Abstract:
:The objective of this study is to identify predictors of prolonged hospital length of stay (LOS) for single ventricle patients following stage 2 palliation (S2P), excluding patients who underwent a hybrid procedure. We explore the impact of demographic features, stage 1 palliation (S1P), interstage I (IS1) management, S2P, and post-surgical care on hospital LOS following S2P. We conducted a retrospective analysis of the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) database. The NPC-QIC database is an established registry of patients with hypoplastic left heart syndrome (HLHS) and its variants. It contains detailed information regarding the demographic features, S1P, IS1, S2P, and interstage 2 (IS2) management of children with HLHS and related single ventricle cardiac malformations. Between 2008 and 2012, there were 477 participants with recorded LOS data in the NPC-QIC registry. Excluding the 29 patients who underwent hybrid procedure, there were 448 participants who underwent a Norwood (or Norwood-variant procedure) as S1P. In order to be included in the NPC-QIC database, participants were discharged to home following S1P and prior to S2P. We found that postoperative LOS among the 448 S2P procedure recipients is most strongly influenced by the need for reoperation following S2P, the need for an additional cardiac catheterization procedure following S2P, the use of non-oral methods of nutrition (e.g., nasogastric tube, total parental nutrition, gastrostomy tube), and the development of postoperative complications. Factors such as age at the time of S2P, the presence of a major non-cardiac anomaly, site participant volume, IS1 course, the type and number of vasoactive agents used following S2P, and the need for more than 1 intensive care unit (ICU) hospitalization (following discharge to the ward but prior to discharge to home) were significant predictors by univariate analysis but not by multivariate analysis. We excluded participants undergoing the hybrid procedure as S1P from this analysis given that the S2P following the initial hybrid is typically a more complicated procedure. Hospital LOS following S2P among children undergoing the Norwood or Norwood-variant procedure as S1P is most strongly influenced by events following S2P and not demographic or S1P factors. Factors most predictive of prolonged LOS include the need for reoperation, the need for an additional cardiac catheterization procedure following S2P, the need for non-oral methods of nutrition, and the development of postoperative complications.
journal_name
Pediatr Cardioljournal_title
Pediatric cardiologyauthors
Baker-Smith CM,Goldberg SW,Rosenthal GLdoi
10.1007/s00246-015-1208-3subject
Has Abstractpub_date
2015-12-01 00:00:00pages
1630-41issue
8eissn
0172-0643issn
1432-1971pii
10.1007/s00246-015-1208-3journal_volume
36pub_type
杂志文章abstract::Myocardial contractility and relaxation are highly dependent on calcium homeostasis. Immature myocardium, as in pediatric patients, is thought to be more dependent on extracellular calcium for optimal function. For this reason, intravenous calcium chloride infusions may improve myocardial function in the pediatric pat...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-015-1322-2
更新日期:2016-03-01 00:00:00
abstract::The epinephrine test has been shown to be a powerful tool to predict the genotype of congenital long QT syndrome (LQTS). The aim of this study was to evaluate its role in the diagnosis and management of LQTS in children. The test (using the Shimizu protocol) was conducted in patients with some evidence of LQTS but in ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-009-9603-2
更新日期:2010-05-01 00:00:00
abstract::Rheumatic heart disease (RHD) is an inflammatory disease that develops following streptococcal infections. IL10 helps to balance immune responses to pathogens. IL10 polymorphisms have been associated with RHD, although results remain inconclusive. Our aim was to investigate the association between IL10 polymorphisms a...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-015-1245-y
更新日期:2016-01-01 00:00:00
abstract::The data on the outcomes of children with heart disease and Down syndrome receiving extracorporeal membrane oxygenation (ECMO) for cardiac or respiratory failure are limited. This study aimed to evaluate morbidity and mortality associated with ECMO in children with Down syndrome and heart disease. Children younger tha...
