28 results on '"Freund MW"'
Search Results
2. Fluorinated steroids do not improve outcome of isolated atrioventricular block
- Author
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v.d. Berg, NWE, Slieker, MG, van Beynum, Ingrid, Bilardo, CM, de Bruijn, D, Clur, SAB, Cornette, J.M.J., Mulder, Ingrid, Haak, MC, van Loo-Maurus, KEH, Manten, GTR, Rackowitz, ABMH, Rammeloo, LAJ, Reimer, A, Rijlaarsdam, MEB, Freund, MW, Pediatrics, and Obstetrics & Gynecology
- Published
- 2016
3. Isolated atrioventricular block in the fetus: a retrospective, multinational, multicenter study of 175 patients
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Eliasson H, Sonesson SE, Sharland G, Granath F, Simpson JM, Carvalho JS, Jicinska H, Tomek V, Dangel J, Zielinsky P, Respondek-Liberska M, Freund MW,Mellander M, Bartron J, Gardiner HM, Oberhoffer R, Fetal Working Group of the European Association of Pediatric Cardiology and Eliasson H, Sonesson SE, Sharland G, Granath F, Simpson JM, Carvalho JS, Jicinska H, Tomek V, Dangel J, Zielinsky P, Respondek-Liberska M, Freund MW,Mellander M, Bartron J, Gardiner HM, Oberhoffer R, Fetal Working Group of the European Association of Pediatric Cardiology
- Published
- 2010
4. Isolated atrioventricular block in the fetus: a retrospective, multinational, multicenter study of 175 patients.
- Author
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Eliasson H, Sonesson SE, Sharland G, Granath F, Simpson JM, Carvalho JS, Jicinska H, Tomek V, Dangel J, Zielinsky P, Respondek-Liberska M, Freund MW, Mellander M, Bartrons J, Gardiner HM, and Fetal Working Group of the European Association of Pediatric Cardiology
- Published
- 2011
- Full Text
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5. Follow-up after biventricular repair of the hypoplastic left heart complex.
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IJsselhof RJ, Duchateau SDR, Schouten RM, Freund MW, Heuser J, Fejzic Z, Haas F, Schoof PH, and Slieker MG
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- Echocardiography, Follow-Up Studies, Heart Ventricles diagnostic imaging, Heart Ventricles surgery, Humans, Retrospective Studies, Treatment Outcome, Hypoplastic Left Heart Syndrome diagnostic imaging, Hypoplastic Left Heart Syndrome surgery
- Abstract
Objectives: In hypoplastic left heart complex patients, biventricular repair is preferred over staged-single ventricle palliation; however, there are too few studies to support either strategy. Therefore, we retrospectively characterized our patient cohort with hypoplastic left heart complex after biventricular repair to measure left-sided heart structures and assess our treatment strategy., Methods: Patients with hypoplastic left heart complex who had biventricular repair between 2004 and 2018 were retrospectively reviewed. Operative results were evaluated and echocardiographic mitral valve (MV) and aortic valve (AoV) dimensions, left ventricular length and left ventricular internal diastolic diameter (LVIDd) were measured preoperatively and during follow-up after 0.5, 1, 3, 5 and 10 years., Results: In 32 patients, the median age at surgery was 10 (interquartile range 5.0) days. The median follow-up was 6.19 (interquartile range 6.04) years. During the 10-year follow-up, the mean Z-scores increased from -2.82 to -1.49 and from -2.29 to 0.62 for MV and AoV, respectively. Analysis of variance results with post hoc paired t-tests showed that growth of left-sided heart structures was accelerated in the first year after repair, but was not equal, with the MV lagging behind the AoV (P = 0.033), resulting in significantly smaller MV Z-scores compared with AoV Z-scores at 10-year follow-up (P < 0.001). There were 2 (6%) early deaths. The major adverse events occurred in 4 (13%) patients. The surgical or catheter-based reintervention was required in 14 (44%) patients., Conclusions: The growth rate of heart structures was most prominent during the first year after biventricular repair with lower growth rate of the MV compared with the AoV., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2020
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6. Neonatal cardiac hypertrophy: the role of hyperinsulinism-a review of literature.
