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1. A National Comparative Investigation of Twins With Congenital Heart Defects for Neurodevelopmental Outcomes and Quality of Life (Same Same, but Different?): Protocol for a Prospective Observational Study

Author

Remmele, Julia, Helm, Paul Christian, Oberhoffer-Fritz, Renate, Bauer, Ulrike MM, Pickardt, Thomas, Ewert, Peter, and Tutarel, Oktay

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundDue to the increased survival rates of patients with congenital heart defects (CHD), associated disorders are an increasing focus of research. Existing studies figured out an association between CHD and its treatment, and neurodevelopmental outcomes including motor competence impairments. All these studies, however, compared their test results with reference values or results of healthy control groups. This comparison is influenced by socioeconomic and genetic aspects, which do have a known impact on neurodevelopmental outcomes. ObjectiveThis study protocol describes a setting that aims to find out the role of CHD and its treatments on neurodevelopmental outcomes, excluding socioeconomic and genetic aspects. Only a twin comparison provides the possibility to exclude these confounding factors. MethodsIn a German-wide prospective cohort study, 129 twin siblings registered in the National Register for Congenital Heart Defects will undergo testing on cognitive function (Wechsler Intelligence Tests age-dependent: Wechsler Adult Intelligence Scale, fourth edition; Wechsler Intelligence Scale for Children, fifth edition; and Wechsler Preschool and Primary Scale of Intelligence, fourth edition) and motor competence (Movement Assessment Battery for Children, second edition). Additionally, the self-reported health-related quality of life (KINDL-R for children, Short Form 36 for adults) and the parent-reported strength and difficulties of the children (Strength and Difficulties Questionnaire, German version) will be assessed by standardized questionnaires. CHD data on the specific diagnosis, surgeries, transcatheter procedures, and additional medical information will be received from patient records. ResultsThe approval of the Medical Ethics Committee Charité Mitte was obtained in June 2018. After getting funded in April 2019, the first enrollment was in August 2019. The study is still ongoing until June 2022. Final results are expected in 2022. ConclusionsThis study protocol provides an overview of the study design’s technical details, offering an option to exclude confounding factors on neurodevelopmental outcomes in patients with CHD. This will enable a specific analysis focusing on CHD and clinical treatments to differentiate in terms of neurodevelopmental outcomes of patients with CHD compared to twin siblings with healthy hearts. Finally, we aim to clearly define what is important to prevent patients with CHD in terms of neurodevelopmental impairments to be able to develop targeted prevention strategies for patients with CHD. Trial RegistrationGerman Clinical Trials Register DRKS00021087; https://tinyurl.com/2rdw8w67 International Registered Report Identifier (IRRID)DERR1-10.2196/26404

Published
2021
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2. WarpEM: Dynamic Time Warping for Accurate Catheter Registration in EM-guided Procedures

Author

Ramadani, Ardit, Ewert, Peter, Schunkert, Heribert, and Navab, Nassir

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

Accurate catheter tracking is crucial during minimally invasive endovascular procedures (MIEP), and electromagnetic (EM) tracking is a widely used technology that serves this purpose. However, registration between preoperative images and the EM tracking system is often challenging. Existing registration methods typically require manual interactions, which can be time-consuming, increase the risk of errors and change the procedural workflow. Although several registration methods are available for catheter tracking, such as marker-based and path-based approaches, their limitations can impact the accuracy of the resulting tracking solution, consequently, the outcome of the medical procedure. This paper introduces a novel automated catheter registration method for EM-guided MIEP. The method utilizes 3D signal temporal analysis, such as Dynamic Time Warping (DTW) algorithms, to improve registration accuracy and reliability compared to existing methods. DTW can accurately warp and match EM-tracked paths to the vessel's centerline, making it particularly suitable for registration. The introduced registration method is evaluated for accuracy in a vascular phantom using a marker-based registration as the ground truth. The results indicate that the DTW method yields accurate and reliable registration outcomes, with a mean error of $2.22$mm. The introduced registration method presents several advantages over state-of-the-art methods, such as high registration accuracy, no initialization required, and increased automation., Comment: The 26th International Conference on Medical Image Computing and Computer Assisted Intervention, MICCAI 2023

Published
2023

3. PATHFINDER-CHD: prospective registry on adults with congenital heart disease, abnormal ventricular function, and/or heart failure as a foundation for establishing rehabilitative, prehabilitative, preventive, and health-promoting measures: rationale, aims, design and methods

