Our Studies

Ongoing Studies

Comparison of Management Strategies for the Neonate with Symptomatic Tetralogy of Fallot

Comparison of Management Strategies for the Neonate with Symptomatic Tetralogy of Fallot
Neonates with tetralogy of Fallot and symptomatic cyanosis (sTOF) require early intervention. Management strategies include initial palliation (IP) followed by later complete repair (CR) or primary repair (PR). This study aimed to thoroughly compare outcomes between these treatment strategies using propensity score adjustment (PSA) to account for baseline differences between groups. Early mortality, risk exposure and procedural complications were lower in the IP group, but cumulative exposures and reinterventions favored the PR group, suggesting each strategy has potential benefits.

Completed Studies

Differences in Cost of Care - PDA Stent and Modified BT Shunt

Differences in Cost of Care - PDA Stent and Modified BT Shunt
In infants with ductal-dependent pulmonary blood flow (PBF), initial palliation with patent ductus arteriosus stent (DAS) or modified Blalock-Taussig shunt (BTS) have comparable mortality but discrepant hospital length of stay (LOS) and procedural complication rates, which may influence cost. With limited economic impact information of these palliation strategies, this multi-center study compared costs of both palliations discovering advantages for DAS patients over the first year of life due largely to lower room and lab costs.

Aortic Valve Morphology & Outcomes

Aortic Valve Morphology & Outcomes
Congenital aortic valve stenosis is relative common congenital heart lesion, that frequently necessitates transcatheter intervention. The natural history of this lesion has been well defined, as has long-term outcomes following transcatheter balloon aortic valvuloplasty. Less well defined, however, is the relationship between underlying valvular morphology and clinical outcomes. This multi-center retrospective study sought to address this query, and demonstrated that aortic valves with lesser commissural fusion and larger openings have higher rates of leaflet tears, which in turn are associated with the development of aortic insufficiency.

PA/IVS Outcomes After RV Decompression

PA/IVS Outcomes After RV Decompression
Outcomes following right ventricular (RV) decompression in infants with pulmonary atresia and intact ventricular septum (PA-IVS) vary widely. Descriptions of these outcomes have previously been limited to small single-center studies. In this retrospective study using a large, multi-center, and modern dataset - by far the largest assembled to date - we demonstrated that the severity of pre-intervention tricuspid valve regurgitation, even more so than tricuspid valve annular dimension, was closely related to key clinical outcomes including risk of reintervention and ultimate circulatory status. Current work focuses on technical aspects of the procedure and medium-term echocardiographic follow-up of RV growth parameters.

BT Shunt vs. PDA Stent for Neonates with Ductal Dependent Pulmonary Blood Flow

BT Shunt vs. PDA Stent for Neonates with Ductal Dependent Pulmonary Blood Flow
Newborns with cyanotic congenital heart disease and ductal dependent pulmonary blood flow (PBF) require a durable source of PBF until a more definitive repair or subsequent palliation can be performed. Treatment options include surgically placed systemic to pulmonary artery shunts (typically a Blalock-Taussig or BT shunt) or transcatheter patent ductus arteriosus stent placement (PDA stent). These approaches may be associated with distinct risks and outcomes. This retrospective study sought to compare adjusted procedural and medium-term outcomes following BT shunt or PDA stent placement in a large multi-center dataset, far eclipsing the size of existing datasets addressing this population. We demonstrated that mortality and the risk of unplanned reintervention to treat cyanosis were similar between cohorts, while morbidity, length of stay, and pulmonary artery size and symmetry at the time of repair/palliation all favored the PDA stent group. Current work focuses on the relative economic impact of these distinct strategies, and on evaluation of both somatic and pulmonary arterial growth during the interstage.

