Pediatric Cardiology最新文献

{"title":"Sonographers as Teachers of Pediatric Echocardiography: A Cross-Sectional Needs Assessment among Four Academic Pediatric Cardiac Centers.","authors":"Ashley E Neal, Piers C A Barker, Colin Dunbar, Benjamin Goot, Tracy Ralston, Bernadette Richards, Indrani Sarkar, Sara Shreve, Stephanie Y Tseng, Garick D Hill","doi":"10.1007/s00246-025-04057-3","DOIUrl":"https://doi.org/10.1007/s00246-025-04057-3","url":null,"abstract":"<p><p>Pediatric cardiac sonographers spend significant time teaching echocardiography. How prepared sonographers are for this crucial role remains unknown. We sought to understand current sonographer knowledge, attitudes, and confidence in teaching pediatric cardiology fellows. This cross-sectional study recruited sonographers and pediatric cardiology fellows at 4 centers by email from Jan-Feb 2025. All subjects provided demographic data and completed a 27-item Interprofessional Attitudes Scale (IPAS), validated to assess healthcare students' cooperative learning beliefs (max score 135). Only sonographers completed a modified 15-item validated Maastricht Clinical Teaching Questionnaire (MCTQ), yielding average ratings (1-5) and teaching ratings (1-10). Open-ended responses were reviewed for recurrent themes. Response rate was 76/124 (61.3%) eligible subjects: 31 fellows and 45 sonographers. Prerequisites for sonographers teaching fellows were skills assessment (42%), certification (39%), time (36%), none (36%), observation (22%), and education-related didactics (11%). IPAS scores [median (IQR)] were available for 29 fellows [116(90-125)] and 35 sonographers [118(93-123)] with no significant difference between groups (p = 0.7). Sonographer MCTQ average ratings were 4.14(3.86-4.50). By Spearman's rank, there was a positive correlation between sonographer MCTQ average rating and time teaching fellows (r = 0.36, p = 0.04) as well as sonographer IPAS (r = 0.44, p = 0.008). Themes from open-ended comments included specialty-specific medical knowledge and technical skills; individualized learning goals and assessment; fostering a positive, supportive learning environment; feedback and communication; time constraints; and general medical education skills. We found that sonographer prerequisites for teaching fellows were inconsistent. Sonographer confidence in teaching was associated with time spent teaching. Updating current pediatric cardiac sonographers on competency-based fellow evaluation is warranted.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Holodiastolic Flow Reversal in the Descending Aorta: A Marker of Concomitant Acute Myocarditis and Aortitis in Children-A Case Series.","authors":"Antonio Manenti, Francesca Coppi","doi":"10.1007/s00246-025-04067-1","DOIUrl":"https://doi.org/10.1007/s00246-025-04067-1","url":null,"abstract":"<p><p>Holodiastolic flow reversal in the descending aorta can complicate acute myocarditis, indicating decreased cardiac output and possible aortitis. This pathology is related to the disappearance of the 'Windkessel' phenomenon, normally enabling the aortic walls to store potential energy during systole, which is released to the thoracic aorta blood flow during diastole. Furthermore, severe low-output syndrome or distributive shock can render the aortic walls incapable of exploiting their elasticity, which usually enhances the power of aortic blood flow. Moreover, the increased release of catecholamines, or their large-scale administration, causes vasoconstriction, mainly in the abdominal aorta and iliac-femoral branches. This increases peripheral resistance, but to a lesser extent in the supra-aortic branches, whose network becomes competitive and remains supplied with a sufficient amount of blood. From a pathological point of view, aortitis can be caused by an increase in the release of inflammatory cytokines, enhanced by ischemia resulting from a decrease in blood supply from the vasa vasorum, a consequence of shock. This pathology, easily detected by Echocardiography, must be considered an important sign of shock and is worthy of further investigation using 4D MRI aortic angiography.