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Stephen Gary Miller

Associate Professor of Pediatrics
Pediatrics, Cardiology
Box 3090 Med Ctr, Durham, NC 27710
Rm 1923A- CHC, BOX3090, Durham, NC 27710

Selected Publications


Surgical Protocol for Partial Heart Transplantation in Growing Piglets.

Journal Article World J Pediatr Congenit Heart Surg · May 23, 2024 Partial heart transplantation is a new approach to deliver growing heart valve implants. Partial heart transplants differ from heart transplants because only the part of the heart containing the necessary heart valve is transplanted. This allows partial he ... Full text Link to item Cite

Prenatal Diagnosis, Management, and Treatment of Fetal Cardiac Disease.

Journal Article Neoreviews · May 1, 2023 Prenatal diagnosis of congenital heart disease makes it possible to optimize and coordinate care of the fetus and pregnant person. Benefits encompass the full spectrum of pre- and perinatal care, from counseling to optimization of pregnancy care and fetal ... Full text Link to item Cite

Parents' decision-making for their foetus or neonate with a severe congenital heart defect.

Journal Article Cardiol Young · June 2022 BACKGROUND: Parents who receive a diagnosis of a severe, life-threatening CHD for their foetus or neonate face a complex and stressful decision between termination, palliative care, or surgery. Understanding how parents make this initial treatment decision ... Full text Link to item Cite

Provider insights on shared decision-making with families affected by CHD.

Journal Article Cardiol Young · November 3, 2021 BACKGROUND AND OBJECTIVES: Little data exist on provider perspectives about counselling and shared decision-making for complex CHD, ways to support and improve the process, and barriers to effective communication. The goal of this qualitative study was to ... Full text Link to item Cite

Left-sided congenitally unguarded tricuspid valve with congenitally corrected transposition of the great arteries: A rare diagnosis confirmed by three-dimensional echocardiography.

Journal Article Echocardiography · July 2020 Left-sided unguarded tricuspid valve disease with congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac malformation, only reported a few times in the literature. Two-dimensional echocardiography (2DE) uses standard views to ... Full text Link to item Cite

Physician Barriers and Facilitators for Screening for Congenital Heart Disease With Routine Obstetric Ultrasound: A National United States Survey.

Journal Article J Ultrasound Med · June 2020 OBJECTIVES: Prenatal detection of congenital heart disease with obstetric screening remains at less than 50% in most population studies, far from what is thought to be achievable. We sought to identify barriers/facilitators for screening from the perspecti ... Full text Link to item Cite

Recovery of the fetal electrocardiogram for morphological analysis from two trans-abdominal channels via optimal shrinkage.

Journal Article Physiol Meas · December 2, 2019 OBJECTIVE: We propose a novel algorithm to recover fetal electrocardiogram (ECG) for both the fetal heart rate analysis and morphological analysis of its waveform from two or three trans-abdominal maternal ECG channels. APPROACH: We design an algorithm bas ... Full text Link to item Cite

Gestational Age, Birth Weight, and Outcomes Six Years After the Norwood Procedure.

Journal Article Pediatrics · May 2019 BACKGROUND: Preterm delivery and low birth weight (LBW) are generally associated with worse outcomes in hypoplastic left heart syndrome (HLHS), but an individual preterm or small neonate may do well. We sought to explore the interactions between gestationa ... Full text Link to item Cite

Improving maternal-infant bonding after prenatal diagnosis of CHD.

Journal Article Cardiol Young · November 2018 BACKGROUND: Infants with prenatally diagnosed CHD are at high risk for adverse outcomes owing to multiple physiologic and psychosocial factors. Lack of immediate physical postnatal contact because of rapid initiation of medical therapy impairs maternal-inf ... Full text Link to item Cite

Reproducibility of Left Ventricular Dimension Versus Area Versus Volume Measurements in Pediatric Patients With Dilated Cardiomyopathy.

Journal Article Circ Cardiovasc Imaging · November 2017 BACKGROUND: Multiple echocardiographic methods are used to measure left ventricular size and function. Clinical management is based on individual evaluations and longitudinal trends. The Pediatric Heart Network VVV study (Ventricular Volume Variability) in ... Full text Link to item Cite

Pulmonary Vein Doppler Patterns in Infants with Single Right Ventricle Anomalies After Initial Staged Palliations.

