CJC Pediatric and Congenital Heart Disease最新文献

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Children With Congenital Heart Disease and the Canadian 24-Hour Movement Guidelines: A Scoping Review

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/j.cjcpc.2024.10.008

Matthew S. Chapelski MSc , Megan Tomyn BSc , Kristina Sobolewski MSc , Amanda Froehlich Chow PhD , Leah J. Ferguson PhD , Charissa Pockett MD , Corey R. Tomczak PhD , Marta C. Erlandson PhD

Factors such as physical activity (PA), sedentary time, screen time, and sleep affect the holistic health of children with congenital heart disease (CHD). Despite this, their proximity to reaching the Canadian 24-hour movement guidelines is unknown. This review sought to synthesize evidence for PA, sedentary time, screen time, and sleep behaviour of children with CHD and compare them with the Canadian 24-hour movement guidelines. Six online databases were searched for research published from January 2010 to May 2024. Eligible articles included research involving children aged 4-20 years with any type of CHD lesion as well as a measure of one of PA, sedentary time, screen time, or sleep, reported in a unit of time. The search resulted in 9199 articles, and after removing ineligible articles, 30 were identified for this review. Of the included articles, 30 measured moderate-to-vigorous PA (MVPA), 8 measured light PA, 14 measured sedentary time, 1 measured screen time, and 3 measured sleep time. Forty percent of studies reported that children with CHD met the MVPA guidelines. Within these, a subset of studies (n = 20) examined the percentage of the sample that reached the guideline and found that an average of 43% of children with CHD attained the MVPA guideline. No conclusions could be made for light PA or sedentary time because there is no clear quantification or numerical recommendation in the Canadian 24-hour movement guidelines. In addition, future research should include evaluations of the screen and sleep time of children with CHD due to very limited research in the area.

{"title":"Children With Congenital Heart Disease and the Canadian 24-Hour Movement Guidelines: A Scoping Review","authors":"Matthew S. Chapelski MSc , Megan Tomyn BSc , Kristina Sobolewski MSc , Amanda Froehlich Chow PhD , Leah J. Ferguson PhD , Charissa Pockett MD , Corey R. Tomczak PhD , Marta C. Erlandson PhD","doi":"10.1016/j.cjcpc.2024.10.008","DOIUrl":"10.1016/j.cjcpc.2024.10.008","url":null,"abstract":"<div><div>Factors such as physical activity (PA), sedentary time, screen time, and sleep affect the holistic health of children with congenital heart disease (CHD). Despite this, their proximity to reaching the Canadian 24-hour movement guidelines is unknown. This review sought to synthesize evidence for PA, sedentary time, screen time, and sleep behaviour of children with CHD and compare them with the Canadian 24-hour movement guidelines. Six online databases were searched for research published from January 2010 to May 2024. Eligible articles included research involving children aged 4-20 years with any type of CHD lesion as well as a measure of one of PA, sedentary time, screen time, or sleep, reported in a unit of time. The search resulted in 9199 articles, and after removing ineligible articles, 30 were identified for this review. Of the included articles, 30 measured moderate-to-vigorous PA (MVPA), 8 measured light PA, 14 measured sedentary time, 1 measured screen time, and 3 measured sleep time. Forty percent of studies reported that children with CHD met the MVPA guidelines. Within these, a subset of studies (n = 20) examined the percentage of the sample that reached the guideline and found that an average of 43% of children with CHD attained the MVPA guideline. No conclusions could be made for light PA or sedentary time because there is no clear quantification or numerical recommendation in the Canadian 24-hour movement guidelines. In addition, future research should include evaluations of the screen and sleep time of children with CHD due to very limited research in the area.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 1","pages":"Pages 34-48"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Growing Up With Congenital Heart Disease: A Qualitative Research Study of Parents’ and Clinicians’ Experiences and Perspectives

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/j.cjcpc.2024.10.006

F. Dylan Nemes BSc , Erica V. Bennett PhD , Kevin C. Harris MD, MHSc , Nicholas Wall BSc , Christine Voss PhD

Background

Families of children with congenital heart disease (CHD) may experience a range of challenges, such as interactions with the medical system, parental stress, and the child’s physical activity (PA) participation. The aim of this study is to explore how those with CHD and their families experience childhood based on parents’ and clinicians’ experiences and perspectives. The ultimate goal is to identify lacking supports (if any) and when children and their parents may be most amendable to receive them.