Author

Freilinger, Sebastian, Kaemmerer, Harald, Pittrow, Robert D., Achenbach, Stefan, Baldus, Stefan, Dewald, Oliver, Ewert, Peter, Freiberger, Annika, Gorenflo, Matthias, Harig, Frank, Hohmann, Christopher, Holdenrieder, Stefan, Hörer, Jürgen, Huntgeburth, Michael, Hübler, Michael, Kohls, Niko, Klawonn, Frank, Kozlik-Feldmann, Rainer, Kaulitz, Renate, Loßnitzer, Dirk, Mellert, Friedrich, Nagdyman, Nicole, Nordmeyer, Johannes, Pittrow, Benjamin A., Pittrow, Leonard B., Rickers, Carsten, Rosenkranz, Stefan, Schelling, Jörg, Sinning, Christoph, Suleiman, Mathieu N., von Kodolitsch, Yskert, von Scheidt, Fabian, and Kaemmerer-Suleiman, Ann-Sophie

Published
2024
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6. Bioelectric Registration of Electromagnetic Tracking and Preoperative Volume Data

Author

Ramadani, Ardit, Maier, Heiko, Bourier, Felix, Meierhofer, Christian, Ewert, Peter, Schunkert, Heribert, and Navab, Nassir

Subjects
Physics - Medical Physics
Abstract

For minimally invasive endovascular surgery, the localization of catheters and guidewires inside the human body is essential. Electromagnetic (EM) tracking is one technology that allows localizing such surgical instruments. For localizing intra-operatively EM-tracked instruments with respect to preoperative volume data, it is necessary to bring pre- and intraoperative imaging into the same coordinate frame. In most existing solutions, such registration requires additional interactions, modifying the procedure's original workflow. We propose a new method taking advantage of Bioelectric signals to initialize and register preoperative volumes to the EM tracking system without significantly changing the interventional workflow. We envision the most natural use-case of our concept in cardiac electrophysiology (EP) procedures, in which EP catheters are already equipped with all the necessary sensing, including electric sensing for the measurement of electrophysiological signals and EM tracking for catheter localization. We use EP catheters for Bioelectric sensing to detect local features of the vasculature while advancing the catheter inside the human body. Such features can be automatically labeled before the procedure within the preoperative data. The combination of Bioelectric and EM tracking can localize vascular features such as bifurcations and stenosis within the EM tracking space. Mapping them to preoperative data automatically registers patients' CT space to EM tracking. The proposed registration process is entirely based on Bioelectric sensed features, with no need for external markers or other interventional imaging devices., Comment: 10 pages, 2 figures, 1 table, proof-of-concept study

Published
2022

13. Safety and efficacy of the Amplatzer™ Trevisio™ intravascular delivery system: Post-approval study results

Author

Hascoet, Sebastien, Baruteau, Alban-Elouen, Jalal, Zakaria, Demkow, Marcin, de Winter, Robbert, Gaio, Gianpiero, Clerc, Jean-Michel, Sabiniewicz, Robert, Eberli, Franz, Santoro, Giuseppe, Dauphin, Claire, Schubert, Stephan, Smolka, Grzegorz, Lutz, Matthias, Moreno, Raul, Pan, Manuel, Gutierrez-Larraya, Federico, Godart, Francois, Carminati, Mario, Ovaert, Caroline, Batteux, Clement, Guerin, Patrice, Thambo, Jean-Benoit, and Ewert, Peter

Published
2023
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21. Sicherheit manueller und maschineller Beatmung pädiatrischer Patienten mit angeborenen Herzfehlern während intrahospitalem Transport und Bildgebung

Author

Ewert, Peter (Prof. Dr.), Ewert, Peter (Prof. Dr.);Meierhofer, Christian (Priv.-Doz. Dr.), Oettgen, Fabienne, Ewert, Peter (Prof. Dr.), Ewert, Peter (Prof. Dr.);Meierhofer, Christian (Priv.-Doz. Dr.), and Oettgen, Fabienne