Journal Article Pediatr Cardiol · August 2017 The aim of this study was to describe serial changes in echocardiographic Doppler pulmonary vein flow (PVF) patterns in infants with single right ventricle (RV) anomalies enrolled in the Single Ventricle Reconstruction trial. Measurement of PVF peak systol ... Full text Link to item Cite

Traumatic Gerbode ventricular septal defect and third-degree heart block.

Journal Article Cardiol Young · March 2017 We present an interesting and rare case of traumatic Gerbode ventricular septal defect and complete heart block. The multimodality images illustrate the diagnosis well. This case is an excellent demonstration of the diagnostic utility of multimodality imag ... Full text Link to item Cite

Ultrasound Examination of the Fetal Heart.

Journal Article Obstet Gynecol Surv · January 2017 Congenital heart disease (CHD) occurs in 4-13 per 1000 births in the United States. While many risk factors for CHD have been identified, more than 90% of cases occur in low-risk patients. Guidelines for fetal cardiac screening during the second trimester ... Full text Link to item Cite

Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

Journal Article J Pediatr · January 2016 OBJECTIVE: To assess the variability in asymmetric growth and its association with neurodevelopment in infants with single ventricle (SV). STUDY DESIGN: We analyzed weight-for-age z-score minus head circumference-for-age z-score (HCAZ), relative head growt ... Full text Link to item Cite

Validation of association of the apolipoprotein E ε2 allele with neurodevelopmental dysfunction after cardiac surgery in neonates and infants.

Journal Article J Thorac Cardiovasc Surg · December 2014 OBJECTIVE: Apolipoprotein E (APOE) genotype is a determinant of neurologic recovery after brain ischemia and traumatic brain injury. The APOE ε2 allele has been associated with worse neurodevelopmental (ND) outcome after repair of congenital heart defects ... Full text Link to item Cite

Corynebacterium endocarditis of a percutaneously placed transcatheter pulmonary valve.

Journal Article Cardiol Young · October 2014 We report a case of endocarditis of a transcatheter pulmonary valve-in-valve in a 14-year-old boy with tetralogy of Fallot. He presented with recurrent low-grade fevers, lethargy, and anorexia. Multiple blood cultures grew a gram-positive rod, Corynebacter ... Full text Link to item Cite

Surgical Protocol for Partial Heart Transplantation in Growing Piglets.

Journal Article World J Pediatr Congenit Heart Surg · May 23, 2024 Partial heart transplantation is a new approach to deliver growing heart valve implants. Partial heart transplants differ from heart transplants because only the part of the heart containing the necessary heart valve is transplanted. This allows partial he ... Full text Link to item Cite

Prenatal Diagnosis, Management, and Treatment of Fetal Cardiac Disease.

Journal Article Neoreviews · May 1, 2023 Prenatal diagnosis of congenital heart disease makes it possible to optimize and coordinate care of the fetus and pregnant person. Benefits encompass the full spectrum of pre- and perinatal care, from counseling to optimization of pregnancy care and fetal ... Full text Link to item Cite

Parents' decision-making for their foetus or neonate with a severe congenital heart defect.

Journal Article Cardiol Young · June 2022 BACKGROUND: Parents who receive a diagnosis of a severe, life-threatening CHD for their foetus or neonate face a complex and stressful decision between termination, palliative care, or surgery. Understanding how parents make this initial treatment decision ... Full text Link to item Cite

Provider insights on shared decision-making with families affected by CHD.

Journal Article Cardiol Young · November 3, 2021 BACKGROUND AND OBJECTIVES: Little data exist on provider perspectives about counselling and shared decision-making for complex CHD, ways to support and improve the process, and barriers to effective communication. The goal of this qualitative study was to ... Full text Link to item Cite

Left-sided congenitally unguarded tricuspid valve with congenitally corrected transposition of the great arteries: A rare diagnosis confirmed by three-dimensional echocardiography.

Journal Article Echocardiography · July 2020 Left-sided unguarded tricuspid valve disease with congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac malformation, only reported a few times in the literature. Two-dimensional echocardiography (2DE) uses standard views to ... Full text Link to item Cite

Physician Barriers and Facilitators for Screening for Congenital Heart Disease With Routine Obstetric Ultrasound: A National United States Survey.

