Medicine and Health Sciences Commons^™

Cardiac Manifestations And Outcomes Of Covid-19 Vaccine-Associated Myocarditis In The Young In The Usa: Longitudinal Results From The Myocarditis After Covid Vaccination (Maciv) Multicenter Study., Supriya S. Jain, Steven A. Anderson, Jeremy M. Steele, Hunter C. Wilson, Juan Carlos Muniz, Jonathan H. Soslow, Rebecca S. Beroukhim, Victoria Maksymiuk, Xander Jacquemyn, Olivia H. Frosch, Brian Fonseca, Ashraf S. Harahsheh, Sujatha Buddhe, Ravi C. Ashwath, Deepika Thacker, Shiraz A. Maskatia, Nilanjana Misra, Jennifer A. Su, Saira Siddiqui, Danish Vaiyani, Aswathy K. Vaikom-House, M Jay Campbell, Jared Klein, Sihong Huang, Christopher Mathis, Matthew D. Cornicelli, Madhu Sharma, Lakshmi Nagaraju, Jocelyn Y. Ang, Santosh C. Uppu, Preeti Ramachandran, Jyoti K. Patel, Frank Han, Jason G. Mandell, Jyothsna Akam-Venkata, Michael P. Dilorenzo, Michael Brumund, Puneet Bhatla, Parham Eshtehardi, Karina Mehta, Katherine Glover, Matthew L. Dove, Khalifah A. Aldawsari, Anupam Kumar, Spencer B. Barfuss, Adam L. Dorfman, Prashant K. Minocha, Alexandra B. Yonts, Jenna Schauer, Andrew L. Cheng, Joshua D. Robinson, Zachary Powell, Shubhika Srivastava, Anjali Chelliah, Yamuna Sanil, Lazaro E. Hernandez, Lasya Gaur, Michael Antonchak, Marla Johnston, Jonathan D. Reich, Narayan Nair, Elizabeth D. Drugge, Lars Grosse-Wortmann

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: We aimed to study the clinical characteristics, myocardial injury, and longitudinal outcomes of COVID-19 vaccine-associated myocarditis (C-VAM).

METHODS: In this longitudinal retrospective observational cohort multicenter study across 38 hospitals in the United States, 333 patients with C-VAM were compared with 100 patients with multisystem inflammatory syndrome in children (MIS-C). We included patients ≤30 years of age with a clinical diagnosis of acute myocarditis after COVID-19 vaccination based on clinical presentation, abnormal biomarkers and/or cardiovascular imaging findings. Demographics, past medical history, hospital course, biochemistry results, cardiovascular imaging, and follow-up information from April 2021 to November 2022 were collected. The primary …

Post-Operative Diagnosis Of Anomalous Left Coronary Artery From The Right Pulmonary Artery Via Transthoracic Echocardiogram, Lavina Desai, Sanket Shah, Edo Bedzra, Christopher Mathis

Posters

A term infant female was diagnosed with a ventricular septal defect (VSD) and aortic coarctation. Preoperative echocardiography and computed tomography angiography (CTA) showed a normal right coronary artery origin, but inconclusive left coronary artery (LCA) origin. There was a normal flow profile in the LCA by echocardiography. She underwent repair with extended end-to-end anastomosis and VSD closure during which surgical inspection revealed a usual appearing, retro pulmonary path of the LCA towards the left sinus of Valsalva. Postoperative echocardiogram revealed mild global dysfunction but no regional wall motion abnormalities.   Repeat echocardiogram revealed severe dysfunction most prominent in the anterolateral and …

Double Aortic Arch With Atresia Of The Left Aortic Arch Proximal To The Left Common Carotid Artery In A Patient With Phace Syndrome – A Management Conundrum, Mohamed Aashiq Abdul Ghayum, Anmol Goyal, Aliessa P. Barnes, Sanket Shah

Research Days

Background Cardiac anomalies in PHACE syndrome (P: posterior fossa anomalies, H: hemangiomas, A: arterial lesions, C: cardiac abnormalities, E: abnormalities of the eye) often consists of complex aortic arch anomalies with double aortic arch (DAA) being an uncommon association. Atresia of the proximal segment of the left arch in DAA is extremely rare and can pose a diagnostic and management conundrum due to formation of a loose vascular ring and asymptomatic nature as seen in our case.