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Use of SGLT2 Inhibitors in Pediatric Heart Failure: A Multi-Eenter Study.","authors":"Ryan Butts, Deipanjan Nandi, Borah Hong, Thomas D Ryan, Juli Sublett-Smith, Humera Ahmed, David M Peng, Victor Benvenuto, Gabrielle Vaughn, Kathleen Simpson, Benjamin Kroslowitz, Joseph Spinner","doi":"10.1007/s00246-025-04062-6","DOIUrl":"https://doi.org/10.1007/s00246-025-04062-6","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ascending Aorta-Descending Aorta Outer/Internal Distance Index as a Potential Novel Method for Predicting Fetal Complete Transposition of the Great Arteries: A Pilot Study.","authors":"Qi Yang, Yanping Ruan, Xiaoyan Gu, Ye Zhang, Xiaowei Liu, Lin Sun, Ying Zhao, Yihua He, Jiancheng Han","doi":"10.1007/s00246-025-04064-4","DOIUrl":"https://doi.org/10.1007/s00246-025-04064-4","url":null,"abstract":"&lt;p&gt;&lt;p&gt;To investigate the ascending aorta (AAO)-descending aorta (DAO) outer/internal distance index (AAO-DAO ODI/IDI) prediction value for fetal complete transposition of the great arteries (D-TGA). Selected D-TGA fetuses between January 2019 and June 2024 as the D-TGA group and an equal number of normal fetuses (gestational age (GA) matched ± 1 week) as the control group. The AAO-DAO outer/internal distance (AAO-DAO OD/ID) and DAO diameter were measured in the aortic arch long-axis view, and the AAO-DAO ODI/IDI were calculated, which are the ratios of AAO-DAO OD/ID to DAO. The relationship between AAO-DAO OD/ID and AAO-DAO ODI/IDI and GA of the normal group was analyzed. The differences in AAO-DAO ODI/IDI between the D-TGA and the normal fetuses were compared, and the difference between the D-TGA with intact ventricular septum (D-TGA-IVS) and the D-TGA with ventricular septal defects (D-TGA-VSD) was compared. The sensitivity and specificity of the receiver operating characteristic (ROC) curve were applied to analyze the discrimination ability of AAO-DAO ODI/IDI for D-TGA and normal fetuses and D-TGA-IVS and D-TGA-VSD. In the normal control group, the DOA ICC was 0.972 (95% CI 0.958-0.982), the AAO-DAO OD ICC was 0.988 (95% CI 0.983-0.992), and the AAO-DAO ID ICC was 0.978 (95% CI 0.967-0.985); in the D-TDA group, the DAO ICC was 0.975 (95% CI 0.956-0.989), the AAO-DAO OD ICC was 0.994 (95% CI 0.991-0.996), and the AAO-DAO ID ICC was 0.991 (95% CI 0.987-0.994). The AAO-DAO OD (r = 0.811, P &lt; 0.001) and AAO-DAO ID (r = 0.707, P &lt; 0.001) increased with increasing GA. The linear regression equations are AAO-DAO OD = 0.087*GA-0.474 (R&lt;sup&gt;2&lt;/sup&gt; = 0.758, N = 69), and AAO-DAO ID = 0.052*GA-0.319 (R&lt;sup&gt;2&lt;/sup&gt; = 0.626, N = 69) respectively. The AAO-DAO ODI (r = 0.080, P = 0.511) and AAO-DAO IDI (r = 0.096, P = 0.433) did not significantly correlate with GA. In the D-TGA group, the AAO-DAO ODI/IDI were greater than the normal group (6.35 ± 0.43 vs 4.65 ± 0.35, t = - 25.385, P &lt; 0.001) and (4.30 ± 0.42 vs 2.69 ± 0.30, t = - 26.050, P &lt; 0.001). In the D-TGA-IVS group, the AAO-DAO ODI/IDI was greater than the D-TGA-VSD group (6.55 ± 0.32 vs 6.09 ± 0.43, t = 5.118, P &lt; 0.001) and (4.50 ± 0.32 vs 4.04 ± 0.39, t = 5.425, P &lt; 0.001). The AAO-DAO ODI AUC was 0.998 (95% CI 0.995-1), and the AAO-DAO IDI AUC was 0.999 (95% CI 0.996-1) for differentiating D-TGA from normal fetuses (twofold cross-validation). When the AAO-DAO ODI cutoff value was 5.34, the sensitivity was 98.6%, the specificity was 97.1%, the positive predictive value (PPV) was 97.1%, and the negative predictive value (NPV) was 98.5%, the positive likelihood ratio (PLR) was 34, and the negative likelihood ratio (NLR) was 0.015; when the AAO-DAO IDI cutoff value was 3.46, the sensitivity was 97.1%, the specificity was 100%, the PPV was 100%, the NPV was 97.2%, and the NLR was 0.029. The AAO-DAO ODI AUC was 0.807 (95% CI 0.696-918), and the AAO-DAO IDI AUC was 0.814 (95% CI 0.712-917) for