Searching for modifiable risk factors for neurodevelopment in congenital heart disease: Lessons from the Giessen/Zurich hypoplastic left heart syndrome experience

In 1980, William Norwood described the survival of three patients with hypoplastic left heart syndrome (HLHS), who had undergone palliative surgery comprising the creation of a conduit from the right ventricle to the descending aorta and banding of the main pulmonary artery [1]. Eight years later, Norwood reported a cohort of 104 consecutive HLHS patients treated with pulmonary artery homograft augmentation of the ascending aorta and aortic arch and a modified right Blalock-Taussig shunt in which there were 30 early and 11 late deaths [2].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research

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Publication date: Available online 10 October 2019Source: Canadian Journal of CardiologyAuthor(s): Marie-A. Chaix, Michael A. Gatzoulis, Gerhard-Paul Diller, Paul Khairy, Erwin N. OechslinAbstractEisenmenger syndrome is the most severe and extreme phenotype of pulmonary arterial hypertension associated with congenital heart disease. A large non-restrictive systemic left-to-right shunt triggers the development of pulmonary vascular disease, progressive pulmonary arterial hypertension and increasing pulmonary vascular resistance at the systemic level, which ultimately results in shunt reversal. Herein, we review the changing...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
CONCLUSIONS: While a majority of pediatric cardiothoracic surgeons are familiar with palliative care, there is variation in perception of appropriate timing of consultation. Significant barriers to consultation still exist, including concern that parents will think they are "giving" up, undermining parental hope, and influence of palliative care on the medical care team's approach. PMID: 31597507 [PubMed - as supplied by publisher]
Source: Journal of Palliative Care - Category: Palliative Care Tags: J Palliat Care Source Type: research
Purpose of review Advanced heart failure in children is characterized by dynamic clinical trajectories, uncertainty of prognosis, and intermittent need for difficult decision-making, often related to novel therapeutic interventions with uncertain impact on quality of life. This review will examine the current role of palliative care to support this unique population. Recent findings Pediatric heart failure patients commonly die in ICUs with high burden of invasive therapies together with end of life care needs. In addition, several studies advocate for integration of palliative care early in disease trajectory, not on...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: CARDIOVASCULAR MEDICINE: Edited by Daniel Bernstein Source Type: research
Journal of Perinatology, Published online: 05 September 2019; doi:10.1038/s41372-019-0490-yEarly palliative care reduces stress in parents of neonates with congenital heart disease: validation of the “Baby, Attachment, Comfort Interventions”
Source: Journal of Perinatology - Category: Perinatology & Neonatology Authors: Source Type: research
Little is known about advance care planning (ACP) and palliative care needs among adults with congenital heart disease (ACHD).
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Little is known about advance care planning (ACP) and palliative care needs among adults with congenital heart disease (ACHD).
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: Special Series: Science in Action: Evidence and Opportunities for Palliative Care Across Diverse Populations and Care Settings Source Type: research
Integration of palliative care (PC) into management of patients with advanced heart disease (AHD) improves quality of life and is endorsed by consensus guidelines. Because of the limited availability of specialty PC providers, equipping cardiologists with communication skills for serious illness conversations is paramount to ensuring access to PC for all patients with AHD. Surveys have shown that fellows in training are frequently involved in late goals of care conversations with AHD patients, yet few receive training in communication skills.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 400 Source Type: research
ConclusionsNeonatal heart transplantation remains a durable therapy with very acceptable long-term survival. Children transplanted in the newborn period have the potential to reach adulthood with minimal need for re-intervention.Graphical abstract
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: Available online 26 July 2019Source: Canadian Journal of CardiologyAuthor(s): David S. Crossland, Alexander Van De Bruaene, Candice K. Silversides, Edward J. Hickey, S. Lucy RocheAbstractThere is mounting recognition that some of the most urgent problems of adult congenital heart disease (ACHD) are the prevention, diagnosis and management of heart failure (HF). Recent expert consensus and position statements emphasise a specific and pressing need to tackle HF in ACHD (ACHD-HF) but also highlight the difficulty of doing so given a current sparsity of data. Some of the challenges will be addressed by this r...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Dr M. Jacobs (Baltimore, Md). Dr Brink and colleagues in Melbourne have reported on associations among acute postoperative events, shunt failure associated with acute events, and mortality after palliative shunt procedures in patients with univentricular cardiac anomalies. This is certainly an important topic. The spectrum of functionally univentricular hearts represents a large and challenging segment of the overall congenital heart disease population, and their management involves arguably the largest fraction of human and institutional resources.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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