2 results
Paediatric and adult congenital cardiology education and training in Europe
- Part of
- Colin J. McMahon, Ruth Heying, Werner Budts, Anna Cavigelli-Brunner, Maria Shkolnikova, Ina Michel-Behnke, Rainer Kozlik-Feldmann, Håkan Wåhlander, Daniel DeWolf, Sylvie Difilippo, Laslo Kornyei, Maria Giovanna Russo, Anna Kaneva-Nencheva, Senka Mesihovic-Dinarevic, Samo Vesel, Gylfi Oskarsson, George Papadopoulos, Andreas C. Petropoulos, Berna Saylan Cevik, Antonis Jossif, Gabriela Doros, Thomas Krusensjerna-Hafstrom, Joanna Dangel, Otto Rahkonen, Dimpna C. Albert-Brotons, Silvia Alvares, Henrik Brun, Jan Janousek, Olli Pitkänen-Argillander, Inga Voges, Inguna Lubaua, Skaiste Sendzikaite, Alan G. Magee, Mark J. Rhodes, Nico A. Blom, Frances Bu’Lock, Katarina Hanseus, Ornella Milanesi
-
- Journal:
- Cardiology in the Young / Volume 32 / Issue 12 / December 2022
- Published online by Cambridge University Press:
- 01 March 2022, pp. 1966-1983
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Background:
Limited data exist on training of European paediatric and adult congenital cardiologists.
Methods:A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries.
Results:Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87–9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63–10.72 million), and one training centre per 4.29 million population (range 1.63–10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1–17), and duration of training was 3 years (range 2–5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R2 = 0.41).
Conclusion:Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.
Does superior caval vein pressure impact head growth in Fontan circulation?
- Tina Trachsel, Christian Balmer, Håkan Wåhlander, Roland Weber, Hitendu Dave, Andrea Poretti, Oliver Kretschmar, Anna Cavigelli-Brunner
-
- Journal:
- Cardiology in the Young / Volume 26 / Issue 7 / October 2016
- Published online by Cambridge University Press:
- 15 January 2016, pp. 1327-1332
-
- Article
- Export citation
-
Background
Patients with bidirectional cavopulmonary anastomosis have unphysiologically high superior caval vein pressure as it equals pulmonary artery pressure. Elevated superior caval vein pressure may cause communicating hydrocephalus and macrocephaly. This study analysed whether there exists an association between head circumference and superior caval vein pressure in patients with single ventricle physiology.
MethodsWe carried out a retrospective analysis of infants undergoing Fontan completion at our institution from 2007 to 2013. Superior caval vein pressures were measured during routine catheterisation before bidirectional cavopulmonary anastomosis and Fontan completion as well as head circumference, adjusted to longitudinal age-dependent percentiles.
ResultsWe included 74 infants in our study. Median ages at bidirectional cavopulmonary anastomosis and Fontan were 4.8 (1.6–12) and 27.9 (7–40.6) months, respectively. Head circumference showed significant growth from bidirectional cavopulmonary anastomosis until Fontan completion (7th (0–100th) versus 20th (0–100th) percentile). There was no correlation between superior caval vein pressure and head circumference before Fontan (R2=0.001). Children with lower differences in superior caval vein pressures between pre-bidirectional cavopulmonary anastomosis and pre-Fontan catheterisations showed increased growth of head circumference (R2=0.19).
ConclusionsPatients with moderately elevated superior caval vein pressure associated with single ventricle physiology did not have a tendency to develop macrocephaly. There is no correlation between superior caval vein pressure before Fontan and head circumference, but between bidirectional cavopulmonary anastomosis and Fontan head circumference increases significantly. This may be explained by catch-up growth of head circumference in patients with more favourable haemodynamics and concomitant venous pressures in the lower range. Further studies with focus on high superior caval vein pressures are needed to exclude or prove a correlation.