Pediatric Cardiology最新文献

{"title":"3D Modeling of Self-Expandable Valves for PPVI in Distinct RVOT Morphologies.","authors":"Ender Odemis, İbrahim Başar Aka, Mete Han Kızılkaya","doi":"10.1007/s00246-025-03796-7","DOIUrl":"https://doi.org/10.1007/s00246-025-03796-7","url":null,"abstract":"<p><p>Tetralogy of Fallot often requires transannular patch repair, leading to pulmonary insufficiency. Percutaneous pulmonary valve implantation (PPVI) with self-expandable valves offers a promising alternative, especially for enlarged right ventricular Queryoutflow tracts (RVOT). Five RVOT types identified in patients with Tetralogy of Fallot reflect anatomical variations due to disease and prior surgeries. This study assesses the Pulsta THV® valve's in vitro hemodynamic performance across these RVOT morphologies using 3D-printed models. Five RVOT morphologies were recreated as 3D models from patient-specific imaging data. The Pulsta THV® valves, available in 28, 30, and 32 mm sizes, were evaluated using the ViVitro Pulse Duplicator System at three cardiac outputs (2, 3.5, and 5 L/min). Hemodynamic performance was assessed by measuring regurgitation rates and pressure gradients in the left and right pulmonary arteries. The Pulsta THV® performed optimally in RVOT Types 1 and 2, demonstrating lower regurgitation rates and pressure gradients, particularly with larger valve sizes. Conversely, RVOT Types 3 and 5 showed increased pressure gradients and hemodynamic variability, indicating less favorable outcomes. The results highlighted the critical role of precise anatomical compatibility, with larger valve sizes proving more effective in enlarged RVOT geometry. Valve sizes tailored to specific RVOT morphologies can enhance PPVI outcomes. Types 1 and 2 are ideal for PPVI, while Types 3 and 5 present challenges due to hemodynamic variability. This study supports 3D modeling and in vitro testing for pre-procedural planning to reduce complications, with future research exploring dynamic imaging and materials mimicking tissue properties.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374555","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":"Virtual Reality Curriculum Increases Pediatric Clerkship Students' Knowledge of Congenital Heart Disease.","authors":"Sarah E Blonsky, Rachel E Henning, Emily M Masterson, David M Axelrod, Stephanie S Handler, Sunkyung Yu, Sonal T Owens","doi":"10.1007/s00246-025-03797-6","DOIUrl":"https://doi.org/10.1007/s00246-025-03797-6","url":null,"abstract":"<p><p>This study aimed to assess the impact of a virtual reality (VR) educational curriculum on the knowledge of congenital heart disease (CHD) among medical students during their pediatric clerkship. A multi-center study was conducted involving medical students from two large academic medical centers. Participants engaged in the Stanford Virtual Heart (SVH) educational program during their pediatric clerkship from July 2020 to September 2021. The study employed a stratified approach for group assignment based on timing of enrollment, with Center 1 stratifying by the first or second half of the academic year and Center 2 by month-long rotations. A validated 27-question assessment tool focused on six common CHDs was administered, with the intervention group completing the SVH before the assessment and the control group completing the SVH after the assessment. Additionally, a qualitative survey gauging the participants' experience was conducted. Results were compared between the intervention and control groups. A total of 373 medical students (179 intervention and 194 control) participated in the study. The intervention group exhibited significantly better performance on the assessment compared to the control group across both medical centers (P value < .0001). More than 92% of participants rated the VR experience as 'easy' or 'very easy' to use. Over 99% of participants recommended integrating the program into the pediatric clerkship curriculum. The SVH curriculum was seamlessly integrated into two medical school pediatric clerkships, resulting in a significant improvement in CHD understanding. The overwhelmingly positive feedback supports the incorporation of VR-based educational tools into medical education.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256068","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":"Rebuttal to Gut Microbiome in Children with Congenital Heart Disease After Cardiopulmonary Bypass Surgery (GuMiBear Study).","authors":"Catherine Stanton, Fatma Koc, Sean Kelleher, Paul Ross, Claire Magnier, Colin J McMahon","doi":"10.1007/s00246-025-03795-8","DOIUrl":"https://doi.org/10.1007/s00246-025-03795-8","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123334","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":"Revealing the Rare: Prenatal Diagnosis of Inferior Vena Cava Aneurysm.","authors":"Miraç Özalp, Murat İbrahim Toplu, Doğan Çağrı Tanrıverdi, Türkay Sarıtaş","doi":"10.1007/s00246-025-03788-7","DOIUrl":"https://doi.org/10.1007/s00246-025-03788-7","url":null,"abstract":"<p><p>This case report highlights the prenatal diagnosis of a rare saccular inferior vena cava (IVC) aneurysm. A 25-year-old gravida 4 para 1 patient underwent detailed ultrasonography at 20 weeks of gestation, revealing a 15 × 10 × 14 mm infrarenal IVC aneurysm. Genetic analysis identified a de novo 2p16.3 deletion of uncertain significance. Serial imaging showed progressive aneurysm dilation and mild cardiomegaly. Postnatal CT angiography confirmed the aneurysm, and anticoagulant therapy was initiated. This report underscores the importance of detailed prenatal imaging and genetic evaluation in the identification and management of rare vascular anomalies, contributing to the understanding of their clinical implications.