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Paauw ND, Stegeman R, de Vroede MAMJ, Termote JUM, Freund MW, and Breur JMPJ
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- Cardiomyopathy, Hypertrophic therapy, Congenital Hyperinsulinism diagnosis, Congenital Hyperinsulinism physiopathology, Diagnosis, Differential, Female, Humans, Infant, Newborn, Pregnancy, Prenatal Diagnosis, Prognosis, Risk Factors, Cardiomyopathy, Hypertrophic diagnosis, Cardiomyopathy, Hypertrophic etiology, Congenital Hyperinsulinism complications
- Abstract
Hypertrophic cardiomyopathy (HCM) in neonates is a rare and heterogeneous disorder which is characterized by hypertrophy of heart with histological and functional disruption of the myocardial structure/composition. The prognosis of HCM depends on the underlying diagnosis. In this review, we emphasize the importance to consider hyperinsulinism in the differential diagnosis of HCM, as hyperinsulinism is widely associated with cardiac hypertrophy (CH) which cannot be distinguished from HCM on echocardiographic examination. We supply an overview of the incidence and treatment strategies of neonatal CH in a broad spectrum of hyperinsulinemic diseases. Reviewing the literature, we found that CH is reported in 13 to 44% of infants of diabetic mothers, in approximately 40% of infants with congenital hyperinsulinism, in 61% of infants with leprechaunism and in 48 to 61% of the patients with congenital generalized lipodystrophy. The correct diagnosis is of importance since there is a large variation in prognoses and there are various strategies to treat CH in hyperinsulinemic diseases.Conclusion: The relationship between CH and hyperinsulism has implications for clinical practice as it might help to establish the correct diagnosis in neonates with cardiac hypertrophy which has both prognostic and therapeutic consequences. In addition, CH should be recognized as a potential comorbidity which might necessitate treatment in all neonates with known hyperinsulinism.What is Known:• Hyperinsulinism is currently not acknowledged as a cause of hypertrophic cardiomyopathy (HCM) in textbooks and recent Pediatric Cardiomyopathy Registry publications.What is New:• This article presents an overview of the literature of hyperinsulinism in neonates and infants showing that hyperinsulinism is associated with cardiac hypertrophy (CH) in a broad range of hyperinsulinemic diseases.• As CH cannot be distinguished from HCM on echocardiographic examination, we emphasize the importance to consider hyperinsulinism in the differential diagnosis of HCM/CH as establishing the correct diagnosis has both prognostic and therapeutic consequences.
- Published
- 2020
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7. Spectrum of heart diseases in children presenting to a paediatric cardiac echocardiography clinic in the Lake Zone of Tanzania: a 7 years overview.
- Author
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Zuechner A, Mhada T, Majani NG, Sharau GG, Mahalu W, and Freund MW
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- Age Factors, Cardiac Surgical Procedures, Female, Heart Defects, Congenital surgery, Heart Diseases surgery, Humans, Infant, Infant, Newborn, Male, Predictive Value of Tests, Prognosis, Registries, Retrospective Studies, Risk Factors, Sex Factors, Tanzania epidemiology, Time Factors, Echocardiography, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital epidemiology, Heart Diseases diagnostic imaging, Heart Diseases epidemiology
- Abstract
Background: Congenital heart diseases (CHD) are among the most common congenital malformations. It is estimated that the incidence of CHD is constant worldwide, but data are rare for most African countries including Tanzania. Even less data are available on the prevalence of acquired heart diseases (AHD) in African children. Rheumatic heart disease (RHD) is the leading cause of AHD and is remaining a public health concern in Sub-Saharan Africa affecting especially the younger population. Both, CHD and AHD contribute substantially to morbidity and mortality during infancy and childhood., Methods: This hospital-based, retrospective review of the registry at the paediatric cardiac clinic of Bugando Medical Centre in the Lake Zone of Tanzania analysed the spectrum of heart diseases of paediatric patients during their first presentation by using simple descriptive statistics., Results: Between September 2009 and August 2016, a total of 3982 patients received cardiac evaluation including echocardiography studies. 1830 (46.0%) pathologic findings were described, out of these 1371 (74.9%) patients had CHD, whereas 459 (25.1%) presented with AHD. 53.9% of the patients with CHD were female and the most common associated syndrome was Down syndrome in 12.8% of patients. In 807 patients (58.9%) diagnosis of CHD was established within the first year of life. The majority of patients (60.1%) were in need of surgical or interventional therapy at time of diagnosis and 6.3% of patients were judged inoperable at the time of first presentation. Nearly 50% of cases with AHD were RHDs followed by dilated cardiomyopathy and pulmonary hypertension without underlying CHD., Conclusions: The spectrum of CHD and AHD from one centre in Tanzania is comparable to findings reported in other countries from the African continent. Echocardiography is a valuable diagnostic tool and the widespread use of it should be enhanced to diagnose heart diseases in a large number and reasonable time. Most patients present late and majority is in need of surgical or interventional treatment, which is still not readily available. Untreated heart diseases contribute substantially to morbidity and mortality during infancy and childhood. Adequate cardiac services should be established and strengthened.
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- 2019
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8. Response to letter to the editor from F. Jacques et al.
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Vos LM, Kammeraad JAE, Freund MW, Blank AC, and Breur JMPJ
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- Humans, Infant, Retrospective Studies, Pacemaker, Artificial
- Published
- 2018
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9. Long-term outcome of transvenous pacemaker implantation in infants: a retrospective cohort study.