Case Description A 5-year-old male, diagnosed with PHACE syndrome, at a different center was noted to have an incidental finding on head imaging …

Rare Complications Associated With Use Of Bovine Pericardium, Mohamed Aashiq Abdul Ghayum, Nitin Madan, William J. Gibson, Sanket Shah

Research Days

Background

Bovine Pericardium (BP), with numerous and improving preparation techniques, has been used extensively for over 50 years in repair of simple and complex congenital heart defects. It has several advantages over other surgical materials. However, there is a paucity of data in the pediatric population regarding complications associated with BP. Herein, we report two rare complications noted with BP use.

Case Description

Case 1. A 14-month-old male, with trisomy 21 and complete Atrioventricular canal defect, repaired using BP. A routine surveillance echocardiogram showed a mass attached to the atrial septum and atrial aspect of the left atrioventricular valve (Figure …

How We Heal Little Hearts: The Piccolo Procedure Explained, Rania Habib, Toby A. Rockefeller

Transformational Pediatrics Podcast

The Piccolo device is an innovative and minimally invasive way to close the Patent ductus arteriosus (PDA) in pediatrics. Dr. Rockefeller talks about how the Piccolo came to fruition, the benefits, and what else is on the horizon for the PDA closure world.

Relationship Between Obesity And Global Longitudinal Strain In The Pediatric Single Ventricle Fontan Population Across Ventricular Morphologies., Nitin Madan, Doaa Aly, Melanie Kathol, Amulya Buddhavarapu, Thomas Rieth, Ashley K. Sherman, Daniel Forsha

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Obesity is associated with diminished myocardial function as measured by strain echocardiography in children and young adults with normal cardiac anatomy. Data are lacking about the effect of obesity on myocardial strain in patients with a single ventricle. In this study, the relationship between body mass index (BMI) and single ventricle myocardial strain in the Fontan population was assessed.

METHODS AND RESULTS: Thirty-eight abnormal BMI Fontan cases (21 overweight and 17 obese) and 30 normal BMI Fontan controls matched based on single ventricular morphology, age, and sex were included in the study. Ventricular morphology was categorized as single right …

Prenatal Diagnosis Of A Ductal-Dependent Branch Pulmonary Artery: Extra Vessels In The 3-Vessel And Trachea View., Anmol Goyal, Maria Kiaffas, Tara Swanson, Melanie Kathol, Sanket Shah, Nitin Madan

Manuscripts, Articles, Book Chapters and Other Papers

Obtaining a three-vessel (3V) and three-vessel and trachea (3VT) view from the fetal upper mediastinum is now considered to be part of standard imaging protocol for routine obstetric cardiac screening examinations. We report two fetal cases of an anomalous pulmonary artery origin, utilizing the standard 3V and 3VT views. Further imaging led to a rare diagnosis of bilateral ductus arteriosus with discontinuous branch pulmonary arteries in the absence of any other congenital heart defect. We briefly discuss the imaging features, differential diagnoses, and management of this rare entity.

Transposition Of The Great Arteries With Intramural Left Main Coronary Artery: Salient Imaging Findings And Description Of Two Operative Techniques, Joshua Holbert, Manasa Gadiraju, Sanket Shah, Edo Bedzra

Posters

Background: Transposition of the great arteries (TGA) is a common cyanotic critical congenital heart disease, with a feasible prenatal diagnosis. Arterial switch operation (ASO) with/without VSD closure is the preferred surgical approach with added challenge when an intramural coronary artery (IMC) is present. ASO is technically quite demanding with IMC, and incidence of post-operative complications and mortality are potentially higher. We present our recent TGA-IMC experience focusing on salient features identified on echocardiography, CT and invasive angiograms, as well as variations in ASO surgical techniques for repair. Methods: Our echo imaging acquisition required high frequency transducers and shallow image depth …

Double Aortic Arch With Atresia Of The Left Aortic Arch Proximal To The Left Common Carotid Artery In A Patient With Phace Syndrome – A Management Conundrum, Mohamed Aashiq Abdul Ghayum, Anmol Goyal, Aliessa P. Barnes, Sanket Shah