Publications
Peer-Reviewed

Petit CJ, Gao K, Goldstein BH, Lang S, Gillespie SE, Kim SI, Sachdeva R. Relation of Aortic Valve Morphologic Characteristics to Aortic Valve Insufficiency and Residual Stenosis in Children with Congenital Aortic Stenosis Undergoing Balloon Valvuloplasty. Am J Cardiol. 2016 Mar 15;117(6):972-9. Epub 2015 Dec 31. PMID: 26805657. View Online Publication
Gao K, Sachdeva R, Goldstein BH, Lang S, Petit CJ. Aortic Valve Morphology Affects Left Ventricular Systolic Function in Children with Congenital Aortic Stenosis. J Invasive Cardiol. 2016 Sep;28(9):381-8. PMID: 27591689. View Online Publication
Petit CJ, Glatz AC, Qureshi AM, Maskatia SA, Justino H, Goldberg DG, Mozumdar N, Whiteside W, Rogers LS, Nicholson GT, Sachdeva R, McCracken C, Kelleman M, Goldstein BH. Outcomes and Risk Factors for Re-Intervention in Children Undergoing Right Ventricle Decompression for Pulmonary Atresia Intact Ventricular Septum: Results from a Multi-Center Collaborative. Circ Cardiovasc Interv. 2017 May;10(5). PMID: 28500137. View Online Publication
Glatz AC, Petit CJ, Goldstein BH, Kelleman MS, McCracken CE, McDonnell A, Mascio C, Shashidharan S, Ligon RA, Ao J, Whiteside W, Wallen WJ, Metcalf CM, Aggarwal V, Agrawal H, Qureshi AM. A Comparison Between Patent Ductus Arteriosus Stent and Modified Blalock-Taussig Shunt as Palliation for Infants with Ductal-Dependent Pulmonary Blood Flow: Insights from the Congenital Catheterization Research Collaborative. Circulation. 2018 Feb 6;137(6):589-601. PMID: 29042354 View Online Publication
Petit CJ, Qureshi AM, Glatz AC, Kelleman M, McCracken C, Ligon RA, Mozumdar N, Whiteside W, Khan A, Goldstein BH. Technical Factors Are Associated with Complications and Repeat Intervention in Neonates Undergoing Transcatheter Right Ventricular Decompression for Pulmonary Atresia and Intact Ventricular Septum: Results from the Congenital Catheterization Research Collaborative. Cardiol Young. 2018 Aug;28(8):1042-1049. PMID: 29909817 View Online Publication
Maskatia SA, Petit CJ, Travers CD, Goldberg DJ, Rogers LS, Glatz AC, Qureshi AM, Goldstein BH, Ao J, Sachdeva R. Echocardiographic Parameters Associated with Clinical Outcome and Right Ventricular Growth Following Right Ventricular Decompression in Patients with Pulmonary Atresia Intact Ventricular Septum: Results from a Multicenter Study. Congenit Heart Dis. 2018 Sep 21. PMID: 30238627 View Online Publication
Qureshi AM, Goldstein BH, Glatz AC, Agrawal H, Aggarwal V, Ligon RA, McCracken C, McDonnell A, Buckey TM, Whiteside W, Metcalf CM, Petit CJ. Classification scheme for ductal morphology in cyanotic patients with ductal dependent pulmonary blood flow and association with outcomes of patent ductus arteriosus stenting. Catheter Cardiovasc Interv. View Online Publication
Petit CJ, Quershi AM, Glatz AC, McCracken CE, Kelleman MS, Nicholson GT, Meadows JJ, Shahanavaz S, Zampi JD, Law MA, Pettus JA, Goldstein BH. Comprehensive Comparative Outcomes in Children with Congenital Heart Disease: The Rationale for the Congenital Catheterization Research Collaborative. Congenital Heart Disease View Online Publication
Goldstein BH, Petit CJ, Qureshi AM, Dai D, Griffis HM, France A, Kelleman MS, McCracken CE, O’Byrne ML, Mascio CE, Shashidaran S, Ligon RA, Whiteside W, Wallen WJ, Agrawal H, Aggarwal V, Glatz AC. Differences in Cost of Care by Palliation Strategy for Infants with Ductal-Dependent Pulmonary Blood Flow: Results from a Multicenter Study of Patent Ductus Arteriosus Stent and Modified Blalock-Taussig Shunt. Circulation: Cardiovasc Interv View Online Publication
Meadows JJ, Qureshi AM, Goldstein BH, Petit CJ, McCracken CE, Kelleman MS, Aggarwal V, Bauser-Heaton H, Combs CS, Gartenberg AJ, Ligon RA, Nicholson GT, Glatz AC. Comparison of Outcomes at Time of Superior Cavopulmonary Connection Between Single Ventricle Patients With Ductal-Dependent Pulmonary Blood Flow Initially Palliated With Either Blalock-Taussig Shunt or Ductus Arteriosus Stent: Results From the Congenital Catheterization Research Collaborative. Circ Cardiovasc Interv. View Online Publication
Bauser-Heaton, H, Qureshi, AM, Goldstein BH, Glatz, AC, Ligon RA, Depaolo, J, McCracken, CE, Kelleman, MS, Petit, CJ. Use of Carotid and Axillary Artery Approach For Stenting the Patent Ductus Arteriosus In Infants with Ductal-Dependent Pulmonary Blood Flow: A Multicenter Study from the Congenital Catheterization Research Collaborative. Catheter Cardiovasc Interv. View Online Publication
Nicholson GT, Glatz AC, Qureshi AM, Petit CJ, Meadows JJ, McCracken C, Kelleman M, Bauser-Heaton H, Gartenberg AJ, Ligon RA, Aggarwal V, Kwakye DB, Goldstein BH. Impact of Palliation Strategy on Interstage Feeding and Somatic Growth for Infants With Ductal-Dependent Pulmonary Blood Flow: Results from the Congenital Catheterization Research Collaborative. J Am Heart Assoc. View Online Publication