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Vos LM, Kammeraad JAE, Freund MW, Blank AC, and Breur JMPJ
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- Adolescent, Age Distribution, Arrhythmias, Cardiac complications, Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Longitudinal Studies, Male, Postoperative Complications diagnosis, Prosthesis Implantation methods, Retrospective Studies, Treatment Outcome, Arrhythmias, Cardiac prevention & control, Cardiac Pacing, Artificial adverse effects, Catheterization, Peripheral adverse effects, Pacemaker, Artificial adverse effects, Postoperative Complications etiology, Prosthesis Implantation adverse effects
- Abstract
Aim: Evaluation of long-term outcome of transvenous pacemaker (PM) implantation in infants., Methods and Results: A retrospective analysis of all transvenous PM implantations in infants <10 kg between September 1997 and October 2001 was made. Indications for PM implantation, age at implantation, and determinants of long-term outcome including cardiac function, PM function, and PM (system) complications were noted. Seven patients underwent transvenous VVI(R) PM implantation. Median age at implantation was 3 days (range: 1 day to 14 months), median weight 3.5 kg (range: 2.3-8.7 kg), and median follow-up 14 years (range: 12.3-16.3 years). Pacemaker indications were congenital complete atrioventricular block (n = 4), long QT syndrome with heart block (n = 2), and post-operative complete atrioventricular block with sinus node dysfunction (n = 1). No procedural complications were noted. Today all patients are alive and symptom free with good PM and cardiac function. Two patients underwent PM generator relocation for imminent skin necrosis and skin traction. Two patients suffered from asymptomatic left subclavian vein occlusion and developed thrombosis on the PM electrode. Three patients were converted to an epicardial PM system, due to atrial perforation after upgrading procedure (n = 1), syncope with need for implantable cardioverter defibrillator implantation (n = 1), and systolic dysfunction with development of dilated cardiomyopathy, which normalized under cardiac resynchronization therapy pacing (n = 1). Two patients needed atrioventricular (AV) valve repair for severe insufficiency. Two patients underwent repositioning of dysfunctional PM leads. In five patients, transvenous leads were removed. Indications were elective lead replacement (n = 1), atrial perforation (n = 1), and switch to an epicardial system (n = 3)., Conclusion: Transvenous PM implantation in infants (<10 kg) is associated with a high incidence of vascular occlusion, thrombosis, and severe atrioventricular valve regurgitation during long-term follow-up. We advocate an epicardial approach for PM implantation in small children., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.)
- Published
- 2017
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10. Interventional VSD-Closure with the Nit-Occlud ® Lê VSD-Coil in 110 Patients: Early and Midterm Results of the EUREVECO-Registry.
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Haas NA, Kock L, Bertram H, Boekenkamp R, De Wolf D, Ditkivskyy I, Freund MW, Gewillig M, Happel CM, Herberg U, Karthasyan E, Kozlik-Feldmann R, Kretschmar O, Kuzmenko Y, Milanesi O, Mueller G, Pongiglione G, Schubert S, Tarusinov G, and Kampmann C
- Subjects
- Adolescent, Child, Child, Preschool, Europe, Female, Heart Septal Defects, Ventricular classification, Humans, Infant, Male, Operative Time, Registries, Retrospective Studies, Treatment Outcome, Cardiac Catheterization methods, Fluoroscopy, Heart Septal Defects, Ventricular therapy, Hemolysis, Septal Occluder Device
- Abstract
In August 2010, the Nit-Occlud
® Lê (EUREVECO) became available for transcatheter coil occlusion of ventricular septal defects (VSDs). Retrospective European Registry for VSD Closure using the Nit-Occlud® Lê-VSD-Coil; analysis of the feasibility, results, safety and follow-up of VSD-closure over a 3-year period in 18 European centers. In 102 of 111 patients (female 66), successful VSD closure was performed (mean age 8.2 years, mean weight 28.82 kg), 81 perimembranous VSDs (48 with aneurysm), 30 muscular VSDs, mean procedure time was 121.1 min, and mean fluoroscopy time was 26.3 min. Short- and midterm term follow-up was possible in 100/102 patients, there was 1 embolization and 1 explantation after 24 months. Immediate complete closure occurred in 49 of 101 patients (48.5%), trivial residual shunt was present in 51 (50.0%), closure rate was 95% after 6 months and 97% after 1 year. Out of the 102 patients, there were 2 severe complications (1.8%) (1 severe hemolysis, 1 embolization) and 8 moderate/transient (=7.2%) including 1 transient AV block. During a mean follow-up period of 31.3 months (range 24-48) and a total follow-up time of 224.75 patient years, no further problems occurred. VSD closure with the Nit-Occlud® Lê VSD coil is feasible and safe with a minimal risk of severe side effects. The long-term effects and safety require further clinical follow-up studies.- Published
- 2017
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11. Fluorinated steroids do not improve outcome of isolated atrioventricular block.
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Van den Berg NW, Slieker MG, van Beynum IM, Bilardo CM, de Bruijn D, Clur SA, Cornette JM, Frohn-Mulder IM, Haak MC, van Loo-Maurus KE, Manten GT, Rackowitz AB, Rammeloo LA, Reimer A, Rijlaarsdam ME, and Freund MW
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- Adult, Atrioventricular Block epidemiology, Female, Follow-Up Studies, Humans, Netherlands epidemiology, Pregnancy, Prenatal Diagnosis methods, Prospective Studies, Treatment Outcome, Atrioventricular Block diagnostic imaging, Atrioventricular Block drug therapy, Fetal Heart diagnostic imaging, Fetal Heart drug effects, Steroids, Fluorinated administration & dosage
- Abstract
Introduction: Congenital atrioventricular block (CAVB) is a rare disorder with a significant morbidity and mortality. Consensus regarding the prescription and efficacy of prenatal corticosteroids is lacking. This nationwide study was initiated to evaluate the effects of prenatal treatment with corticosteroids on the outcome of CAVB in The Netherlands., Methods: All fetuses identified with isolated congenital AVB-II° or AVB-III° in any of the eight academic fetal heart centers of The Netherlands between 2003 and 2013 were included and reviewed., Results: Fifty-six fetuses were included. Fourteen (25%) fetuses were treated with dexamethasone. We found no differences between the steroid-treated and untreated cases regarding in utero progression of the AVB (63% vs 67% respectively), survival to birth (86% vs 84%), pacemaker implantations (74% vs 58%) or long-term dilated cardiomyopathy (13% vs 17%). Steroid treated fetuses demonstrated more in utero growth restriction (38% vs 11%)., Conclusion: No benefit from prenatal corticosteroid treatment was demonstrated for fetuses with isolated CAVB in this study. However, we found negative side effects. Our data provide no evidence to support the routine administration of corticosteroids for the treatment of fetal CAVB., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2016
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12. Midterm Follow-Up After Biventricular Repair of the Hypoplastic Left Heart Complex.
