CJC Pediatric and Congenital Heart Disease最新文献

{"title":"A Canadian Experience With a Percutaneous Microaxial Ventricular Assist Device in Children With Cardiogenic Shock","authors":"Bhavikkumar D. Langanecha MD ,&nbsp;Alyssa Power MD ,&nbsp;Rachel D. Vanderlaan MD, PhD ,&nbsp;Osami Honjo MD, PhD ,&nbsp;Oshri Zaulan MD, MHA ,&nbsp;Andrea Maurich MN ,&nbsp;Rajiv Chaturvedi MB, BChir, MD, PhD ,&nbsp;Aamir Jeewa MB, BCh","doi":"10.1016/j.cjcpc.2025.01.004","DOIUrl":"10.1016/j.cjcpc.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>The experience of a percutaneous microaxial (Impella) left ventricular assist device in children with cardiogenic shock is limited. The primary objective of this study was to review our institutional clinical outcomes of Impella use in children with cardiogenic shock.</div></div><div><h3>Methods</h3><div>This is a single-center retrospective study of all adult-sized children who underwent Impella implantation from June 2019 to December 2024. Clinical outcomes, hemodynamics, and device complication data were collected.</div></div><div><h3>Results</h3><div>A total of 7 patients (female = 4) with a median (interquartile range [IQR]) age of 15 years (14.5, 16.5 years) and a median weight of 50.9 kg (46.5, 59.85 kg) underwent Impella insertion during the study period. Five patients underwent Impella insertion for hemodynamic support and 2 for left ventricular decompression while on extracorporeal membrane oxygenation (ECMO) support. The underlying cardiac diagnoses were dilated cardiomyopathy (4 of 7), myocarditis (2 of 6), and hypertrophic cardiomyopathy with presumed myocarditis (1 of 7). The median (IQR) duration of support was 5 days (2, 7 days). The median (IQR) duration of intensive care unit and hospital stay was 13 days (10.5, 19 days) and 23 days (15, 54 days), respectively. Three patients were ultimately bridged to a durable ventricular assist device, and 2 patients had recovery of myocardial function. One patient developed significant aortic regurgitation, which necessitated device explantation and conversion to central ECMO after 38 hours of support, and one patient had withdrawal of life-sustaining measures due to significant brain injury unrelated to Impella.</div></div><div><h3>Conclusions</h3><div>There is increasing use of percutaneous microaxial pumps for supporting children in cardiogenic shock and left ventricle decompression on ECMO support. This report identifies the initial Canadian experience as an addition to the mechanical circulatory support armamentarium.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 160-169"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S2772-8129(25)00053-3","DOIUrl":"10.1016/S2772-8129(25)00053-3","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Page A1"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fontan Circulation and Hepatic Venous Pressure Gradient: Are Bridging Collaterals One of the Weak Links?","authors":"Ashish H. Shah MD ,&nbsp;Katrijn Jansen MD ,&nbsp;Alexander C. Egbe MD, MPH ,&nbsp;Iain D.C. Kirkpatrick MD","doi":"10.1016/j.cjcpc.2025.01.005","DOIUrl":"10.1016/j.cjcpc.2025.01.005","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 138-139"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Clinic Activity Promotion for Children With Congenital Heart Disease: Randomized Clinical Trial","authors":"Patricia E. Longmuir PhD ,&nbsp;Jane Lougheed MD ,&nbsp;Andrew S. Mackie MD ,&nbsp;Kambiz Norozi MD, PhD ,&nbsp;Jenna Yaraskavitch MHK ,&nbsp;Alyssa Chappell BScN, RN ,&nbsp;Adam Dempsey PhD ,&nbsp;Angelica Blais MSc ,&nbsp;Rae Foshaug ,&nbsp;Andrew Willan PhD ,&nbsp;Jennifer Graham BSc","doi":"10.1016/j.cjcpc.2025.01.003","DOIUrl":"10.1016/j.cjcpc.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>An effective in-clinic physical activity counseling intervention is needed to increase physical activity motivation and participation among children with moderate or severe congenital heart disease and enable clinicians to comply with activity promotion recommendations.</div></div><div><h3>Methods</h3><div>This pragmatic, single-blind multicenter randomized clinical trial evaluated the intervention feasibility/efficacy among children aged 5-17 years. Clinicians delivered key messages, encouraged activity questions and discussion, and provided kinesiologist support. The primary outcome was daily activity (PiezoRx pedometer steps), assessed after the clinic visit and then monthly for 6 months. Clinic visit length, % counseled, patient/family perceptions, and kinesiology referral assessed health care system impacts.</div></div><div><h3>Results</h3><div>A total of 155 children (60 female, 10.8 ± 3.6 years of age) with moderate (n = 119) or severe (n = 36) diagnoses were included in this study. Initial daily step counts, adjusted for age, did not differ between the groups (mean difference = 776 ± 515 steps per day, <em>P</em> = 0.13). Typically active intervention participants’ mean daily steps over 6 months (adjusted for baseline age, sex, season, and steps) were stable above 12,000 steps per day. Typically active control steps declined, becoming significantly below intervention participants by month 5 (<em>P</em> = 0.006). Highly active participants at baseline (&gt;14,000 steps per day) in both study groups maintained their activity (<em>P</em> = 0.91). Virtually all (97%) intervention participants were counseled, and the clinic visit duration did not differ by group (<em>P</em> = 0.95).