differenti","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Optimal Management of Cardiac Disease in m.3243A > G Carriers Requires Comprehensive, Close, and Long-Term Follow-up Care.","authors":"Josef Finsterer","doi":"10.1007/s00246-025-04066-2","DOIUrl":"https://doi.org/10.1007/s00246-025-04066-2","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Survival on the Pediatric Heart Transplant Waiting List.","authors":"Chase Robinson, Garrett Wortham, Megan Crawford, Eric Shin, William Dreyer, Iki Adachi, Abbas Rana","doi":"10.1007/s00246-025-04032-y","DOIUrl":"https://doi.org/10.1007/s00246-025-04032-y","url":null,"abstract":"<p><p>Advancements in pediatric heart failure management and mechanical circulatory support devices necessitate evaluating survival outcomes for children on the heart transplant waiting list. This study examines survival rates of pediatric patients (ages 0-18) on the heart transplant waiting list from 1987-2023. A retrospective analysis of the United Network for Organ Sharing (UNOS) database was conducted for survival of pediatric candidates (ages 0-18) listed for heart transplant from 1987 to 2023. Patients over 18 and combined transplant candidates were excluded, resulting in a total of 18,536 candidates studied. These candidates were followed from listing to death, transplantation, or clinical improvement warranting removal from the waitlist. Analysis involved unadjusted and adjusted survival rates, with Kaplan-Meier survival curves and competing risk analysis models used to assess survival. For competing risk analysis, the primary outcome was waitlist mortality, while transplantation and removal from the waiting list due to improvement were competing outcomes. Variables analyzed include demographic data, body mass index (BMI), dialysis, extracorporeal membrane oxygenation (ECMO), use of ventricular assist devices (VADs), and functional status at listing. One-year survival for pediatric waitlist candidates improved from 21.1% in 1987-1990 to 70.5% in 2021-2023 (P < .05). Adjusted analyses showed a reduction in mortality risk across eras. Survival for pediatric heart transplant candidates has significantly improved over time. Policy changes in allocation and mechanical support advancements have contributed to enhanced outcomes. Future research should refine pediatric transplant criteria and further investigate assist devices' role in improving waitlist survival.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes and Complications of Pulmonary Valve Replacement: A Meta-Analysis of Mechanical Versus Biological Prostheses.","authors":"Kourosh Vahidshahi, Seyed Ali Mofidi, Soroush Oraee, Kiana Ghafourian, Shahryar Rajai Firouzabadi, Ida Mohammadi, Sana Mohammad Soltani, Hedieh Shayesteh, Parham Dastjerdi, Negar Ghotbi, Melika Abdollahi, Anahid Meysami, Mehrnaz Mesdaghi, Somaye Fatahi","doi":"10.1007/s00246-025-04026-w","DOIUrl":"https://doi.org/10.1007/s00246-025-04026-w","url":null,"abstract":"<p><p>This meta-analysis exclusively examines pulmonary valve replacement (PVR) outcomes in congenital heart disease (CHD) patients. CHD affects nearly 1% of live births globally, with a significant subset eventually requiring PVR due to valve dysfunction following primary repair procedures. Choosing between mechanical and biological valves is challenging, as both have significant limitations, including thrombosis, bleeding, degradation, and the need for reoperations. This study systematically evaluates the long-term outcomes and complications of PVR options to provide evidence-based guidance. Its goal is to optimize care and improve outcomes for pediatric CHD patients. This systematic review and meta-analysis followed PRISMA guidelines to compare outcomes and complications of mechanical versus biological PVR in congenital heart disease patients. A comprehensive search was conducted in PubMed, World of Science, and Scopus, screening studies based on defined inclusion and exclusion criteria. Data extraction and analysis were performed independently by two reviewers, with pooled