Discover and read the best of Twitter Threads about #CHD

Most recents (22)

Today marks the start of #WHA75!

This week, @WHO, Ministries of Health, civil society, & more will discuss #GlobalHealth priorities.

Missing on agenda? #GlobalSurgery & ๐Ÿซ€ care.

Hence, I'll be sharing key points, papers, & developments in #GlobalCardiacSurgery in 75 tweets ๐Ÿ‘‡ Image
(1/75) To start, what *is* #GlobalCardiacSurgery?

GCS extends far beyond OR, from community-based disease detection & efficient referral networks to timely care, long-term follow-up, robust supply chains & adequate financial risk protection. #WHA75

Read: academic.oup.com/ejcts/article/โ€ฆ Image
(2/75) Why does #GlobalCardiacSurgery matter?

โš ๏ธ Every year, 18 million people die from #CVD

๐Ÿซ€ 500 million live with CVD; 100s of millions more to come.

๐Ÿฅ Up to 1/3 will require #CTSurgery or interventional care in lifetime

Data @IHME_UW: healthdata.org/results/data-vโ€ฆ

#WHA75 ImageImageImage
Read 77 tweets
9) Many risk factors modulate the propensity of LDL-C to traverse the endothelium and enter the arterial intima. See ๐Ÿ”“academic.oup.com/eurheartj/artiโ€ฆ.
10) It now appears that the passage of #LDL into the #intima is not a merely passive process whereby the concentration in blood & the permeability of the endothelium determine LDL accumulation.
11) Itโ€™s #Transcytosis (an active process), through a vesicular pathway involving #caveolae, scavenger receptors (#SRB1) and activin like receptor kinase 1 (#ALK1). Hence for a given blood level of LDL-C the amount of atherosclerosis is variable.
Read 36 tweets
My first attempt at a tweetatorial. A๐Ÿงต on pulmonary overcirculation
#FOAMed #cardiotwitter #pedscards #CHD @cardionerds @UofLPeds @UofLPedsCCM 1/20
The term pulmonary overcirculation or overcirculation gets used a lot when discussing kids with CHD, usually without a specific set of criteria. If a patient is not progressing as expected, is hospitalized, or has a complication frequently overcirculation is blamed. 2/20
But what is really occurring when we refer to overcirculation? In a structurally normal ๐Ÿซ€, the pulmonary and systemic circuits work in series. The blood flow to the ๐Ÿซ (Qp) is the same as it is to the body (Qs). 3/20
Read 20 tweets
Dr. Lantin giving a Top 10 review of #ACCACPC research in 2020, a truly crazy year! #ACC21
๐Ÿ”Ÿ No mention of 2020 could possibly ignore the effects of the global pandemic on research, patient care, and the way we share knowledge. #COVID19 #ACC21
9โƒฃ Imaging indices correlate with prognosis.
- Transplant/VAD-free survival correlates with MPI-DTI z-score
- Left atrial strain correlates with PCWP and helps identify graft rejection/failure
#ACC21
Read 22 tweets
Of interest to the #CHD and #ACHD community, Matthew Gillespie of @HeartCare4Kids, a leader in transcatheter pulmonary valves, gave an update on the state of the art over in the Right Sided Valve Interventions session, and as he rightly points out, it all started with CHD! #ACC21
Who needs pulmonary valve replacement?
๐Ÿ‘‰~40K babies born w/ #CHD each yr
๐Ÿ‘‰~22% have RVOT abnormalities
๐Ÿ‘‰For those w/ RV-PA conduits we've had Melody/Sapien valves
๐Ÿ‘‰For the 85% of RVOT pts w/o conduits with PR, these usu won't work due to dilated/distorted/dynamic RVOTs
#ACC21
Work that started ~2004 with Phil Bonhoeffer culminated in first-in-man implantation of a self-expanding RVOT valve reported in 2010 with several devices now available incl. the Medtronic Harmony devices and the Edwards Alterra combined with their Sapien valve in the US. #ACC21
Read 9 tweets
Here are a couple of #ACC21 posters on pregnancy outcomes for women with heart disease, one from @LLUHealth on #CHD with RVOT dysfunction and one from @HopkinsMedicine on valvular heart disease, worth checking out. @doctorpianist @AllisonGHaysMD @kalamityjack #CardioObstetrics
In @abbykhanmd's talk Saturday, she highlighted three commonly used risk models for predicting adverse outcomes in pregnant women with heart disease: the modified WHO criteria, CARPREG II, and ZAHARA. #ACC21
Generally speaking, left-sided obstructive lesions (AS/MS) are known to impart the highest risk, while pulmonary valve disease and aortic regurgitation are regarded as relatively low risk and MR/TR fall somewhere in between. #ACC21
Read 6 tweets
Starting off the Nuts & Bolts of Pregnancy and Congenital Heart Disease session with a pre-test question... #CardioObstetrics #ACC21 #ACHD
Keep this chart in mind. Pregnancy is a prolonged period of cardiovascular stress with increased cardiac output, plasma volume, and heart rate. Things get really interesting during labor/delivery with acute increases in BP and CO. Image
Various risk scores available: Modified WHO classification, CARPREG II, ZAHARA score. But clinical experience is extremely important since CHD patients are very heterogeneous and may not be well-represented in studies ImageImageImage
Read 15 tweets
1/n Once in a while, that new young child with a prior echo stating " primum asd" turns out to be something else...
I'll label this clip : " so far so good' #echofirst #CHD
2/n this is plax
3/n subcostal 4ch view. this one carries the label : "moment of truth? "
Read 10 tweets
@HeartLifeCanada @pumpinghearts @MarcBains @iamnickevans @ShelleyZieroth @dranulala @robmentz First, reaction to what #patients think about the new #UniversalDefinition ... A step forward ... ? But it is still #failure Should be #FunctionNotFailure /2
@HeartLifeCanada @pumpinghearts @MarcBains @iamnickevans @ShelleyZieroth @dranulala @robmentz What about #CHD "Does this mean I was at risk when I was born?" ... "I could be at risk for HF, but how am I to manage my days is still missing ... " "It's nice that there are categories, but how do you translate that to people who need to process it?" /3
@HeartLifeCanada @pumpinghearts @MarcBains @iamnickevans @ShelleyZieroth @dranulala @robmentz "You can go back and forth between stages" ... at least HF and Advanced HF. The NYHA classes seem to recognize the transient nature..." Heart failure should remain heart failure, but clinics should be #FunctionNotFailure /4
Read 9 tweets
3rd regular episode of @pedsintensiva, podcast that bridges the gap btw literature & practice for #pedsICU

