Congenital Heart Disease Clinical Trial
Official title:
A Review of the Diagnosis, Treatment and Outcomes of Children With Critical Congenital Heart Defects
Congenital heart disease in infants and children often challenges healthcare providers both
in regards to diagnosis and in the management of these conditions. The field becomes more
complicated as one examines the myriad of defects that present and the complex care that is
required. Over the last 20-25 years, the remarkable advances in the medical and surgical
management of the most complex lesions have decreased neonatal mortality, such that many
more survive the neonatal period. Therefore, new challenges regarding the continued care of
this patient cohort of high-risk infants and children exist. In order to continue the
improvement of treatment(s) offered to these patients, continuous review and analysis of the
current standard of care is needed.
In this study, the investigators will collect information related to the current surgical
and medical therapies offered to patients enrolled in the High Risk Congenital Heart Program
at Children's Healthcare of Atlanta. All of the procedure and visit information will be a
part of the child's standard of care. This information will be placed in a database. The
investigators hope to learn more about the short-term and long-term effects of current
therapies and procedures.
Patients, age newborn to 21 years, followed in the High Risk Congenital Heart Defect Clinic
at Children's Healthcare of Atlanta at Egleston will be asked to participate in this trial.
The term "high risk" is assigned to a patient with the following diagnoses or medical
problems: critical aortic stenosis, truncus arteriosus (with or without interrupted aortic
arch), patients with complex single ventricle physiology (such as hypoplastic left heart
syndrome, unbalanced AV canal, tricuspid atresia, transposition of the great vessels with
ventricular septal defect and pulmonary stenosis, mitral atresia, pulmonary atresia with
intact ventricular septum), left ventricular outflow tract obstruction requiring Konno
procedure, transposition of the great vessels (with or without ventricular septal defect),
pulmonary atresia with ventricular septal defect, interrupted aortic arch (with or without
ventricular septal defect), anatomy requiring "double switch" procedure, aortic arch
abnormality requiring transverse arch graft, total anomalous pulmonary venous return,
anatomy requiring any of the following procedures: Damas-Kaye-Stansel procedure, ventricular
septal defect enlargement, or resection of subpulmonic stenosis during arterial switch
procedure, atrial septectomy, neonatal repositioning of the tricuspid valve for Ebstein
anomaly, Ross procedure in infancy; mitral stenosis with mitral valve replacement in
infancy, and any other cardiac abnormality requiring surgical repair in infancy with
residual hemodynamically significant lesions. In addition, patients with infantile Marfan
syndrome, or kawasaki disease with coronary artery aneurysm will also be included.
Informed consent will be obtained from the parent or legally authorized representative for
all study participants. An Assent, either verbal or written, will also be obtained if the
child is over the age of six (6). A sequential and unique subject number (i.e. NES.001,
NES.002) will be assigned by the investigator or designee to each qualified subject after
informed consent has been obtained. Once a subject number is assigned, it will not be used
again by the investigator. Subjects who are asked to participate but refuse participation in
the study will not be assigned a study number.
Investigational Plan:
A single-center, retrospective registry design will be utilized. After consent, the
following data will be collected from each study participant's chart each time he or she
attends clinic:
- Name
- Contact information (or confirm contact information)
- Names of other care providers
- Primary Diagnosis
- Secondary Diagnoses
- Age at time of visit
- Vital signs including blood pressure, heart rate, respirations, pulse oximetry
- Weight at time of visit
- If applicable, echocardiography data including m-mode, tissue doppler and color flow
Doppler
- History and Physical including surgical history
- Medications
- Nutritional Status
- Growth Parameters
- If applicable, most recent standard of care laboratories
- If applicable, MRI results
- EKG findings
All procedures are standard of care. The collection of data for this registry will not
effect the care provided to each patient. The individual physician has the right to diagnose
and treat each patient according to standard of care procedures and his/her own medical
judgement.
Participation in this registry will last as long as the patient is being followed in the
high risk clinic at Children's Healthcare of Atlanta.
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