Journal Article J Ultrasound Med · June 2020 OBJECTIVES: Prenatal detection of congenital heart disease with obstetric screening remains at less than 50% in most population studies, far from what is thought to be achievable. We sought to identify barriers/facilitators for screening from the perspecti ... Full text Link to item Cite

Recovery of the fetal electrocardiogram for morphological analysis from two trans-abdominal channels via optimal shrinkage.

Journal Article Physiol Meas · December 2, 2019 OBJECTIVE: We propose a novel algorithm to recover fetal electrocardiogram (ECG) for both the fetal heart rate analysis and morphological analysis of its waveform from two or three trans-abdominal maternal ECG channels. APPROACH: We design an algorithm bas ... Full text Link to item Cite

Gestational Age, Birth Weight, and Outcomes Six Years After the Norwood Procedure.

Journal Article Pediatrics · May 2019 BACKGROUND: Preterm delivery and low birth weight (LBW) are generally associated with worse outcomes in hypoplastic left heart syndrome (HLHS), but an individual preterm or small neonate may do well. We sought to explore the interactions between gestationa ... Full text Link to item Cite

Improving maternal-infant bonding after prenatal diagnosis of CHD.

Journal Article Cardiol Young · November 2018 BACKGROUND: Infants with prenatally diagnosed CHD are at high risk for adverse outcomes owing to multiple physiologic and psychosocial factors. Lack of immediate physical postnatal contact because of rapid initiation of medical therapy impairs maternal-inf ... Full text Link to item Cite

Reproducibility of Left Ventricular Dimension Versus Area Versus Volume Measurements in Pediatric Patients With Dilated Cardiomyopathy.

Journal Article Circ Cardiovasc Imaging · November 2017 BACKGROUND: Multiple echocardiographic methods are used to measure left ventricular size and function. Clinical management is based on individual evaluations and longitudinal trends. The Pediatric Heart Network VVV study (Ventricular Volume Variability) in ... Full text Link to item Cite

Pulmonary Vein Doppler Patterns in Infants with Single Right Ventricle Anomalies After Initial Staged Palliations.

Journal Article Pediatr Cardiol · August 2017 The aim of this study was to describe serial changes in echocardiographic Doppler pulmonary vein flow (PVF) patterns in infants with single right ventricle (RV) anomalies enrolled in the Single Ventricle Reconstruction trial. Measurement of PVF peak systol ... Full text Link to item Cite

Traumatic Gerbode ventricular septal defect and third-degree heart block.

Journal Article Cardiol Young · March 2017 We present an interesting and rare case of traumatic Gerbode ventricular septal defect and complete heart block. The multimodality images illustrate the diagnosis well. This case is an excellent demonstration of the diagnostic utility of multimodality imag ... Full text Link to item Cite

Ultrasound Examination of the Fetal Heart.

Journal Article Obstet Gynecol Surv · January 2017 Congenital heart disease (CHD) occurs in 4-13 per 1000 births in the United States. While many risk factors for CHD have been identified, more than 90% of cases occur in low-risk patients. Guidelines for fetal cardiac screening during the second trimester ... Full text Link to item Cite

Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

Journal Article J Pediatr · January 2016 OBJECTIVE: To assess the variability in asymmetric growth and its association with neurodevelopment in infants with single ventricle (SV). STUDY DESIGN: We analyzed weight-for-age z-score minus head circumference-for-age z-score (HCAZ), relative head growt ... Full text Link to item Cite

Validation of association of the apolipoprotein E ε2 allele with neurodevelopmental dysfunction after cardiac surgery in neonates and infants.

Journal Article J Thorac Cardiovasc Surg · December 2014 OBJECTIVE: Apolipoprotein E (APOE) genotype is a determinant of neurologic recovery after brain ischemia and traumatic brain injury. The APOE ε2 allele has been associated with worse neurodevelopmental (ND) outcome after repair of congenital heart defects ... Full text Link to item Cite

Corynebacterium endocarditis of a percutaneously placed transcatheter pulmonary valve.

Journal Article Cardiol Young · October 2014 We report a case of endocarditis of a transcatheter pulmonary valve-in-valve in a 14-year-old boy with tetralogy of Fallot. He presented with recurrent low-grade fevers, lethargy, and anorexia. Multiple blood cultures grew a gram-positive rod, Corynebacter ... Full text Link to item Cite

Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature.