CPR & #ECMO in Single V patients w Ravi Thiagarajan Division Chief of Cardiac ICU @bostonchildrens

Tweetorial ๐Ÿ‘‡

tinyurl.com/CPRandECMOsingโ€ฆ

#pedscards #pedsCICU #CHD
@BostonChildrens Single V pts are ++ risk for arrest & #ECMO support

Many pts die & more have morbidity, even in best centers

Prevention of arrest is more important & effective than rescue CPR/ECMO โ€“ great work by @pc4quality in making prevention sexy!

#pedsICU #pedscards #pedsCICU #CHD
@BostonChildrens @pc4quality ECPR (extracorporeal-CPR) is only ever as good as the CPR you get beforehand

Getting a pt onto #ECMO is busy but donโ€™t forget the prime importance of good quality CPR w minimal interruptions on the way there

#pedsICU #pedscards #pedsCICU #CHD
Read 19 tweets
#PedsICU #PedsCICU #PedsCards Drawing attention to this @pc4quality study by @JustinElhoff and Martina Steurer-Miller (needs a handle!) and team....1/x

Relationship between gestational age and outcomes after congenital heart surgery pubmed.ncbi.nlm.nih.gov/33080235/
This is one of those great studies where we followed the data and found something that was interesting to us, worthy of follow-up, and potentially actionable. In addition to studying the relationship between gestational age and outcome after #CHD surgery...2/x
We looked at the association between corrected gestational age and outcome. We frequently struggle to determine the "right" time to take a premature patient with CHD to the operating room. On the one hand, we want them to achieve sufficient organ maturity...3/x
Read 8 tweets
Checkout my slides from our #TCTConnect abstract presentation. Learn how we use #3Dprinting @KidsAtColumbia to care for our patients with #CHD. Abstract TCT196 for full video clips! 1/10
#TCT2020 @ColumbiaSurgery @MartyMleon @mmamas1973 @jgranadacrf @Drroxmehran @mirvatalasnag Image
Our J750 @Stratasys is housed in the Vagelos Center and is a multimaterial multicolor #3Dprinter. We reviewed our #3Dmodeling and #3Dprinting cases over 2 years. 2/10
#TCTConnect #TCT2020 #crf @purviparwani @PushpaShivaram @ShelbyKuttyMD @DrJenniferCo_Vu @iamritu @MaterialiseNV Image
We have created 32 models over 2 years for indications of ๐Ÿ‘‰complex #CHD
๐Ÿ‘‰#VAD planning
๐Ÿ‘‰AAOCA or
๐Ÿ‘‰other #CHD 3/10
#TCTConnect #TCT2020 #CRF #3Dprinting
#womeninmedicine #WomenInSTEM
@ebrosenzweig @ShannonNNees @kt_heartfailure @Heart_SCCT @SCMRorg Image
Read 11 tweets
1st ever regular episode of Pediatrica Intensiva, the podcast that bridges the gap btw literature & practice for #pedsICU

Borderline Left Hearts w @laussen_peter from @BostonChildrens @SickKidsNews, part 1 of Single Ventricle season

Tweetorial๐Ÿ‘‡

apple.co/36FG2EN
Borderline Left Hearts are subset of pts w critical L heart obstruction, best defined as:
1.โ€˜Output of aortic valve inadequate to maintain lifeโ€™ (so need to maintain duct until 1st intervention) &;
2.Present & need intervention in neonatal period

#PedsICU #PedsCICU #CHD /2
Infants w critical left heart obstruction are on spectrum
