A5017892536- Congenital Heart Disease Studies
- Cardiac Structural Anomalies and Repair
- Cardiac Valve Diseases and Treatments
- Pulmonary Hypertension Research and Treatments
- Cardiovascular Issues in Pregnancy
- Tracheal and airway disorders
- Cardiac, Anesthesia and Surgical Outcomes
- Vascular anomalies and interventions
- Cardiovascular and Diving-Related Complications
- Ultrasound in Clinical Applications
- Central Venous Catheters and Hemodialysis
- Cardiac Arrhythmias and Treatments
- Infective Endocarditis Diagnosis and Management
- Cardiovascular Effects of Exercise
- Cardiovascular Conditions and Treatments
- Radiation Dose and Imaging
- Vascular Procedures and Complications
- Aortic Disease and Treatment Approaches
- Coronary Artery Anomalies
- Mechanical Circulatory Support Devices
- Renal and Vascular Pathologies
- Acute Myocardial Infarction Research
- Healthcare Policy and Management
- Cardiac and Coronary Surgery Techniques
- Advanced X-ray and CT Imaging
Duke Medical Center
2013-2024
Duke University
2009-2024
Duke University Hospital
2013-2023
Duke University Health System
2023
St. Gregory's University
2012-2016
Duke Children's Hospital & Health Center
2014
University of Florida
2013
Medical University of South Carolina
2013
Vanderbilt University
2006-2010
Monroe Carell Jr. Children's Hospital
2010
Postoperative atrial fibrillation (AF), a frequent complication after cardiac surgery, causes morbidity and prolongs hospitalization. Inotropic drugs are commonly used perioperatively to support ventricular function. This study tested the hypothesis that use of inotropic is associated with postoperative AF.We evaluated perioperative risk factors in 232 patients who underwent elective surgery. All were sinus rhythm at Sixty-seven (28.9%) developed AF mean 2.9+/-2.1 days Patients stayed...
We sought to develop a scoring system that predicts the risk of serious adverse events (SAE's) for individual pediatric patients undergoing cardiac catheterization procedures.Systematic assessment SAE in can be challenging view wide variation procedure and patient complexity as well rapidly evolving technology.A 10 component was originally developed based on expert consensus review existing literature. Data from an international multi-institutional registry (CCISC) between 2008 2013 were...
Background— Recoarctation after the Norwood procedure increases risk for mortality. The Single Ventricle Reconstruction (SVR) trial randomized subjects with a single right ventricle undergoing to modified Blalock-Taussig shunt or ventricle–pulmonary artery shunt. We sought determine incidence of recoarctation, factors, and outcomes in SVR trial. Methods Results— was defined by intervention, either catheter based surgical. Univariate analysis multivariable Cox proportional hazard models were...
Determine sildenafil exposure and hemodynamic effect in children after Fontan single-ventricle surgery.
Objectives: To determine sildenafil exposure and hemodynamic effect in children after stage II single-ventricle surgery. Design: Prospective, dose escalation trial. Setting: Single-center, pediatric catheterization laboratory. Patients: Twelve poststage surgical palliation undergoing elective cardiac catheterization: median age 1.9 years (range, 0.8, 4.0), weight 11 kg (8, 13), nine females, 10 with a single right ventricle. Interventions: Catheterization echocardiography performed before...
Abstract Objectives Describe the use of three‐dimensional (3D) patent ductus arteriosus (PDA) modeling to better define ductal anatomy improve preprocedural planning for stent placement. Background Ductal stenting is an alternative surgical shunting in patients with dependent pulmonary blood flow. often complex extreme tortuosity and risk artery isolation, thus increasing procedural risks. Methods CT angiograms were segmented produce 3D PDA models. morphology was characterized attention...
Abstract Objectives To assess safety, efficacy, and intermediate term outcomes of percutaneous interventions in Mustard patients. Background Baffle leaks obstruction are present 20% survivors. Surgical reintervention is associated with high mortality. Methods Retrospective review performed at three adult congenital catheterization programs. Results Overall, 26 catheterizations 29 were 22 patients (mean age 32.4 ± 8.3 years). Previous laser pacemaker lead extraction was successful seven...