Posters

Background Cardiac anomalies in PHACE syndrome (P: posterior fossa anomalies, H: hemangiomas, A: arterial lesions, C: cardiac abnormalities, E: abnormalities of the eye) often consists of complex aortic arch anomalies with double aortic arch (DAA) being an uncommon association. Atresia of the proximal segment of the left arch in DAA is extremely rare and can pose a diagnostic and management conundrum due to formation of a loose vascular ring and asymptomatic nature as seen in our case. Case Description A 5-year-old male, diagnosed with PHACE syndrome, at a different center was noted to have an incidental finding on head imaging …

Health Equity And Policy Considerations For Pediatric And Adult Congenital Heart Disease Care Among Minoritized Populations In The United States., Keila N. Lopez, Kiona Y. Allen, Carissa M. Baker-Smith, Katia Bravo-Jaimes, Joseph Burns, Bianca Cherestal, Jason F. Deen, Brittany K. Hills, Jennifer H. Huang, Ramiro W. Lizano Santamaria, Carlos A. Lodeiro, Valentina Melo, Jasmine S. Moreno, Flora Nuñez Gallegos, Harris Onugha, Tony A. Pastor, Michelle C. Wallace, Deidra A. Ansah

Manuscripts, Articles, Book Chapters and Other Papers

Achieving health equity in populations with congenital heart disease (CHD) requires recognizing existing disparities throughout the lifespan that negatively and disproportionately impact specific groups of individuals. These disparities occur at individual, institutional, or system levels and often result in increased morbidity and mortality for marginalized or racially minoritized populations (population subgroups (e.g., ethnic, racial, social, religious) with differential power compared to those deemed to hold the majority power in the population). Creating actionable strategies and solutions to address these health disparities in patients with CHD requires critically examining multilevel factors and health policies that continue to drive health inequities, including …

Association Between Remote Monitoring And Interstage Morbidity And Death In Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups., Bianca Cherestal, Lori A. Erickson, Janelle R. Noel-Macdonnell Phd, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Matthew Files, Sarah Clauss, Natalie Jayaram

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES.

METHODS AND RESULTS: Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the …

Atrial Appendage Accessory Pathway Ablation: Tips For Recognition And Approach To Ablation, Nikola Dragisic, Emily R. Backes, Lindsey Malloy-Walton, Philip M. Chang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

3-Year Follow-Up Of A Prospective, Multicenter Study Of The Amplatzer Piccolo™ Occluder For Transcatheter Patent Ductus Arteriosus Closure In Children ≥ 700 Grams., Brian H. Morray, Shyam K. Sathanandam, Thomas Forbes, Matthew Gillespie, Darren Berman, Aimee K. Armstrong, Shabana Shahanavaz, Thomas Jones, Toby A. Rockefeller, Henri Justino, David Nykanen, Courtney Weiler, Dan Gutfinger, Evan M. Zahn

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: This study describes 3-year follow-up of 200 infants weighing ≥ 700 grams who underwent transcatheter patent ductus arteriosus (PDA) closure with the Amplatzer Piccolo™ Occluder.

STUDY DESIGN: Between June 2017 and February 2019, 200 children were enrolled in this U.S. study (NCT03055858). PDA closure, survival, and device- or procedure-related events were evaluated. A total of 156 of the available 182 patients (86%) completed the study.

RESULTS: The implant success rate was 95.5% (191/200). At 3 years, PDA closure was observed in 100% (33/33) of patients. Survival was >95% with 9 reported deaths. No deaths were adjudicated as device- or …

Rare Complications Associated With Use Of Bovine Pericardium, Mohamed Aashiq Abdul Ghayum, Nitin Madan, William Gibson, Sanket Shah

Posters

Background Bovine Pericardium (BP), with numerous and improving preparation techniques, has been used extensively for over 50 years in repair of simple and complex congenital heart defects. It has several advantages over other surgical materials. However, there is a paucity of data in the pediatric population regarding complications associated with BP. Herein, we report two rare complications noted with BP use. Case Description Case 1. A 14-month-old male, with trisomy 21 and complete Atrioventricular canal defect, repaired using BP. A routine surveillance echocardiogram showed a mass attached to the atrial septum and atrial aspect of the left atrioventricular valve (Figure …

Identification Of Critical Illness-Related Corticosteroid Insufficiency After Congenital Heart Surgery With Next Generation Sequencing, Juan S. Farias, Nicholas Diehl, Lori A. Erickson, Jenny Marshall, Nataliya Kibiryeva, Kelly S. Tieves, Jorge Cross-Bu, Jaime Silva-Gburek

