Publications by authors named "T L Spray"
Importance: Neurodevelopmental outcomes for children with congenital heart defects (CHD) have improved minimally over the past 20 years.
Objectives: To assess the feasibility and tolerability of maternal progesterone therapy as well as the magnitude of the effect on neurodevelopment for fetuses with CHD.
Design, Setting, And Participants: This double-blinded individually randomized parallel-group clinical trial of vaginal natural progesterone therapy vs placebo in participants carrying fetuses with CHD was conducted between July 2014 and November 2021 at a quaternary care children's hospital.
Increased utilization of the hybrid procedure is not associated with improved early survival for newborns with hypoplastic left heart syndrome: a single-centre experience.
Eur J Cardiothorac Surg
March 2024
Article Synopsis
- - The study aimed to compare the Hybrid and Norwood procedures for treating patients with hypoplastic left heart syndrome and assess their impact on hospital mortality from 1984 to 2022.
- - Over the years, 1,899 patients underwent the Norwood procedure while 82 had the Hybrid procedure, with Hybrid usage rising to 30% by the last analysis period, but it was linked to higher hospital mortality after adjusting for risk factors.
- - Despite the increased adoption of the Hybrid procedure, overall mortality rates have remained stable, suggesting the need for further evaluation of the Hybrid approach in terms of its efficacy.
Pulmonary atresia with intact ventricular septum: Intended strategies.
J Thorac Cardiovasc Surg
November 2022
Objective: Neonatal interventional strategies for pulmonary atresia with intact ventricular septum are based on tricuspid valve hypoplasia and right ventricle-dependent coronary circulation. We sought to evaluate long-term outcomes comparing biventricular (BiV) versus single-ventricle (SV) strategies.
Methods: Retrospective review was performed of 119 patients diagnosed with pulmonary atresia with intact ventricular septum from 1995 to 2018.
Objective: We investigated the incidence and predictors of failure to undergo the Fontan in children with hypoplastic left heart syndrome who survived superior cavopulmonary connection.
Methods: The cohort consists of all patients with hypoplastic left heart syndrome who survived to hospital discharge after superior cavopulmonary connection between 1988 and 2017. The primary outcome was attrition, which was defined as death, nonsuitability for the Fontan, or cardiac transplantation before the Fontan.
Background The superior cavo-pulmonary connection was introduced at our institution in 1988 for infants undergoing surgery for hypoplastic left heart syndrome. Patients with hypoplastic left heart syndrome remain at high risk for mortality in the time period between the Norwood procedure and the superior cavo-pulmonary connection. The primary objectives of this study were to compare interstage mortality across 4 eras and analyze factors that may impact interstage mortality.
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