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080691","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 Impact of High Burden Idiopathic Premature Ventricular Contractions in Pediatric versus Adult Populations. A Retrospective Cohort Study.","authors":"Lamyaa Elsayed Allam, Mervat Aboulmaaty Nabih, Mohamed Basyouni Helal, Abdallah R Allam, Ahmed Nabil Ali","doi":"10.1007/s00246-025-03784-x","DOIUrl":"https://doi.org/10.1007/s00246-025-03784-x","url":null,"abstract":"<p><p>Idiopathic premature ventricular contractions (PVCs) can occur in up to 40% of children with structurally normal hearts. The study aims to assess the impact of high-burden idiopathic PVCs on children in comparison with adults in terms of symptoms, distribution of origin, management strategies, and safety considerations. This is a single-center retrospective cohort study that included patients with frequent PVCs (> 10% burden in Holter monitoring) and categorized by age into adult group (≥ 18 years) and pediatric group. Data encompassed demographic profiles, clinical symptoms, echocardiographic findings, electrocardiographic analyses, and one-year follow-up management. A total of 224 PVC cases were collected during a 2-year study (120 children and 104 adults). Syncope occurred significantly more in children than adults (15.8% vs. 0.9%, p = 0.003). In children, the right ventricular outflow tract (RVOT) free wall was the predominant site (48 patients; 40%), while the septal RVOT was most common in adults (35 patients; 33.7%). Pediatric cases exhibited significantly higher PVCs originating from the outflow tract (92.5% vs. 69.2%; p = 0.001). Nevertheless, there were no significant differences between groups regarding the safety, acute, and one-year outcomes of RF ablation. Age disparities were evident in syncope incidence and PVC origin, with no variance in PVC-induced myopathy prevalence or the safety and outcomes of RF catheter ablation between children and adults.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074851","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":"Single-Chamber and Dual-Chamber Pacemaker Devices in Adults with Moderate and Complex Congenital Heart Disease: A Single Tertiary Referral Center Experience.","authors":"Giovanni Papaccioli, Fulvio La Rocca, Giovanni Domenico Ciriello, Anna Correra, Diego Colonna, Emanuele Romeo, Antonio Orlando, Nicola Grimaldi, Michela Palma, Berardo Sarubbi","doi":"10.1007/s00246-024-03444-6","DOIUrl":"10.1007/s00246-024-03444-6","url":null,"abstract":"<p><p>The number of device implantation procedures has increased in adult patients with congenital heart disease (ACHD). Despite significant improvements in materials and implantation techniques, these patients are exposed to higher risk of device related complications than general population. Herein, we describe our single tertiary referral center experience on transvenous pacemaker (PM) implantation and follow-up in adult patients with moderate and complex congenital heart disease (CHD) as limited data are available on long-term outcome. We considered all adults with moderate and complex CHD aged more than 16 years who underwent transvenous single-chamber and dual-chamber PM implant for sinus node dysfunction or atrioventricular block between January 2013 to December 2022 at our Unit. Seventy-one ACHD patients were included in the study (mean age 38.6 ± 15.2 years, 64% with moderate CHD, 36% with complex CHD). Among 32 patients implanted with a dual chamber PM (DDD PM), 4 devices were reprogrammed in VDD mode, 3 in VVI and 2 in AAI mode during follow-up because of lead dysfunction or permanent atrial arrhythmia. In addition, 26 patients had a single chamber PM (AAI or VVI PM) and 13 patients had single-lead pacing system with a free-floating atrial electrode pair (VDD PM). Just one of 13 single-lead VDD PM was reprogrammed in VVI mode due to a low atrial sensing. In DDD PM group, 10 re-interventions were needed due to lead dysfunction (8 cases) and lead-related infective endocarditis (2 cases). Only 3 patients in the single-lead PM group developed lead dysfunction with 2 re-interventions needed, but no infective endocarditis was reported. The rate of long-term complications is high in moderate and complex ACHD with transvenous PM devices, and it is mainly lead-related. In our experience, the less leads implanted, the less complications will occur. Considering the heterogeneity of the ACHD population, transvenous single-chamber or dual-chamber PM device implantation should always be tailored on the single patient, balancing risks and benefits in this complex population.