Methods

We recruited parents/guardians of children with CHD and clinicians involved in care provision for children with CHD. Participants completed life story interviews, with key events from parent/guardian interviews mapped to a timeline. Data were analysed using reflexive thematic analysis.

Results

Twelve parents of 11 children with CHD, with diagnoses spanning from mild to complex, and 12 clinicians (42% paediatric cardiologists, 33% nurses, and 25% other) were interviewed. Three themes were identified: (1) overwhelmed—the relationship between parents and the health care system, (2) trauma and resilience—the emotional side to raising a child with CHD, and (3) PA … more than just fun. Subthemes explored challenges of education, communication, and living away from the hospital, traumatic experiences, the need for parental support, different approaches to PA counselling, providing role models, barriers to successful PA promotion, and tools for improvement.

Conclusions

This study highlights the need for changes to how and when information is communicated to families of children with CHD and an increase in the number and types of support mechanisms available.

{"title":"Growing Up With Congenital Heart Disease: A Qualitative Research Study of Parents’ and Clinicians’ Experiences and Perspectives","authors":"F. Dylan Nemes BSc , Erica V. Bennett PhD , Kevin C. Harris MD, MHSc , Nicholas Wall BSc , Christine Voss PhD","doi":"10.1016/j.cjcpc.2024.10.006","DOIUrl":"10.1016/j.cjcpc.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Families of children with congenital heart disease (CHD) may experience a range of challenges, such as interactions with the medical system, parental stress, and the child’s physical activity (PA) participation. The aim of this study is to explore how those with CHD and their families experience childhood based on parents’ and clinicians’ experiences and perspectives. The ultimate goal is to identify lacking supports (if any) and when children and their parents may be most amendable to receive them.</div></div><div><h3>Methods</h3><div>We recruited parents/guardians of children with CHD and clinicians involved in care provision for children with CHD. Participants completed life story interviews, with key events from parent/guardian interviews mapped to a timeline. Data were analysed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>Twelve parents of 11 children with CHD, with diagnoses spanning from mild to complex, and 12 clinicians (42% paediatric cardiologists, 33% nurses, and 25% other) were interviewed. Three themes were identified: (1) overwhelmed—the relationship between parents and the health care system, (2) trauma and resilience—the emotional side to raising a child with CHD, and (3) PA … more than just fun. Subthemes explored challenges of education, communication, and living away from the hospital, traumatic experiences, the need for parental support, different approaches to PA counselling, providing role models, barriers to successful PA promotion, and tools for improvement.</div></div><div><h3>Conclusions</h3><div>This study highlights the need for changes to how and when information is communicated to families of children with CHD and an increase in the number and types of support mechanisms available.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 1","pages":"Pages 22-33"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prenatal Detection of Wolff-Parkinson-White Syndrome Using the Atrioventricular Interval on Fetal Echocardiogram

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/j.cjcpc.2024.09.003

Pierre-Olivier Veillette MD , Emilia Beauchamp , Cecilia Gonzalez Corcia MD , Jean-Luc Bigras MD

Background

Fetal Doppler echocardiography has been widely used for the detection and characterization of fetal tachyarrhythmias. Doppler interrogation of the superior vena cava and the aorta (SVC-Ao) is used to determine the electrophysiological etiology of arrhythmias. The present study aims to investigate if the SVC-Ao technique in fetal echocardiograms could identify fetuses with Wolff-Parkinson-White (WPW) syndrome.

Methods

We retrospectively searched for consecutive fetal echocardiograms with evidence of tachyarrhythmias performed at the CHU Sainte-Justine from January 2000 to July 2021. The primary outcome was defined as the presence of pre-excitation on postnatal electrocardiogram (ECG) in the context of a prenatal tachyarrhythmia and the identification of a short atrioventricular (AV) interval.

Results

From a cohort of 69 patients presenting with fetal tachyarrhythmia diagnosed by echocardiography, AV intervals were measured in 9 fetuses (13%) that showed WPW on the postnatal surface ECG. The AV interval measured using fetal echocardiography showed a median of 107 ms (interquartile range: 104-116 ms), representing a z-score of –1.27 (–2.01 to –0.56). Six fetuses (67%) had repeated AV intervals ≤–2 standard deviation. Three (33%) had WPW on postnatal surface ECG but did not have short AV intervals on fetal echocardiograms, representing a false negative for the diagnostic yield of the technique.