prevalence rates calculated using a random-effects model. Ethical approval was not required as only published data were analyzed. This meta-analysis included 158 studies with a marked imbalance between valve types: 145 biological PVR studies (20,499 patients) versus only 13 mechanical PVR studies (1060 patients) from 7178 screened articles. This 19:1 patient ratio reflects the clinical rarity of mechanical PVR in CHD patients. For biological PVR, valve dysfunction rates increased over time: 4% at 1 year, 8% at 2-3 years, 12% at 4-6 years, 31% at 7-10 years, and 27% at 15-20 years. Reintervention rates also rose: 3% at 1 year, 7% at 2-3 years, 12% at 4-6 years, 29% at 7-10 years, and 43% at 15-20 years. Redo-PVR rates followed a similar trend: 2% at 1 year, 4% at 2-3 years, 8% at 4-6 years, 22% at 7-10 years, and 26% at 15-20 years. Mortality rates remained stable: 4% at 1-3 years, 6% at 4-6 years, and 6% at 15-20 years. Complications included arrhythmias (5%), infective endocarditis (3%), and overall complications (11%). For mechanical PVR, valve dysfunction was 4%, reoperation 6%, and redo-PVR 5%. Thrombosis occurred in 9%, bleeding in 4%, and mortality was 1%. Mechanical valves showed lower reintervention rates but higher thrombosis risks compared to biological valves. PVR shows low long-term mortality and complication rates for both mechanical and biological valves, though mechanical valves reduce redo-PVR but increase thrombosis and bleeding risks. The limited mechanical PVR data necessitates cautious interpretation due to small sample sizes and potential selection bias. Future research should explore outcomes across diverse patients, CHD types, and implantation methods.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Strategy for Thromboprophylaxis in Fontan Circulation: A Systematic Review and Meta-analysis with a Focus on Ethnic Differences.","authors":"Kyung-Jin Oh, Jue Seong Lee, Jae Hee Seol, Hee Joung Choi, Min Jung Cho, Miyoung Choi, Jin Young Song, Jo Won Jung, Jae Yoon Na, Jin Ah Kim, Soo-Jin Kim","doi":"10.1007/s00246-025-04019-9","DOIUrl":"https://doi.org/10.1007/s00246-025-04019-9","url":null,"abstract":"<p><p>Fontan circulation alters cardiovascular hemodynamics to maintain circulation using a single ventricle, which may consequently increase the risk of thromboembolism. This highlights the need for effective thromboprophylaxis strategies. This study assessed optimal thromboprophylaxis regimens for patients with Fontan circulation through a comprehensive meta-analysis of literature focused on personalized, ethnicity-based approaches. PubMed, Embase, and Cochrane Library databases were searched to identify studies reporting the thromboembolic and bleeding outcomes of patients with Fontan circulation. Thirty reports-four randomized controlled trials and 26 cohort studies-were analyzed. Aspirin (risk ratio [RR], 0.46; 95% confidence interval [CI], 0.2-1.08; p = 0.07), warfarin (RR, 0.40; 95% CI, 0.24-0.65; p < 0.001), and direct oral anticoagulants (DOACs) (RR, 0.22; 95% CI, 0.01-7.57; p = 0.4) were compared with no antithrombotic therapy, and only warfarin use resulted in a statistically significant reduction in thromboembolic risk, whereas the effects of aspirin and DOACs were not statistically significant. In the East Asian subgroup, aspirin significantly decreased thromboembolic risk, compared with no intervention (RR, 0.31; 95% CI, 0.16-0.58; p < 0.001), and was significantly more effective than warfarin (RR, 0.57; 95% CI, 0.37-0.88; p = 0.01). Bleeding risk showed no significant between-group differences. Compared with no intervention, thromboprophylaxis in patients with Fontan circulation reduces thromboembolic risk. Although our findings should be carefully interpreted because of the limited data, they indicate that aspirin may be more effective than warfarin in East Asian patients, underscoring the need for further research into ethnicity-tailored thromboprophylaxis strategies.