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Freund JE, den Dekker MH, Blank AC, Haas F, and Freund MW
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- Echocardiography, Female, Follow-Up Studies, Heart Ventricles diagnostic imaging, Humans, Hypoplastic Left Heart Syndrome diagnostic imaging, Hypoplastic Left Heart Syndrome mortality, Infant, Newborn, Male, Netherlands epidemiology, Postoperative Period, Retrospective Studies, Survival Rate trends, Time Factors, Cardiac Surgical Procedures methods, Heart Ventricles surgery, Hypoplastic Left Heart Syndrome surgery
- Abstract
Background: In neonates with hypoplastic left heart complex (HLHC), biventricular repair is considered superior to univentricular repair. The Z-scores of the mitral and the aortic valve annulus are primary factors for the choice of repair. Predictive cutoff values for the feasibility and optimal outcome of biventricular repair are unknown. This study assesses the growth of left side heart structures and the midterm outcome after biventricular repair with an interatrial fenestration in our HLHC population., Methods: Retrospective study of 19 HLHC patients who underwent biventricular repair in a single tertiary referral center between 2004 and 2013. The cardiac dimensions (mitral and aortic valve annulus, left ventricle inlet length, left ventricular internal diastolic dimension) were measured before and at 6, 12, 24, and 48 months after biventricular repair., Results: The follow-up ranged from 2 to 98 months. There was no early mortality, and the midterm survival rate was 95%. One patient died of a noncardiac- and nonintervention-related cause. Seven patients (37%) required a total of 8 reinterventions because of recurring or residual obstructive lesions. After biventricular repair, the left cardiac structures grew significantly., Conclusions: Neonatal biventricular repair is successful and safe in HLHC patients, even with preoperative mitral and aortic valve annulus Z-scores of -4.5 and -5.5, respectively. Residual or restenosis required reintervention in 37% of our HLHC population, but was not significantly correlated with the magnitude of the preoperative Z-scores. Within the first 6 months of follow-up, the Z-scores almost normalized., (Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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13. Effective radiation dosage of three-dimensional rotational angiography in children.
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Peters M, Krings G, Koster M, Molenschot M, Freund MW, and Breur JM
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- Adolescent, Child, Child, Preschool, Computer Simulation, Female, Humans, Infant, Infant, Newborn, Male, Models, Biological, Relative Biological Effectiveness, Reproducibility of Results, Sensitivity and Specificity, Angiography methods, Imaging, Three-Dimensional methods, Radiation Dosage, Radiation Exposure analysis, Radiation Protection methods, Radiometry methods
- Abstract
Aims: Three-dimensional rotational angiography (3DRA) is a relatively new but promising imaging technique in the paediatric catheterization laboratory. However, data on effective dose (ED) of this technique in children are lacking. The purpose of this study is to provide ED of 3DRA and to correlate this with parameters readily available in daily practice. Furthermore, the effect of dose-reducing techniques is evaluated., Methods and Results: Effective doses were calculated with Monte Carlo PCXMC 2.0 in 14 patients who underwent a total of 17 3DRAs at our paediatric catheterization laboratory. Median age was 5.7 years (range 1 day-16.6 years). Median ED was 1.6 milliSievert (mSv) (range 0.7-4.9). Effective dose did not correlate with age and body surface area but did correlate with dose area product (DAP) and milliGray (mGy) with r(2) of 0.75 and 0.83, respectively. Reduction of the total amount of frames from 248 to 133 per rotation resulted in further dose reduction of over 50% with preserved image quality., Conclusion: The median ED of 3DRA in children is 1.6 mSv and correlates with DAP and mGy. This dose can be halved by applying frame reduction. A significant further dose reduction can be achieved by obtaining additional knowledge of the equipment used., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)
- Published
- 2015
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14. Transcatheter embolization of a large aneurysm in a congenital coronary cameral fistula from the left coronary artery to the right ventricle.