Abstract Objectives To externally validate the CRISP score, and determine if refinements might improve clinical utility. Background The score estimates risk of serious adverse events (SAEs) for pediatric catheterization. Methods Pediatric (age < 18) procedures reported to Congenital Cardiovascular Interventional Study Consortium registry from 05/08 09/17 ( n = 29,830, 27 centers) were divided into a development dataset 14,784 earlier procedures, validation 15,046 more recent procedures....
BACKGROUND: Covered stent correction for a sinus venosus atrial septal defect (SVASD) was first performed in 2009. This innovative approach initially viewed as experimental and reserved highly selected patients with unusual anatomic variants. In 2016, increasing numbers of procedures began to be performed, several centers, it is now offered standard care option alongside surgical repair. However, covered SVASD not recognized by regulatory authorities, the minds many pediatric adult...
Abstract Objectives To examine the effect of implementing postcatheterization ultrasound (US) on femoral arterial thrombosis detection rates and factors associated with in infants. Background Although is an uncommon complication cardiac catheterization, it can cause limb threatening complications. Previous studies assessing utility postprocedure US to detect infants have utilized as adjunct standard clinical methods, are small scale, or include cohorts within older populations. Methods We...
To present our experience with the Angiojet thrombectomy system for percutaneous in infants following cardiac surgery.Arterial and venous thrombosis after pediatric surgery is life threatening, particularly infants. The best method treating these patients has not been determined. rheolytic (Possis Medical, Minneapolis, MN) a of thrombus removal proven safety efficacy adults.We reviewed medical records angiograms all procedures which was used at institution during years 2005 through 2007.Ten...
Previous studies have identified risk factors for femoral arterial thrombosis after paediatric cardiac catheterisation, but none of them evaluated the clinical and economic significance this complication at population level. Therefore, we examined national prevalence impact catheterisation in children.Patients⩽18 years age who underwent were 2003-2009 Kids' Inpatient Database. Patients stratified by as follows: <1 year or 1-18 age. The primary outcome was lower extremity during same...
Objective: Many children with a congenital heart defect undergo surgical correction requiring cardiopulmonary bypass. One-sixth of these patients take an angiotensin-converting enzyme inhibitor for failure treatment. The effect inhibition on the fibrinolytic and inflammatory response in undergoing bypass is unknown. In adults, attenuates increase plasminogen activator inhibitor-1 after bypass, whereas interleukin-6 uncertain. This study tests hypothesis that preoperative postoperative...
A combination of low serum calcium (Ca), high phosphorus (P), and magnesium (Mg) has been observed in individual captive ruminants, primarily affecting kudu (Tragelaphus strepsiceros), eland (Taurotragus oryx), nyala angasii), bongo eurycerus), giraffe (Giraffa camelopardalis). These mineral abnormalities have associated with chronic laminitis, acute tetany, seizures, death. Underlying rumen disease secondary to feeding highly fermentable carbohydrates was suspected be contributing the...
Pulmonary embolism (PE) is a significant cause of morbidity and mortality among hospitalized patients, thrombolytics are the mainstay treatment. However, for patients who fail or have contraindications to thrombolytic therapy, catheter‐based therapies, such as AngioVac aspiration system, emerged an alternative surgical embolectomy. Here, we present novel case 22 year‐old woman with Fontan circulation developed severe postpartum cardiomyopathy saddle PE. She failed therapy but underwent...
To quantify the impact of image optimization on absorbed radiation dose and associated risk in children undergoing cardiac catheterization.Various imaging fluoroscopy system technical parameters including camera magnification, source-to-image distance, collimation, antiscatter grids, beam quality, pulse rates, all affect but have not been well studied younger children.We used anthropomorphic phantoms (ages: newborn 5 years old) to measure surface exposure from various approaches estimated...
Mycobacterium mucogenicum is an unusual cause of central venous catheter and wound infections in immunocompromised persons. The organism often found drinking water resistant to many disinfectants. We report a cord blood transplant recipient who developed infection after the patient herself had flushed her with tap water. was successfully treated by removal administration antimicrobial therapy.
The use of systemic-to-pulmonary shunts (SPS) in neonates with single ventricle heart defects and ductal-dependent pulmonary blood flow (ddPBF) was historically associated high morbidity mortality at our center. As a result, we transitioned to the preferential ductus arteriosus stents (DS) when feasible. This report describes initial results this strategy.A single-center study patients that received DS or SPS from 2015 2019 performed assess whether decreased in-hospital increased survival...