Conclusions

Doppler echocardiographic AV interval measurements in fetuses with arrhythmias allow identification of prenatal WPW. The early diagnosis of WPW offers the possibility of a more comprehensive postnatal management plan, including the neonatology and cardiology teams, as well as preparing in advance for specific antiarrhythmic drug therapy.

{"title":"Prenatal Detection of Wolff-Parkinson-White Syndrome Using the Atrioventricular Interval on Fetal Echocardiogram","authors":"Pierre-Olivier Veillette MD , Emilia Beauchamp , Cecilia Gonzalez Corcia MD , Jean-Luc Bigras MD","doi":"10.1016/j.cjcpc.2024.09.003","DOIUrl":"10.1016/j.cjcpc.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Fetal Doppler echocardiography has been widely used for the detection and characterization of fetal tachyarrhythmias. Doppler interrogation of the superior vena cava and the aorta (SVC-Ao) is used to determine the electrophysiological etiology of arrhythmias. The present study aims to investigate if the SVC-Ao technique in fetal echocardiograms could identify fetuses with Wolff-Parkinson-White (WPW) syndrome.</div></div><div><h3>Methods</h3><div>We retrospectively searched for consecutive fetal echocardiograms with evidence of tachyarrhythmias performed at the CHU Sainte-Justine from January 2000 to July 2021. The primary outcome was defined as the presence of pre-excitation on postnatal electrocardiogram (ECG) in the context of a prenatal tachyarrhythmia and the identification of a short atrioventricular (AV) interval.</div></div><div><h3>Results</h3><div>From a cohort of 69 patients presenting with fetal tachyarrhythmia diagnosed by echocardiography, AV intervals were measured in 9 fetuses (13%) that showed WPW on the postnatal surface ECG. The AV interval measured using fetal echocardiography showed a median of 107 ms (interquartile range: 104-116 ms), representing a <em>z</em>-score of –1.27 (–2.01 to –0.56). Six fetuses (67%) had repeated AV intervals ≤–2 standard deviation. Three (33%) had WPW on postnatal surface ECG but did not have short AV intervals on fetal echocardiograms, representing a false negative for the diagnostic yield of the technique.</div></div><div><h3>Conclusions</h3><div>Doppler echocardiographic AV interval measurements in fetuses with arrhythmias allow identification of prenatal WPW. The early diagnosis of WPW offers the possibility of a more comprehensive postnatal management plan, including the neonatology and cardiology teams, as well as preparing in advance for specific antiarrhythmic drug therapy.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 1","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk Factors Associated With Ventricular Dysfunction in Wolff-Parkinson-White Syndrome

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/j.cjcpc.2024.09.005

Hiroko Asakai MD, PhD , Sharmila Udupa MDCM , Christine Chiu-Man MSc , Elizabeth A. Stephenson MD, MSc

Background

Wolff-Parkinson-White (WPW) syndrome is associated with ventricular dysfunction in the absence of sustained tachyarrhythmias. Our aim was to determine the prevalence of ventricular dysfunction and to assess risk factors associated with this condition.

Methods

A single-centre retrospective analysis of all patients <18 years of age with WPW syndrome and normal cardiac anatomy who underwent an electrophysiology study ablation over a 14-year period was performed. Patients with an ejection fraction <55% were defined as having ventricular dysfunction.

Results

Among 305 patients, 14 cases (4.5%) with ventricular dysfunction were identified. In 4 of 14 cases (28%), the presenting symptom was heart failure, and only 6 of 14 (43%) had symptoms of palpitations or documented supraventricular tachycardia. The vast majority of patients with dysfunction had right-sided pathways, and only 2 patients had a left-sided pathway locations. Right anteroseptal, anterior, and anterolateral accessory pathway locations were more common in the dysfunction group. The presence of multiple pathways and pathway characteristics assessed during electrophysiology study were comparable between the 2 groups.

