coarctation repair survivors remain at increased risk of cardiovascular death. An important proportion require repair site reintervention. Specialist follow-up and aggressive cardiovascular risk factor management are mandatory to improve long-term outcomes.
journal_name
Congenit Heart Disjournal_title
Congenital heart diseaseauthors
Caruana M,Grech Vdoi
10.1111/chd.12488subject
Has Abstractpub_date
2017-09-01 00:00:00pages
588-595issue
5eissn
1747-079Xissn
1747-0803journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Children and adolescents with congenital heart disease (CHD) and their families require qualified combined medical and psychosocial information, care, and counseling. This study aimed to analyze CHD patients' and parents' perception of disease-specific knowledge, state of health, and impairments experienced ...
journal_title:Congenital heart disease
pub_type: 杂志文章,多中心研究
doi:10.1111/chd.12581
更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, particularly pulmonary vascular resistance and systemic vascular resis...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12662
更新日期:2018-09-01 00:00:00
abstract::We report a 51-year-old patient with platypnea-orthodeoxia syndrome after percutaneous closure of a secundum atrial septal defect, an unusual complication of this modality of treatment. Echocardiography, the main diagnostic technique in the present case, showed that one of the percutaneous device's rims was fixed to t...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2012.00639.x
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Deficient retro-aortic rim has been identified as a risk factor for device erosion following trans-catheter closure of atrial septal defects (ASDs). Transthoracic echocardiography (TTE) is the primary screening method for subjects for possible device closure of ASD, but its reliability in measuring retro-aort...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12226
更新日期:2015-07-01 00:00:00
abstract::A 22-year-old female with no medical history presented to the emergency room with 2 weeks of rapidly worsening dyspnea on exertion, orthopnea, and cough. On cardiac auscultation, she was noted to have to-and-fro murmurs and a continuous murmur with signs of right heart failure. Echocardiographic images obtained showed...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/j.1747-0803.2010.00467.x
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare neurological development of children with cyanotic or hemodynamically impaired congenital heart disease (CHD) and healthy controls by using "Bayley Scales of Infant and Toddler Development Screening Test, Third Edition" (Bayley-III). PATIENTS:Children with CHD (n = 37...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12269
更新日期:2015-11-01 00:00:00
abstract:INTRODUCTION:Improved weight gain during the interstage (IS) period has been shown to improve overall outcomes in patients with single ventricle physiology (SVP). This emphasis on nutrition may have untoward effects, such as increasing anxiety/stress levels in caregivers, who are already known to be at risk for increas...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12257
更新日期:2015-03-01 00:00:00
abstract:PURPOSE:The aim of this article was to assess the role of MRI in the diagnosis and management of a variety of complex aortic arch anomalies. MATERIALS AND METHODS:Imaging was performed on a 1.5T Philips Gyroscan Intera. We retrospectively reviewed all cardiac MR scans performed from November 2003 to February 2007 at o...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2008.00174.x
更新日期:2008-03-01 00:00:00
abstract:INTRODUCTION:Heart transplant recipients are at risk for developing left ventricular (LV) dysfunction. While traditional echocardiographic parameters have limitations, speckle tracking echocardiography (STE) is a novel technique shown to be more sensitive and accurate in adult studies for evaluating ventricular systoli...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12263
更新日期:2015-07-01 00:00:00
abstract::Isolated left ventricular (LV) apical hypoplasia is a recently described congenital abnormality characterized by: (1) a truncated and spherical LV configuration with rightward bulging of the interventricular septum, (2) deficiency of the myocardium within the LV apex with adipose tissue infiltrating the apex, (3) orig...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00489.x
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Published case reports suggest that congenital portosystemic venous connections (PSVC) and other abdominal venous anomalies may be relatively frequent and potentially important in patients with polysplenia syndrome. Our objective was to investigate the frequency and range of portal and other abdominal systemi...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/j.1747-0803.2010.00478.x
更新日期:2011-01-01 00:00:00
abstract::While right ventricle to pulmonary artery homograft is the surgical procedure of choice for relieving right ventricle outflow tract obstruction; it is limited by the need for multiple surgical replacements owing to progressive conduit obstruction, valve dysfunction, or patient growth. Since January 2010, percutaneous ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12013
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Amiodarone is a highly effective antiarrhythmic therapy, however its toxicity profile often limits treatment. This is particularly relevant in adults with congenital heart disease (CHD), who are often young and in whom other antiarrhythmic agents commonly fail or are contraindicated. We sought to determine in...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12657
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Recent advances in various disciplines of medicine have significantly changed the courses following cardiac surgery in children. On-table extubation (OTE) after open heart surgery in children is evolving. OBJECTIVE:To assess the rate of postoperative complications in children extubated on table after open h...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12277
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To provide data on the value of fused cardiac hybrid imaging with coronary computed tomography angiography (CCTA) and positron emission tomography myocardial perfusion imaging (PET-MPI) in patients with complex coronary artery anomalies (CCAA). DESIGN/SETTING:This is a retrospective, single-center study. PA...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12402
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:Intraatrial Mustard baffle repair of dextro-transposition of the great arteries (d-TGA) is vulnerable to complications, typically obstruction and leaks. Because patients often require pacemakers or intracardiac electrophysiology studies (EPS)/ablation for arrhythmias, narrowed or obstructed baffles restrict c...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00532.x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Robust risk-adjustment algorithms are often necessary if data from clinical registries is to be used to compare rates of important clinical outcomes between participating centers. Although such algorithms have been successfully developed for surgical and catheter-based cardiac interventions in children, outc...
