Aspirin Nonresponsiveness in Congenital Heart Disease-Prevalence, Risk Factors, and Management.

Background: Aspirin is frequently utilized for antiplatelet therapy in children with congenital heart disease (CHD). Patients who are unresponsive to aspirin, as measured by aspirin reaction units (ARU), are at higher risk for thrombotic events. It is undetermined if dose modification of aspirin results in adequate responsiveness in these patients.

Navigating life with single-ventricle CHD: psychosocial needs across adulthood.

Objective: The population of adults with single-ventricle congenital heart disease (CHD) is growing. This study explores their lived experiences through an adult developmental psychology framework.

Methods: Individuals aged 18 and older with single-ventricle CHD participated in Experience Group sessions and 1:1 interviews.

Multidisciplinary Surgical Care for a Cervical Esophageal Duplication Cyst.

We present a case of a three-month-old male who presented with a cervical esophageal duplication cyst requiring early surgical intervention. The patient presented with feeding difficulties, poor weight gain, and respiratory distress. Due to the position of the cervical esophageal duplication cyst and airway compression, this unique case required a multidisciplinary surgical approach involving both otolaryngology and cardiothoracic surgery.

Incidence and Outcomes of Iatrogenic Complete Atrioventricular Block After Congenital Heart Surgery.

Background: Iatrogenic complete atrioventricular block (ICAVB) has long been noted as a major complication after congenital heart surgery (CHS), and it contributes to complex postoperative care and potentially affects patients' outcomes.

Methods: This study is a retrospective review of the Pediatric Health Information System database from January 1, 2004 to September 30, 2023. All patients who underwent The Society of Thoracic Surgeons benchmark procedures were included.

Revisiting the Role of Balloon Atrial Septostomy Prior to the Arterial Switch Operation.

Objectives: Patients with dextro-transposition of the great arteries (d-TGA) frequently undergo balloon atrial septostomy (BAS) prior to the arterial switch operation (ASO) to promote atrial-level mixing. Balloon atrial septostomy has inherent risks as an invasive procedure and may not always be necessary. This study revisits the routine utilization of BAS prior to ASO.

Impact of electrophysiologists at daily multidisciplinary report in a paediatric cardiac care unit.

Background: Paediatric cardiac electrophysiologists are essential in CHD inpatient care, but their involvement is typically limited to consultation with individual patients. In our integrated heart centre, an electrophysiologist reviews all cardiac inpatient telemetry over the preceding 24 hours and participates in daily multidisciplinary morning report. This study investigates the impact of the strategy of consistent, formalised electrophysiologist presence at multidisciplinary morning report.

Successful explantation of children from the Berlin Heart EXCOR® ventricular assist device: A systematic review.

Background: The Berlin Heart EXCOR® (BHE) can bridge children with severe heart failure to transplantation, but some are successfully weaned and spared transplantation. This study seeks to identify characteristics of children amenable to successful explantation with BHE support.

Methods: Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines were used.

Outcomes of thoracic aortic interventions in Marfan syndrome in the state of Texas over 11 years.

Objectives: Marfan syndrome is a heritable connective tissue disorder with significant aortopathy and conveys substantial cardiovascular morbidity. This study characterizes the mortality and morbidities of thoracic aortic interventions (TAI) in the Marfan syndrome population in the state of Texas from 2009 to 2019.

Methods: A retrospective review of the Texas Inpatient Discharge Dataset from 1 January 2009 to 31 December 2019.

The journey of becoming a congenital heart surgeon: Too long, too costly, too unpredictable.

Objective: The pathway to become a congenital heart surgeon (CHS) is challenging and unpredictable. Previous voluntary manpower surveys have shed partial light on this problem but have not included all trainees. We believe that this arduous journey merits more attention.

Pacemaker Management and In-Hospital Outcomes in Neonatal Congenital Atrioventricular Block.

Background: Neonatal congenital atrioventricular block (nCAVB) is rare, causes bradycardia, confers high mortality, and frequently requires pacing. In-hospital outcomes and pacemaker management in nCAVB are limited.

Objectives: The purpose of this study was to analyze pacing and outcomes of nCAVB with and without congenital heart disease (CHD) using a multicenter database.

Evaluating variation in pre-operative evaluation and planning for children undergoing atrial or ventricular septal defect repair.

Background: CHD care is resource-intensive. Unwarranted variation in care may increase cost and result in poorer health outcomes. We hypothesise that process variation exists within the pre-operative evaluation and planning process for children undergoing repair of atrial septal defect or ventricular septal defect and that substantial variation occurs in a small number of care points.

Pericardial Effusions After the Arterial Switch Operation: A PHIS Database Review.