Conclusions

The prevalence of ventricular dysfunction in WPW syndrome in children was 4.5%, and this is seen more frequently with right anteroseptal, anterior, and anterolateral pathway locations. Risk analysis identified these pathway locations to be associated with a 4-fold risk of developing ventricular dysfunction (odds ratio: 4.32 [confidence interval: 1.38-14.18], P = 0.012). Because of this rare complication, serial assessment of ventricular function is recommended regardless of arrhythmia burden and an ablation should be considered in the presence of dysfunction.

{"title":"Risk Factors Associated With Ventricular Dysfunction in Wolff-Parkinson-White Syndrome","authors":"Hiroko Asakai MD, PhD , Sharmila Udupa MDCM , Christine Chiu-Man MSc , Elizabeth A. Stephenson MD, MSc","doi":"10.1016/j.cjcpc.2024.09.005","DOIUrl":"10.1016/j.cjcpc.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Wolff-Parkinson-White (WPW) syndrome is associated with ventricular dysfunction in the absence of sustained tachyarrhythmias. Our aim was to determine the prevalence of ventricular dysfunction and to assess risk factors associated with this condition.</div></div><div><h3>Methods</h3><div>A single-centre retrospective analysis of all patients <18 years of age with WPW syndrome and normal cardiac anatomy who underwent an electrophysiology study ablation over a 14-year period was performed. Patients with an ejection fraction <55% were defined as having ventricular dysfunction.</div></div><div><h3>Results</h3><div>Among 305 patients, 14 cases (4.5%) with ventricular dysfunction were identified. In 4 of 14 cases (28%), the presenting symptom was heart failure, and only 6 of 14 (43%) had symptoms of palpitations or documented supraventricular tachycardia. The vast majority of patients with dysfunction had right-sided pathways, and only 2 patients had a left-sided pathway locations. Right anteroseptal, anterior, and anterolateral accessory pathway locations were more common in the dysfunction group. The presence of multiple pathways and pathway characteristics assessed during electrophysiology study were comparable between the 2 groups.</div></div><div><h3>Conclusions</h3><div>The prevalence of ventricular dysfunction in WPW syndrome in children was 4.5%, and this is seen more frequently with right anteroseptal, anterior, and anterolateral pathway locations. Risk analysis identified these pathway locations to be associated with a 4-fold risk of developing ventricular dysfunction (odds ratio: 4.32 [confidence interval: 1.38-14.18], <em>P</em> = 0.012). Because of this rare complication, serial assessment of ventricular function is recommended regardless of arrhythmia burden and an ablation should be considered in the presence of dysfunction.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 1","pages":"Pages 10-16"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Better Precision in Fetal Arrhythmia Diagnosis and Management: Pre-excitation in Fetus or the Cardiologist?

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/j.cjcpc.2024.10.010

Santokh Singh Dhillon MD, FRCPC, FHRS

引用次数: 0

Information for Readers

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/S2772-8129(25)00004-1

引用次数: 0

Home Milrinone Therapy for Paediatric Advanced Heart Failure Patients: A Canadian Single-Centre Experience

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/j.cjcpc.2024.10.005

Ahmed A. Hassan MBBCh , Aamir Jeewa MBBCh , Lujayn Mahmoud BSc , Harni Ganesarasa BSc , Dawn Nicolson BSc , Sunghoon Minn BSc , Emilie Jean-St-Michel MDCM, MSc , Kristen George CNP

Background

End-stage heart failure (ESHF) is the primary reason for heart transplantation in children with cardiomyopathy. Despite optimizing oral heart failure (HF) medications, some paediatric patients progress to ESHF, necessitating mechanical circulatory support and/or transplantation. Continuous milrinone intravenous support has been used to bridge paediatric patients to transplant. This study aimed to review and report the safety and outcomes of our home milrinone therapy (HMT) programme.

Methods

This single-centre, retrospective cohort study included paediatric patients discharged on HMT between 2001 and 2022. Data were collected from the SickKids HF Database. Outcomes of interest included frequency and indications for rehospitalization, catheter-related complications, and outcomes at the conclusion of therapy.

Results

Thirty-six patients were included, with a median age of 3.6 years and a median weight of 13.1 kg at HMT initiation. HMT was used as a bridge to transplantation (58%) recovery/candidacy (22%), palliative care (17%), and surgical repair (3%). The median duration on HMT was 88 days. Twenty-four patients (67%) were readmitted at least once with a total of 70 admissions, primarily due to central line-related issues (35%) and worsening HF (32%). Among patients discharged as a bridge to transplant, 52% were admitted from home for transplant, whereas 33% required readmission until transplant. No deaths were directly related to HMT.

