Publications by authors named "Thomas Witter"
Objective: To describe neurodevelopment and follow-up services in preschool children with heart disease (HD).
Design: Secondary analysis of a prospectively collected multicentre dataset.
Setting: Three London tertiary cardiac centres.
Objectives: Given the current excellent early mortality rates for paediatric cardiac surgery, stakeholders believe that this important safety outcome should be supplemented by a wider range of measures. Our objectives were to prospectively measure the incidence of morbidities following paediatric cardiac surgery and to evaluate their clinical and health-economic impact over 6 months.
Design: The design was a prospective, multicentre, multidisciplinary mixed methods study.
Unlabelled: Introduction The objective of this study was to prospectively validate the "Brief Developmental Assessment", which is a new early recognition tool for neurodevelopmental abnormalities in children with heart disease that was developed for use by cardiac teams.
Methods: This was a prospective validation study among a representative sample of 960 pre-school children with heart disease from three United Kingdom tertiary cardiac centres who were analysed grouped into five separate age bands.
Results: The "Brief Developmental Assessment" was successfully validated in the older four age bands, but not in the youngest representing infants under the age of 4 months, as pre-set validation thresholds were met - lower 95% confidence limit for the correlation coefficient above 0.
Background: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity.
Methods: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality.
Background: Partial Risk Adjustment in Surgery (PRAiS), a risk model for 30-day mortality after children's heart surgery, has been used by the UK National Congenital Heart Disease Audit to report expected risk-adjusted survival since 2013. This study aimed to improve the model by incorporating additional comorbidity and diagnostic information.
Methods: The model development dataset was all procedures performed between 2009 and 2014 in all UK and Ireland congenital cardiac centers.
Objective: To implement routine in-house monitoring of risk-adjusted 30-day mortality following paediatric cardiac surgery.
Design: Collaborative monitoring software development and implementation in three specialist centres.
Patients And Methods: Analyses incorporated 2 years of data routinely audited by the National Institute of Cardiac Outcomes Research (NICOR).
Objective: The study aims to assess whether the increasing use of cardiovascular magnetic resonance imaging in place of diagnostic cardiac catheterization in the management of pediatric patients with congenital heart disease has had an impact on pediatric cardiac care.
Design: Retrospective analysis of data was used.
Setting: The study was performed at the Evelina Children's Hospital Cardiology Department.
Objectives: This study sought to investigate changes in magnetic resonance imaging (MRI) ventricular volumes and vascular dimensions before hemi-Fontan (HF) and before total cavopulmonary connection (TCPC) in children with hypoplastic left heart syndrome (HLHS).
Background: The systemic right ventricle (RV) in HLHS is subject to significant changes in volume loading throughout the surgical stages of palliation, particularly after the HF.
Methods: Fifty-eight patients had paired pre-HF and pre-TCPC MRI for assessment of changes of RV volumes, neoaortic flow, and vascular dimensions.