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Freund JE, Yuko-Jowi C, and Freund MW
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- Aortography, Coronary Aneurysm diagnosis, Coronary Aneurysm etiology, Coronary Angiography, Coronary Vessel Anomalies diagnosis, Embolization, Therapeutic instrumentation, Female, Heart Ventricles diagnostic imaging, Humans, Prosthesis Design, Septal Occluder Device, Treatment Outcome, Vascular Fistula diagnosis, Young Adult, Cardiac Catheterization instrumentation, Coronary Aneurysm therapy, Coronary Vessel Anomalies complications, Embolization, Therapeutic methods, Heart Ventricles abnormalities, Vascular Fistula complications
- Abstract
A congenital coronary cameral fistula (CCCF) is characterized by left ventricular dysfunction, electrocardiographic changes due to a reduced left coronary blood flow and impaired physical activity. CCCF's with a giant aneurysm are very rarely seen. The presence of a giant aneurysm imposes even greater health risks. We report a case of a CCCF from the left coronary artery to the right ventricle with a large distal aneurysm in a 20-year-old woman that we closed percutaneously with coils for the closure of ventricular septal defects (VSD) and persistent ductus arteriosus (PDA)., (© 2014 Wiley Periodicals, Inc.)
- Published
- 2015
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15. Authors' reply.
- Author
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Slieker MG and Freund MW
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- Female, Humans, Male, Algorithms, Aortic Valve diagnostic imaging, Echocardiography methods, Hypoplastic Left Heart Syndrome diagnostic imaging, Mitral Valve diagnostic imaging
- Published
- 2014
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16. Authors' reply.
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Freund MW, den Dekker MH, Blank AC, Haas F, and Slieker MG
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- Female, Humans, Male, Algorithms, Aortic Valve diagnostic imaging, Echocardiography methods, Hypoplastic Left Heart Syndrome diagnostic imaging, Mitral Valve diagnostic imaging
- Published
- 2014
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17. Comparability of Z-score equations of cardiac structures in hypoplastic left heart complex.
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den Dekker MH, Slieker MG, Blank AC, Haas F, and Freund MW
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- Female, Humans, Image Enhancement methods, Infant, Newborn, Male, Reproducibility of Results, Sensitivity and Specificity, Algorithms, Aortic Valve diagnostic imaging, Echocardiography methods, Hypoplastic Left Heart Syndrome diagnostic imaging, Mitral Valve diagnostic imaging
- Abstract
Background: Hypoplastic left heart complex (HLHC) is characterized by a mitral valve or an aortic valve annular Z score < -2, antegrade flow in the ascending aorta, ductal dependency, coarctation or aortic arch hypoplasia, and absence of significant (sub)valvar stenosis. The Z scores of the mitral and aortic valve annuli are major determinants of HLHC. Therefore, the algorithm for Z-score calculation is essential for diagnosis. However, no single universal method of calculation is in use. In the scientific literature addressing HLHC, various Z-score calculation methods have been applied. The aim of this study was to evaluate Z scores derived from two-dimensional echocardiographic dimensions in patients with HLHC., Methods: To compare the different published methods using two-dimensional echocardiographic measures for Z-score calculation, a cohort of 18 newborns diagnosed with HLHC was retrospectively evaluated. In addition, the methods to determine body surface area in newborns were evaluated., Results: Three Z-score calculation methods were included and compared. Using the method of Daubeney et al. to calculate Z scores in our cohort illustrated a lack of correlation beyond a Z score < 0, compared with the methods of Zilberman et al. and Pettersen et al. Z scores calculated using Zilberman et al.'s and Pettersen et al.'s methods were fairly consistent. The equations used by Pettersen et al. are based on the largest population of neonates., Conclusion: Although the different methods for calculating Z scores for mitral and aortic valve dimensions correspond fairly well in the normal range, Z scores < -2 diverge substantially. A useful scientific comparison of published data and outcomes of patients with HLHC remains elusive. The Z-score calculation algorithms used by Pettersen et al. appear to be the most appropriate for use in an evaluation of HLHC. Because these different methods can yield different values, reporting the method as well as the Z score is essential for an accurate diagnosis. Similarly, the method used to determine body surface area should be reported., (Copyright © 2013 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.)
- Published
- 2013
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18. Sotalol as first-line treatment for fetal tachycardia and neonatal follow-up.
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van der Heijden LB, Oudijk MA, Manten GT, ter Heide H, Pistorius L, and Freund MW
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- Atrial Flutter complications, Echocardiography, Female, Follow-Up Studies, Humans, Hydrops Fetalis, Pregnancy, Prenatal Care methods, Retrospective Studies, Tachycardia, Supraventricular complications, Treatment Outcome, Anti-Arrhythmia Agents therapeutic use, Atrial Flutter drug therapy, Fetal Diseases drug therapy, Sotalol therapeutic use, Tachycardia, Supraventricular drug therapy
- Abstract
Objectives: In fetal tachycardia, pharmacological therapy with digoxin, flecainide and sotalol has been reported to be effective. In a recent retrospective multicenter study, sotalol was considered to be less effective than the other drugs in treatment of fetal supraventricular tachycardia (SVT). The aim of this study was to re-evaluate the efficacy and safety of maternally administered sotalol in the treatment of fetal tachycardia., Methods: This was a retrospective review of the records of 30 consecutive fetuses with tachycardia documented on M-mode echocardiography between January 2004 and December 2010 at Wilhelmina Children's Hospital, a tertiary referral university hospital. Patients were subdivided into those diagnosed with supraventricular tachycardia and those with atrial flutter (AF) and presence of hydrops was noted. Other variables investigated included QTc interval measured on maternal electrocardiogram before and after initiation of antiarrhythmic therapy, fetal heart rhythm and heart rate pre- and postnatally, oral maternal drug therapy used, time to conversion to sinus rhythm (SR), percentage of fetuses converted following transplacental treatment, maternal adverse effects, presence or absence of tachycardia as noted on postnatal ECG, postnatal therapy or prophylaxis and neonatal outcome. Findings are discussed with reference to the literature., Results: A total of 28 patients (18 with SVT, 10 with AF) were treated with sotalol as first-line therapy. Fetal hydrops was present in six patients (five with SVT, one with AF). All hydropic patients converted antenatally to SR (67% with sotalol as a single-drug therapy, 33% after addition of flecainide). Of the non-hydropic patients, 91% converted to SR (90% with sotalol only, 10% after addition of flecainide or digoxin). In 9% (with AF) rate control was achieved. There was no mortality. No serious drug-related adverse events were observed. Postnatally, rhythm disturbances were detected in 10 patients, two of whom still had AF. In eight, SVT was observed within 3 weeks postnatally, and in five of these within 72 hours., Conclusions: Sotalol can be recommended as the drug of first choice for treatment of fetal AF and has been shown to be an effective and safe first-line treatment option for SVT, at least in the absence of hydrops. Postnatal maintenance therapy after successful prenatal therapy is not necessarily indicated, as the risk of recurrence is low beyond 72 hours of age., (Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.)
