A5054597319- Congenital Heart Disease Studies
- Cardiac Valve Diseases and Treatments
- Pulmonary Hypertension Research and Treatments
- Cardiac Structural Anomalies and Repair
- Coronary Artery Anomalies
- Cardiovascular Issues in Pregnancy
- Cardiac Arrhythmias and Treatments
- Cardiovascular Function and Risk Factors
- Advanced MRI Techniques and Applications
- Infective Endocarditis Diagnosis and Management
- Atrial Fibrillation Management and Outcomes
- Cardiovascular Effects of Exercise
- Aortic Disease and Treatment Approaches
- Cardiac pacing and defibrillation studies
- Cardiovascular and Diving-Related Complications
- Heart Rate Variability and Autonomic Control
- Cardiac Imaging and Diagnostics
- Cardiovascular and exercise physiology
- Vascular anomalies and interventions
- Cardiovascular Conditions and Treatments
- Tracheal and airway disorders
- Cardiomyopathy and Myosin Studies
- Cardiac electrophysiology and arrhythmias
- Pericarditis and Cardiac Tamponade
- Vascular Anomalies and Treatments
King's College London
2017-2025
Guy's and St Thomas' NHS Foundation Trust
2016-2025
St Thomas' Hospital
2017-2024
Royal Brompton Hospital
2023
Great Ormond Street Hospital
2007-2020
University College London
2004-2020
National Health Service
2020
Evelina London Children's Healthcare
2020
King's College - North Carolina
2020
University College Hospital at Westmoreland Street
2004-2013
Background— The timing of pulmonary valve replacement (PVR) for free incompetence in patients with congenital heart disease remains a dilemma clinicians. We wanted to assess the determinants improvement after PVR regurgitation over wide range patient ages and use any identified predictors compare clinical outcomes between groups. Methods Results— Seventy-one (mean age 22±11 years; range, 8.5 64.9; 72% tetralogy Fallot) underwent severe regurgitation. New York Heart Association class improved...
Evaluation of right ventricular (RV) function in patients with pulmonary regurgitation (PR) after tetralogy repair remains challenging because abnormal RV loading conditions.We examined 124 patients, aged 21+/-11.4 years, who had at 3.7+/-3.5 years. By Doppler echocardiography, 33 mild, 22 moderate, and 69 severe PR; 55 significant tricuspid (TR). Myocardial velocities, myocardial acceleration during isovolumic contraction (IVA), strain, strain rate were measured LV base. Tricuspid valve...
<h3>Objective</h3> To evaluate the scale and clinical importance of loss to follow-up past patients with serious congenital heart disease, using a common malformation as an example. better understand antecedents specialist patients' attitudes returning. <h3>Design</h3> Cohort study NHS number functionality. Content thematic analysis telephone interviews subset contacted after follow-up. <h3>Patients, intervention setting</h3> Longitudinal complete consecutive list all 1085 UK repair...
Advances in the diagnosis and management of congenital heart disease have led to a marked improvement survival adult with (ACHD) patients. However, ACHD patients are heterogeneous population, large spectrum anatomic substrates even within specific lesions. In addition, nature previous surgery other intervention is highly variable rendering each patient unique residual haemodynamic abnormalities very common. As population continues age, acquired will also require cardiac imaging assessment....
Pulmonary valve replacement (PVR) after repair of tetralogy Fallot is commonly required and burdensome. Detailed anatomic physiologic characteristics survivors free from late PVR with good exercise capacity are not well described in a literature focusing on the indications for PVR.Survival freedom were tracked 1085 consecutive patients receiving standard single institution 1964 to 2009. Of 152 total deaths, 100 occurred within first postoperative year. Surviving between 10 50 years age had...
Main pulmonary artery (mPA) dilatation has been reported in patients with isolated valve (PV) stenosis. The aim of our study was to detect the incidence mPA and aneurysm PV stenosis association function. In this single-centre retrospective observational all a diagnosis referred centre were enrolled. Patients divided into two groups (children adults) according age. Echocardiography, cardiac magnetic resonance imaging (MRI) computed tomography (CT) reviewed. MPA defined as ≥2 Z-Score children...
Objective: Percutaneous pulmonary valve insertion (PPVI) is an evolving alternative to surgical insertion. The aim of this study review the acute complications PPVI requiring emergency rescue surgery. Patients and methods: Between 09/2000 01/2007, 152 patients (pts), received a PPVI. Patient's charts were reviewed in retrospect. Results: Emergency surgery (ERS) took place 6 pts (3.9%). Indications for ERS were: homograft rupture two pts, dislodgment stented dilated right ventricular outflow...