Abstract

Im Rahmen der Behandlung von Patienten auf der Intensivstation kann es im Behandlungsverlauf und für die Therapieplanung notwendig sein, Untersuchungen durchzuführen, die räumlich getrennt von der Intensivstation stattfinden. In der vorliegenden Arbeit wurde die Sicherheit von manueller und maschineller Beatmung von kinderkardiologischen Intensivpatienten mit angeborenen Herzfehlern im Alter von ≤ 48 Monaten während intrahospitalem Transport und CT/MRT in Hinsicht auf Veränderungen von Vitalparametern und Blutgaswerten sowie Auftreten von Komplikationen untersucht., In the context of treatment of patients in the intensive care unit, it may be necessary to perform examinations during the course of treatment and for therapy planning that take place spatially separated from the intensive care unit. In the present study, the safety of manual and mechanical ventilation of pediatric intensive care patients with congenital heart disease aged ≤ 48 months during intrahospital transport and CT/MRI was investigated with regard to changes in vital signs and blood gas values as well as the occurrence of adverse events.

Published
2024

22. Klinischer Verlauf von Erwachsenen mit Fallot'scher Tetralogie oder Pulmonalatresie mit Ventrikelseptumdefekt über einem Alter von 40 Jahren

Author

Ewert, Peter (Prof. Dr.), Ewert, Peter (Prof. Dr.);Moretti, Alessandra (Prof. Dr.), Schwall, Laurent Louis Aloyse, Ewert, Peter (Prof. Dr.), Ewert, Peter (Prof. Dr.);Moretti, Alessandra (Prof. Dr.), and Schwall, Laurent Louis Aloyse

Abstract

Diese Dissertation befasst sich mit dem klinischen Verlauf von Erwachsenen mit Fallot'scher Tetralogie (TOF) oder Pulmonalatresie mit Ventrikelseptumdefekt (PA/VSD) über einem Alter von 40 Jahren. Diese Patienten erreichen aufgrund besserer Diagnostik und Therapien immer höhere Lebensalter. Damit steigt jedoch auch ihre Wahrscheinlichkeit für Komorbiditäten. Ziel der Studie ist die Erfassung der aktuellen Morbidität, Mortalität und möglicher Risikofaktoren von oben genanntem Patientenkollektiv., This dissertation focuses on the clinical course of adults with tetralogy of Fallot (TOF) or pulmonary atresia with ventricular septal defect (PA/VSD) over the age of 40. These patients are living longer and longer due to improved diagnostics and therapies. However, this also increases their likelihood of comorbidities. The aim of the study is to record the current morbidity, mortality and possible risk factors of the above-mentioned patient population.

Published
2024

27. Development of Weight and Height Age z-Score after Total Cavopulmonary Connection.

Author

Bilic, Carlo, Staehler, Helena, Niedermaier, Carolin, Schaeffer, Thibault, Cuman, Magdalena, Heinisch, Paul Philipp, Burri, Melchior, Piber, Nicole, Hager, Alfred, Ewert, Peter, Hörer, Jürgen, and Ono, Masamichi

Subjects
HYPOPLASTIC left heart syndrome, ODDS ratio
Abstract

Objective We aimed to analyze somatic growth of patients after total cavopulmonary connection (TCPC) as well as to identify factors influencing postoperative catch-up growth. Methods A total of 309 patients undergoing TCPC at 4 years old or less between 1994 and 2021 were included. Weight for age z-score (WAZ) and height for age-z-score (HAZ) at TCPC and at postoperative time between 1 and 3 years were calculated. Factors influencing somatic growth were analyzed. Results Most frequent diagnosis and initial palliation were hypoplastic left heart syndrome (HLHS) (34%) and the Norwood procedure (51%), respectively. Median age and weight at TCPC were 2.0 (IQR: 1.7–2.5) years and 11.3 (10.5–12.7) kg, respectively. Median 519 days after TCPC, a significant increase in WAZ (−0.4 to −0.2, p < 0.001) was observed, but not in HAZ (−0.6 to −0.6, p = 0.38). Older age at TCPC (p < 0.001, odds ratio [OR]: 2.6) and HLHS (p = 0.007, OR: 2.2) were risks for low WAZ after TCPC. Older age at TCPC (p = 0.009, OR: 1.9) and previous Norwood procedure (p = 0.021, OR: 2.0) were risks for low HAZ after TCPC. Previous bidirectional cavopulmonary shunt (BCPS) was a protective factor for both WAZ (p = 0.012, OR: 0.06) and HAZ (p = 0.028, OR: 0.30) at TCPC. Conclusion In patients undergoing TCPC at the age of 4 years or less, a significant catch-up growth was observed in WAZ after TCPC, but not in HAZ. Previous BCPS resulted to be a protective factor for a better somatic development at TCPC. HLHSs undergoing Norwood were considered as risks for somatic development after TCPC. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Reintervention and Survival After Transcatheter Pulmonary Valve Replacement