- Published
- 2013
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19. Native atretic coarctation of the aorta in a 37-year-old hypertensive woman, treated with a low-profile covered stent.
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Freund MW, Vollebregt AM, Krings G, Vonken EP, Agostoni P, and Meijboom FJ
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- 2013
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20. Fetal heart disease: severity, associated anomalies and parental decision.
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Nell S, Wijngaarde CA, Pistorius LR, Slieker M, ter Heide H, Manten GT, and Freund MW
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- Abnormalities, Multiple physiopathology, Adult, Cohort Studies, Decision Making, Female, Fetal Diseases physiopathology, Heart Defects, Congenital physiopathology, Hospitals, Special, Humans, Male, Netherlands, Parents, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Referral and Consultation, Retrospective Studies, Severity of Illness Index, Ultrasonography, Prenatal, Abnormalities, Multiple diagnostic imaging, Abortion, Eugenic, Fetal Diseases diagnostic imaging, Heart Defects, Congenital diagnostic imaging
- Abstract
Objective: This study describes the association between the complexity of congenital cardiac and extracardiac malformations, and the parental decision of pregnancy continuation or termination., Methods: Congenital heart defects (CHD) was diagnosed by ultrasound in 251 fetuses before the 24th week (23 + 6 weeks) of gestation during the four year period from 2007 to 2010. All fetuses from the Utrecht region were referred to our center due to a strict referral pattern. The complexity and severity of the cardiac and possible extracardiac malformations were retrospectively categorized by a pediatric cardiologist and a perinatologist who were blinded to the pregnancy outcome. The groups with and without termination of pregnancy were compared using a univariate analysis and multivariate logistic regression., Results: In 119 (47%) of the 251 fetuses, parents opted for termination of pregnancy. In 103 of these cases (87%) there was a high complex or lethal cardiac, or a major or lethal extracardiac malformation. Of the 132 continued pregnancies, 42 fetuses (32%) had a high complex or lethal cardiac, or a major or lethal extracardiac malformation. There were significantly more terminations of pregnancy in case of a high or lethal complex cardiac or extracardiac anomaly (71 vs. 15%, p <0.001)., Conclusion: Parents opted for termination of pregnancy significantly more often in cases with high complex cardiac and extracardiac malformations. It was rare for parents to opt for pregnancy termination in the absence of a severe cardiac or extracardiac malformation., (Copyright © 2013 S. Karger AG, Basel.)
- Published
- 2013
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21. Chiari's network as a cause of fetal and neonatal pathology.
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Bendadi F, van Tijn DA, Pistorius L, and Freund MW
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- Echocardiography, Female, Humans, Infant, Newborn, Pregnancy, Heart Defects, Congenital complications, Hydrops Fetalis etiology, Tricuspid Valve abnormalities, Vena Cava, Inferior abnormalities
- Abstract
Chiari's network is a remnant of the eustachian valve located in the right atrium. Incomplete involution of the fetal sinus venosus valves results in "redundant" Chiari's network, which may compromise cardiovascular function. This report describes a case with the novel finding of prenatal compromise due to redundant Chiari's network and an uncommon case with significant postnatal symptoms. In both cases, the symptoms (fetal hydrops and postnatal cyanosis) resolved spontaneously. The variety of cardiovascular pathologies described in the literature is believed to be associated with persistence of a Chiari network. Knowledge about this not always harmless structure is important for perinatologists, pediatricians, and pediatric cardiologists alike. The clinical importance of this rare pathology is that prenatal counseling may anticipate a generally positive outcome and that surgical intervention generally should be avoided.
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- 2012
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22. Juxtaductal coarctation of both pulmonary arteries in a cat.