Publications
Pending

Goldstein BH, Qureshi AM, Meadows JJ, Nicholson GT, Bauser-Heaton H, Petit CJ, Pater C, Kelleman M, Mozumdar N, Aggarwal V, Agrawal H, Ligon RA, Christensen J, McCracken C, Glatz AC. Impact of Treatment Strategy on Outcomes in Isolated Pulmonary Artery of Ductal Origin: A Multicenter Report from the Congenital Catheterization Research Collaborative. (Submitted to Peds Cardiology)
Shahanavaz S, Qureshi AM, Petit CJ, Goldstein BH, Glatz AC, Bauser-Heaton H, McCracken C, Kelleman MS, Law MA, Nicholson GT, Zampi JD, Pettus JA, Meadows JJ. Factors Influencing Reintervention Following Ductal Artery Stent Implantation for Ductal-dependent Pulmonary Blood Flow - Results from the Congenital Catheterization Research Collaborative (Submitted to Circ Interventions)
Bauser-Heaton H, Qureshi AM, Goldstein BH, Glatz AC, Ligon, RA Jr., Gartenberg A, Aggarwal V, Shashidharan S, McCracken CE, Kelleman MS, Petit CJ. Comparison of Patent Ductus Arteriosus Stent and Blalock-Taussig Shunt as Palliation for Neonates with Sole Source Ductal-Dependent Pulmonary Blood Flow: Results from the Congenital Catheterization Research Collaborative (Submitted to Peds Cardiology)

