Neonatal Gerbode Defect Resulting in Cardiogenic Shock.

Congenital Gerbode defects, consisting of a deficiency in the membranous septum causing left ventricle-to-right atrium shunting, are rarely hemodynamically significant. Here, we present the case of a neonate with a large unrestrictive Gerbode defect, patent foramen ovale, patent ductus arteriosus, and pulmonary valve insufficiency resulting in a circular intracardiac shunt and cardiogenic shock. The patient was managed with venoarterial extracorporeal membrane oxygenation followed by neonatal Gerbode defect repair.

Additive value of invasive haemodynamic assessment for predicting post-operative outcomes after Fontan.

Routine pre-Fontan cardiac catheterization remains standard practice at most centres. However, with advances in non-invasive risk assessment, an invasive haemodynamic assessment may not be necessary for all patients.Using retrospective data from patients undergoing Fontan palliation at our institution, we developed a multivariable model to predict the likelihood of a composite adverse post-operative outcome including prolonged length of stay ≥ 30 days, hospital readmission within 6 months, and death and/or transplant within 6 months.

Improving maternal-infant bonding after prenatal diagnosis of CHD.

Background: Infants with prenatally diagnosed CHD are at high risk for adverse outcomes owing to multiple physiologic and psychosocial factors. Lack of immediate physical postnatal contact because of rapid initiation of medical therapy impairs maternal-infant bonding. On the basis of expected physiology, maternal-infant bonding may be safe for select cardiac diagnoses.

Coronary Disease and Modifying Cardiovascular Risk in Adult Congenital Heart Disease Patients: Should General Guidelines Apply?

There are >1.4 million adult congenital heart disease (CHD; ACHD) patients living in the United States. Coronary artery disease (CAD) is at least as prevalent in ACHD patients as in the general population and has become a leading cause of their mortality.

The ventricular volume variability study of the Pediatric Heart Network: study design and impact of beat averaging and variable type on the reproducibility of echocardiographic measurements in children with chronic dilated cardiomyopathy.

Background: Clinical trials often rely on echocardiographic measures of left ventricular size and function as surrogate end points. However, the quantitative impact of factors that affect the reproducibility of these measures is unknown. To address this issue, the National Heart, Lung, and Blood Institute-funded Pediatric Heart Network designed a longitudinal observational study of children with known or suspected dilated cardiomyopathy aged 0 to 22 years from eight pediatric clinical centers.

Global longitudinal cardiac strain and strain rate for assessment of fetal cardiac function: novel experience with velocity vector imaging.

Background: Cardiac strain and strain rate are new methods to quantitate fetal cardiac function. Doppler-based techniques are regional measurements limited by angle of insonation. Newer feature-tracking algorithms permit angle independent measurements from two-dimensional datasets.

Use of the monoplane intracardiac imaging probe in high-risk infants during congenital heart surgery.

Unlabelled: Imaging options are limited in high-risk infants with small or abnormal oropharyngeal anatomy during congenital heart surgery.

Methods: All cases in which the monoplane intracardiac echo probe was used for transesophageal intraoperative imaging over a 15-month period at a single institution were reviewed.

Results: Eleven patients underwent intraoperative imaging using the intracardiac probe.