Pericardial effusion (PCE) is a significant complication after pediatric cardiac surgery. This study investigates PCE development after the arterial switch operation (ASO) and its short-term and longitudinal impacts. A retrospective review of the Pediatric Health Information System database.

Examining the Real-Life Journey of Individuals and Families Affected by Single-Ventricle Congenital Heart Disease.

Background The lifetime journey of patients with single-ventricle congenital heart disease is characterized by long-term challenges that are incompletely understood and still unfolding. Health care redesign requires a thorough understanding of this journey to create and implement solutions that improve outcomes. This study maps the lifetime journey of individuals with single-ventricle congenital heart disease and their families, identifies the most meaningful outcomes to them, and defines significant challenges in the journey.

Trisomy 18: disparities of care and outcomes in the State of Texas between 2009 and 2019.

Objective: To perform a statewide characteristics and outcomes analysis of the Trisomy 18 (T18) population and explore the potential impact of associated congenital heart disease (CHD) and congenital heart surgery.

Study Design: Retrospective review of the Texas Hospital Inpatient Discharge Public Use Data File between 2009 and 2019, analysing discharges of patients with T18 identified using ICD-9/10 codes. Discharges were linked to analyse patients.

Open and endoscopic fetal myelomeningocele surgeries display similar in-hospital safety profiles in a large, multi-institutional database.

Background: Open intrauterine fetal myelomeningocele repair has demonstrated decreased ventriculoperitoneal shunting and improved motor outcomes despite maternal and fetal risks. Few data directly compare the safety of open vs endoscopic approaches.

Objective: This study aimed to analyze in-hospital maternal and fetal outcomes of pregnant patients undergoing open vs endoscopic fetal myelomeningocele repair using a large, multi-center database.

Experiences and insights from partners of individuals with single-ventricle CHD: a pilot qualitative research study.

Introduction: With advances in care, an increasing number of individuals with single-ventricle CHD are surviving into adulthood. Partners of individuals with chronic illness have unique experiences and challenges. The goal of this pilot qualitative research study was to explore the lived experiences of partners of individuals with single-ventricle CHD.

Hospitalisations of children and adults with Hypoplastic Left Heart Syndrome in Texas from 2009 to 2019.

Introduction: Hypoplastic Left Heart Syndrome accounts for a significant proportion of CHD morbidity and mortality, despite improvements in care and improved survival. This study evaluates number of, reasons for, and trends in discharges of patients with hypoplastic left heart syndrome over 11 years in Texas.

Methods: The Texas Inpatient Discharge Dataset Public Use File captures almost all discharges in Texas and was reviewed from 2009 to 2019.

Routine Perioperative Esmolol After Infant Tetralogy of Fallot Repair: Single-Center Retrospective Study of Hemodynamics.

Objectives: Currently, surgical repair of tetralogy of Fallot (TOF) is associated with an 1.1% 30-day mortality rate. Those with junctional ectopic tachycardia (JET) and restrictive right ventricular physiology have poorer outcomes.

Effect of Long-term Exercise Training on Physical Performance and Cardiorespiratory Function in Adults With CKD: A Randomized Controlled Trial.

Rationale & Objective: The safety and efficacy of long-term exercise training in reducing physical functional loss in older adults with advanced CKD and comorbidity is uncertain.

Study Design: Multicenter, parallel group, randomized controlled trial.

Settings & Participants: Adults 55 years and older with estimated glomerular filtration rate (eGFR) of 15 to <45 mL/min/1.

Mental health diagnoses in hospitalized adults with congenital heart disease in the state of Texas: A 10-year review.

Background: Adults with congenital heart disease (ACHD) face psychological challenges. Furthermore, ACHD patients experience an under-recognition of mental health disorders (MHD). Understanding the impact of MHDs on ACHD hospitalizations may better inform and help re-design the ACHD care model.

Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease.

Arrhythmias account for 55 per 100,000 patient evaluations in pediatric emergency departments. Most arrhythmias in children are amenable to medical management or cardioversion. Rarely, arrhythmias lead to significant hemodynamic instability requiring extracorporeal membrane oxygenation (ECMO) support.

Aortic dissection and ruptures in adult congenital heart disease in Texas from 2009 to 2019.

Objectives: Acute thoracic aortic dissection and rupture (TADR) has an incidence of 5-7 per 100 000-person years. Today, most children with congenital heart disease (CHD) survive to become adults with congenital heart disease (ACHD). This study evaluates TADR in patients with ACHD in a large, hospitalized patient population over 11 years to evaluate the incidence, risk factors and outcomes associated with TADR.