Publications by authors named "Adrian Dancea"
Article Synopsis
- The study focused on children under 18 with tetralogy of Fallot and the effects of pulmonary valve replacement (PVR), particularly its timing and impact on health outcomes.
- Researchers analyzed data from 316 patients born in Québec from 1982 to 2015, looking at hospitalization rates, interventions, and mortality rates comparing those who received PVR to those who did not.
- Results indicated that while patients who had PVR experienced higher rates of cardiac hospitalizations, their overall health outcomes regarding all-cause hospitalizations, cardiac procedures, and mortality were similar to those without PVR.
Article Synopsis
- A national registry for congenital heart disease (CHD) in Canada aims to streamline research, cut costs, and enhance statistical power by automatically identifying CHD patients from existing clinical data.
- This project successfully extracted data from 885,287 echocardiogram reports and 70,121 clinical records, identifying over 43,000 children and nearly 5,000 fetuses with CHD.
- The initial registry in Québec demonstrates the potential for a centralized, user-friendly database that can support various CHD research projects and potentially expand to a national level.
Article Synopsis
- - The study analyzed long-term follow-up data from 904 patients with tetralogy of Fallot in Québec, revealing that about 50.3% experienced loss to follow-up (LTFU) over 30 years, but many returned to care, with 70.6% still actively monitored after three decades.
- - Key factors that reduced the risk of LTFU included surgical repairs using conduits and transannular patches, both of which significantly decreased the likelihood of patients falling out of care.
- - Interestingly, while LTFU patients had fewer cardiac hospitalizations and interventions, their rates of cardiac mortality were similar to those who continued follow-up, suggesting that not attending regular care did not significantly impact overall survival.
Article Synopsis
- - The study investigated how early cardiac function impacts outcomes like death and severe bronchopulmonary dysplasia (BPD) in extremely premature infants born before 29 weeks, through a retrospective analysis of 176 infants from 2015 to 2019.
- - Findings revealed that infants who experienced death/severe BPD had lower birth weights and showed reduced heart function on echocardiograms taken within 21 days, with specific measurements indicating worse cardiac performance and potential pulmonary issues.
- - The research concluded that diminished cardiac function early in life correlates with increased risks of severe BPD and related pulmonary hypertension, suggesting the importance of monitoring heart health in neonates and its potential role in predicting outcomes.
Article Synopsis
- The study investigated how the degree of prematurity (specifically the gestational age at birth) affects cardiac size and function in extremely preterm infants at near-term age.
- Researchers analyzed data from infants born at less than 29 weeks of gestational age, comparing those born before and after 26 weeks.
- Results showed that infants born before 26 weeks had significantly smaller left heart dimensions compared to their slightly more mature counterparts, highlighting potential long-term cardiac concerns.
Article Synopsis
- The study aimed to compare vascular flow trends in the anterior cerebral artery (ACA) of neonates with congenital heart defects (CHD), focusing on those with and without diastolic systemic steal during their first week of life.
- Researchers used Doppler ultrasound and echocardiography to analyze 38 neonates daily from day 1 to 7, categorizing them based on the presence of retrograde flow in the aorta.
- Results showed that while peak systolic and mean velocities increased over time regardless of retrograde status, those with retrograde flow experienced a significant decrease in ACA-end-diastolic velocity and increases in resistive and pulsatility indexes, indicating cerebrovascular steal in the first week of life.
Article Synopsis
- The study aimed to assess the factors linked to significant pulmonary hypertension (PH) in infants born prematurely and how it affects their heart function at 36 weeks postmenstrual age (PMA).
- Out of 387 infants, 222 were studied, with 24 (11%) showing significant PH, which was linked to lower heart function metrics, including reduced tricuspid annular plane systolic excursion and peak longitudinal strain in both the right and left ventricles.
- The results indicate that premature infants with significant PH experience changes in heart function affecting both sides of the heart, highlighting a deeper cardiac issue related to their PH condition.