Conclusions

HMT is a safe and effective method for supporting children with ESHF. This therapy allows children to return to their home environment.

{"title":"Home Milrinone Therapy for Paediatric Advanced Heart Failure Patients: A Canadian Single-Centre Experience","authors":"Ahmed A. Hassan MBBCh , Aamir Jeewa MBBCh , Lujayn Mahmoud BSc , Harni Ganesarasa BSc , Dawn Nicolson BSc , Sunghoon Minn BSc , Emilie Jean-St-Michel MDCM, MSc , Kristen George CNP","doi":"10.1016/j.cjcpc.2024.10.005","DOIUrl":"10.1016/j.cjcpc.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>End-stage heart failure (ESHF) is the primary reason for heart transplantation in children with cardiomyopathy. Despite optimizing oral heart failure (HF) medications, some paediatric patients progress to ESHF, necessitating mechanical circulatory support and/or transplantation. Continuous milrinone intravenous support has been used to bridge paediatric patients to transplant. This study aimed to review and report the safety and outcomes of our home milrinone therapy (HMT) programme.</div></div><div><h3>Methods</h3><div>This single-centre, retrospective cohort study included paediatric patients discharged on HMT between 2001 and 2022. Data were collected from the SickKids HF Database. Outcomes of interest included frequency and indications for rehospitalization, catheter-related complications, and outcomes at the conclusion of therapy.</div></div><div><h3>Results</h3><div>Thirty-six patients were included, with a median age of 3.6 years and a median weight of 13.1 kg at HMT initiation. HMT was used as a bridge to transplantation (58%) recovery/candidacy (22%), palliative care (17%), and surgical repair (3%). The median duration on HMT was 88 days. Twenty-four patients (67%) were readmitted at least once with a total of 70 admissions, primarily due to central line-related issues (35%) and worsening HF (32%). Among patients discharged as a bridge to transplant, 52% were admitted from home for transplant, whereas 33% required readmission until transplant. No deaths were directly related to HMT.</div></div><div><h3>Conclusions</h3><div>HMT is a safe and effective method for supporting children with ESHF. This therapy allows children to return to their home environment.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 1","pages":"Pages 17-21"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk Factors for Pericardiocentesis After Paediatric Cardiac Surgery

CJC Pediatric and Congenital Heart Disease

Pub Date : 2025-02-01 DOI: 10.1016/j.cjcpc.2024.10.009

Vikhashni Nagesh MD , Alyssa Chappell BScN , Jesse Batara MPH , Andrew S. Mackie MD, SM

Background

Pericardial effusions are common after paediatric cardiac surgery and can lead to cardiac tamponade in a small minority. However, it is difficult to predict which patients with an effusion will require pericardiocentesis. Therefore, among children with a postoperative effusion, we sought to identify risk factors for requiring pericardiocentesis.

Methods

We conducted a case-control study including paediatric patients who underwent cardiac surgery between January 1, 2005, and July 1, 2020, at the Stollery Children’s Hospital. Cases were defined as those who underwent pericardiocentesis within 2 months of cardiac surgery and were compared with controls who had an effusion but did not require pericardiocentesis. Controls were matched 2:1 to cases based on age and year of surgery.

Results

There were 42 cases and 84 controls. The median age at surgery was 3.0 years (interquartile range [IQR]: 0.5-6.4 years) among cases and 2.2 years (IQR: 0.4-5.8 years) among controls. The median weight at surgery was 13.5 kg (IQR: 6.4-18.0 kg) among cases and 13.5 kg (IQR: 4.9-23.1 kg) among controls. The use of anticoagulation or antiplatelet agents (odds ratio [OR]: 3.6, 95% confidence interval [CI]: 1.5-8.2, P < 0.01) in the postoperative period was independently associated with effusions requiring drainage. The use of prednisone postoperatively (OR: 3.3, 95% CI: 0.8-14.0, P = 0.10) and a history of previous pericardial effusion (OR: 4.7, 95% CI: 0.9-25.6, P = 0.08) were associated with a higher odds of pericardiocentesis but did not reach statistical significance.

