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Successful use of the Heart Ware HVAD as Bridge to Transplantation in an 8year Old Boy with a Previous History of Berlin Heart EXCOR Support

Sahulee, Raj; Rajagopal, Hari
ORIGINAL:0012333
ISSN: 2329-9517
CID: 2786842

Pediatric Pulmonary Hypertension [Editorial]

Rajagopal, Hari; Karnik, Ruchika; Sahulee, Raj
PMID: 26933230
ISSN: 1526-3347
CID: 2782482

Characteristics of systemic hypertension in preterm children

Shah, Ankur B; Hashmi, S Sharukh; Sahulee, Raj; Pannu, Hariyadarshi; Gupta-Malhotra, Monesha
The prevalence of essential hypertension (EH) among preterm children is unknown. The authors evaluated consecutive children with a diagnosis of hypertension and prematurity (gestational age <37 weeks) in a tertiary pediatric hypertension clinic and identified 36 preterm hypertensive children. Among these preterm children, 23 were diagnosed in the neonatal intensive care unit (NICU; infantile) and 13 were diagnosed at an older age (childhood). When compared with patients with a childhood diagnosis, patients with an infantile diagnosis had a significantly lower gestational age, longer duration of hospitalization in the NICU, and a higher incidence of perinatal risk factors for hypertension. None with infantile diagnosis had EH, whereas 46% with childhood diagnosis had EH. Among premature children, systemic hypertension was either diagnosed in infancy or in childhood, with each age at diagnosis having unique risk factors and clinical course. Although 83% of preterm children had secondary hypertension, EH was diagnosed in 17% and was only seen in those diagnosed beyond infancy.
PMCID:4405455
PMID: 25775924
ISSN: 1751-7176
CID: 2782492

Centers for Disease Control "high-risk" donor status does not significantly affect recipient outcome after heart transplantation in children

Sahulee, Raj; Lytrivi, Irene D; Savla, Jill J; Rossano, Joseph W
BACKGROUND: In 2004, the United Network for Organ Sharing (UNOS) added the label "high-risk donor" (HRD) for any organ donor who met the Centers for Disease Control (CDC) criteria for high-risk behavior for infection. The aim of this study was to calculate the rate of HRD graft use in heart transplantation in children and determine the differences in outcome from those who received standard-risk donor (SRD) grafts. METHODS: We reviewed information from the UNOS database regarding transplants performed between June 30, 2004 and July 31, 2012. Heart transplant recipients <18 years old were divided into two groups based on the donor's risk status. Demographic data on donors and recipients were collected. Survival analysis was performed to compare survival based on donor status. We also compared episodes of rejection before hospital discharge and the length of stay after transplantation by donor status. RESULTS: During the study period, 2,782 pediatric heart transplantations were performed and 116 (4.1%) patients received a CDC HRD graft. Recipients of HRD grafts were significantly older and heavier than those who received an SRD graft (8.5 vs 6.5 years, p < 0.001 and 35.7 vs 26.9 kg, p < 0.001). There was no difference in patient survival (log rank, p = 0.88) between groups. There was no difference in rejection prior to discharge (17.2 vs 16.4%, p = 0.81) or length of stay after transplantation (26.1 vs 27.6 days, p = 0.58). CONCLUSIONS: CDC HRD graft status does not appear to significantly affect recipient outcome after heart transplantation in children.
PMID: 25037771
ISSN: 1557-3117
CID: 2782502

CDC "High Risk" Donor Status Does Not Significantly Effect Patient Outcome in Pediatric Heart Transplantation [Meeting Abstract]

Sahulee, R; Savla, JJ; Lytrivi, ID; Rossano, JW
ISI:000333866700610
ISSN: 1557-3117
CID: 2782512

Systemic hypertension requiring treatment in the neonatal intensive care unit

Sahu, Raj; Pannu, Hariyadarshi; Yu, Robert; Shete, Sanjay; Bricker, John T; Gupta-Malhotra, Monesha
OBJECTIVES: To determine the difference in the risk factors for systemic hypertension in preterm and term infants in the neonatal intensive care unit (NICU). STUDY DESIGN: Data were collected from an existing database of NICU children and confirmed by chart review. Systemic hypertension was defined when 3 separate measurements of systolic and/or diastolic blood pressure were >95th percentile and an antihypertensive medication was administered for >2 weeks in the NICU. RESULTS: Of 4203 infants, we identified 53 (1.3%) with treated hypertension, of whom 74% were preterm, 11% required surgical intervention, and 85% required medications on discharge. The presence of a patent ductus arteriosus, umbilical catheterization, left ventricular hypertrophy, hypertensive medication at discharge, and mortality was similar between the term and preterm infants. The major risk factors for preterm infants, especially those <28 weeks' gestation, were bronchopulmonary dysplasia and iatrogenic factors, but, in term infants, they were systemic diseases. Term infants were diagnosed with hypertension earlier during hospitalization, had a shorter duration of stay in the NICU, and had a higher incidence of hypertension needing >3 medications than preterm infants. CONCLUSIONS: Perinatal risk factors are significant contributors to infantile hypertension. Term infants were diagnosed with hypertension earlier, had a shorter duration of stay, and had a higher incidence of resistant hypertension than preterm infants.
PMCID:3675186
PMID: 23394775
ISSN: 1097-6833
CID: 2786802

Bimodal onset of systemic hypertension in preterm children [Meeting Abstract]

Shah, Ankur Bharat; Sahu, R; Pannu, Hariyadarshi; Bricker, J Timothy; Gupta-Malhotra, Monesha S
ORIGINAL:0012621
ISSN: 0735-1097
CID: 3132052

Risk Factors for Hypertension in Preterm Children Differ Based on Age at Onset [Meeting Abstract]

Shah, A; Sahu, R; Pannu, H; Numan, MT; Bricker, JT; Gupta-Malhotra, M
ORIGINAL:0012622
ISSN: 1680-0745
CID: 3132042

Conivaptan therapy in an infant with severe hyponatremia and congestive heart failure [Case Report]

Sahu, Raj; Balaguru, Duraisamy; Thapar, Vandana; Haque, Ikram; Pham-Peyton, Chi; Bricker, J Timothy
Conivaptan is a nonspecific arginine vasopressin receptor antagonist that has been used as therapy in adults who have hypervolemic hyponatremia due to congestive heart failure. Its use in children with congestive heart failure has not been reported. We describe the use of conivaptan in a 4-month-old infant girl with severe hypervolemic hyponatremia and heart failure. A therapeutic weight-based dose was extrapolated from the adult dose. Conivaptan therapy was administered for 48 hours, after which the patient recovered from her hyponatremia without untoward effects. Arginine vasopressin receptor antagonists such as conivaptan may be useful as therapy for hyponatremia associated with heart failure. Further studies are required before conivaptan can be recommended for routine use in children.
PMCID:3461679
PMID: 23109779
ISSN: 1526-6702
CID: 2786812

Transcatheter Stent Therapy in Children: An Update

Sahu, Raj; Rao, P Syamasundar
ORIGINAL:0012332
ISSN: 2161-0665
CID: 2786832