journal_title:Pediatric cardiology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00246-014-0945-z
更新日期:2014-12-01 00:00:00
abstract::We present a neonatal case with intractable atrial flutter that did not respond to digitalization and electrical cardioversion. Intravenous flecainide administration completely resolved the atrial flutter. Proarrhythmic effects were not induced by flecainide administration. Although the efficacy of flecainide for atri...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-003-0226-8
更新日期:2004-03-01 00:00:00
abstract::A patient with pulmonary valve stenosis associated with pseudohypertrophic muscular dystrophy is reported. The anomalies were detected by two-dimensional echocardiography and elevated serum enzymes, conformed by right ventriculography and muscles biopsy. The association between these two pathologies is unknown. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-001-0051-x
更新日期:2002-03-01 00:00:00
abstract::Fifty infants with interrupted aortic arch (IAA), admitted between 1979 and 1988, were reviewed. They usually presented early in severe cardiac failure or shock. In the initial 5-year period, 17 of the 21 infants underwent diagnostic or confirmatory cardiac catheterization, in contrast with the latter 5 years when onl...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF00838779
更新日期:1992-10-01 00:00:00
abstract::While exercise stress testing (EST) is an important tool, little is known about its use for determining ischemia in patients with hypoplastic left heart syndrome (HLHS) and Fontan palliation. We sought to determine the frequency of ST segment changes during EST in HLHS patients after Fontan and examine results of furt...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-015-1312-4
更新日期:2016-03-01 00:00:00
abstract::Dilated cardiomyopathy (DCM) is an important cause of chronic congestive cardiac failure in children. In patients with idiopathic DCM, endothelium vasomotor function is disturbed. There are many studies on the roles of nitric oxide (NO) and adrenomedullin (AM) in adult patients with DCM. However, to our knowledge, no ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-002-0352-8
更新日期:2003-07-01 00:00:00
abstract::Paroxysmal non-reentrant supraventricular tachycardia due to double ventricular response through antegrade dual atrioventricular nodal pathways by a single atrial excitation has been reported in limited adult cases but not in pediatric patients with structurally normal hearts or with congenital heart defects. We repor...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0326-4
更新日期:2013-03-01 00:00:00
abstract::We report our experience with asymptomatic valvar aortic stenosis diagnosed during infancy. During the period between November 1, 1986 and October 31, 1992 a total of 13 infants were diagnosed with asymptomatic aortic stenosis, 5 of whom showed rapid progression over the first 2 years of life. Two of these asymptomati...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002469900105
更新日期:1997-01-01 00:00:00
abstract::Crossed pulmonary arteries (CPAs) are a rare abnormality in which the ostium of the left pulmonary artery originates superior to the right pulmonary artery and to its right. Recognition of this rare pathology is important because it generally is accompanied by other congenital heart defects, extracardiac anomalies, an...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-013-0714-4
更新日期:2013-01-01 00:00:00
abstract::The genetic basis of congenital heart disease remains unknown in most of the cases. Recently, a novel mouse model shed new light on the role of CCN1/CYR61, a matricellular regulatory factor, in cardiac morphogenesis. In a candidate gene approach, we analyzed a cohort of 143 patients with atrial septal defects (ASD) by...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-014-1001-8
更新日期:2015-02-01 00:00:00
abstract::Quantification of pulmonary regurgitation (PR), pulmonary flow distribution, and ventricular function is important for clinical surveillance in repaired Tetralogy of Fallot (TOF). Cardiovascular magnetic resonance (CMR) is the established reference, but cost, test duration, and patient discomfort are potential limitat...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-018-2035-0
更新日期:2019-03-01 00:00:00
abstract::Maintaining patency of the ductus arteriosus pending surgical intervention can be critical to the survival of the neonate with ductal dependent congenital heart disease. Spontaneously delayed ductal closure has been observed clinically and experimentally in newborns with critical pulmonic stenosis. Infants with ductal...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02263445
更新日期:1987-01-01 00:00:00
abstract::The American Academy of Pediatrics (AAP) recommends that any child diagnosed with hypertension have an echocardiogram to evaluate for the presence of left-ventricular (LV) hypertrophy (LVH) and advocates that LVH is an indication to initiate or intensify antihypertensive therapy. However, there is no consensus on the ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-013-0829-7
更新日期:2014-04-01 00:00:00
abstract::Exercise testing can highlight repolarisation abnormalities in adults with coronary artery disease. Late after Kawasaki disease (KD), increased QT dispersion (QTd) has been reported on resting ECG in children, but there are no reported studies of QTd during exercise. Our objective was to determine the pattern of QTd r...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0201-3