Journal Article Catheter Cardiovasc Interv · August 1, 2014 OBJECTIVES: The objectives of this manuscript are two-fold: (a) to describe the clinical characteristics and management of four pediatric patients with bacterial endocarditis (BE) after Melody pulmonary valve implantation (MPVI); and (b) to review the lite ... Full text Link to item Cite

Anti-hypertensive drugs in children and adolescents.

Journal Article World J Cardiol · May 26, 2014 Worldwide the prevalence of essential hypertension in children and adolescents continues to increase. Traditionally providers have used "off-label" drugs to treat pediatric hypertension, meaning that rigorous clinical trials of these drugs have not been sp ... Full text Link to item Cite

Doppler flow patterns in the right ventricle-to-pulmonary artery shunt and neo-aorta in infants with single right ventricle anomalies: impact on outcome after initial staged palliations.

Journal Article J Am Soc Echocardiogr · May 2013 BACKGROUND: A Pediatric Heart Network trial compared outcomes in infants with single right ventricle anomalies undergoing Norwood procedures randomized to modified Blalock-Taussig shunt (MBTS) or right ventricle-to-pulmonary artery shunt (RVPAS). Doppler p ... Full text Link to item Cite

Maternal autoantibody levels in congenital heart block and potential prophylaxis with antiinflammatory agents.

Journal Article Am J Obstet Gynecol · January 2013 OBJECTIVE: The importance of maternal autoantibody levels in congenital heart block and elucidation of maternal factors that may reduce disease burden require further clarification. STUDY DESIGN: Pregnancies complicated by maternal anti-Ro antibodies from ... Full text Link to item Cite

Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy?: the Single Vventricle Reconstruction trial.

Journal Article Circulation · May 29, 2012 BACKGROUND: The Pediatric Heart Network trial comparing outcomes in 549 infants with single right ventricle undergoing a Norwood procedure randomized to modified Blalock-Taussig shunt or right ventricle-pulmonary artery shunt (RVPAS) found better 1-year tr ... Full text Link to item Cite

Isolated right subclavian artery arising from the right pulmonary artery via a right-sided ductus arteriosus with associated pulmonary steal phenomenon.

Journal Article Cardiol Young · April 2012 We present a patient with DiGeorge syndrome and an isolated right subclavian artery arising from the right pulmonary artery via a right-sided ductus arteriosus. The patient showed a subclavian and pulmonary steal with perfusion of the right arm and right l ... Full text Link to item Cite

Global longitudinal cardiac strain and strain rate for assessment of fetal cardiac function: novel experience with velocity vector imaging.

Journal Article Echocardiography · January 2009 Featured Publication BACKGROUND: Cardiac strain and strain rate are new methods to quantitate fetal cardiac function. Doppler-based techniques are regional measurements limited by angle of insonation. Newer feature-tracking algorithms permit angle independent measurements from ... Full text Link to item Cite

Use of the monoplane intracardiac imaging probe in high-risk infants during congenital heart surgery.

Journal Article Echocardiography · October 2008 Featured Publication UNLABELLED: Imaging options are limited in high-risk infants with small or abnormal oropharyngeal anatomy during congenital heart surgery. METHODS: All cases in which the monoplane intracardiac echo probe was used for transesophageal intraoperative imaging ... Full text Link to item Cite

Reliability of two-dimensional echocardiography in the assessment of clinically significant abnormal hemidiaphragm motion in pediatric cardiothoracic patients: Comparison with fluoroscopy.

Journal Article Pediatr Crit Care Med · September 2006 Featured Publication OBJECTIVE: To assess the utility and reliability of echocardiographic assessment of hemidiaphragm motion abnormalities in pediatric cardiothoracic patients. DESIGN: Retrospective observational study, with post hoc blinded assessment of echocardiographic an ... Full text Link to item Cite

Transcatheter interventions across an inferior vena cava filter.

Journal Article Catheter Cardiovasc Interv · July 2003 Featured Publication Patients who suffer from an embolic event often undergo placement of an inferior vena caval filter. Few data are available regarding treatment of this patient population with concurrent right-to-left shunting across an atrial communication. We report four ... Full text Link to item Cite