</div></div><div><h3>Conclusions</h3><div>Over 6 months, participants receiving a brief, standardized in-clinic activity counseling intervention with on-going kinesiology support were more likely to achieve the recommended daily physical activity. Counseling was feasible for clinicians to deliver during a routine clinic visit enabling compliance with recommended practice.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> #<span><span>NCT03435354</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 150-159"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Filamin C Cardiomyopathy With Myocarditis in Childhood","authors":"Mannat Dhillon MD ,&nbsp;Steven C. Greenway MD ,&nbsp;James A. White MD, PhD ,&nbsp;Noelle Mahon RN ,&nbsp;Jeffrey Shaw MD ,&nbsp;Omid Kiamanesh MD","doi":"10.1016/j.cjcpc.2025.01.002","DOIUrl":"10.1016/j.cjcpc.2025.01.002","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 170-172"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National Survey of Cardiologists on Scope of Practice, Knowledge Gaps, and Educational Priorities in Adult Congenital Heart Disease Care in Canada","authors":"Maria Luz Garagiola MD ,&nbsp;Luc Beauchesne MD ,&nbsp;Robin Ducas MD ,&nbsp;Omid Salehian MD ,&nbsp;Gnalini Sathananthan MBBS, MPhil ,&nbsp;Jonathan Windram MBChB ,&nbsp;Jasmine Grewal MD ,&nbsp;Sarah Blissett MD, MHPE","doi":"10.1016/j.cjcpc.2025.03.001","DOIUrl":"10.1016/j.cjcpc.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>The increasing number of people with adult congenital heart disease (ACHD) leads to greater involvement of non-ACHD cardiologists in their care. Defining and supporting the educational priorities of non-ACHD cardiologists is key to ensure care of this population.</div></div><div><h3>Methods</h3><div>Between November 2023 and March 2024, Canadian cardiologists were invited to participate via email and the Canadian Cardiology Society bulletin. They self-identified as ACHD or non-ACHD cardiologists. The survey explored (1) self-identified knowledge gaps of non-ACHD cardiologists, (2) current scope of practice of non-ACHD cardiologists, and (3) ACHD perspectives on the recommended scope of practice of non-ACHD cardiologists. Educational priorities were defined as diagnoses or topics frequently identified as self-identified knowledge gaps or in the current or recommended scope of practice.</div></div><div><h3>Results</h3><div>A total of 133 of 1263 Canadian Cardiology Society members participated, of whom 32 were ACHD specialists. Thirty-three percent of non-ACHD cardiologists did not have an ACHD specialist on-site, and 24% indicated that there was no ACHD specialist within 100 km. Non-ACHD cardiologists encountered patients with ACHD in the inpatient (42%) and outpatient settings (42%), whereas ACHD cardiologists predominantly encountered outpatients (81%). Frequent self-identified knowledge gaps included great complexity diagnoses and management of pregnancy, arrhythmias, and heart failure. Recommended and current scope of practice involved simple and moderate diagnoses.</div></div><div><h3>Conclusions</h3><div>Targeted educational resources for non-ACHD cardiologists should initially focus on the identified educational priorities, including simple and some moderate diagnoses, a primer on great complexity diagnoses, acute management of heart failure and arrhythmias, and a primer on pregnancy in patients with ACHD.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 129-137"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic Assessment of Atrial Function in Patients With Fontan Palliation: Feasibility, Reproducibility, and Prognostic Implications","authors":"Sara ElZalabany MBBCh,&nbsp;Amr Moustafa MBBCh,&nbsp;Ali Ali MD,&nbsp;Ahmed T. Abdelhalim MBBCh,&nbsp;Ahmed E. Ali MBBCh,&nbsp;Luke J. Burchill MBBS, PhD,&nbsp;Maan Jokhadar MD,&nbsp;Alexander C. Egbe MD, MPH, MS","doi":"10.1016/j.cjcpc.2025.02.002","DOIUrl":"10.1016/j.cjcpc.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Atrial strain provides a global assessment of left heart diastolic function in patients with biventricular circulation, and it is used for risk stratification. However, the role of atrial strain imaging for risk stratification in patients with Fontan palliation has not been studied, and this is likely related to the complex anatomy of the pulmonary venous atrium in this population. The purpose of this study was to assess the feasibility and reproducibility of echocardiographic indices of pulmonary venous atrial function and their relationship to clinical outcomes.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of adults with Fontan palliations who underwent transthoracic echocardiogram at Mayo Clinic (2003-2023). Atrial reservoir strain was used as a measure of global atrial function and was assessed using speckle tracking imaging. The relationship between atrial reservoir strain and death/transplant was assessed using multivariable Cox regression analysis.