Posters

Introduction: Critical illness-related corticosteroid insufficiency (CIRCI) which is characterized by relative inadequate cortisol levels in relation to increased demand during periods of severe stress is common after cardiac surgery and is a cause of hemodynamic instability. The purpose of this study was to identify possible genetic abnormalities related to CIRCI in pediatric patients after congenital heart surgery. Methods: Single-center retrospective study of neonates who underwent cardiac surgery between August 2018 to July 2020. We included patients who had obtained postoperative cortisol levels and next gen DNA-sequencing (NGS) as previous standard of care. Analysis methods are displayed in Figure 1. Results: …

Multi-Disciplinary Collaboration And The Use Of Technology In The Reduction Of Cardiac Surgical Site Infections, Kelly Fehlhafer, Tiffany Mullen, Elizabeth Chang, Stacy Reynolds, Shannon Lysaught, Stephanie Doughty, Jessica Nichols

Posters

No abstract provided.

Standard Atrial Epicardial Wire Placement Leads To Improved Atrial Signal Identification And Pacemaker Sensing, Nir Atlas, William Gibson, J Hermsen, A Harmon, J Torgeson, Lindsey Malloy-Walton, N Von Bergen

Posters

Background: Atrial arrhythmias are common after pediatric cardiac surgery and are associated with increased morbidity and mortality. Atrial epicardial wires (AEW), utilized to diagnose and treat atrial arrhythmias, are known to malfunction during post-operative care. There are no pediatric prospective studies examining ideal placement of AEW. Methods: This prospective multicenter pilot study compared atrial amplitudes, pacing sensitivities and thresholds via AEW placed at Bachmann’s Bundle (BB) and the right-sided interatrial groove (RSIG) versus the surgeon’s standard placement (control locations) in 26 patients aged less than six years old undergoing cardiac surgery. Participants received four total AEW - two at the …

An Unusual Cardiomegaly Culprit: Case Report Of A Hemodynamically Significant Portosystemic Shunt, Zoetta L. Mcloughlin Md, Melanie Kathol, Amanda Mcintosh

Posters

Background: Cardiomegaly discovered in the fetal or neonatal period may be the first sign of cardiac disease. However, the differential diagnosis for cardiomegaly with a structurally and functionally normal heart includes cardiomyopathies as well as non-cardiac etiologies, including extracardiac shunt lesions and vascular malformations, among others. Thus, unexplained cardiomegaly requires further investigation for extracardiac anomalies. In this case, we focus on an unusual etiology of diffuse cardiac dilatation – intrahepatic portosystemic shunt – that was initially misdiagnosed as dilated cardiomyopathy. Case Description: A 9-year-old male with history of learning difficulty and tall stature was seen for follow-up of diffuse cardiomegaly …

Development Of A Kineisophobia Scale For Adolescents With Heart Disease: A Preliminary Analysis Of Validity And Reliability, David A. White, Jami Gross-Toalson, Emily Cramer, Lindsey Malloy-Walton, Mollie Walton, Laura Martis, Brandy Enneking, Kelli M. Teson, Jessica S. Watson, Dara Watkins, William R. Black

Posters

No abstract provided.

Ehealth Technology In Cardiac Exercise Therapeutics For Pediatric Patients With Congenital And Acquired Heart Conditions: A Summary Of Evidence And Future Directions., David A. White, Aimee M. Layton, Tracy Curran, Naomi Gauthier, William B. Orr, Kendra Ward, Meg Vernon, Matthew N. Martinez, Malloree C. Rice, Katherine Hansen, Megan Prusi, Jesse E. Hansen

Manuscripts, Articles, Book Chapters and Other Papers

Many children and adolescents with congenital and acquired heart disease (CHD) are physically inactive and participate in an insufficient amount of moderate-to-vigorous intensity exercise. Although physical activity (PA) and exercise interventions are effective at improving short- and long-term physiological and psychosocial outcomes in youth with CHD, several barriers including resource limitations, financial costs, and knowledge inhibit widespread implementation and dissemination of these beneficial programs. New and developing eHealth, mHealth, and remote monitoring technologies offer a potentially transformative and cost-effective solution to increase access to PA and exercise programs for youth with CHD, yet little has been written on this topic. …

Cardiac Biomarkers Differentiate Kawasaki Disease From Multisystem Inflammatory Syndrome In Children Associated With Covid-19, Mollie Walton

Research Days

Background: Kawasaki disease (KD) and Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 show considerable clinical overlap. The goal of this study was to determine if cardiac biomarkers can differentiate KD from MIS-C.

