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  • Cambridge University Press (CUP)  (4)
  • Vetter, Victoria L.  (4)
  • 1
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    Online Resource
    Somatic growth failure after the Fontan operation
    Cambridge University Press (CUP) ; 2000
    In:  Cardiology in the Young Vol. 10, No. 5 ( 2000-09), p. 447-457
    Details
    In: Cardiology in the Young, Cambridge University Press (CUP), Vol. 10, No. 5 ( 2000-09), p. 447-457
    Abstract: Our study was designed to characterize the patterns of growth, in the medium term, of children with functionally univentricular hearts managed with a hemi-Fontan procedure in infancy, followed by a modified Fontan operation in early childhood. Failure of growth is common in patients with congenital cardiac malformations, and may be related to congestive heart failure and hypoxia. Repair of simple lesions appears to reverse the retardation in growth. Palliation of the functionally single ventricular physiology with a staged Fontan operation reduces the adverse effects of hypoxemia and prolonged ventricular volume overload. The impact of this approach on somatic growth is unknown. Retrospectively, we reviewed the parameters of growth of all children with functionally univentricular hearts followed primarily at our institution who had completed a staged construction of the Fontan circulation between January 1990 and December 1995. Measurements were available on all children prior to surgery, and annually for three years following the Fontan operation. Data was obtained on siblings and parents for comparative purposes. The criterions of eligibility for inclusion were satisfied by 65 patients. The mean Z score for weight was-1·5± 1·2 at the time of the hemi-Fontan operation. Weight improved by the time of completion of the Fontan circulation (−0·91 ±0·99), and for the first two years following the Fontan operation, but never normalized. The mean Z scores for height at the hemi-Fontan and Fontan operations were −0·67 ±1·1 and −0·89±1·2 respectively. At most recent follow-up, with a mean age of 6·1 ± 1·3 years, and a mean time from the Fontan operation of 4·4±1·4 years, the mean Z score for height was −1·15 ±1·2, and was significantly less than comparable Z scores for parents and siblings. In our experience, children with functionally univentricular hearts who have been palliated with a Fontan operation are significantly underweight and shorter than the general population and their siblings
    Type of Medium: Online Resource
    ISSN: 1047-9511 , 1467-1107
    URL: Article
    DOI: 10.1017/S1047951100008118
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2000
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  • 2
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    Report from the Task Force of the European Society of Cardiology for the interpretation of the neonatal electrocardiogram
    Cambridge University Press (CUP) ; 2002
    In:  Cardiology in the Young Vol. 12, No. 6 ( 2002-12), p. 592-608
    Details
    In: Cardiology in the Young, Cambridge University Press (CUP), Vol. 12, No. 6 ( 2002-12), p. 592-608
    Abstract: The prevention of unexpected cardiac events in the young remains elusive. Among them, some are lethal. Early identification of life-threatening arrhythmogenic disorders which often manifest in infancy, childhood or even later, may allow initiation of effective preventive therapies. A large prospective study has indicated that some infants with prolongation of the QT interval in the first week of life died suddenly, and would have previously been labelled as victims of the sudden infant death syndrome. Furthermore, in infants with this diagnosis, post-mortem molecular screening has revealed the presence of the long QT syndrome. As an evolution of this background, some European countries have begun to consider the possibility of introducing in their National Health Services the performance of an electrocardiogram during the first month of life in all newborns, as part of a programme for cardiovascular screening. Most adult cardiologists, however, have no or minimal experience with electrocardiograms recorded in infants. Accordingly, the European Society of Cardiology has instituted a Task Force with the objective of creating guidelines for the interpretation of the neonatal electrocardiogram, focusing on the most clinically relevant abnormalities and on the ensuing options for management and referral. The main objective of the present document is to provide adult cardiologists with a practical approach to neonatal electrocardiography, and paediatricians and neonatologists with a tool that should facilitate medical interaction on cardiologic issues. There are important differences between neonatal and adult electrocardiograms. When a cardiologist examines the electrocardiogram of an apparently normal and healthy infant, the focus has to be on distinguishing between patterns that should cause no alarm, and those that require action or additional investigations. To provide clues for this distinction has been the main objective of the members of this Task Force. Whenever possible or appropriate, we have also suggested steps in management.
    Type of Medium: Online Resource
    ISSN: 1047-9511 , 1467-1107
    URL: Article
    DOI: 10.1017/S1047951102001087
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2002
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  • 3
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    Ventricular tachycardia in infants with structurally normal heart: a benign disorder
    Cambridge University Press (CUP) ; 2010
    In:  Cardiology in the Young Vol. 20, No. 06 ( 2010-12), p. 641-647
    Details
    In: Cardiology in the Young, Cambridge University Press (CUP), Vol. 20, No. 06 ( 2010-12), p. 641-647
    Type of Medium: Online Resource
    ISSN: 1047-9511 , 1467-1107
    URL: Article
    DOI: 10.1017/S1047951110000867
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2010
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  • 4
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    Functional health status in children and adolescents after Fontan: comparison of generic and disease-specific assessments
    Cambridge University Press (CUP) ; 2014
    In:  Cardiology in the Young Vol. 24, No. 3 ( 2014-06), p. 469-477
    Details
    In: Cardiology in the Young, Cambridge University Press (CUP), Vol. 24, No. 3 ( 2014-06), p. 469-477
    Abstract: Purpose: The aim of this study was to compare associations between generic versus disease-specific functional health status assessments and patient and clinical characteristics for patients with severe congenital heart disease. Methods: This was a cross-sectional observational study involving 325 single ventricle patients, aged 10–18 years, after Fontan procedure. Enrolled patients underwent a medical history review, laboratory testing, and assessment of the functional health status by completion of the generic Child Report Child Health Questionnaire and the disease-specific Congenital Heart Adolescent and Teenage questionnaire. Correlated conceptually equivalent domains from both questionnaires were identified and their associations with patient and clinical variables were compared. Results: From the generic assessment, patients perceived marginally lower physical functioning (p = 0.05) but greater freedom from bodily pain compared with a normal population (p 〈 0.001). The equivalent physical functioning/limitations domain of the generic instrument, compared with the disease-specific instrument, had similar associations (higher multi-variable model R 2 ) with medical history variables (R 2 = 0.14 versus R 2 = 0.12, respectively) and stronger associations with exercise testing variables (R 2 = 0.22 versus R 2 = 0.06). Similarly, the corresponding freedom from bodily pain/symptoms domains from both questionnaires showed a greater association for the generic instrument with medical history variables (R 2 = 0.15 versus R 2 = 0.09, respectively) and non-cardiac conditions (R 2 = 0.13 versus R 2 = 0.06). The associations of each questionnaire with echocardiographic results, cardiac magnetic resonance imaging results, and serum brain natriuretic peptide levels were uniformly weak (R 2 range 〈 0.01 to 0.04). Conclusions: Assessment of the physical functional health status using generic and disease-specific instruments yields few differences with regard to associations between conceptually similar domains and patient and clinical characteristics for adolescents after Fontan procedure.
    Type of Medium: Online Resource
    ISSN: 1047-9511 , 1467-1107
    URL: Article
    DOI: 10.1017/S1047951113000632
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2014
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