journal_title:Congenital heart disease
pub_type: 杂志文章,多中心研究
doi:10.1111/chd.12050
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:Stent placement has become a widely used method of treatment for coarctation of the aorta (COA). Our goal was to find echocardiographic indices that would correlate best with directly measured gradients across the coarctation stent. MATERIAL AND METHODS:Pediatric patients with COA who underwent intra-aortic ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2009.00300.x
更新日期:2009-07-01 00:00:00
abstract::This review synthesizes the empirical literature on outcomes and experiences of transfer and transition from pediatric to adult care for young people with congenital heart disease. A systematic review of papers published between January 2001 and May 2013 that examined outcomes or experiences of transfer and transition...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/chd.12251
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE: The objective of this study is to evaluate the safety and feasibility of the AZUR hydrogel-polymer coated platinum coil (hydrocoil) for vascular occlusion in patients with congenital cardiovascular disease (CCVD). DESIGN: Retrospective case review. PATIENTS: Eight patients with CCVD who underwent attemp...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00583.x
更新日期:2012-05-01 00:00:00
abstract::We report on a 3-year-old male who underwent transcatheter stent fenestration of the inferior portion of an extracardiac total cavopulmonary connection in the setting of hypoplastic left heart syndrome. Transhepatic approach, following an unsuccessful attempt from the femoral vein facilitated delivery of a diabolo-sha...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00488.x
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:It is unclear whether neonates with interrupted aortic arch (IAA) and a smaller left ventricular outflow tract may have improved outcomes with a Yasui operation (ventricular outflow bypass procedure) over a primary complete repair. This study sought to identify preoperative echocardiographic parameters to dif...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12599
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Left cardiac sympathetic denervation (LCSD) exerts significant antifibrillatory effects in patients with long QT syndrome (LQTS). Recently, electromechanical window (EMW) has emerged as a novel torsadogenic marker in LQTS, superior to QT interval (QTc) in distinguishing symptomatic from asymptomatic patients...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12332
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Open cardiac surgery has traditionally been the gold standard for repair of ventricular septal defect (VSD). The inherent risks and complications associated with open surgery and the incidence of postoperative residual VSD are significant disadvantages of the open surgical approach. OBJECTIVE:To evaluate th...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12357
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:To investigate functional health status among adults previously operated for aortic coarctation (CoA) compared with healthy subjects; to assess the influence of medication and exercise capacity on patients' functional health. DESIGN:Questionnaire-based investigation among 119 patients who underwent surgical...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00595.x
更新日期:2011-11-01 00:00:00
abstract::An 18-year-old patient with a window type of patent ductus arteriosus and acquired rheumatic mitral stenosis is reported for its rarity. The pitfalls in the diagnosis and surgical management of this condition are discussed. ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00558.x
更新日期:2013-01-01 00:00:00
abstract:AIM:The Fontan circulation is highly dependent on ventilation, improving pulmonary blood flow and cardiac output. A reduced ventilatory function is reported in these patients. The extent of this impairment and its relation to exercise capacity and quality of life is unknown and objective of this study. METHODS:This mu...
journal_title:Congenital heart disease
pub_type: 杂志文章,多中心研究
doi:10.1111/chd.12694
更新日期:2019-03-01 00:00:00
abstract::Obesity is pandemic in Western society. Currently, approximately 100 million Americans are overweight (body mass index > 25 kg/m2) or obese (body mass index > 30 kg/m2). The pandemic is largely attributable to the relatively recent (from an evolutionary perspective) adoption of a sedentary lifestyle, coupled with the ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00618.x
更新日期:2012-03-01 00:00:00
abstract::Protein-losing enteropathy (PLE) is a rare, but serious complication in single ventricle patients after Fontan palliation, and is associated with a 5-year mortality of 46%. We describe a patient with PLE after Fontan palliation who achieved remission with high-dose spironolactone (an aldosterone antagonist), but had t...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2009.00320.x
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Physician decisions drive most of the increases in health care expenditures, yet virtually no published literature has sought to understand the types of evidence used by physicians as they make decisions in real time. METHODS:Ten pediatric cardiologists recorded every clinically significant decision made ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2010.00433.x
更新日期:2010-07-01 00:00:00