Published Abstracts

Petit CJ, Gao K, Goldstein BH, Lang S, Kim S, Sachdeva R. Aortic Valve Morphology Influences Outcomes of Balloon Aortic Valvuloplasty in Children with Congenital Aortic Stenosis. (National Presentation at the 87th Scientific Sessions of the American Heart Association, Chicago, IL, 2014). Circulation 2014;130:A19605.
Petit CJ, Glatz AC, Qureshi AM, Maskatia SA, Justino H, Goldberg DG, Mozumdar N, Whiteside W, Rogers LS, Nicholson GT, Sachdeva R, McCracken C, Kelleman M, Goldstein BH. Outcomes and Risk Factors for Re-Intervention in Children Undergoing Right Ventricle Decompression for Pulmonary Atresia Intact Ventricular Septum: Results from a Multi-Center Collaborative. (National Presentation at the 65th Scientific Sessions of the American College of Cardiology, Chicago, IL, 2016). J Am Coll Cardiol 2016;67(13_S):927.
Glatz AC, Petit CJ, Goldstein BH, Kelleman MS, McCracken CE, McDonnell A, Mascio C, Shashidharan S, Ligon RA, Ao J, Whiteside W, Wallen WJ, Metcalf CM, Aggarwal V, Agrawal H, Heinle JS, Qureshi AM. A Comparison Between Ductus Arteriosus Stent and Modified Blalock-Taussig Shunt as Palliation for Infants with Ductal-Dependent Pulmonary Blood Flow: Insights from a Multi-Center Collaborative. (National Presentation and receipt of the CVDY Outstanding Research Award in Pediatric Cardiology at the 89th Scientific Sessions of the American Heart Association, New Orleans, LA, 2016). Circulation 2016;134:A14470.
Maskatia SA, Travers CD, Goldberg DJ, Rogers LS, Glatz AC, Qureshi AM, Goldstein BH, Petit CJ, Ao J, Sachdeva R. Echocardiographic Parameters Associated with Clinical Outcome and Right Ventricular Growth Following Right Ventricular Decompression in Patients with Pulmonary Atresia Intact Ventricular Septum: Results from a Multicenter Study. (National Presentation at the 89th Scientific Sessions of the American Heart Association, New Orleans, LA, 2016). Circulation 2016;134:A.
Petit CJ, Glatz AC, Qureshi AM, Kelleman MS, McCracken C, Mozumdar N, Ao J, Khan A, Whiteside W, Goldstein BH. Technical Factors Are Associated with Outcomes Following Right Ventricle Decompression for Neonates with Pulmonary Atresia and Intact Ventricular Septum: Results from a Multicenter Collaborative. (National Presentation at Pediatric and Adult Interventional Cardiac Symposium, Miami, FL, 2017).
Qureshi AM, Goldstein BH, Glatz AC, Agrawal H, Aggarwal V, Ligon RA, McCracken C, McDonnell A, Buckey TM, Whiteside W, Metcalf CM, Petit CJ. Classification scheme for ductal morphology in cyanotic patients with ductal dependent pulmonary blood flow and association with outcomes of patent ductus arteriosus stenting. (National Presentation and receipt of the Best Oral Abstract Award at the Pediatric and Adult Interventional Cardiac Symposium, Miami, FL, 2017).
Goldstein BH, Petit CJ, Qureshi AM, Dai D, Griffis HM, France A, Kelleman MS, McCracken CE, O’Byrne ML, Mascio CE, Shashidaran S, Ligon RA, Whiteside W, Wallen WJ, Agrawal H, Aggarwal V, Glatz AC. Differences in Cost of Care by Palliation Strategy for Infants with Ductal-Dependent Pulmonary Blood Flow: Results from a Multicenter Study of Patent Ductus Arteriosus Stent and Modified Blalock-Taussig Shunt. (National Presentation at the 90th Scientific Sessions of the American Heart Association, Anaheim, CA, 2017). Circulation 2017;136: 17195.
Goldstein BH, Qureshi AM, Meadows JJ, Nicholson GT, Bauser-Heaton H, Petit CJ, Pater C, Kelleman M, Mozumdar N, Aggarwal V, Agrawal H, Ligon RA, Christensen J, McCracken C, Glatz AC. Impact of Treatment Strategy on Outcomes in Isolated Pulmonary Artery of Ductal Origin: A Multicenter Report from the Congenital Catheterization Research Collaborative. (National Presentation at the Society for Cardiovascular Angiography and Interventions Scientific Sessions, San Diego, CA, 2018).
Bauser-Heaton H, Qureshi AM, Goldstein BH, Glatz AC, Nicolson GT, Meadows JJ, McCracken CE, Mossad E, Wilson E, Petit CJ. Percutaneous Patent Ductus Arteriosus Stenting Using the Carotid or Axillary Artery: A Multicenter Study from the Congenital Catheterization Research Collaborative. (National Presentation at the Society for Cardiovascular Angiography and Interventions Scientific Sessions, San Diego, CA, 2018)