-One end: clearly inadequate L heart structures -> single V pathway
-Other end, clearly adequate (even if bit small) -> biV pathway
- Pts in middle are TRICKY (hence this podcast)

#PedsICU #PedsCICU #CHD #pedscards /3
Read 37 tweets
Happy #VivienThomasDay! Today marks 110 years since the birth of Dr. Vivien Thomas. Although he never went to medical school, the surgical techniques he developed, such as the BTT shunt, are the foundation on which congenital heart surgery today was built. #CHD #ESCCongress2020
After graduating from high school, Thomas enrolled at Tennessee Agricultural & Industrial State College (now @TSUedu) as a pre-med. Unfortunately, the Great Depression depleted his savings, so he left college and found work as an assistant in Alfred Blalock's lab at @VUmedicine.
Blalock was doing research in traumatic shock and needed Thomas to help perform surgery on lab animals. Thomas learned quickly, and Blalock gave him more and more independence in the lab. Years later, surgical trainees who worked with Thomas would marvel at his surgical skill.
Read 10 tweets
Join us @ZDMSociety on Sept 8 for the Virtual Seminar "Developmental Mechanisms of Cardiovascular Anomalies"!

Excited to talk w/ @whitefishlab, @vg_biomarina & @noelresearchlab about #zebrafish, cardiovascular #devbio & disease. #CHD

*2020 ZMDS membership/registration is FREE!* Image
The Virtual Seminars continue through Dec with topics spanning xenografts, host-pathogen interactions, blood (featuring @ritafior @LabBerman @ValerieWittamer and more... Image
...therapeutic target identification, and cancer (featuring @TheBlackburnLab and more!).

Sign up, and enjoy #zebrafish disease modeling from your favorite chair, sofa, porch, etc. Image
Read 3 tweets
If you care for #PedsCICU patients or #CHD patients in the #PedsICU & aren't engaged with PC4, the outstanding recap of the #CardiacArrestPrevention project results by @bubblesdadee is one great example of how you can change your practice & outcomes as a @pc4quality center! 1/3
Significant reduction in #cardiacarrest by this #CollaborativeQI project lead to many lives saved! It's possible to #PreventCardiacArrest! Over 110 of our PC4 family participated in today's call to review the results, which were previously presented at #AHA19 @AHAMeetings!
2/3
Thanks to @TheCHF for their generous support of PC4 & @CardiacUnited for helping us collaborate to change the paradigm in #CHD research! 3/3
Read 3 tweets
Tweetorial of @AparnaHoskote โ€˜s fantastic talk on #ecmo pearls for #singleventricle #chd in the #PedsCICU #PedsICU at #jpccim2019. Single ventricle pts have 43% ecmo survival. Several tweets to follow with pearls for how to optimize! @PICS_Conference @PCICS2 @PICSociety
1/10
Pearl 1: Timing is important; go on #ecmo electively
#jpccim2019 2/10
Pearl 2: hypoxemia is a better indication with better prognosis than hypotension (I.e. shunt issues are better than cardiac dysfunction) #jpccim2019 3/10
Read 10 tweets
โšก๏ธ #YesCCT Coronary Plaque Assessment #Tweetorial โšก๏ธ