Background: Pulmonary regurgitation after tetralogy of Fallot (ToF) repair is associated with right ventricular dilatation, failure and arrhythmia. Timing technique for re-intervention remain controversial. Methods: Our recent approach to reconstruct the dilated ventricle outflow tract (RVOT) as a fibro-muscular sleeve support pulmonary homograft valve conduit in orthotopic position. Indication based on clinical magnetic resonance (MR) criteria. We reviewed all patients who underwent RVOT...
Objective: To evaluate the effects on ventricular function and volumes following right outflow tract reconstruction (RVOTR) with pulmonary homograft replacement (PVR) percutaneous valve implantation (PPVI) for predominant regurgitation. This study was not intended to compare two approaches. Methods: We prospectively examined 25 patients (mean age 21 ± 13 years, 96% tetralogy of Fallot, 1/25 conduit dysfunction) who had PVR RVOTR severe regurgitation (PR), 11 20 9 64% 9/11 underwent PPVI PR....
To assess the clinical performance of three-dimensional, free-breathing, Magnetization Transfer Contrast Bright-and-black blOOd phase-SensiTive (MTC-BOOST) sequence in adult congenital heart disease (ACHD).In this prospective study, participants with ACHD undergoing cardiac MRI between July 2020 and March 2021 were scanned T2-prepared balanced steady-state free precession proposed MTC-BOOST sequence. Four cardiologists scored their diagnostic confidence on a four-point Likert scale for...
Abstract OBJECTIVES Anomalous aortic origin of a coronary artery (AAOCA) is group rare congenital heart defects with various clinical presentations. The lifetime-risk an individual living AAOCA unknown, and data from multicentre registries are urgently needed to adapt current recommendations guide optimal patient management. European Registry (EURO-AAOCA) aims assess differences regard management between centres. METHODS EURO-AAOCA prospective, registry including 13 Herein, we evaluated in...
AimsTo prospectively evaluate homograft function with cardiac magnetic resonance (CMR) imaging 1 year after insertion into the pulmonary position, and to assess impact of in situ geometry, surgical factors, 'intrinsic' properties on early valve incompetence.
AimsWe aimed to assess the impact of surgical pulmonary valve replacement (PVR) for severe regurgitation (PR) on biventricular function and its effect exercise capacity.
Abstract Introduction Patients with repaired tetralogy of Fallot have good long-term survival but less is known about the subjectively assessed quality life or objectively measured functional status those who not required subsequent pulmonary valve replacement. We these parameters in a group children and adults free from replacement after repair. Methods results A random sample 50 subjects – 16 34 adults, aged 4.1–56.7 years had undergone repair were underwent cardiopulmonary exercise...
In 2018, the position paper 'Imaging adult with congenital heart disease: a multimodality imaging approach' was published. The highlights, in first part, different modalities applied disease patients. second these are discussed more detailed for moderate to complex anatomical defects. Because of length paper, simple lesions were not touched on. However, use shunt still poorly known. One is looking structured recommendations on which they can rely when dealing an (undiscovered) lesion. This...
Background Tetralogy of Fallot is a congenital heart disease that requires surgical repair without which survival through childhood extremely rare. The aim this paper to use data from the mandatory follow-up patients with model health-related costs and outcomes over first 55-years life. Method A decision analytical was developed establish for up 55 years after diagnosis compared natural progression. Data Adult Congenital Heart Disease (ACHD) centres follow Great Ormond Street Hospital...
The right ventricle (RV) is often overlooked in the evaluation of cardiac performance and treatment left ventricular (LV) heart diseases. However, recent evidence suggests RV may play an important role maintaining systemic function delivering stroke volume (SV). We used exercise magnetic resonance biomechanical modeling to investigate LV regulation. studied SV augmentation during by pharmacologically inducing negative chronotropy (sHRi) healthy volunteers investigating training-induced...
Abstract Aims Atrial septal defects (ASD) are associated with atrial arrhythmias, but the arrhythmia substrate in these patients is poorly defined. We hypothesized that bi-atrial fibrosis present and right arrhythmias ASD patients. aimed to evaluate extent of investigate relationships between fibrosis, shunt fraction, age. Methods results Patients uncorrected secundum ASDs (n = 36; 50.4 ± 13.6 years) underwent cardiac magnetic resonance imaging late gadolinium enhancement. Comparison was...