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  1. Article ; Online: A left-sided veno-venous bridge.

    Buddhavarapu, Amulya / Anderson, Robert H / Shirali, Girish S / Gibson, William J / Shah, Sanket S

    Cardiology in the young

    2021  Volume 32, Issue 6, Page(s) 1007–1009

    Language English
    Publishing date 2021-10-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951121004315
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  2. Article ; Online: Three-dimensional echocardiography in congenital heart disease.

    Shirali, Girish S

    Echocardiography (Mount Kisco, N.Y.)

    2012  Volume 29, Issue 2, Page(s) 242–248

    Abstract: Complex intracardiac anatomy and spatial relationships are inherent to congenital heart defects (CHDs). Recognition of the limitations of two-dimensional echocardiography has stimulated clinical interest in three-dimensional imaging. The current review ... ...

    Abstract Complex intracardiac anatomy and spatial relationships are inherent to congenital heart defects (CHDs). Recognition of the limitations of two-dimensional echocardiography has stimulated clinical interest in three-dimensional imaging. The current review examines contemporary studies in the following areas where three-dimensional echocardiography has provided additive value in CHD: (1) visualization of morphology, (2) quantitation of chamber sizes and ventricular function, and (3) image-guided interventions.
    MeSH term(s) Child ; Echocardiography, Three-Dimensional/methods ; Echocardiography, Three-Dimensional/trends ; Echocardiography, Transesophageal/methods ; Heart Defects, Congenital/diagnostic imaging ; Humans
    Language English
    Publishing date 2012-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 843645-9
    ISSN 1540-8175 ; 0742-2822
    ISSN (online) 1540-8175
    ISSN 0742-2822
    DOI 10.1111/j.1540-8175.2011.01612.x
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  3. Article ; Online: Development and Initial Validation of a Frailty Score for Pediatric Patients with Congenital and Acquired Heart Disease.

    Studyvin, Sarah / Birnbaum, Brian F / Staggs, Vincent S / Gross-Toalson, Jami / Shirali, Girish / Panchangam, Chaitanya / White, David A

    Pediatric cardiology

    2022  Volume 45, Issue 4, Page(s) 888–900

    Abstract: Frailty is a multi-dimensional clinical syndrome that is associated with increased morbidity and mortality and decreased quality of life. Children/adolescents with heart disease (HD) perform significantly worse for each frailty domain compared to non-HD ... ...

    Abstract Frailty is a multi-dimensional clinical syndrome that is associated with increased morbidity and mortality and decreased quality of life. Children/adolescents with heart disease (HD) perform significantly worse for each frailty domain compared to non-HD peers. Our study aimed to create a composite frailty score (CFS) that can be applied to children/adolescents with HD and evaluate associations between the CFS and outcomes. Children and adolescents (n = 30) with HD (73% single ventricle, 20% heart failure, 7% pulmonary hypertension) were recruited from 2016 to 2017 (baseline). Five frailty domains were assessed at baseline using measures validated for pediatrics: (1) Slowness: 6-min walk test; (2) Weakness: handgrip strength; (3) Fatigue: PedsQL Multi-dimensional Fatigue Scale; (4) Body composition: triceps skinfold thickness; and (5) Physical activity questionnaire. Frailty points per domain (range = 0-5) were assigned based on z-scores or raw questionnaire scores and summed to produce a CFS (0 = least frail; 25 = most frail). Nonparametric bootstrapping was used to identify correlations between CFS and cross-sectional change in outcomes over 2.2 ± 0.2 years. The mean CFS was 12.5 ± 3.5. In cross-sectional analyses of baseline data, correlations (|r|≥ 0.30) were observed between CFS and NYHA class, the number of ancillary specialists, total prescribed medications, heart failure medications/day, exercise test derived chronotropic index and percent predicted VO
    MeSH term(s) Adolescent ; Humans ; Child ; Frailty ; Quality of Life ; Cross-Sectional Studies ; Hand Strength ; Heart Diseases/complications ; Heart Failure/complications ; Fatigue/complications
    Language English
    Publishing date 2022-11-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800857-7
    ISSN 1432-1971 ; 0172-0643
    ISSN (online) 1432-1971
    ISSN 0172-0643
    DOI 10.1007/s00246-022-03045-1
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  4. Article ; Online: Association Between Remote Monitoring and Interstage Morbidity and Death in Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups.

    Cherestal, Bianca / Erickson, Lori A / Noel-MacDonnell, Janelle R / Shirali, Girish / Graue Hancock, Hayley S / Aly, Doaa / Files, Matthew / Clauss, Sarah / Jayaram, Natalie

    Journal of the American Heart Association

    2023  Volume 12, Issue 23, Page(s) e031069

    Abstract: Background: Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel ...