Article Synopsis
- - The study compares long-term outcomes (30 years) of two surgical techniques for correcting tetralogy of Fallot (TOF): the transannular patch (TAP) and valve-sparing (VS) procedures, focusing on risks like pulmonary regurgitation and incomplete obstruction relief.
- - Conducted in Quebec, Canada, the research analyzed data from 1980 to 2015, matching 528 patients who received either TAP or VS procedures based on their preoperative conditions, using a retrospective cohort design.
- - Main outcomes included all-cause mortality and cardiovascular interventions, with findings showing a total of 683 patients in the study, where follow-ups averaged around 16 years, contributing to comprehensive long-term survival and
Article Synopsis
- Among children with congenital heart disease (CHD), earlier surgical repair may improve cardiovascular outcomes, but its impact on neurodevelopment is still uncertain.
- A study compared neurocognitive disorder (NCD) occurrences in CHD patients based on the complexity of their surgeries and the age at which they received interventions.
- Findings revealed that more complex surgeries and younger ages at intervention correlated with a higher risk of developing NCDs, although differences in NCD rates were not significant between certain groups (like surgical vs. percutaneous repairs).
Article Synopsis
- The TRIVIA study aims to assess the long-term effects of surgical treatments for tetralogy of Fallot (TOF) by analyzing patient data from Québec between 1980 and 2017, focusing on anatomy, genetic factors, and residual lesions after surgery.
- The study includes over 1000 TOF patients with a median follow-up of 17.1 years, allowing the researchers to evaluate key outcomes like mortality and hospitalizations using advanced statistical models.
- By merging administrative health data with detailed clinical information, this research aims to provide better evidence for managing congenital heart diseases like TOF, addressing gaps in existing guidelines.
Article Synopsis
- The study investigates long-term outcomes of tetralogy of Fallot (TOF) patients over 30 years, focusing on two types: classic TOF and TOF with pulmonary atresia (TOF-PA) alongside genetic conditions.
- It includes data from 960 subjects born between 1980 and 2015 in Québec, revealing that classic TOF patients have a higher survival rate (95%) compared to TOF-PA patients (78%).
- Additionally, the presence of genetic conditions significantly impacts survival rates, with lower outcomes for both TOF types, emphasizing the need for better risk assessment and family counseling.
Article Synopsis
- Advances in care have led to more neonates surviving cardiac repairs, prompting a study to assess the prevalence of chronic kidney disease (CKD) and hypertension six years post-surgery, as well as the potential impact of cardiac surgery-associated acute kidney injury (CS-AKI).
- The study involved 58 children who underwent congenital heart surgery between 2005 and 2012, revealing that 17% had CKD, 30% had hypertension, and 58% experienced CS-AKI; however, CS-AKI was not linked to CKD or hypertension.
- The findings highlight the importance of monitoring for CKD and hypertension in these children, as the conditions are prevalent, and the study suggests current definitions of CS-AKI
Article Synopsis
- There is a lack of data and guidelines regarding renal follow-up for neonates after cardiovascular surgery, leading to a study that evaluates post-operative renal function and factors affecting follow-up care.
- A retrospective study was conducted on children aged 5-7 who had neonatal cardiac surgery, analyzing factors linked to post-discharge creatinine measurements and estimating glomerular filtration rate using laboratory values.
- Findings revealed that 30% of kids did not have any creatinine measured after surgery, and for those who did, there was no consistent follow-up pattern, indicating the need for a systematic follow-up approach to monitor kidney health in these children.
Article Synopsis
- The study examines the long-term effects of acute kidney injury (AKI) in children admitted to pediatric intensive care units (PICUs), focusing on kidney abnormalities and blood pressure issues after 6 years.
- Researchers found that 25% of the 277 children had AKI, with those who experienced stage 2/3 AKI having significantly higher odds of developing chronic kidney disease signs and elevated blood pressure.
- The findings indicate that kidney and blood pressure problems are prevalent years after PICU admission and are linked to prior AKI, highlighting the need for further research to improve follow-up care and reduce health risks.