By @CoronaryDoc + @AChoiHeart

โœ… Why Plaque Assessment?
โœ… High Risk Plaque Features
โœ… Plaque Characterization/Quantification
โœ… Supporting Clinical Data

#CardioTwitter #ACCImaging #SCCT2019 @heart_scct @journalCCT
1/14
2/14
As #SCD or #MI is 1st symptom of #atherosclerosis in 2/3 of pts, early ID of #CAD is of paramount importance

#YesCCT allows for
โœ… ID of plaque
โœ… Quant. of plaque
โœ… Characterization of plaque
โœ… Arterial remodeling

Lin, @LubbDup & @lesleejshaw: bit.ly/2x1b5Yz
3/14
Serial angiographic studies have demonstrated an accelerated & rapid plaque progression before most cases of ACS

Rapid plaque growth โžก๏ธ plaque rupture โžก๏ธ thrombus formation โžก๏ธ MI

@LubbDup & @JonathonLeipsic et al: bit.ly/2WIt5Bj
Read 14 tweets
Association of vitamin K with cardiovascular events and all-cause mortality: a systematic review and meta-analysis

doi.org/10.1007/s00394โ€ฆ

#nutrition #VitaminK #CVD #CHD
- "Our results suggested that higher dietary phylloquinone and menaquinone intakes were consistently associated with a lower risk of total CHD, and higher dp-ucMGP concentration was associated with a higher risk of all-cause and CVD mortality...
"...In general, these data support potential benefts of vitamin K on the prevention of CVD events and all-cause mortality"
Read 10 tweets
It's open heart surgery's 66th birthday! On September 2, 1952, Dr. F. John Lewis at @UMNChildrens closed an atrial septal defect in 5yo Jacqueline Johnson using only total-body hypothermia, allowing him to halt her circulation for 5-1/2 minutes as he performed the operation. #CHD
Using cooling blankets, Jacqueline was cooled to 28ยฐC before her chest was opened, her systemic veins and pulmonary artery were clamped, and her right atrium opened. In the photo Lewis appears at the near side of the table. Standing on a stool behind him is Dr. Walt Lillehei.
After quickly closing the hole and checking his work, Lewis closed up the heart and unclamped the vessels. Jacqueline's body was rewarmed in a watering trough ordered from a Sears catalog. She made a successful recovery and was discharged after 11 days. Lewis had made history.
Read 8 tweets
Anyone remember the young man pictured here with Princess Di? On Aug 13, 1985, at 3 years old, Jamie Gavin of Dublin made headlines internationally as the youngest person at the time to undergo heart-lung transplant. The surgery was performed by Sir Magdi Yacoub. #CHD #DonateLife
Jamie was born with hypoplastic left heart syndrome (#HLHS). Surgical options then were few. Bill Norwood had only just published his initial series on HLHS palliation; most centers remained wary. In 1984, another baby with HLHS, Baby Fae, received a baboon heart transplant.
Just 5 months before Jamie's operation, Yacoub's team had performed a heart-lung transplant on 5yo Brooke Matthews of Australia, who was at the time the youngest heart-lung recipient. Her story generated drama when her father held up a hamburger stand to help pay for her surgery!
Read 5 tweets
Dr. Helen Taussig, considered to be the founder of pediatric cardiology and best known for her role in developing the Blalock-Taussig shunt operation for "blue babies," was born 120 years ago today. Happy birthday, Dr. Taussig! #CHD
As several others have pointed out, Dr. Taussig persisted in the face of great adversityโ€”no small part of which was due to her gender at a time when medicine was dominated by menโ€”to become one of the most influential physicians of our time. A few highlights...
Harvard Medical School missed a few opportunities to claim what is now known as the Blalock-Taussig shunt. When she initially expressed interest in a medical career, Harvard allowed Dr. Taussig to sit in on some courses but would not issue a woman any credit toward a degree.
Read 18 tweets

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