</div></div><div><h3>Results</h3><div>Of 518 patients, the assessment of atrial strain was feasible in 411 (79%), with modest intraobserver and interobserver reproducibility (intraclass correlation: 0.83, 95% confidence interval [CI]: 0.76-0.89 and intraclass correlation: 0.81, 95% CI: 0.74-0.87, respectively). The correlates of atrial dysfunction (worse atrial reservoir strain) were older age, systemic ventricular systolic dysfunction, and history of atrial fibrillation. There was a 13% decrease in the risk of death/transplant for every 5% increase in atrial reservoir strain (adjusted hazard ratio: 0.87, 95% CI: 0.72-0.92, <em>P</em> = 0.02) after adjustment for demographic indices, surgical/anatomic indices, and comorbidities/end-organ function.</div></div><div><h3>Conclusions</h3><div>Echocardiographic assessment of pulmonary venous atrial strain was feasible and reproducible and can be used for risk stratification in adults with Fontan palliation.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 121-128"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life in Children 4-5 Years After Open Heart Surgery in Early Infancy","authors":"Luiz Almeida MD ,&nbsp;Sunita Vohra MSc, MD ,&nbsp;Jeffrey A. Johnson PhD ,&nbsp;Sara Khademioureh PhD ,&nbsp;Irina Dinu PhD ,&nbsp;Charlene M.T. Robertson MD ,&nbsp;Ari R. Joffe MD ,&nbsp;Gonzalo Garcia Guerra PhD, MD ,&nbsp;Complex Pediatric Therapies Follow-up Program (CPTFP)","doi":"10.1016/j.cjcpc.2025.01.001","DOIUrl":"10.1016/j.cjcpc.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQL) is an important outcome measure in pediatrics. We aimed to determine HRQL of children who underwent complex cardiac surgery at age ≤6 weeks with follow-up at age 4-5 years.</div></div><div><h3>Methods</h3><div>We prospectively followed an inception cohort of children after complex cardiac surgery (CCS) performed at age ≤6 weeks at Stollery Children’s Hospital between 2000 and 2014. At the 4- to 5-year follow-up visit, parents completed the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL). Scores were compared with a normative healthy population and with children with chronic illness of a similar age. Predictors of PedsQL scores were determined using univariate and multiple linear regressions, with <em>P</em> ≤ 0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>Of 712 children who underwent CCS at ≤6 weeks of life, 119 (16.7%) died and 140 did not complete the HRQL questionnaire (for multiple reasons), leaving 453 of 593 (76.4%) survivors included. At 4- to 5-year follow-up, the PedsQL total score (mean: 79.5, standard deviation [SD]: 16.3) was significantly lower than that in the healthy normative population (mean: 87.4, SD: 12.7) and similar to that in children with chronic illness (mean: 76.0, SD: 19.3). Patients after single ventricle palliation had a significantly lower PedsQL total score (mean: 72.8, SD: 17.1) than that in patients after biventricular repairs (mean: 82.4, SD: 15.1). Independent risk factors for lower PedsQL scores consistently included single ventricle palliation, chromosomal abnormality, extracorporeal membrane oxygenation, and the number of noncardiac hospitalizations.</div></div><div><h3>Conclusion</h3><div>The HRQL of children who underwent CCS in early infancy is lower than that of healthy children but similar to that of children with other chronic illnesses.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 140-149"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Management of Ventricular Tachycardia in an Adult Case of Unrepaired Pulmonary Atresia With Ventricular Septal Defect: A Case Report","authors":"Masao Matsuda MD ,&nbsp;Suguru Nishiuchi MD, PhD ,&nbsp;Makoto Miyake MD, PhD ,&nbsp;Hirokazu Kondo MD, PhD ,&nbsp;Toshihiro Tamura MD, PhD","doi":"10.1016/j.cjcpc.2025.02.001","DOIUrl":"10.1016/j.cjcpc.2025.02.001","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 173-177"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Discourse on Percutaneous Closure of the Patent Ductus Arteriosus in Premature Neonates: Controversy, Remedy, or Paradox of Choice?","authors":"Wisam Abozaid MD ,&nbsp;Souvik Mitra MD, MSc, PhD ,&nbsp;Bonny Jasani MD, DM ,&nbsp;Lee Benson MD ,&nbsp;Steven Lee Rathgeber MD, MSc","doi":"10.1016/j.cjcpc.2024.12.002","DOIUrl":"10.1016/j.cjcpc.2024.12.002","url":null,"abstract":"<div><div>Whether conversations about the patent ductus arteriosus (PDA) are engaging and productive or controversial and inconclusive, they are commonplace within the neonatal intensive care unit. “To close or not to close” is often the final question that concludes these conversations. Even in the era when surgical closure was the only option for intervention, a consensus on the best management was typically difficult to achieve. The development and widespread adoption of percutaneous PDA closure in premature neonates has now added a new dimension to these conversations and converted the binary question to a more nuanced process that incorporates less invasive options. Because the procedure has been well established and shown to be safe in appropriately selected babies, it is timely to consider what, if any, aspects of the decision-making process have changed in the premature neonate. This article is a comprehensive review of the current literature on the minimally invasive transcatheter PDA closure procedure in premature babies and aims to examine the impact of this procedure on clinical decision-making in neonatology practice.</div></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":"4 3","pages":"Pages 109-120"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}