CJC Pediatric and Congenital Heart Disease最新文献

{"title":"Headaches in Children After Transcatheter Device Closure of Atrial Septal Defects: A Single-Centre Experience","authors":"Joshua D. Griesman MBBCh, MSc,&nbsp;Audrey C. Marshall MD, MPH","doi":"10.1016/j.cjcpc.2024.01.001","DOIUrl":"10.1016/j.cjcpc.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><p>Transcatheter device closure (TDC) is the most common treatment for isolated atrial septal defects in children. In the adult population, the incidence of new-onset migraine headache after TDC is well recognized and is estimated at 15%. New-onset headache after paediatric TDC has not been well described. We reviewed our centre’s experience to estimate the rate of headache complaints among paediatric patients after TDC.</p></div><div><h3>Methods</h3><p>We performed a single-centre, retrospective review of all children who underwent TDC between January 1, 2018, and December 31, 2021. For the included patients, we comprehensively reviewed the electronic medical record to identify patients reported to experience post-TDC headache.</p></div><div><h3>Results</h3><p>A total of 165 consecutive patients underwent TDC during the study period. Of these, 134 met inclusion criteria, and 20 patients (15%) had headache documented in the electronic medical record. Of 20 patients, 4 (20%) had headaches that led to further investigation or changed postprocedural medical management. Two patients had brain magnetic resonance imaging to investigate headaches; both studies were interpreted as nonpathologic. One patient required emergency department management for status migrainosus. A second, with a prior history of migraine, required admission for migraine exacerbation. In addition to those needing symptomatic management, 3 patients had a change in their antiplatelet regimen from aspirin to clopidogrel.</p></div><div><h3>Conclusions</h3><p>Our study suggests a minimal estimate of 15% as the incidence of headache in children who undergo TDC. This estimate can inform counselling before TDC. Determination of the true incidence will require focused prospective data collection.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812924000022/pdfft?md5=b6c62dd1ba4ffb938ceba9b71f4ae4c1&pid=1-s2.0-S2772812924000022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139639622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Esophageal Varices in Adults With Fontan Palliation and Liver Cirrhosis","authors":"Marwan H. Ahmed MBBS ,&nbsp;William R. Miranda MD ,&nbsp;Patrick S. Kamath MD ,&nbsp;Moira H. Sugrue MD ,&nbsp;C. Charles Jain MD ,&nbsp;Maan Jokhadar MD ,&nbsp;Luke J. Burchill MBBS, PhD ,&nbsp;Heidi M. Connolly MD ,&nbsp;Alexander C. Egbe MD, MPH, MS","doi":"10.1016/j.cjcpc.2024.01.002","DOIUrl":"10.1016/j.cjcpc.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>The purpose of this study was to define the risk and outcomes of esophageal varices in adults with Fontan palliation and liver cirrhosis undergoing esophagogastroduodenoscopy (EGD).</p></div><div><h3>Method</h3><p>The results of EGD, abdominal ultrasound, and liver biopsy, as well as clinic notes from the hepatologist, were reviewed to determine the diagnosis of cirrhosis and esophageal varices. The incidence of acute gastrointestinal bleeding complication was assessed among patients with esophageal varices using the time of EGD as the baseline.</p></div><div><h3>Results</h3><p>Of 149 patients with Fontan palliation and liver cirrhosis, the prevalence of esophageal varices at baseline EGD was 34% (51 of 149). Of 98 patients without esophageal varices at baseline EGD, 27 (27%) underwent subsequent EGD, of whom 11 showed a new diagnosis of esophageal varices. The incidence of a new diagnosis of esophageal varices was 9% per year. Of 62 patients with esophageal varices, 9 (15%) had acute gastrointestinal bleeding complications during 45 (37-62) months of follow-up, yielding an incidence of 5% per year. Of the 9 patients, 8 underwent EGD and variceal banding during the hospitalization for bleeding and 1 patient died of septicaemia. Of the 8 patients who survived to hospital discharge, 2 patients were readmitted for esophageal bleeding within 12 months from the index hospitalization. Higher hepatic vein wedge pressure and hepatic vein pressure gradient were associated with esophageal varices and bleeding complications.</p></div><div><h3>Conclusions</h3><p>In this selected sample of adults with Fontan palliation and liver cirrhosis, esophageal varices were relatively common, and patients with esophageal varices had risk of bleeding complications.