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Grewing A, Jujjavarapu H, Price C, Eilers LF, Zimmerman S, Hiermandi N, Qureshi AM, Kellermayer R, Britt JJ. Esophageal Lesion Reveals an Aortic Pseudoaneurysm in the Setting of Actinomyces odontolyticus Bacteremia. JACC Case Rep 2023; 15:101867. [PMID: 37283823 PMCID: PMC10240280 DOI: 10.1016/j.jaccas.2023.101867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 06/08/2023]
Abstract
A toddler presented with hematemesis a few weeks after ingesting a penny. Workup revealed an esophageal lesion communicating with an aortic pseudoaneurysm in the setting of Actinomyces odontolyticus bacteremia. A. odontolytica is an oropharyngeal bacteria known to cause fistulas when introduced into tissue planes. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Anneliese Grewing
- Address for correspondence: Dr Anneliese Grewing, Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, 1 Baylor Plaza #32, Houston, Texas 77030, USA.
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Ubeda Tikkanen A, Vova J, Holman L, Chrisman M, Clarkson K, Santiago R, Schonberger L, White K, Badaly D, Gauthier N, Pham TDN, Britt JJ, Crouter SE, Giangregorio M, Nathan M, Akamagwuna UO. Core components of a rehabilitation program in pediatric cardiac disease. Front Pediatr 2023; 11:1104794. [PMID: 37334215 PMCID: PMC10275574 DOI: 10.3389/fped.2023.1104794] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/17/2023] [Indexed: 06/20/2023] Open
Abstract
There is increasing effort in both the inpatient and outpatient setting to improve care, function, and quality of life for children with congenital heart disease, and to decrease complications. As the mortality rates of surgical procedures for congenital heart disease decrease, improvement in perioperative morbidity and quality of life have become key metrics of quality of care. Quality of life and function in patients with congenital heart disease can be affected by multiple factors: the underlying heart condition, cardiac surgery, complications, and medical treatment. Some of the functional areas affected are motor abilities, exercise capacity, feeding, speech, cognition, and psychosocial adjustment. Rehabilitation interventions aim to enhance and restore functional ability and quality of life for those with physical impairments or disabilities. Interventions such as exercise training have been extensively evaluated in adults with acquired heart disease, and rehabilitation interventions for pediatric patients with congenital heart disease have similar potential to improve perioperative morbidity and quality of life. However, literature regarding the pediatric population is limited. We have gathered a multidisciplinary team of experts from major institutions to create evidence- and practice-based guidelines for pediatric cardiac rehabilitation programs in both inpatient and outpatient settings. To improve the quality of life of pediatric patients with congenital heart disease, we propose the use of individualized multidisciplinary rehabilitation programs that include: medical management; neuropsychology; nursing care; rehabilitation equipment; physical, occupational, speech, and feeding therapies; and exercise training.
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Affiliation(s)
- Ana Ubeda Tikkanen
- Department of Pediatric Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United States
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, United States
- Department of Orthopedic Surgery, Boston Children’s Hospital, Boston, MA, United States
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
| | - Joshua Vova
- Department of Physiatry, Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Lainie Holman
- Department Pediatric Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, United States
| | - Maddie Chrisman
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Kristin Clarkson
- Department of Pediatric Physical Medicine and Rehabilitation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Rachel Santiago
- Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA, United States
| | - Lisa Schonberger
- Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA, United States
| | - Kelsey White
- Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA, United States
| | - Daryaneh Badaly
- Learning and Development Center, Child Mind Institute, New York, NY, United States
| | - Naomi Gauthier
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Tam Dan N. Pham
- Department of Pediatric Cardiology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| | - Jolie J. Britt
- Department of Pediatric Cardiology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States
| | - Scott E. Crouter
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee Knoxville, Knoxville, IL, United States
| | - Maeve Giangregorio
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Meena Nathan
- Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, United States
| | - Unoma O. Akamagwuna
- Department Pediatric Physical Medicine and Rehabilitation, Texas Children's Hospital, Houston, TX, United States
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, TX, United States
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Eilers LF, Britt JJ, Weigand J, Penny DJ, Gowda ST, Qureshi AM, Stapleton GE, Khan A, Webb MK, Bansal M. Pre-Fontan Assessment Utilizing Combined Cardiac Catheterization and Cardiac MRI: Comparison to the Pre-Fontan Catheterization. Pediatr Cardiol 2023:10.1007/s00246-023-03178-x. [PMID: 37210685 DOI: 10.1007/s00246-023-03178-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/10/2023] [Indexed: 05/22/2023]
Abstract
Single ventricle patients eligible for Fontan completion undergo pre-Fontan catheterization for hemodynamic and anatomic assessment prior to surgery. Cardiac magnetic resonance imaging may be used to evaluate pre-Fontan anatomy, physiology, and collateral burden. We describe our center's outcomes in patients undergoing pre-Fontan catheterization combined with cardiac magnetic resonance imaging. A retrospective review of patients undergoing pre-Fontan catheterization from 10/2018 to 04/2022 at Texas Children's Hospital was performed. Patients were divided into 2 groups: combined cardiac magnetic resonance imaging and catheterization (combined group) and those who underwent catheterization only (catheterization only group). There were 37 patients in the combined group and 40 in the catheterization only group. Both groups were similar in age and weight. Patients undergoing combined procedures received less contrast, and experienced less in-lab time, fluoroscopy time and catheterization procedure time. Median radiation exposure was lower in the combined procedure group but was not statistically significant. Intubation and total anesthesia times were higher in the combined procedure group. Patients undergoing a combined procedure were less likely to have collateral occlusion performed than in the catheterization only group. Bypass time, intensive care unit length of stay, and chest tube duration were similar in both groups at the time of Fontan completion. Combined pre-Fontan assessment decreases catheterization procedure and fluoroscopy time associated with cardiac catheterization at the expense of longer anesthetic times, and results in similar Fontan outcomes compared to when cardiac catheterization alone is utilized.
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Affiliation(s)
- Lindsay F Eilers
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Jolie J Britt
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Justin Weigand
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Daniel J Penny
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Srinath T Gowda
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Athar M Qureshi
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Gary E Stapleton
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Asra Khan
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Melissa K Webb
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA
| | - Manish Bansal
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, E 1920, Houston, TX, 77030, USA.
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Horne D, Britt JJ, Miller-Hance WC, Das S, Mery CM. Chronic Ascending Aortic Pseudoaneurysm in a Child Secondary to a Retained Palm Frond. World J Pediatr Congenit Heart Surg 2016; 7:649-50. [PMID: 27587505 DOI: 10.1177/2150135116658017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 06/07/2016] [Indexed: 11/17/2022]
Affiliation(s)
- David Horne
- Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA
| | - Jolie J Britt
- Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA
| | - Wanda C Miller-Hance
- Department of Anesthesiology, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA
| | - Shailendra Das
- Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA
| | - Carlos M Mery
- Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA
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