Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Background: Children from mothers with Systemic Lupus Erythematosus are frequently born with congenital heart block. This study aimed at evaluating long-term outcome because long-term data are scarce. Methods: In the database pediatric and congenital heart disease (University Hospitals Leuven), 19 children from Systemic Lupus Erythematosus mothers and who were born with or developed atrio-ventricular block were identified. All records were reviewed for disease course and outcome. Results: Median follow up time was 7 years (IQR 4.5-13 years). One child had no heart block at birth and developed only a first-degree block during follow-up. One had a second-degree heart block and developed a complete heart block. Seventeen patients (89%) were born with a complete heart block. Seventeen patients (89%) needed a definitive pacemaker. In all, epicardial leads were used at first implantation. Eighty-two percent received their pacemaker in the first year of life. The first battery had a median lifetime of 5 years (IQR 3.5-5 years), the second 6 years (IQR 4.5-6.3 years) and the third 5 years (IQR 5-6 years). 47% of patients needed a lead replacement due to lead problems. Only one pericardial tamponade after pacemaker implantation. No device or lead infections occurred. The left ventricular systolic function at latest follow-up was normal for all. No patients died. Conclusion: In children with heart block born from Systemic Lupus Erythematosus mothers, an early need for pacemaker implantation was documented. The overall battery life was acceptable, but there was a high need for lead replacement. Complication rate was low. Late outcome was good.

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Background: The bidirectional Glenn procedure (BDG) as a final palliation in patients with congenital heart disease (CHD) is present in patients with an anatomical/functional single ventricle, who were unsuited to progress further to a Fontan circulation and in patients with a biventricular circulation to off-load the subpulmonary ventricle. Methods: We performed a retrospective study on all the patients of the Pediatric and Adult Congenital Heart Disease of the University Hospitals Leuven database who underwent BDG as their final palliation before May 2018. Patients who underwent total cavopulmonary connection (TCPC) or were scheduled for TCPC were excluded. We stratified patients according to intention to treat (biventricular repair-BR or univentricular repair (UVR) and final type of circulation (UV-Glenn vs one-and-a-half repair (OAHR)). Results: Of 66 patients identified, there were 18 patients originally aimed for complete BR but eventually required a BDG and 48 patients originally aimed for UVR. In the BR-group, 2/18 died whereas 23/48 died in the UVR-group with 88% of deaths occurring within the first year. In the BR-group, 4/18 had UV-Glenn and 11/18 OAHR. In the UVR-group, 16/48 had UV-Glenn and 8/48 OAHR. In the UVR-group, the Norwood procedure (HR5.53,95%CI2.29-13.3;p<0.001), a retrograde shunt (HR2.4,95%CI1.03-5.56;p=0.042), or the absence of anterograde flow (HR4.64,95%CI1.89-11.4;p=0.001) before BDG, ECMO HR3.63-95%CI1.21-11.08;p=0.022) and post-operative complications (HR514,95%CI1.94-13.63;p=0.001) were negatively associated with mortality in this second group, while higher systemic saturations before BDG ((HR0,95,95% CI0.90-0.95;p=0.047) and age >1 year at the time of BDG (HR0.42, 95%CI0.23-0.77;p=0.005) were positively associated with mortality. Conclusion: The Glenn-only group is a heterogenous population. In patients undergoing a BDG as a final palliation mortality is high in the first year after the procedure, but survival appears good thereafter. In our series survival was better if the initial intention to treat was BR rather than UVR. Furthermore, Norwood procedure, shunting before BDG, absence of anterograde flow, post-operative complications, saturations before Glenn and age at the time of the BDG were identified as predictors for survival in the UVR group

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Aims: Because of the detrimental effects of pulmonary regurgitation after repair with a transannular patch (TAP) in patient with tetralogy of fallot, our clinical practice is changing to perform earlier pulmonary valve replacement. Our objective was to determine whether the incidence of death and VT is reduced by earlier PVR and to examine if this approach results in more complications of PVR. Methods and results: Out of a single-center cohort of 280 TOF patients repaired with a TAP, 106 patients underwent PVR before the age of 16 years, 47 patient after the age of 16 years and in 126 patients no PVR was performed. Overall survival was 93% after a mean follow-up of 22 (±14) years. Survival in patients with previous PVR is significantly better than in patients without (P = 0.033). Early PVR (< 16 years) is associated with higher survival-rates (P = 0.027), but suffer form significant more complications (P < 0.001). Conclusion: Early PVR reduced over-all mortality compared with late or no PVR, this survival benefit is accompanied by higher rates of complications.