Publications by authors named "Hager A"
Little is known about the skeletal muscle characteristics (fibre type proportion and size, location of nuclei, presence of fat infiltration) in children with liver disease with radiologically determined myopenia (low muscle mass). During liver transplantation (LTx) surgery, biopsies from the rectus abdominis muscle were collected. Muscle fibre types (I, I/IIA, IIA, IIA/X, IIX) and CSA index (µm/m2) were determined using immunofluorescence staining.
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- * The revised 2022 guidelines from the European Society of Cardiology/European Respiratory Society address PH but only briefly consider the needs of adults with congenital heart defects.
- * The article aims to enhance understanding of ACHD management by exploring various aspects such as diagnostics, specialized therapies, and unique circumstances, thereby addressing gaps in current guidelines.
Article Synopsis
- * The 2022 guidelines by the European Society of Cardiology and the European Respiratory Society address PH management but only briefly cover the specific needs of adults with congenital heart defects.
- * This article reviews various aspects of ACHDs and PH, including their epidemiology, risk factors, and management challenges, aiming to enhance awareness and care strategies for this patient population.
Objective: This study aims to assess the surgical outcome of borderline hypoplastic left ventricle before and after the induction of the left ventricle rehabilitation strategy.
Methods: A retrospective review investigated patients with borderline hypoplastic left ventricle who underwent surgical intervention between 2012 and 2022. The patient cohort was stratified into two groups based on the initiation of left ventricle rehabilitation: an early-era group (E group, 2012-2017) and a late-era group (L group, 2018-2022).
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- The study investigates the link between aorto-pulmonary and veno-venous collaterals and the development of plastic bronchitis in patients following the Fontan procedure from 1994 to 2022.
- Out of 635 patients analyzed, 15 (2.4%) developed plastic bronchitis, with those affected showing significantly higher rates of aorto-pulmonary (60% vs. 14%) and veno-venous collaterals (53% vs. 14%).
- Findings suggest that managing these collaterals could help prevent plastic bronchitis, which poses added health risks for patients post-Fontan procedure.
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- The study compared pulmonary artery growth in infants with univentricular hearts who received ductus stenting (DS) versus those who had a systemic to pulmonary shunt (SPS) for initial palliation from 2009 to 2022.
- A total of 130 infants were evaluated, revealing that while most pulmonary artery metrics were similar between groups, the DS group had a significantly lower left pulmonary artery index and a higher occurrence of veno-venous collaterals compared to the SPS group.
- The findings suggest that infants after DS are more likely to need further pulmonary artery interventions between stages II and III palliation, highlighting the need for further investigation into long-term outcomes after the Fontan procedure
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- This study investigates the challenging condition known as failing Fontan in patients who have undergone total cavopulmonary connection, focusing on its incidence, causes, risk factors, and treatment options.
- Out of 634 patients analyzed from 1994 to 2022, 76 were diagnosed with failing Fontan, resulting in an incidence rate of 1.48 per 100 patient-years, and key symptoms included protein-losing enteropathy and hospital readmissions.
- Key risk factors for developing failing Fontan include having a dominant right ventricle and elevated pulmonary artery pressure prior to surgery, while patients showed a survival rate of 77% ten years after failure onset; zlog-
Objective: We have left antegrade pulmonary blood flow (APBF) at bidirectional cavopulmonary shunt (BCPS) only for high-risk patients. This study evaluates the indication and the outcomes of patients with APBF, compared to those without APBF.
Methods: Patients with APBF after BCPS were identified among patients who underwent BCPS between 1997 and 2022.
Introduction: Sarcopenia is common in children after liver transplantation (LTx). Resistance training (RT) may be effective in combating sarcopenia.
Objectives: The purpose of the study was to test the feasibility and impact of a 12-week RT program on skeletal muscle mass (SMM), muscle strength, physical performance (PP), and child-parent perspectives about RT.
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- The study investigates the effects of low birth weight on outcomes for patients undergoing staged palliation for single ventricle heart conditions.
- It found that patients with low birth weight (2.5 kg or less) had higher mortality rates and were less likely to progress to further stages of treatment compared to those with normal weight.
- The findings suggest that low birth weight significantly negatively impacts survival rates even five years post-treatment, emphasizing the need for closer monitoring of these at-risk patients throughout their care.
Background: Patient-driven innovation in health care is an emerging phenomenon with benefits for patients with chronic conditions, such as cystic fibrosis (CF). However, previous research has not examined what may facilitate or hinder the implementation of such innovations from the provider perspective.
Objective: The aim of this study was to explain variations in the adoption of a patient-driven innovation among CF clinics.
Sedentary lifestyle is reported to be associated with diminished exercise capacity, resulting in increased cardiovascular risk in adults with congenital heart disease (CHD). This cross-sectional study examined the association between objectively measured physical activity (PA) and exercise capacity in children and adolescents with CHD. Therefore, 107 patients (aged 13.
View Article and Find Full Text PDFBackground And Objectives: Older adults experiencing neurocognitive disease (NCD) contend with complex care often characterized by high emotional strain. Mitigating complex care with decision support tools can clarify options. When used in conjunction with the practice of shared decision making (SDM), these tools can improve satisfaction and confidence in treatment.