    Abstract Background: Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES.
    Methods and results: Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the basis of 6 variables relating to SES. Hierarchical logistic regression, adjusted for potential confounding characteristics, was used to determine the association between SES and death or transplant listing during the interstage period. Of 610 infants, 39 (6.4%) died or were listed for transplant. In unadjusted analysis, the rate of reaching the primary outcome between SES tertiles was similar (
    Conclusions: In a large multicenter cohort of infants with single-ventricle heart disease enrolled in a digital remote monitoring program during the interstage period, we found no difference in outcomes based on SES. Our study suggests that this novel technology could help mitigate differences in outcomes for this fragile population of patients.
    MeSH term(s) Humans ; Infant ; Heart Ventricles/surgery ; Retrospective Studies ; Risk Factors ; Socioeconomic Factors ; Treatment Outcome ; Univentricular Heart
    Language English
    Publishing date 2023-11-28
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.123.031069
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  5. Article ; Online: Three dimensional echocardiography in congenital heart defects.

    Shirali, Girish S

    Annals of pediatric cardiology

    2010  Volume 1, Issue 1, Page(s) 8–17

    Abstract: Three dimensional echocardiography (3DE) is a new, rapidly evolving modality for cardiac imaging. Important technological advances have heralded an era where practical 3DE scanning is becoming a mainstream modality. We review the modes of 3DE that can be ...

    Abstract Three dimensional echocardiography (3DE) is a new, rapidly evolving modality for cardiac imaging. Important technological advances have heralded an era where practical 3DE scanning is becoming a mainstream modality. We review the modes of 3DE that can be used. The literature has been reviewed for articles that examine the applicability of 3DE to congenital heart defects to visualize anatomy in a spectrum of defects ranging from atrioventricular septal defects to mitral valve abnormalities and Ebstein's anomaly. The use of 3DE color flow to obtain echocardiographic angiograms is illustrated. The state of the science in quantitating right and left ventricular volumetrics is reviewed. Examples of novel applications including 3DE transesophageal echocardiography and image-guided interventions are provided. We also list the limitations of the technique, and discuss potential future developments in the field.
    Language English
    Publishing date 2010-02-04
    Publishing country India
    Document type Journal Article
    ZDB-ID 2430956-4
    ISSN 0974-5149 ; 0974-2069
    ISSN (online) 0974-5149
    ISSN 0974-2069
    DOI 10.4103/0974-2069.41050
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  6. Article ; Online: Echocardiography of coarctation of the aorta, aortic arch hypoplasia, and arch interruption: strategies for evaluation of the aortic arch.

    Goudar, Suma P / Shah, Sanket S / Shirali, Girish S

    Cardiology in the young

    2016  Volume 26, Issue 8, Page(s) 1553–1562

    Abstract: Aim Echocardiography is the modality of choice for the diagnosis and serial follow-up of aortic arch pathology. In this article, we review the types of obstruction of the aortic arch, various classification schemes of coarctation of the aorta and ... ...

    Abstract Aim Echocardiography is the modality of choice for the diagnosis and serial follow-up of aortic arch pathology. In this article, we review the types of obstruction of the aortic arch, various classification schemes of coarctation of the aorta and interrupted aortic arch, methodology for optimal echocardiographic imaging of the aortic arch, and key echocardiographic measurements for accurate diagnosis of obstruction and hypoplasia of the aortic arch. Finally, we will discuss the limitations of echocardiography in optimal imaging of the aortic arch and the use of other non-invasive imaging modalities such as CT or MRI to provide additional information in these cases.
    Background: Coarctation of the aorta is the more common lesion of the two, with an estimated incidence of four in every 10,000 live births in the United States of America. Interrupted aortic arch is rarer, with an incidence of 19 per one million live births. 1 There is a spectrum of pathology of obstruction of the aortic arch, ranging from coarctation of the aorta with and without hypoplasia of the arch to interrupted aortic arch. Both these lesions are frequently encountered in congenital cardiology practice, and will be discussed in the remainder of this article. Obstruction of the aortic arch in the setting of hypoplastic left heart structures or atresia of the aortic valve is beyond the scope of this review and will not be discussed further.
    MeSH term(s) Aorta, Thoracic/abnormalities ; Aorta, Thoracic/diagnostic imaging ; Aortic Coarctation/diagnostic imaging ; Aortic Rupture/diagnostic imaging ; Aortic Valve/abnormalities ; Computed Tomography Angiography ; Echocardiography, Doppler, Color ; Humans ; Infant ; Magnetic Resonance Imaging
    Language English
    Publishing date 2016-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951116001670
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  7. Article ; Online: Single ventricular strain measures correlate with peak oxygen consumption in children and adolescents with Fontan circulation.