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Szatmári V, Freund MW, Veldhuis Kroeze EJ, and Strengers J
- Subjects
- Animals, Aortic Coarctation diagnostic imaging, Aortic Coarctation pathology, Cats, Ductus Arteriosus, Patent complications, Ductus Arteriosus, Patent diagnostic imaging, Ductus Arteriosus, Patent pathology, Ductus Arteriosus, Patent veterinary, Dyspnea etiology, Dyspnea veterinary, Echocardiography veterinary, Fatal Outcome, Heart Murmurs etiology, Heart Murmurs veterinary, Liver diagnostic imaging, Liver pathology, Lung pathology, Male, Myocardium pathology, Orchiectomy, Postmortem Changes, Pulmonary Artery diagnostic imaging, Pulmonary Artery pathology, Radiography, Thoracic veterinary, Aortic Coarctation veterinary, Pulmonary Artery abnormalities
- Abstract
A 4-year-old, male, neutered cat was referred because of recurrent episodes of dyspnea. Physical examination revealed a harsh systolic murmur, with the point of maximal intensity in the left heart base, with an intensity of 4 out of 6. Echocardiographic diagnosis was severe supravalvular pulmonary artery stenosis. A selective right ventricular angiocardiogram showed an absence of arterial blood flow to the left lung lobes. A balloon dilatation of the localized stenosis of the right pulmonary artery was attempted with cardiac catheterization. However, when the catheter was passed through the stenosis, the blood flow to the lungs temporarily completely ceased, which led to death. Postmortem examination revealed a circumscribed stenosis of both pulmonary arteries at the site of the bifurcation, where the ligamentum arteriosum was attached. Histopathology showed that the localized ridge-like stenosis at the pulmonary artery bifurcation was caused by connective tissue. The suspected cause of this congenital anomaly is the presence of ectopic ductal tissue in the wall of the pulmonary artery. When the ductus arteriosus closes at birth, pulmonary artery stenosis developed because of constriction of the ectopic ductal tissue.
- Published
- 2010
- Full Text
- View/download PDF
23. Prognosis for neonates with enterovirus myocarditis.
- Author
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Freund MW, Kleinveld G, Krediet TG, van Loon AM, and Verboon-Maciolek MA
- Subjects
- Cardiomyopathy, Dilated virology, Electrocardiography, Enterovirus Infections complications, Enterovirus Infections diagnostic imaging, Female, Follow-Up Studies, Heart Aneurysm virology, Humans, Infant, Newborn, Male, Myocarditis diagnosis, Myocarditis diagnostic imaging, Prognosis, Ultrasonography, Enterovirus B, Human isolation & purification, Enterovirus Infections diagnosis, Myocarditis virology
- Abstract
Objective: To assess the severity of the disease and the long-term cardiac prognosis for neonates who developed enterovirus (EV) myocarditis within the first weeks of life., Design: Clinical presentation, echocardiographic and ECG findings and the outcome of seven infants with EV myocarditis admitted to the intensive care unit are reported. Additionally, 28 previously reported cases are described., Results: Seven neonates presented with cardiac failure within 17 days after birth requiring respiratory and circulatory support. Echocardiography showed dilatation and severe dysfunction of the left ventricle in all and mitral regurgitation in six. In six patients the echocardiographic pattern resembled myocardial infarction. ECG showed complete loss of the R-wave and a new Q-wave in the left precordial leads in all. Two infants died and five developed long-term cardiac sequelae requiring medication. In all survivors aneurysm formation in the left ventricular wall was found weeks to months later. One patient is awaiting heart transplantation. Coxsackie virus B was detected in blood, cerebrospinal fluid, nasopharyngeal swab or stool by PCR or culture. The mortality of previously described neonates combined with our seven cases was 31% (11/35). Among the survivors 66% (16/24) developed severe cardiac damage. Only 23% (8/35) of the infants fully recovered., Conclusions: EV myocarditis is a rare but severe disease in the neonatal period, which often leads to death or results in serious chronic cardiac sequelae like chronic heart failure, aneurysm formation within the left ventricle and mitral regurgitation. Chronic cardiac drug therapy is necessary in the majority of these patients.
- Published
- 2010
- Full Text
- View/download PDF
24. Association between antidepressant drug use during pregnancy and child healthcare utilisation.
- Author
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Ververs TF, van Wensen K, Freund MW, van der Heide M, Visser GH, Schobben AF, de Jong-van den Berg LT, and Egberts AC
- Subjects
- Antidepressive Agents administration & dosage, Antidepressive Agents therapeutic use, Cohort Studies, Delivery of Health Care statistics & numerical data, Depressive Disorder epidemiology, Drug Administration Schedule, Female, Heart Defects, Congenital chemically induced, Heart Defects, Congenital epidemiology, Humans, Infant, Infant, Newborn, Male, Maternal-Fetal Exchange, Netherlands epidemiology, Patient Acceptance of Health Care statistics & numerical data, Pregnancy, Pregnancy Complications epidemiology, Antidepressive Agents adverse effects, Child Health Services statistics & numerical data, Depressive Disorder drug therapy, Pregnancy Complications drug therapy, Prenatal Exposure Delayed Effects epidemiology
- Abstract
Objective: To evaluate healthcare utilisation by children who were exposed to antidepressant drug use during pregnancy and those whose mothers stopped using antidepressants before pregnancy compared with a control group., Design: Cohort study. Setting Health insurance records in the Netherlands., Population: A total of 38 602 children born between 2000 and 2005., Methods: Survey of child healthcare utilisation in relation to gestational antidepressant use., Main Outcome Measure: Healthcare utilisation rates during the first year of life, with special emphasis to medical care related to cardiac disease., Results: Children of mothers who used antidepressants during pregnancy showed increased healthcare use during the first year of life, independent of the mother's healthcare use. The relative risk of more than two visits to general practitioners was 1.5 (95% confidence interval, CI: 1.3-1.8) in the continuous antidepressant users group and 1.3 (95% CI: 1.2-1.5) in the group of children whose mothers stopped taking medication. In both study groups there was a trend towards more drug use for infections and inflammation compared with the control group. Children continuously exposed to antidepressants had an increased risk of cardiac interventions such as cardiovascular surgery or heart catheterisation, relative risk of 5.6 (95% CI: 1.8-17.4). The risk of physiotherapy was twice as high in the antidepressant group compared with the control group (relative risk 2.0; 95% CI: 1.5-2.6)., Conclusion: Antidepressant use during pregnancy is associated with increased child healthcare utilisation and increased risk of major cardiac interventions in early childhood.