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- A study assessed the prevalence of veno-venous collaterals (VVCs) in patients who underwent total cavopulmonary connection (TCPC) from 1994 to 2022, finding VVCs in 15% of those evaluated.
- The research included 635 patients, most commonly diagnosed with hypoplastic left heart syndrome, with VVCs developing around 2.8 years post-surgery.
- While VVCs did not significantly affect survival rates, they were linked to an increased risk for plastic bronchitis, and interventional closure of VVCs improved oxygen saturation in 66% of treated patients.
The number of adults with congenital heart defects (CHD) is steadily rising and amounts to approximately 360,000 in Germany. CHD is often associated with pulmonary hypertension (PH), which may develop early in untreated CHD. Despite timely treatment of CHD, PH not infrequently persists or recurs in older age and is associated with significant morbidity and mortality.
View Article and Find Full Text PDFObjectives: Our goal was to evaluate the impact of variable morphology of the native ascending aorta after the Norwood I procedure in patients with hypoplastic left heart syndrome/aortic atresia on long-term survival and systemic right ventricular dysfunction.
Methods: Of 151 survivors of the Norwood procedure for hypoplastic left heart syndrome/aortic atresia at our institution between January 2001 and December 2020, we included patients with available and measurable aortograms prior to stage II palliation. The diameter of the native ascending aorta, the length of the native ascending aorta and the angle between the native ascending aorta and the proximal pulmonary artery were measured.
To evaluate the relationship of aortopulmonary collaterals and the development of central pulmonary arteries during staged palliation. A total of 287 patients, who underwent staged palliation with bidirectional cavopulmonary shunt and total cavopulmonary connection between 2008 and 2019, had available angiography. Pulmonary artery index was calculated using pulmonary angiography as described by Nakata and colleagues.
View Article and Find Full Text PDFBackground: Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults.
Methods: This 12-month, assessor-blinded, three-armed multicentre randomised clinical trial was conducted in adults aged ≥ 65 years identified as at risk of falling.
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- Atrioventricular valve regurgitation is a significant issue in patients with univentricular hearts and poses challenges for surgical repairs, which are crucial for improving outcomes.
- A study reviewed surgeries from 1994 to 2021 on 202 patients with univentricular hearts, finding that 15.8% needed atrioventricular valve surgery, with varying outcomes based on valve types and surgical techniques used.
- Although the surgeries had low immediate and long-term mortality rates (3.1% and 9.7% respectively), a notable number of patients (30.9%) required reoperations within 10 years.
Introduction: Docetaxel can cause fluid retention reactions (FRRs) and hypersensitivity reactions (HSRs). The manufacturer recommends a multi-day oral dexamethasone premedication to prevent these toxicities, but steroid related side effects and regimen compliance remain a concern. This study aimed to determine if modified dexamethasone premedication regimens resulted in differences in HSRs or FRRs to docetaxel.
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- The study aimed to assess heart function and valve regurgitation in babies who underwent the Norwood procedure over a period from 2001 to 2020.
- Researchers analyzed echocardiograms of 335 patients to compare outcomes between those who had a modified Blalock-Taussig shunt versus a right ventricle to pulmonary artery conduit.
- Results showed that although ventricular function initially worsened with the Blalock-Taussig shunt, it improved after the procedure compared to the conduit approach, but differences in valve regurgitation were less pronounced after the second stage of treatment.
Aims: In each cardiopulmonary exercise test (CPET), resting spirometry is performed in advance. In patients with a congenital heart defect (CHD), lung volumes are often impaired. This study investigates correlations between lung volumes and CPET parameters and determines, whether body plethysmography provides substantial additional information for these patients.
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- The study aimed to find early postoperative indicators that could predict complications after total cavopulmonary connection surgery, analyzing factors like pulmonary artery pressure, arterial pressure, oxygen saturation, and lactate levels.
- A total of 249 patients, primarily young children, were evaluated, with specific postoperative measurements showing significant correlations with various complications, such as chest tube drainage and adverse events.
- Key findings included optimal cut-off values for pulmonary artery pressures and mean arterial pressures that could help predict complications, emphasizing the importance of early monitoring in improving patient outcomes.
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- The study compares outcomes between infants with univentricular hearts who received either ductus stenting or surgical systemic-to-pulmonary shunt (SPS) for initial palliation from 2009 to 2022.
- Hospital mortality rates were similar for both groups, but those with ductus stenting had significantly shorter ICU and hospital stays despite experiencing higher rates of acute complications.
- The likelihood of reaching stage II palliations was nearly the same for both groups, but patients with SPS had better ratios of left to right pulmonary artery areas at stage II.
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- The study assessed exercise capacity in patients who underwent different types of Fontan procedures for heart defects, focusing on the impact of pulmonary blood flow patterns.
- A total of 227 patients were involved, and those with pulsatile blood flow after the Fontan-Björk procedure showed significantly better exercise results compared to other procedures and non-pulsatile patients.
- The findings highlight the critical role of pulsatile pulmonary blood flow in enhancing long-term exercise performance for Fontan procedure survivors.