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Outcomes of Self-expanding VenusP-valve Implantation in Dysfunctional Right Ventricular Outflow Tracts in Pediatric Patients: A Single-Center Evolving Experience.","authors":"Sebastian Góreczny, Maksym Lazu, Marc Gewillig, Mariusz Stańczyk, Andrzej Rudziński, Reinhardt Becht, Phouc Duong, Michał Wyrobek, Shakeel Qureshi","doi":"10.1007/s00246-025-04048-4","DOIUrl":"https://doi.org/10.1007/s00246-025-04048-4","url":null,"abstract":"<p><p>Recent introduction into clinical practice of large self-expanding valves addressees the issue of dilated dysfunctional right ventricular outflow tracts (RVOTs). The purpose of this study was to determine the safety and short-term efficacy of the VenusP-valve (Venus MedTech) implantation in the pulmonary position in the pediatric group of patients with emphasis on the evolving qualification criteria and implantation techniques. Over a 14-month period, 15 patients < 18 years-old with severe pulmonary regurgitation underwent successful PPVI with the self-expanding VenusP-valve. All types of RVOT anatomies were represented in the study group. Desired valve position during the first attempt was achieved in 13 patients (87%). When compared between the first and second half of the study period, there was a significant difference toward less oversizing: 3.3 ± 1.4 mm versus 1.8 ± 0.7 mm, p = 0.039. On final angiography, trivial pulmonary regurgitation was present in 9 patients (60%). In the remaining 6 patients (40%), the valve was competent. Adverse events were limited to two patients (13.3%) with transient rhythm disturbances without any clinical sequelae. During a median follow-up of 11.5 months (range 7.9-21 months), all the valves remained normally functioning with no need for reinterventions and no episodes of infective endocarditis. The VenusP-valve implantation was safely and effectively performed in pediatric patients with all types of large dysfunctional RVOTs. With modified techniques of implantation, limited femoral vein access or stented pulmonary artery branches, the valves can be successfully implanted.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Trauma Informed Family Meeting: A New Model of Information Sharing and Family Support During Cardiac Admission.","authors":"Colette Gramszlo, Aaron DeWitt, Jennifer K Walter","doi":"10.1007/s00246-025-04054-6","DOIUrl":"https://doi.org/10.1007/s00246-025-04054-6","url":null,"abstract":"<p><p>While best practice guidelines for family meetings in pediatric CICU settings emphasize empathic listening, deliberation, and a focus on family experiences and values, recent research reveals that cardiac care teams face barriers when putting these guidelines into practice. Exposure to traumatic medical experiences impacts the degree to which both family members and cardiac clinicians are able to engage in collaborative conversations during family meetings. Instead, these meetings often become lengthy summaries of the patient's medical history, bringing us no closer to the goal of family centered partnership, an essential component of care for children with complex cardiac conditions. We propose the Trauma Informed Family Meeting (TIFM), which draws upon relational ethics, trauma informed care principles, and the most current empirical research on teamwork and family centered care in CICUs. Central to an effective TIFM are structured, pre-family meeting huddles, which provide opportunities for critical care teams to support one another, establish a shared understanding of medical facts and treatment recommendations, and develop an effective communication strategy. We propose guidelines for TIFMs, including those to be used before and during a TIFM. By shifting our perspective on the purpose of family meetings, a TIFM has the potential to set families on a trajectory to be fully engaged in treatment planning and medical decision-making, to ensure clinicians receive necessary supports, and for teams and families to emerge as strong partners in a child's cardiac care.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}