    Goudar, Suma / Forsha, Daniel / White, David A / Sherman, Ashley / Shirali, Girish

    Cardiology in the young

    2022  Volume 33, Issue 7, Page(s) 1136–1142

    Abstract: Introduction: Children with a single ventricle post-Fontan palliation are at increased risk of poor outcomes with peak oxygen consumption acting as a surrogate outcome marker. The purpose of this study is to evaluate the relationship between peak oxygen ...

    Abstract Introduction: Children with a single ventricle post-Fontan palliation are at increased risk of poor outcomes with peak oxygen consumption acting as a surrogate outcome marker. The purpose of this study is to evaluate the relationship between peak oxygen consumption and echocardiographic measures of ventricular function and deformation, including ventricular global longitudinal strain and dyssynchrony, in children and adolescents following Fontan palliation.
    Methods: Patients (age 8-21 years) with single ventricle post-Fontan palliation were prospectively recruited and participated in an echocardiogram, including views optimised for two-dimensional speckle tracking, and a cardiopulmonary exercise test on a cycle ergometer to maximal volitional fatigue.
    Results: Thirty-eight patients (mean age 13.7 ± 2.3 years) post-Fontan palliation had either a single left ventricular (n = 20), single right ventricular (n = 14), or biventricular (n = 4) morphology. Peak oxygen consumption (24.9 ± 5.6 ml/kg/minute) was correlated with global longitudinal strain (r = -0.435, p = 0.007), a strain discoordination time to peak index (r = -0.48, p = 0.003), and the presence of an electro-mechanical dyssynchrony strain pattern (p = 0.008). On multivariate regression modelling, these three variables were associated with peak oxygen consumption independently of age and sex. The single right ventricular group had evidence of possible diastolic dysfunction by E/e' compared to the single left ventricular and biventricular groups (p = 0.001).
    Conclusions: Strain analysis measures are correlated with peak oxygen consumption in this cohort of children, adolescents, and young adults following Fontan palliation, suggesting that ventricular mechanics may influence the efficiency of the Fontan circulation.
    MeSH term(s) Young Adult ; Humans ; Child ; Adolescent ; Adult ; Fontan Procedure/adverse effects ; Heart Ventricles ; Echocardiography/methods ; Ventricular Function ; Oxygen Consumption
    Language English
    Publishing date 2022-07-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951122002323
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  8. Article ; Online: Physical Activity Patterns in Children and Adolescents With Heart Disease.

    White, David A / Willis, Erik A / Panchangam, Chaitanya / Teson, Kelli M / Watson, Jessica S / Birnbaum, Brian F / Shirali, Girish / Parthiban, Anitha

    Pediatric exercise science

    2020  Volume 32, Issue 4, Page(s) 233–240

    Abstract: Purpose: To quantify the differences in daily physical activity (PA) patterns, intensity-specific volumes, and PA bouts in youth with and without heart disease (HD).: Methods: Seven-day PA was measured on children/adolescents with HD (n = 34; median ... ...

    Abstract Purpose: To quantify the differences in daily physical activity (PA) patterns, intensity-specific volumes, and PA bouts in youth with and without heart disease (HD).
    Methods: Seven-day PA was measured on children/adolescents with HD (n = 34; median age 12.4 y; 61.8% male; 70.6% single ventricle, 17.7% heart failure, and 11.8% pulmonary hypertension) and controls without HD (n = 22; median age 12.3 y; 59.1% male). Mean counts per minute were classified as sedentary, light, and moderate to vigorous PA (MVPA), and bouts of MVPA were calculated. PA was calculated separately for each hour of wear time from 8:00 to 22:00. Multilevel linear mixed modeling compared the outcomes, stratifying by group, time of day, and day part (presented as median percentage of valid wear time [interquartile range]).
    Results: Compared with the controls, the HD group had more light PA (33.9% [15%] vs 29.6% [9.5%]), less MVPA (1.7% [2.5%] vs 3.2% [3.3%]), and more sporadic bouts (97.4% [5.7%] vs 89.9% [9.2%]), but fewer short (2.0% [3.9%] vs 7.1% [5.7%]) and medium-to-long bouts (0.0% [1.9%] vs 1.6% [4.6%]) of MVPA. The HD group was less active in the late afternoon, between 15:00 and 17:00 (P < .03). There were no differences between groups in sedentary time.
    Conclusion: Children/adolescents with HD exhibit differences in intensity-specific volumes, PA bouts, and daily PA patterns compared with controls.
    Language English
    Publishing date 2020-09-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1042382-5
    ISSN 1543-2920 ; 0899-8493
    ISSN (online) 1543-2920
    ISSN 0899-8493
    DOI 10.1123/pes.2020-0073
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  9. Article ; Online: Interstage Home Monitoring for Infants With Single Ventricle Heart Disease: Education and Management: A Scientific Statement From the American Heart Association.