Conclusions

The use of postoperative anticoagulation was independently associated with the need for pericardiocentesis. Type of surgical procedure was not associated with the need for drainage.

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引用次数: 0

Advance Care Planning for Adults With Moderate-to-Severe Congenital Heart Disease: Readiness Trial

CJC Pediatric and Congenital Heart Disease

Pub Date : 2024-12-01 DOI: 10.1016/j.cjcpc.2024.09.001

Jessica D. Jenkins BN, MN, NP , Kayla Poku BSc , Connor Hass , Michelle A.L. Kotelko BEd, BA , David Campbell MD, BSc , Michelle Keir MD, MSc

Background

Adults with congenital heart disease (CHD) are growing in number and living longer with complex lesions; however, many are at risk of death in midlife. Conversations about advance care planning (ACP) in this population have been found to be infrequent and not part of regular outpatient care. The intent of this study was to explore readiness of patients with adult CHD (ACHD) to discuss ACP and assess the impact of interventions to support ACP conversations.

Methods

We conducted a prospective, randomized, single-centre trial of adults with moderate to severe CHD. Simply, the control group was asked if they were ready to discuss their wishes if they were to become seriously ill. The intervention group was provided 2 additional resources with the readiness question, the modified Lyon Family-Centered ACP survey and a patient-partner created ACHD-ACP video.

Results

A total of 111 responses (control [n = 59] and intervention group [n = 52]) were collected for analysis. Women represented 59.0% of the participants. The mean age was 39.6 years (standard deviation = 14.8 years). No significant difference was found between the control and experimental groups’ readiness (94.9% and 90.4%, respectively). Most participants (92.8%) responded positively towards initiating conversations related to end-of-life and ACP discussions.

Conclusions

We found that adults with CHD are ready to have ACP conversations as part of their outpatient care. Patient preferences and values should guide ACP conversations; further research is needed to determine whether the modified Lyon Family-Centered ACP survey and ACHD-ACP video are helpful adjuncts for ACP in outpatient clinics.

{"title":"Advance Care Planning for Adults With Moderate-to-Severe Congenital Heart Disease: Readiness Trial","authors":"Jessica D. Jenkins BN, MN, NP , Kayla Poku BSc , Connor Hass , Michelle A.L. Kotelko BEd, BA , David Campbell MD, BSc , Michelle Keir MD, MSc","doi":"10.1016/j.cjcpc.2024.09.001","DOIUrl":"10.1016/j.cjcpc.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Adults with congenital heart disease (CHD) are growing in number and living longer with complex lesions; however, many are at risk of death in midlife. Conversations about advance care planning (ACP) in this population have been found to be infrequent and not part of regular outpatient care. The intent of this study was to explore readiness of patients with adult CHD (ACHD) to discuss ACP and assess the impact of interventions to support ACP conversations.</div></div><div><h3>Methods</h3><div>We conducted a prospective, randomized, single-centre trial of adults with moderate to severe CHD. Simply, the control group was asked if they were ready to discuss their wishes if they were to become seriously ill. The intervention group was provided 2 additional resources with the readiness question, the modified Lyon Family-Centered ACP survey and a patient-partner created ACHD-ACP video.</div></div><div><h3>Results</h3><div>A total of 111 responses (control [n = 59] and intervention group [n = 52]) were collected for analysis. Women represented 59.0% of the participants. The mean age was 39.6 years (standard deviation = 14.8 years). No significant difference was found between the control and experimental groups’ readiness (94.9% and 90.4%, respectively). Most participants (92.8%) responded positively towards initiating conversations related to end-of-life and ACP discussions.</div></div><div><h3>Conclusions</h3><div>We found that adults with CHD are ready to have ACP conversations as part of their outpatient care. Patient preferences and values should guide ACP conversations; further research is needed to determine whether the modified Lyon Family-Centered ACP survey and ACHD-ACP video are helpful adjuncts for ACP in outpatient clinics.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"3 6","pages":"Pages 256-264"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fostering Global Collaboration Around Kawasaki Disease. Reflections From the 14th International Kawasaki Disease Symposium

CJC Pediatric and Congenital Heart Disease

Pub Date : 2024-12-01 DOI: 10.1016/j.cjcpc.2024.10.004

Adriana H. Tremoulet MD, MAS , Nagib Dahdah MD, MBA, FRCPC

引用次数: 0

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