Objectives/Goal: The goal of this study was to determine if cardiac biomarkers differentiate KD from MIS-C.

Methods/Design: The International Kawasaki Disease Registry enrolled (n=2903) contemporaneous KD and MIS-C patients1st, 2020, through June 30th, 2022. The study population was confined to KD patients meeting American Heart Association KD criteria with no prior COVID-19 infection and MIS-C patients meeting Centers for Disease Control and Prevention criteria with confirmed …

Association Between Remote Monitoring And Interstage Morbidity And Mortality In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal

Research Days

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation.

Objectives/Goal: We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period.

Methods/Design: Using the CHAMP database, we identified 610 infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with …

Therapeutic Plasma Exchange To Alleviate Ventricular Tachycardia After Diphenhydramine Ingestion, Kaushal Dosani, Lejla Music Aplenc, Stephen Pfeiffer

Research Days

Background: The Covid-19 pandemic has adversely affected the mental health of children causing an increased incidence of suicide attempts. Diphenhydramine is a common household medication and is frequently ingested by children. Toxic doses of diphenhydramine can affect the cardiovascular and central nervous system. In the heart, diphenhydramine blocks fast sodium channels and potassium channels which can result in conduction abnormalities including sinus tachycardia, widening of QRS duration, ventricular tachycardia and torsades de pointes. Massive ingestion can cause severe cardiovascular collapse which may require ECMO support

Objectives/Goal: To describe a novel method of clearing highly protein-bound diphenhydramine molecules from circulation after …

Improving Imaging Practices Following Arterial Switch Operation, Mollie Walton, Nir Atlas, Sanket Shah

Research Days

Problem Statement/Question: Long-term risk in post-operative cardiac patients exists, and morbidity may be avoided with advanced imaging surveillance.

Background/Project Intent (Aim Statement): The Appropriate Use Criteria (AUC) for Multimodality Imaging During Follow-Up Care of Patients with Congenital Heart Disease (CHD) was published in 2020 by the American College of Cardiology Foundation. This includes a subsection for D-Looped Transposition of the Great Arteries (D-Loop TGA). The arterial switch operation (ASO) is the preferred method for surgical repair of D-Loop TGA. Appropriate and timely use of advanced imaging is essential in optimizing long-term postsurgical outcomes. The objective of this quality improvement (QI) …

A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe

Posters

Introduction: Propionic Acidemia (PA) is a disorder related to abnormal protein and lipid metabolism resulting in progressive neurological injury and dilated cardiomyopathy (DCM). Interventions for PA and secondary disease manifestations can require multi-organ transplantation. Herein we report the case of a child with PA and end-stage DCM requiring left ventricular assist device (LVAD) support with eventual heart-liver transplant. Case Report: A 17 year old male diagnosed in childhood with PA developed chronically progressive DCM culminating in end stage heart failure with acute decompensations. In a recurrent admission, he progressed to require dual inotropic support and systemic anticoagulation for new LV …

Gender Dysphoria In Adolescents With Ehlers-Danlos Syndrome., Jordan T. Jones, William R. Black, Christine Moser, Eric T. Rush, Lindsey Malloy-Walton

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Ehlers-Danlos Syndrome represents a family of heritable connective tissue disorders that include joint hypermobility, tissue fragility, and skin hyperextensibility. Ehlers-Danlos Syndrome presents with clinical sequela across multiple body systems that require multidisciplinary care. Little is known about adolescents with Ehlers-Danlos Syndrome who are transgender and gender diverse. To date, there have been no reports of transgender and gender diverse youth in pediatric patients with Ehlers-Danlos Syndrome. The objective of this study was to characterize transgender and gender diverse adolescents with Ehlers-Danlos Syndrome seen in a pediatric multidisciplinary specialty clinic.