    Rudd, Nancy A / Ghanayem, Nancy S / Hill, Garick D / Lambert, Linda M / Mussatto, Kathleen A / Nieves, Jo Ann / Robinson, Sarah / Shirali, Girish / Steltzer, Michelle M / Uzark, Karen / Pike, Nancy A

    Journal of the American Heart Association

    2020  Volume 9, Issue 16, Page(s) e014548

    Abstract: This scientific statement summarizes the current state of knowledge related to interstage home monitoring for infants with shunt-dependent single ventricle heart disease. Historically, the interstage period has been defined as the time of discharge from ... ...

    Abstract This scientific statement summarizes the current state of knowledge related to interstage home monitoring for infants with shunt-dependent single ventricle heart disease. Historically, the interstage period has been defined as the time of discharge from the initial palliative procedure to the time of second stage palliation. High mortality rates during the interstage period led to the implementation of in-home surveillance strategies to detect physiologic changes that may precede hemodynamic decompensation in interstage infants with single ventricle heart disease. Adoption of interstage home monitoring practices has been associated with significantly improved morbidity and mortality. This statement will review in-hospital readiness for discharge, caregiver support and education, healthcare teams and resources, surveillance strategies and practices, national quality improvement efforts, interstage outcomes, and future areas for research. The statement is directed toward pediatric cardiologists, primary care providers, subspecialists, advanced practice providers, nurses, and those caring for infants undergoing staged surgical palliation for single ventricle heart disease.
    MeSH term(s) American Heart Association ; Caregivers/education ; Checklist ; Communication ; Enteral Nutrition ; Home Nursing/education ; Home Nursing/methods ; Humans ; Hypoplastic Left Heart Syndrome/blood ; Hypoplastic Left Heart Syndrome/nursing ; Hypoplastic Left Heart Syndrome/physiopathology ; Hypoplastic Left Heart Syndrome/surgery ; Infant ; Monitoring, Physiologic/methods ; Norwood Procedures/methods ; Oximetry/methods ; Oxygen/blood ; Palliative Care/methods ; Patient Care Team/organization & administration ; Patient Discharge/standards ; Quality Improvement ; Reoperation ; Risk Factors ; Transitional Care/organization & administration ; Transitional Care/standards ; United States ; Weight Gain
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2020-08-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.119.014548
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  10. Article ; Online: Internal right ventricular band for multiple ventricular septal defects in a neonate undergoing arterial switch and aortic arch repair.

    Carroll, William W / Shirali, Girish S / Bradley, Scott M

    The Annals of thoracic surgery

    2011  Volume 91, Issue 1, Page(s) 289–291

    Abstract: A neonate presented with d-transposition of the great arteries, aortic arch hypoplasia, aortic coarctation, and multiple ventricular septal defects. During the arterial switch procedure and the aortic arch repair, a fenestrated Gore-Tex disk (W.L. Gore & ...

    Abstract A neonate presented with d-transposition of the great arteries, aortic arch hypoplasia, aortic coarctation, and multiple ventricular septal defects. During the arterial switch procedure and the aortic arch repair, a fenestrated Gore-Tex disk (W.L. Gore & Assoc, Flagstaff, AZ) was sewn into the right ventricular outflow tract to restrict pulmonary blood flow. The internal right ventricular band successfully controlled the pulmonary blood flow, maintaining a systemic oxygen saturation of 88% to 92%, and allowing growth from 3.5 to 10.5 kg. At 8 months of age, the internal band in the patient was removed, and the ventricular septal defects were successfully closed.
    MeSH term(s) Aorta, Thoracic/abnormalities ; Aorta, Thoracic/surgery ; Heart Septal Defects, Ventricular/surgery ; Humans ; Infant, Newborn ; Male ; Transposition of Great Vessels/surgery
    Language English
    Publishing date 2011-01
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/j.athoracsur.2010.06.012
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