更新日期:2012-06-01 00:00:00
abstract::Routine use of intraoperative transesophageal echocardiography (TEE) is a safe monitoring and diagnostic method during pediatric congenital cardiac surgery. However, the question of whether intraoperative TEE is accurate and cost effective for patients with tetralogy of Fallot (TOF) has not been raised. This study aim...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0423-4
更新日期:2013-02-01 00:00:00
abstract::Children and adolescents with congenital heart disease often do not have the opportunity, inclination, or education to participate in safe and effective exercise. The consequences of this behavioral pattern affect not only cardiopulmonary parameters, but also psychosocial factors, especially when lack of participation...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-020-02413-z
更新日期:2020-12-01 00:00:00
abstract::Patients post-bidirectional Glenn (BDG) operation are at risk of left and right pulmonary artery (LPA and RPA) hypoplasia. Transthoracic echocardiograms (TTE) in active children can miss essential elements of anatomy. Procedural sedation improves image quality but increases risk of adverse events. We hypothesized that...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-020-02342-x
更新日期:2020-06-01 00:00:00
abstract::Ultrasound Doppler was used to establish time of ductal closure, normal values for blood flow velocity in the pulmonary artery (PA), and time interval between pulmonary valve closure (Pc) and tricuspid valve opening (To) in 37 healthy neonates. Ductal closure had occurred in 23% of the children within 12 h after deliv...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::We report a unique case of tricuspid and pulmonary atresia with idiopathic progressive ductus arteriosus restriction in utero. Diligent predelivery planning and a controlled delivery environment led to a favorable outcome. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0391-8
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:This study aimed to measure and compare right ventricular (RV) function in normal infants and those with pulmonary hypertension (PHT) using the myocardial performance index (RVMPI) and to investigate the relationship between RV function and pulmonary artery pressure. METHODS:A case-control study measured RV...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-008-9285-1
更新日期:2009-02-01 00:00:00
abstract::A retrospective study of children dying with active varicella revealed 11 of 17 cases who had unsuspected interstitial myocarditis at the time of their death. In addition, a prospective study of 6 children, consecutively admitted to the hospital with active varicella, were evaluated for evidence of cardiac dysfunction...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02082333
更新日期:1982-01-01 00:00:00
abstract::A 10-month-old boy was referred for tachypnea and heart murmur. An echocardiogram showed unexplained left heart dilation without evidence of an intracardiac shunt. A 64-slice computed tomographic contrast-enhanced angiography showed a large tortuous anomalous artery arising from the descending thoracic aorta and suppl...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-008-9287-z
更新日期:2009-01-01 00:00:00
abstract::With the advent of cardiac magnetic resonance imaging and high-resolution echocardiography, cardiac catheterization is unnecessary in clinical protocols in the "routine" single ventricle patient. Catheterization adds little to clinical care in these cases, and there are significant risks and costs associated with it. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
doi:10.1007/s00246-004-0960-6
更新日期:2005-03-01 00:00:00
abstract::Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a heritable cardiomyopathy characterized by fibro-fatty replacement of right ventricular myocardium. Diagnostic criteria, established in 1994 and modified in 2010, are based on predominately adult manifestations of ARVC/D. The goal of this paper is ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-015-1327-x
更新日期:2016-04-01 00:00:00
abstract::Tricuspid valve malformation is a rare congenital heart disease. Prenatal diagnosis of Ebstein's anomaly (EA) and tricuspid valve dysplasia (TVD) is associated with high mortality. There are conflicting reports concerning accurate prognostication after diagnosis in utero. The aim of our study was to assess prognostic ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0355-z
更新日期:2012-12-01 00:00:00
abstract::This study was performed to evaluate the hemodynamic status of children admitted to the intensive care unit, using suprasternal and transesophageal Doppler ultrasound, and to establish a suitable noninvasive technique to monitor trends in cardiac output in critically ill children. Twenty children were studied over a p...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-001-0014-2
更新日期:2002-01-01 00:00:00
abstract::In 810 schoolchildren (aged 5-14 years) the prevalence of a grade 1-3/6 vibratory innocent heart murmur (VIHM) is 41%. Restricted to a grade 2 or 3 VIHM, the prevalence is 14%, decreasing from 21% in the age-class 5-6 years to 8% for children 13-14 years of age. The prevalence of a grade 3 VIHM is 1%. Together with a ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF00798120
更新日期:1994-11-01 00:00:00