Author

McElhinney, Doff B., Zhang, Yulin, Levi, Daniel S., Georgiev, Stanimir, Biernacka, Elżbieta Katarzyna, Goldstein, Bryan H., Shahanavaz, Shabana, Qureshi, Athar M., Cabalka, Allison K., Bauser-Heaton, Holly, Torres, Alejandro J., Morray, Brian H., Armstrong, Aimee K., Millan-Iturbe, Oscar, Peng, Lynn F., Aboulhosn, Jamil A., Rużyłło, Witold, Berger, Felix, Sondergaard, Lars, Schranz, Dietmar, Cheatham, John P., Jones, Thomas K., Ewert, Peter, and Schubert, Stephan

Published
2022
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34. Continuous Long-Term Assessment of Heart Rate Variability in Adults with Cyanotic Congenital Heart Disease after Surgical Repair

Author

Pieringer, Felix, primary, Suleiman, Mathieu N., additional, Kaemmerer-Suleiman, Ann-Sophie, additional, Dewald, Oliver, additional, Freiberger, Annika, additional, Huntgeburth, Michael, additional, Nagdyman, Nicole, additional, Neidenbach, Rhoia, additional, von Scheidt, Fabian, additional, Kaemmerer, Harald, additional, Ewert, Peter, additional, Weyand, Michael, additional, Freilinger, Sebastian, additional, and Harig, Frank, additional

Published
2024
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37. Multicenter Study of Endocarditis After Transcatheter Pulmonary Valve Replacement

Author

McElhinney, Doff B., Zhang, Yulin, Aboulhosn, Jamil A., Morray, Brian H., Biernacka, Elżbieta Katarzyna, Qureshi, Athar M., Torres, Alejandro J., Shahanavaz, Shabana, Goldstein, Bryan H., Cabalka, Allison K., Bauser-Heaton, Holly, Georgiev, Stanimir, Berger, Felix, Millan-Iturbe, Oscar, Peng, Lynn F., Armstrong, Aimee K., Levi, Daniel S., Fronczak-Jakubczyk, Aneta, Sondergaard, Lars, Anderson, Jason H., Schranz, Dietmar, Jones, Thomas K., Cheatham, John P., Schubert, Stephan, and Ewert, Peter

Published
2021
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41. Langzeitverlauf nach Truncus Arteriosus Communis Korrektur

Author

Hörer, Jürgen (Prof. Dr.), Hörer, Jürgen (Prof. Dr.);Ewert, Peter (Prof. Dr.), Kusmenkov, Ekatharina, Hörer, Jürgen (Prof. Dr.), Hörer, Jürgen (Prof. Dr.);Ewert, Peter (Prof. Dr.), and Kusmenkov, Ekatharina

Abstract

Diese Arbeit dokumentiert und analysiert das bisher größte Single-Center-Kollektiv nach operativer Korrektur eines Truncus arteriosus communis. Die Auswertung zeigt die Verbesserung der Versorgung über 4 Jahrzehnte auf und stratifiziert das aktuell bestehende Risiko des Eingriffes. Zudem werden die Ergebnisse verschiedener Pulmonalklappen verglichen und der Einfluss der Truncusklappe auf die Mortalität beschrieben. Die Analyse zeigt hohe Überlebensraten bis in die vierte Lebensdekade., This work documents and analyzes the largest single-center collective to date following surgical repair of common arterial trunk. Improvements in care and outcome over 4 decades are demonstrated and the current risk profile is stratified. Furthermore, the results of different pulmonary grafts are compared and the influence of the truncal valve is described. Evaluation of long-term outcome shows high survival rates up to the fourth decade of life.

Published
2024

48. Impact of aortopulmonary collaterals on adverse events after total cavopulmonary connection

Author

Osawa, Takuya, primary, Schaeffer, Thibault, additional, Borgmann, Kristina, additional, Schmiel, Mervin, additional, Staehler, Helena, additional, Di Padua, Chiara, additional, Heinisch, Paul Philipp, additional, Piber, Nicole, additional, Mutsuga, Masato, additional, Hager, Alfred, additional, Ewert, Peter, additional, Hörer, Jürgen, additional, and Ono, Masamichi, additional

Published
2023
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