Pediatric cardiac devices, summer's role in heart defects, QOL highlight ACC meeting

March 30, 2009

Nearly two of every three children who have routine procedures for heart disorders may be receiving treatment with a device designated for an off-label use, according to new study findings.

Nearly two of every three children who have routine procedures for heart disorders may be receiving treatment with a device designated for an off-label use, according to new study findings. This was one of several pediatric cardiology findings presented at the American College of Cardiology's annual meeting in Orlando, FL, this week.

Researchers at Cincinnati Children's Hospital Medical Center assessed medical records of 473 children treated with 595 transcatheter procedures at CCHMC from 2005 to 2008. Off-label devices, such as stent implantations and balloon dilations, were used in 63% of patients and in 50% of all procedures.

Consequently, study presenter Robert Beekman, MD suggests relevant US government agencies should consider pediatric applications when approving cardiac devices.

In another ACC meeting highlight, study results have shown a potentially fatal congenital heart disease in newborns seems to spring up more often in the summer, according to CCHMC researchers. They suggest environment, in addition to genes, may be a significant contributing factor.

This study involved nearly 1,500 newborns from 38 children's hospitals in the United States who had left-sided congenital heart diseases, such as hypoplastic left heart syndrome (HLHS). In the study's 10-year duration (1996 to 2006), researchers discovered a seasonal link to occurrence of HLHS specifically, but not to other left-sided diseases. Peak periods of HLHS happened from April to July with dips in occurrence in January.

In a third ACC meeting highlight, a new discovery shows that just because a child or teen may survive successful repair of a complex heart defect doesn't mean everything's OK otherwise. Although children and youth who undergo such procedures have a 90% or higher survival rate, often quality of life is not so high.

The study, performed at seven U.S. pediatric medical centers, found certain patients tend to have lower quality of life after heart procedures. In recording after-effects, researchers, led by Bradley Marino, MD, constructed the Pediatric Cardiac Quality of Life Inventory (PCQLI) to document health-related quality of life in parents and their children and adolescents (age range: 8 to 18). A total of 759 pairs of patients, who had one or more cardiac surgical procedures, and their parents participated.

In children age 8 to 12, lower QOL scores were connected to African-American race, genetic defects, non-thoracic surgery and sternotomy. Additionally, mental health disorders in parents of children and teens of any age foretold lower QOL scores.