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812924000186/pdfft?md5=a36a4d2e82ec1551f1693a20c1a0dc6a&pid=1-s2.0-S2772812924000186-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139830274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Sodium-Glucose Cotransporter 2 Inhibitor Use in Adults With Congenital Heart Disease","authors":"Snigdha Karnakoti MBBS,&nbsp;Kartik Andi MBBS,&nbsp;William R. Miranda MD,&nbsp;C. Charles Jain MD,&nbsp;Luke J. Burchill MBBS, PhD,&nbsp;Maan Jokhadar MD,&nbsp;Heidi M. Connolly MD,&nbsp;Alexander C. Egbe MD, MPH, MS","doi":"10.1016/j.cjcpc.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2024.02.001","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812924000198/pdfft?md5=a7dc6c26b726b8cab7ca6f41e1e1f0cb&pid=1-s2.0-S2772812924000198-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141485058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S2772-8129(24)00045-9","DOIUrl":"https://doi.org/10.1016/S2772-8129(24)00045-9","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812924000459/pdfft?md5=9155f16b601b46e0535dbe7ef066e24d&pid=1-s2.0-S2772812924000459-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141485057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the Local Activation Time Histogram “Trough” to Identify the Slow Conduction Channel in Complex Congenital Heart Disease Macro-re-entrant Arrhythmias","authors":"Nathan C. Denham BM, PhD ,&nbsp;Robert D. Anderson MBBS, PhD ,&nbsp;Raja Selvaraj MBBS, MD, DM ,&nbsp;Andrew C.T. Ha MD ,&nbsp;Krishnakumar Nair MD","doi":"10.1016/j.cjcpc.2023.12.004","DOIUrl":"10.1016/j.cjcpc.2023.12.004","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812924000010/pdfft?md5=f563297a8567061816d883c563ce7d41&pid=1-s2.0-S2772812924000010-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139637664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Prevalence of the Electrocardiographic Early Repolarization Pattern in Young Patients With Vagally Mediated Syncope: A Case-Control Study","authors":"Mohit Singla MD, MBA ,&nbsp;Pascal N. Tyrrell PhD ,&nbsp;Manveer Khural MD ,&nbsp;Gil J. Gross MD","doi":"10.1016/j.cjcpc.2023.10.013","DOIUrl":"10.1016/j.cjcpc.2023.10.013","url":null,"abstract":"<div><h3>Background</h3><p>Electrocardiographic early repolarization (EER) is linked with idiopathic ventricular fibrillation in adults. It is frequently seen in children, with poorly understood significance. Some evidence suggests that it could be a vagally mediated phenomenon. A retrospective case-control study was undertaken to test the hypothesis that EER is more common among children with typical vasovagal syncope (VVS) than among their peers with nonvagal syncope (NVS) or with no syncope.</p></div><div><h3>Methods</h3><p>Patients aged 4-18 years with syncope were identified by a single-centre database search followed by a review of history for features of VVS (n = 150) or NVS (n = 84). The first available electrocardiogram (ECG) for VVS or for NVS was retrieved. Age- and sex-matched children with no known syncope or heart disease were then identified (n = 216). ECGs were assessed separately for EER based on published criteria by 2 observers blinded to patients’ clinical status.</p></div><div><h3>Results</h3><p>Mean age was 12.3 ± 3.2 years, and heart rate was 74.2 ± 16.5 beats/min. EER was more prevalent in VVS (33.3%) than among patients with NVS (19.1%; odds ratio: 2.29; confidence interval: 1.32-5.50) or among those with no syncope (12.5%; odds ratio: 3.14; confidence interval: 1.81-5.46). Heart rates were significantly lower in VVS and NVS (heart rate: 70.1 ± 13.8 and 70.7 ± 12.4 beats/min, respectively) compared with children with no syncope (heart rate: 78.2 ± 18.0 beats/min), both <em>P</em> &lt; 0.001.</p></div><div><h3>Conclusions</h3><p>EER is more common in paediatric patients with VVS than those with NVS or without syncope, consistent with a possible vagal contribution to the ECG finding.