METHODS: A retrospective chart review was performed and it was …

Cardiac Biomarkers In Differentiating Kawasaki Disease And Multisystem Inflammatory Syndrome In Children Associated With Covid-19, Mollie Walton, Geetha Raghuveer, K Kamakoti, N Dahdah, L Garrido, S Tierney, T Harris, M Khoury, M Hicar, E Braunlin, D Thacker, M Khare, F Dallaire, R Lowndes, I Glassmeyer, J Ballweg, G Goldenberg, S Merves, C Manlhiot, P Farid, Bw Mccrindle

Posters

Introduction – Kawasaki disease (KD) and Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 show considerable clinical overlap making differentiation challenging, particularly in the absence of evidence of evidence of prior COVID-19. Hypothesis – Cardiac biomarkers can differentiate KD from MIS-C. Methods – The International KD Registry enrolled n=2903 contemporaneous KD, MIS-C and acute COVID-19 pediatric patients from 42 sites in 8 countries from January 2020 through July 2022. The study population was confined to 1489 MIS-C patients meeting CDC criteria with confirmed evidence of prior COVID-19 infection and 387 KD patients meeting AHA guideline criteria with confirmed evidence …

Microrna Expression Levels Change In Neonatal Patients During And After Exposure To Cardiopulmonary Bypass., Lance Hsieh, Lan N. Tu, Alison Paquette, Quanhu Sheng, Shilin Zhao, Douglas C. Bittel, James O'Brien, Kasey Vickers, Peter Pastuszko, Vishal Nigam

Manuscripts, Articles, Book Chapters and Other Papers

Background The systemic inflammation that occurs after exposure to cardiopulmonary bypass (CPB), which is especially severe in neonatal patients, is associated with poorer outcomes and is not well understood. In order to gain deeper insight into how exposure to bypass activates inflammatory responses in circulating leukocytes, we studied changes in microRNA (miRNA) expression during and after exposure to bypass. miRNAs are small noncoding RNAs that have important roles in modulating protein levels and function of cells. Methods and Results We performed miRNA-sequencing on leukocytes isolated from neonatal patients with CPB (n=5) at 7 time points during the process of CPB, …

Safety, Timing, And Outcomes Of Early Postoperative Cardiac Catheterization Following Congenital Heart Surgery, Karoline Krzywda, Jeremy Affolter, Darcie Al-Hassan, William Gibson, Ryan Romans, Kelly S. Tieves

Posters

Intro: Historically, early postoperative (<6weeks) cardiac catheterization (EPOCC) was considered high risk and often delayed. Recently, the safety of early postoperative cardiac catheterization has been demonstrated. The timing of catheterization in the struggling postoperative patient remains variable and optimal timing remains uncertain. There is limited data on the impact of EPOCC on outcomes such as length of stay, duration of mechanical ventilatory or extracorporeal support, and surgical or catheter- based interventions. The aim of this study was to describe our experience with EPOCC and its impact on management, length of stay, and duration of mechanical ventilatory support. Methods: This is a descriptive retrospective cohort study of patients who underwent cardiac surgery between 01/01/2010 and 12/31/2019 and cardiac catheterization within 30 days after surgery. Patients with catheterization for LA decompression on ECMO, endomyocardial biopsy, or BAS post hybrid procedure were excluded. We collected information surrounding timing, indication, and complications of catheterization, duration of mechanical ventilation/ECMO, and ICU/hospital LOS and compared these differences in patients who underwent EPOCC < 72hours (earlier) versus >72hours (later). Data was analyzed using IBM SPSS, version 28. Chi-square and Student’s t-test, or appropriate nonparametric tests were used to compare categorical and continuous variables, respectively. Results: There were 2542 surgeries performed during the study period with 167 patients undergoing cardiac catheterization within the defined 30 days. Twenty-six patients met exclusion criteria, leaving 141 patients for analyses. Median time from surgery to EPOCC was 10 days (1-30), with 26 patients(18.4%) having an earlier EPOCC. Interventions were performed in 70 patients (49.6%), not statistically different in those with earlier vs later EPOCC [n=9 (12.9%) vs …

Impact Of Remote Monitoring During The Interstage Period On Outcomes In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal, Lori Erickson, Janelle R. Noel-Macdonnell, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Natalie Jayaram

Posters

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation. We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period. Methods: Using the CHAMP database, we identified 607infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with a Windows-based …