Publications by authors named "Christian Drolet"
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.
Objectives: To determine guideline adherence pertaining to pulmonary valve replacement (PVR) referral after tetralogy of Fallot (TOF) repair.
Methods: Children and adults with cardiovascular magnetic resonance imaging scans and at least moderate pulmonary regurgitation were prospectively enrolled in the Comprehensive Outcomes Registry Late After TOF Repair (CORRELATE). Individuals with previous PVR were excluded.
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.
Background: Comprehensive assessment of tetralogy of Fallot (TOF) outcomes extends beyond morbidity and mortality to incorporate patient-reported outcomes (PROs), including quality of life (QOL) and health status (HS).
Objectives: This study explored PROs in adolescents and adults with TOF and delineated variables associated with PROs.
Methods: This was a cross-sectional observational study within a larger prospective registry of adolescents and adults with repaired TOF and moderate or greater pulmonary regurgitation from North America, Europe, and Asia.
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
Background: Z scores are the method of choice to report dimensions in pediatric echocardiography. Z scores based on body surface area (BSA) have been shown to cause systematic biases in overweight and obese children. Using aortic valve (AoV) diameters as a paradigm, the aims of this study were to assess the magnitude of z score underestimation in children with increased body mass index z score (BMI-z) and to determine if a predicting model with height and weight as independent predictors would minimise this bias.
View Article and Find Full Text PDFArticle 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
- Bicuspid aortic valve (BAV) is a common congenital heart defect with genetic links, leading to recommendations for echocardiographic screening of first-degree relatives (FDR) of affected patients.
- A study conducted at Centre Hospitalier Universitaire de Laval from 2015 to 2018 assessed the screening effectiveness in 713 FDR, revealing that 6.6% had BAV and 5.4% had aortic valve dysfunction, with rare instances of ascending aorta dilatation.
- Although the prevalence of BAV in FDR aligns with adult studies supporting current screening guidelines, challenges remain in fully implementing these recommendations in pediatric care, including gaps in screening completion and differences in healthcare practices.
Background: Reference values for cardiac magnetic resonance imaging (cMRI) in children and young adults are scarce. This leads to risk stratification of patients with congenital heart diseases being based on volumes indexed to body surface area (BSA). We aimed to produce cMRI Z score equations for ventricular volumes in children and young adults and to test whether indexing to BSA resulted in an incorrect assessment of ventricular dilation according to sex, body composition, and growth.
View Article and Find Full Text PDFFibrin sheath formation around long-term indwelling central venous catheters is common and usually benign. Fibrin sheath can persist after catheter removal and rarely leads to complications. This is a report of three pediatric oncology patients that required cardiac surgery for cardiac embolization of a "ghost" catheter several years after catheter removal.
View Article and Find Full Text PDFBackground: Aortic valve replacement in children represents an important challenge. Concerns regarding pulmonary autograft and homograft longevity requiring reoperations are well recognized. Very long-term outcomes after the Ross procedure are still unknown.
View Article and Find Full Text PDFCardiac hemangioma is rare, even more when leading to a cardiovascular collapse in a seemingly healthy newborn. A 6-day-old neonate had a tamponade caused by a basolateral hemangioma of the left ventricle. Partial surgical resection was performed.
View Article and Find Full Text PDFBackground: The left pulmonary artery (LPA) contributes more than the right (RPA) to total pulmonary regurgitation (PR) in patients after tetralogy of Fallot (TOF) repair, but the mechanism of this difference is not well understood. This study aimed to analyze the interplay between heart and lung size, mediastinal geometry, and differential PR.
Methods: Forty-eight Cardiovascular Magnetic Resonance (CMR) studies in patients after TOF repair were analyzed.
Background: Chronic hemodynamically relevant pulmonary regurgitation (PR) resulting in important right ventricular dilation and ventricular dysfunction is commonly seen after tetralogy of Fallot (TOF) repair. Late adverse clinical outcomes, including exercise intolerance, arrhythmias, heart failure and/or death accelerate in the third decade of life and are cause for considerable concern. Timing of pulmonary valve replacement (PVR) to address chronic PR is controversial, particularly in asymptomatic individuals, and effect of PVR on clinical measures has not been determined.
View Article and Find Full Text PDFBackground: The use of a fenestration in the Fontan pathway remains controversial, partly because its hemodynamic effects and clinical consequences are insufficiently understood. The objective of this study was to quantify the magnitude of fenestration flow and to characterize its hemodynamic consequences after an intermediate interval after surgery.
Methods: Twenty three patients with a fenestrated extracardiac conduit prospectively underwent investigation by cardiac magnetic resonance (CMR), echocardiography, and invasive manometry under the same general anesthetic 12 ± 4 months after Fontan surgery.
Several articles have proposed echocardiographic reference values in normal pediatric subjects, but adequate validation is often lacking and has not been reviewed. The aim of this study was to review published reference values in pediatric two-dimensional and M-mode echocardiography with a specific focus on the adequacy of the statistical and mathematical methods used to normalize echocardiographic measurements. All articles proposing reference values for transthoracic pediatric echocardiography were reviewed.
View Article and Find Full Text PDFObjective: Aortopulmonary collaterals are a frequent phenomenon in patients after bidirectional cavopulmonary connection. The aortopulmonary collateral flow volume can be quantified using cardiac magnetic resonance imaging. However, the significance of aortopulmonary collateral flow for the postoperative outcome after total cavopulmonary connection is unclear and was sought to be determined.
View Article and Find Full Text PDFBackground: The management of pediatric discrete subaortic stenosis remains controversial.
Objectives: Document the natural history and surgical outcomes for discrete subaortic stenosis to adolescence.
Methods: Retrospective review of clinical and echocardiographic findings in 74 patients diagnosed in childhood between 1985 and 1998.