Machine Learning to Predict Interstage Mortality Following Single Ventricle Palliation: A NPC-QIC Database Analysis
This study aimed to leverage advanced machine learning algorithms to optimize risk-prediction models and identify features most predictive of interstage mortality. This study utilized retrospective data from the National Pediatric Cardiology Quality Improvement Collaborative and included all patients who underwent stage I palliation and survived to hospital discharge (2008 –2019). Multiple machine learning models were evaluated, including logistic regression, random forest, gradient boosting trees, extreme gradient boost trees, and light gradient boosting machines. A total of 3267 patients were included with 208 (6.4%) i...
Source: Pediatric Cardiology - June 27, 2023 Category: Cardiology Source Type: research
Safety and Short-Term Outcomes for Infants & lt; 2.5 kg Undergoing PDA Device Closure: A C3PO Registry Study
AbstractTo evaluate short-term procedural outcomes and safety for infants < 2.5 kg who underwent catheterization with intended patent ductus arteriosus (PDA) device closure in a multi-center registry, as performance of this procedure becomes widespread. A multi-center retrospective review was performed using data from the Congenital Cardiac Catheterization Project on Ou tcomes (C3PO) registry. Data were collected for all intended cases of PDA closure in infants < 2.5 kg from April 2019 to December 2020 at 13 participating sites. Successful device closure was defined as device placement at the conclusion ...
Source: Pediatric Cardiology - June 27, 2023 Category: Cardiology Source Type: research
Automatic Segmentation of the Fetus in 3D Magnetic Resonance Images Using Deep Learning: Accurate and Fast Fetal Volume Quantification for Clinical Use
This study also illustrates the confounding effects of fetal weight on absolute blood flow, and emphasizes the benefit of indexed measurements for physiological assessment. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 27, 2023 Category: Cardiology Source Type: research
Medium-term Outcome of Prenatally Diagnosed Hypoplastic Left-Heart Syndrome and Impact of a Restrictive Atrial Septum Diagnosed in-utero
Conclusion: Medium-term outcomes of prenatally diagnosed HLHS have improved however it should be noted that almost 40% do not get to surgical palliation, which is vital to those doing fetal counselling. There remains significant mortality particularly in fetuses with in-utero diagnosed RAS. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 27, 2023 Category: Cardiology Source Type: research
Risk of in-hospital Deterioration for Children with Single Ventricle Physiology
AbstractChildren with single ventricle physiology (SV) are at high risk of in-hospital morbidity and mortality. Identifying children at risk for deterioration may allow for earlier escalation of care and subsequently decreased mortality.We conducted a retrospective chart review of all admissions to the pediatric cardiology non-ICU service from 2014 to 2018 for children < 18 years old. We defined clinical deterioration as unplanned transfer to the ICU or inpatient mortality. We selected children with SV by diagnosis codes and defined infants as children < 1 year old. We compared demographic, vital sign, and...
Source: Pediatric Cardiology - June 27, 2023 Category: Cardiology Source Type: research
Fetal Echocardiographic Variables Associated with Pre-Surgical Mortality in Truncus Arteriosus: A Pilot Study
AbstractTruncus arteriosus (TA) is a rare congenital heart defect that can be prenatally detected by fetal echocardiography. However, prognostication and prenatal counseling focus primarily on surgical outcomes due to limited fetal and neonatal pre-surgical mortality data. We aimed to describe the incidence and identify predictors of pre-surgical mortality in prenatally detected TA. This two-center, retrospective cohort study included fetuses diagnosed with TA between 01/2010 and 04/2020. The primary outcome was pre-surgical mortality, defined by fetal or neonatal pre-surgical death or primary listing for transplantation p...