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812923001653/pdfft?md5=890aa631d4ed1af635c0b5204d972a8f&pid=1-s2.0-S2772812923001653-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135615598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extravascular Central Venous Line Removal and Endovascular Covered Stent Implantation Guided by 3-Dimensional Computed Tomographic Reconstruction","authors":"Sarah Pradhan MD, MSc ,&nbsp;Rachel D. Vanderlaan MD, PhD ,&nbsp;Lee Benson MD","doi":"10.1016/j.cjcpc.2023.12.005","DOIUrl":"10.1016/j.cjcpc.2023.12.005","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812924000174/pdfft?md5=d57042c748730c9c16672cf174bb39ad&pid=1-s2.0-S2772812924000174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139631952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Genotype-Phenotype Interactions on Cardiovascular Function in Paediatric Loeys-Dietz Syndrome","authors":"Nairy Khodabakhshian PhD ,&nbsp;Alison J. Howell MD ,&nbsp;Pablo Perez Lopez MD ,&nbsp;Wei Hui MD ,&nbsp;Luc L. Mertens MD, PhD ,&nbsp;Vitor C. Guerra MD, PhD","doi":"10.1016/j.cjcpc.2023.12.003","DOIUrl":"https://doi.org/10.1016/j.cjcpc.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>The relationship between genotype and phenotypical vascular and cardiac properties in paediatric Loeys-Dietz syndrome (LDS) patients are not well characterized. This study explores the phenotypical differences in aortic properties and cardiac structural and functional parameters between paediatric LDS patients with <em>TGFBR1</em> and <em>TGFBR2</em> mutations.</p></div><div><h3>Methods</h3><p>We included 32 LDS patients with either <em>TGFBR1</em> (n = 17) or <em>TGFBR2</em> (n = 15) mutations. Echocardiographic data included aortic dimensions, distensibility, strain, and stiffness at the level of the annulus, sinuses of Valsalva, sinotubular junction, ascending aorta, and descending aorta. Parameters for left ventricular size and function were also recorded.</p></div><div><h3>Results</h3><p>Demographics were similar between the groups. Patients with <em>TGFBR2</em> were more likely to have undergone aortic surgery (47% vs 12%, <em>P</em> = 0.057) and use angiotensin receptor blockers (93% vs 47%, <em>P</em> = 0.015). Aortic <em>z</em> scores were significantly larger in the <em>TGFBR2</em> group at the level of the aortic valve annulus (<em>P</em> = 0.007), sinuses of Valsalva (<em>P</em> = 0.001), sinotubular junction (<em>P</em> = 0.001), and ascending aorta (<em>P</em> = 0.054). Patients with <em>TGFBR2</em> also had significantly lower aortic distensibility and strain coupled with higher stiffness index at the level of the annulus, sinotubular junction, and ascending aorta. Parameters for the descending aorta, cardiac morphology, and cardiac function were similar between the groups.</p></div><div><h3>Conclusions</h3><p>Paediatric LDS patients with <em>TGFBR2</em> present with more severe cardiovascular phenotypes than patients with <em>TGFBR1</em> with larger aortic dimensions and increased aortic stiffness. Our findings suggest that genotypes should be taken into consideration in the clinical management of paediatric LDS patients.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812923002026/pdfft?md5=3651d91d1771023d5bed1cde008ad648&pid=1-s2.0-S2772812923002026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S2772-8129(24)00025-3","DOIUrl":"https://doi.org/10.1016/S2772-8129(24)00025-3","url":null,"abstract":"","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812924000253/pdfft?md5=8f75a1bacccf1285426f44da6547c10b&pid=1-s2.0-S2772812924000253-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tetralogy of Fallot in Low- and Middle-Income Countries","authors":"Nabil Dib MD ,&nbsp;Vincent Chauvette MD, PhD(c) ,&nbsp;Momar Sokhna Diop MD ,&nbsp;Ismail Bouhout MD ,&nbsp;Mehdi Hadid MD ,&nbsp;Christophe Vô MD ,&nbsp;Paul Khairy MD, PhD ,&nbsp;Nancy Poirier MD","doi":"10.1016/j.cjcpc.2023.12.002","DOIUrl":"10.1016/j.cjcpc.2023.12.002","url":null,"abstract":"<div><p>Low- and middle-incomes countries (LMICs) have limited resources for the diagnosis and treatment of congenital heart diseases such as tetralogy of Fallot. This is in part due to lack of infrastructures, financial means, and expertise. As a result, patients undergo surgery much later than in high-income countries. This delay in treatment results in right ventricular dysfunction, cardiac arrhythmias, and poor psychomotor development—complications that are all related to chronic hypoxia. There are limited data and a few small studies of patients treated for tetralogy of Fallot in LMICs, and, therefore, the aim of this review is to analyse and summarize the surgical outcomes of this LMIC population.</p></div>","PeriodicalId":100249,"journal":{"name":"CJC Pediatric and Congenital Heart Disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772812923002014/pdfft?md5=c5488d524219a63258cc64d51aef73e7&pid=1-s2.0-S2772812923002014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139017103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}