Article Synopsis
- Bronchopulmonary dysplasia (BPD) is a serious condition that frequently affects extremely premature infants and has become more common over the past 20 years, leading to higher rates of health complications and mortality.
- Recent research highlights the impact of BPD on lung development, particularly regarding pulmonary vasculature, and has increased awareness of the risk of pulmonary arterial hypertension (PH) in affected infants.
- This review aims to summarize the current understanding of the relationship between PH and BPD, assess existing literature on the topic, and suggest improved strategies for screening and diagnosing PH in infants with BPD.
Article Synopsis
- Fluid overload post-cardiac surgery in children can lead to negative outcomes in the Pediatric Intensive Care Unit (PICU), and this study aimed to understand its prevalence and risk factors.
- The study involved a retrospective analysis of patients under 18 who underwent cardiac surgery, revealing that peak fluid overload occurred on the second day of PICU admission with significant risk factors identified.
- Results indicated that greater fluid overload on day 2 was linked to longer hospital stays and extended mechanical ventilation, highlighting the importance of managing fluid levels in these patients.
Article Synopsis
- This study compares the outcomes of balloon angioplasty (BAP) for treating native coarctation of the aorta (NaCo) and postsurgical recoarctations (ReCo) in infants under one year old.
- It analyzed data from infants who underwent BAP between 2003 and 2012, focusing on clinical results, echocardiography, hemodynamics, and angiography.
- Findings revealed that while both groups showed some improvement in gradient reduction and complication rates, NaCo patients had a higher recoarctation rate requiring further intervention shortly after initial BAP, indicating potential challenges in managing native CoAo.
Article Synopsis
- Pediatric heart failure (HF) is a significant cause of health issues and deaths among children, necessitating clear guidelines for diagnosis and management.
- The guidelines aim to help healthcare providers working in clinics or emergency rooms identify heart disease symptoms in children who haven't had their condition diagnosed yet.
- Developed using the GRADE methodology, these guidelines include practical recommendations for clinical use and do not cover advanced treatments like ventricular assist devices.
Article Synopsis
- Percutaneous interventions are increasingly used alongside other treatments for heart failure related to congenital heart disease, particularly when the left ventricle is overworked due to issues like aortic stenosis or coarctation.
- Procedures such as balloon dilation of the aortic valve effectively enhance blood flow and heart function in newborns and can address large shunts from defects like ventricular septal defects.
- Innovations in catheter-based techniques, including pulmonary valve dilation and implantable valves, are improving outcomes for patients with complex congenital heart issues, especially in those with single ventricle physiology or hypoplastic left heart syndrome.
Article Synopsis
- This study examined Kawasaki disease (KD) cases in Quebec, Canada, focusing on coronary artery complications in a predominantly Caucasian population.
- It analyzed 38 patients diagnosed with giant coronary artery aneurysms, which were a small percentage of the total KD cases reviewed between 1976 and 2008.
- The report highlighted outcomes like freedom from serious cardiac events and noted five fatalities, emphasizing the need for larger studies to better understand KD in non-Asian populations.
Article Synopsis
- * A total of 33 healthcare professionals used the tool during 31 handovers, resulting in a significant improvement in the total handover score and specific information areas without extending the time taken for handover.
- * Although there was a trend indicating fewer high-risk postoperative events in the group using the tool, the improvement wasn't statistically significant.
Article Synopsis
- The study aimed to assess the outcomes of a transcatheter aortic valve implantation (TAVI) program using both transfemoral and transapical techniques, particularly in patients considered inoperable due to porcelain aorta or frailty.
- A total of 345 procedures were analyzed, revealing a 93.3% procedural success rate, with 30-day mortality at 10.4% and a median follow-up mortality rate of 22.1%, influenced by factors like sepsis and chronic diseases.
- Results indicated that patients with porcelain aorta or frailty had similar acute outcomes as others and even showed better 1-year survival rates, suggesting TAVI is a viable option for high-risk patients.