Source: Pediatric Cardiology - June 27, 2023 Category: Cardiology Source Type: research
Retrograde Pulmonary Valve Perforation and Stenting through a Major Aorto-Pulmonary Collateral Artery
We present a unique case of retrograde pulmonary valve perforation and stenting of the right ventricular outflow tract through a major aorto-pulmonary collateral artery. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 27, 2023 Category: Cardiology Source Type: research
Utility of Screening Fetal Echocardiograms at a Single Institution Following Normal Obstetric Ultrasound in Fetuses with Down Syndrome
AbstractFetal echocardiograms (F-echo) are recommended in all pregnancies when the fetus has Down syndrome (DS) even if there was a prior obstetric scan (OB-scan) that was normal. The utility of a screening F-echo in this high-risk population when an OB-scan is normal is unknown. Goal of this study was to evaluate if any diagnosis of a critical congenital heart disease (CHD) was missed in a fetus with DS who had a normal OB-scan. Secondary goal was to determine if any CHD was missed postnatally when an OB-scan was read as normal. Retrospective chart review of all fetuses that had a F-echo whose indication was DS between 1/...
Source: Pediatric Cardiology - June 23, 2023 Category: Cardiology Source Type: research
Pilot Project: Heart Chargers —A Successful Model for a Home-Based Physical Activity Program Utilizing Telemedicine for Fontan Patients
AbstractFontan patients have decreased exercise capacity which further declines throughout adolescence. A positive exercise capacity trajectory in children predicts better adult Fontan outcomes. Hospital-based physical activity programs improve exercise capacity and attenuate the age-expected decline in Fontan patients. The purpose of this project was to investigate the feasibility and safety of a partially reimbursable 12-month, home-based, individualized physical activity program (Heart Chargers) for Fontan patients utilizing telemedicine. The Heart Chargers team included a cardiologist, nurse coordinator, and exercise p...
Source: Pediatric Cardiology - June 22, 2023 Category: Cardiology Source Type: research
Correction to: Fetal Tricuspid Valve Agenesis/Atresia: Testing Predictions of the Embryonic Etiology
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 20, 2023 Category: Cardiology Source Type: research
Evaluating How Physician Attitudes May Affect Practice in Fetal Cardiac Counseling
AbstractAdvances in fetal cardiac imaging over the last few decades have allowed for increased prenatal detection and detailed counseling of congenital heart disease (CHD). When CHD is detected, fetal cardiologists are faced with the challenge of providing nuanced prenatal counseling. Studies in other specialties have shown that differences in physician attitudes exist around termination of pregnancy and correlate with variations in the counseling provided to parents. We conducted an anonymous cross-sectional survey of fetal cardiologists in New England (n = 36) regarding attitudes toward termination of pregnancy and t...
Source: Pediatric Cardiology - June 19, 2023 Category: Cardiology Source Type: research
Association Between Race/Ethnicity and Severity of Illness in Pediatric Cardiomyopathy and Myocarditis
Conclusion: Black patients have higher severity of illness on firs t admission to the ICU, which may reflect differences in access to care. Black patients are less likely to receive a heart transplant. Additionally, Black patients and those with unreported race/ethnicity had higher odds of CPR, which was not mediated by severity of illness, suggesting variations in care may persist after admission. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 17, 2023 Category: Cardiology Source Type: research
Cardiac Computed Tomographic Angiography Evaluation of Right Ventricle-Pulmonary Artery Conduits with Surgical Correlation
AbstractRight ventricle-pulmonary artery (RV-PA) conduits are used in the treatment of certain congenital heart disease (CHD). RV-PA conduit complications might develop over time and require intervention. To evaluate how well cardiac computed tomographic angiography (CCTA) performs compared to transthoracic echocardiography (TTE) in evaluating RV-PA conduit complications by using surgical findings as the reference standard. A retrospective chart review of all patients over a 5-year period who underwent CCTA for RV-PA conduit evaluation was performed. Patient demographics and clinical data were recorded. Preoperative CCTA a...
Source: Pediatric Cardiology - June 16, 2023 Category: Cardiology Source Type: research
Challenges in Accurate Diagnosis of HCC in FALD: A Case Series
We present 6 cases to demonstrate our center ’s experience and the challenges in diagnosing HCC within this patient population. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 15, 2023 Category: Cardiology Source Type: research