- Published
- 2009
- Full Text
- View/download PDF
25. Successful percutaneous balloon valvuloplasty in a preterm infant weighing 1500 g with critical pulmonary valve stenosis.
- Author
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Freund MW, Schouten T, Lemmers P, Schroer C, and Strengers J
- Abstract
We describe a successful cardiac intervention in an infant, born at 32 weeks of gestation, with a birth weight of 1040 g, who had a critical pulmonary valve stenosis with the right ventricular pressure twice the systemic pressure. Continuous prostaglandin E infusion kept the arterial duct open and at the age of four weeks and a weight of 1500 g a balloon valvuloplasty was performed, which reduced the systolic right ventricular pressure to below the systemic pressure. Two weeks later the procedure was repeated because of increasing right ventricular pressure. At two months of age the mean systolic transpulmonary Doppler gradient was 30 mmHg with an adequate right ventricular volume. The neurological status of the infant was normal and the femoral vein was patent. Timely interventional heart catheterisation is a successful method of treatment in critical pulmonary valve stenosis in infants with a low birth weight. (Neth Heart J 2008;16:264-6.).
- Published
- 2008
- Full Text
- View/download PDF
26. Life threatening cavopulmonary thrombus: resolution within 24 h with tissue plasminogen activator.
- Author
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Malagon I, Evens FC, and Freund MW
- Subjects
- Acute Disease, Angiography, Female, Heparin administration & dosage, Humans, Infant, Postoperative Complications diagnosis, Postoperative Complications drug therapy, Superior Vena Cava Syndrome diagnosis, Time Factors, Vena Cava, Superior diagnostic imaging, Fibrinolytic Agents therapeutic use, Heart Diseases drug therapy, Pulmonary Atresia surgery, Superior Vena Cava Syndrome drug therapy, Thrombosis drug therapy, Tissue Plasminogen Activator therapeutic use
- Published
- 2008
- Full Text
- View/download PDF
27. Pentalogy of Cantrell : successful early correction.
- Author
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Korver AM, Haas F, Freund MW, and Strengers JL
- Subjects
- Coronary Angiography, Heart Atria abnormalities, Heart Ventricles diagnostic imaging, Humans, Infant, Newborn, Male, Syndrome, Thorax abnormalities, Tomography, X-Ray Computed, Abdominal Wall abnormalities, Abnormalities, Multiple surgery, Diverticulum surgery, Heart Diseases surgery, Heart Septal Defects, Ventricular surgery, Heart Ventricles abnormalities
- Abstract
The pentalogy of Cantrell is a rare midline developmental field complex often with a dismal outcome. We present a newborn qualifying for Cantrell's pentalogy with an abdominal wall defect, a diaphragmatic defect and a heart defect, a ventricular septal defect (VSD) and a left ventricular diverticulum. Early operative correction following accurate diagnostic work-up was prompted at the age of 11 weeks because of progressive heart failure. Beside correction of the VSD and the abdominal and diaphragmatic defects, resection of the distal part of the diverticulum was possible without damage to the LAD and preserving good contractility. Two years postoperative follow-up is uneventful.
- Published
- 2008
- Full Text
- View/download PDF
28. Aortico-right ventricular tunnel: prenatal diagnosis leading to neonatal survival.
- Author
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Freund MW, Stoutenbeek P, van der Laan M, ter Heide H, Evens J, Strengers J, and Haas F
- Subjects
- Aortic Valve surgery, Echocardiography, Doppler methods, Female, Heart Defects, Congenital diagnosis, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital surgery, Heart Ventricles surgery, Humans, Infant, Newborn, Pregnancy, Aortic Valve abnormalities, Aortic Valve diagnostic imaging, Heart Ventricles abnormalities, Heart Ventricles diagnostic imaging, Prenatal Diagnosis methods
- Abstract
In the 36th week of gestation a large aortico-right ventricular tunnel with an otherwise structurally normal heart was diagnosed by fetal echocardiography. This report describes for the first time the impact of the timely prenatal diagnosis of an aortico-right ventricular tunnel followed by successful management in early infancy., (Copyright 2007 S. Karger AG, Basel.)
- Published
- 2007
- Full Text
- View/download PDF
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