Shahanavaz S, Qureshi AM, Petit CJ, Goldstein BH, Glatz AC, Bauser-Heaton H, McCracken CE, Kelleman MS, Law MA, Nicholson GT, Zampi JD, Pettus JA, Meadows JJ. Factors Influencing Reintervention Following PDA Stent Implantation for Ductal Dependent Pulmonary Blood Flow - Results from the Congenital Catheterization Research Collaborative (National Presentation at the Society for Cardiovascular Angiography and Interventions Scientific Sessions, Las Vegas, NV 2019)
Law MA, Glatz AC, Shahanavaz S, Zampi JD, Nicholson GT, Meadows JJ, Goldstein BH, Bauser-Heaton H, Petit CJ, Chai PJ, Romano J, Mascio C, Caldarone C, McCracken CE, Kelleman MS, Eilers L, Healan S, Smith J, Asztalos I, Kamsheh A, Juma S, Hock K, Pettus J, Pajk A, Qureshi A. Impact of Physiologic Palliation Strategy on Outcomes in the Symptomatic Neonate with Tetralogy of Fallot: Insights from The Congenital Catheterization Research Collaborative J Am Coll Cardiol. 2020 Mar, 75 (11_Supplement_1) 566
Qureshi AM, Caldarone CA, Romano JC, Chai PJ, Mascio CE, Glatz AC, Petit CJ, McCracken CE, Kelleman MS, Nicholson GT, Meadows JJ, Zampi JD, Shahanavaz S, Law MA, Eilers LF, Healan S, Juergensen S, Smith J, Raulston J, Batlivala S, Pettus J, Pajk A, Goldstein BH, and the CCRC Investigators. Comparison of Management Strategies for the Neonate with Symptomatic Tetralogy of Fallot and Body Weight Less than 2.5 kg: Insights from the Congenital Catheterization Research Collaborative (National Presentation at the American Association for Thoracic Surgery 100th Annual Virtual Meeting, May 2020)
Shahanavaz, S, Qureshi AM, Glatz AC, Zampi JD, Nicholson GT, Meadows JJ, Goldstein BH, Petit CJ, Bauser-Heaton H, Kelleman M, McCracken C, Chai PJ, Romano JC, Maskatia S, Eilers L, Hock KM, Healan SJ, Smith J, Asztalos IB, Kamsheh AA, Ligon Jr. RA, Juma S, Raulston J, Khan HQ, Pettus JA, Pajk AL, Law MA. Outcomes following balloon pulmonary valvuloplasty in symptomatic neonates with tetralogy of Fallot - Results from the Congenital Catheterization Research Collaborative (National Presentation at the Society for Cardiovascular Angiography and Interventions Virtual Scientific Sessions, May 2020)
Nicholson GT, Goldstein BH, Petit CJ, Qureshi AM, Glatz AC, McCracken CE, Kelleman MS, Meadows JJ, Zampi JD, Shahanavaz S, Mascio CE, Chai PJ, Romano JC, Asztalos IB, Kamsheh AM, Healan SJ, Smith J, Ligon RA, Pettus JA, Juma S, Raulston JJ, Huskey JL, Batlivala SP, Pajk AL, Eilers LF, Khan HQ, Merritt TC, Candor M, Juergensen S, Rinderknecht FA, Bauser-Heaton H, Law MA Impact of Neonatal Management Strategy on Feeding and Somatic Growth in Infants with Symptomatic Tetralogy of Fallot: Results from the Congenital Catheterization Research Collaborative (National Presentation at the Pediatric Academic Societies Neonatology Summer Webinar Series, July 2020)
Christopher J Petit, Mark Law, Andrew C Glatz, Paul Chai, Jennifer Romano, Jeffrey Zampi, Jeffery J Meadows, George Nicholson, Shabana Shahanavaz, Michael Kelleman, Courtney McCracken, Christopher Mascio, Sarosh P Batlivala, Ivor Asztalos, Alicia Kamsheh, Steven Healan, Justin Smith, Joelle A Pettus, Andrew Dailey Schwartz, James Raulston, Krissie Hock, Amy Pajk, Bryan H Goldstein Comparison of Management Strategies for the Neonate With Symptomatic Tetralogy of Fallot and Hypoplastic Branch Pulmonary Arteries: Results From the Congenital Catheterization Research Collaborative (National Presentation at the American Heart Association Scientific Sessions, November 2020).
Bauser-Heaton H, Goldstein BH, Petit CJ, Qureshi AM, McCracken CE, Kelleman MS, Nicholson GT, Law MA, Zampi JD, Shahanavaz S, Mascio C, Chai P, Romano J, Batlivala SP, Maskatia SA, Asztalos I, Smith J, Eilers L, Kamsheh A, Healan SJ, Pettus JA, Ligon A, Dailey-Schwartz A, Raulston JE, Glatz AC, Meadows JJ. Comparison of Treatment Strategies for Neonates With Tetralogy of Fallot and Pulmonary Atresia: A Report From the Congenital Catheterization Research Collaborative (National Presentation at the American Heart Association Scientific Sessions, November 2020)

Grants & Awards

CVDY Outstanding Research Award in Pediatric Cardiology; 89th Scientific Sessions of the American Heart Association, New Orleans, LA Andrew C Glatz November 2016
Best Oral Abstract Award; Pediatric and Adult Interventional Cardiac Symposium (PICS-AICS), Miami, FL Athar M Qureshi January 2017
Top Clinical Science Session Finalist, AHA 2019 Bryan H Goldstein November 2019
Project Heart Grant: Neurodevelopmental Outcomes after Neonatal Intervention in Tetralogy of Fallot. Jeffrey D Zampi and George T Nicholson September 2020