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"467-474"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730228","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":"Heterotaxy Syndromes and Transposition: Common Genetic Basis or a Serendipitous Association?","authors":"Thazhathu Veettil Sreelal, Saurabh Kumar Gupta, Pujitha Vidiyala, Niraj Nirmal Pandey","doi":"10.1007/s00246-024-03638-y","DOIUrl":"10.1007/s00246-024-03638-y","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"506-507"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126335","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":"Predicting Peri-Operative Cardiorespiratory Adverse Events in Children with Idiopathic Pulmonary Arterial Hypertension Undergoing Cardiac Catheterization Using Echocardiography: A Cohort Study.","authors":"Timothy J W Dawes, Valentine Woodham, Emma Sharkey, Angus McEwan, Graham Derrick, Vivek Muthurangu, Shahin Moledina, Lucy Hepburn","doi":"10.1007/s00246-024-03447-3","DOIUrl":"10.1007/s00246-024-03447-3","url":null,"abstract":"<p><p>General anesthesia in children with idiopathic pulmonary arterial hypertension (PAH) carries an increased risk of peri-operative cardiorespiratory complications though risk stratifying individual children pre-operatively remains difficult. We report the incidence and echocardiographic risk factors for adverse events in children with PAH undergoing general anesthesia for cardiac catheterization. Echocardiographic, hemodynamic, and adverse event data from consecutive PAH patients are reported. A multivariable predictive model was developed from echocardiographic variables identified by Bayesian univariable logistic regression. Model performance was reported by area under the curve for receiver operating characteristics (AUC_roc) and precision/recall (AUC_pr) and a pre-operative scoring system derived (0-100). Ninety-three children underwent 158 cardiac catheterizations with mean age 8.8 ± 4.6 years. Adverse events (n = 42) occurred in 15 patients (16%) during 16 catheterizations (10%) including cardiopulmonary resuscitation (n = 5, 3%), electrocardiographic changes (n = 3, 2%), significant hypotension (n = 2, 1%), stridor (n = 1, 1%), and death (n = 2, 1%). A multivariable model (age, right ventricular dysfunction, and dilatation, pulmonary and tricuspid regurgitation severity, and maximal velocity) was highly predictive of adverse events (AUC_roc 0.86, 95% CI 0.75 to 1.00; AUC_pr 0.68, 95% CI 0.50 to 0.91; baseline AUC_pr 0.10). Pre-operative risk scores were higher in those who had a subsequent adverse event (median 47, IQR 43 to 53) than in those who did not (median 23, IQR 15 to 33). Pre-operative echocardiography informs the risk of peri-operative adverse events and may therefore be useful both for consent and multi-disciplinary care planning.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"475-484"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Atrial Arrhythmia in Adults with Repaired Tetralogy of Fallot.","authors":"Zachary E Falk, Annette M Aldous, Seiji Ito, Jeffrey P Moak","doi":"10.1007/s00246-024-03436-6","DOIUrl":"10.1007/s00246-024-03436-6","url":null,"abstract":"<p><p>Tetralogy of Fallot (TOF), the most common cyanotic congenital heart disease in adults, has excellent long-term survival. However, many patients (30-45%) develop late arrhythmias. Previous studies have identified predictors of arrhythmia (atrial or ventricular) using clinical markers that predate arrhythmia onset by many years. Our objective was to develop a predictive model for incident atrial arrhythmias within two years of clinical evaluation and diagnostic testing. A single-center nested unmatched case-control study of 174 adults with repaired TOF. We included only patients with results from ECG and echocardiogram data in the required time interval (3-24 months before first arrhythmia for cases; 24 months of follow-up for controls). A predictive multivariable model for risk of incident atrial arrhythmia was developed using logistic regression with a least absolute shrinkage and selection operator (LASSO). Of 41 demographic, surgical, and diagnostic variables, six were selected as having predictive value for atrial arrhythmia based on cross validation. The factors with the greatest predictive value in decreasing order were moderate / severe tricuspid regurgitation (adjusted odds ratio (OR) 149.42), QRS fragmentation (OR 28.08), severe pulmonary regurgitation (OR 8.22), RV systolic dysfunction (OR 2.95), 1st degree AV block (OR 2.59), and age at time of surgical repair (OR 1.02). Predictors for atrial arrhythmia in our study suggested abnormal right ventricle anatomical function and electrophysiologic properties (conduction and repolarization) as the primary underlying substrate.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"420-430"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139692591","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":"Computed Tomography Measurement of the Aorta in Midaortic Syndrome in Children and Adolescents and Their Clinical Manifestations and Outcomes.","authors":"Seung Min Baek, Yoon Seong Lee, Mi Kyoung Song, Sang Yun Lee, Eun Jung Bae, Gi Beom Kim","doi":"10.1007/s00246-023-03399-0","DOIUrl":"10.1007/s00246-023-03399-0","url":null,"abstract":"<p><p>Midaortic syndrome (MAS) presents challenges in diagnosis due to the absence of well-defined diagnostic criteria in pediatric patients. This retrospective study aimed to aid in the diagnosis of MAS by employing computed tomography (CT) to measure the z-score of the aorta as well as to identify and understand its clinical features. CT images, echocardiography findings, and medical records of 17 patients diagnosed with MAS between 1997 and 2023 were reviewed, and z-scores were calculated. Aortic size on follow-up CT, blood pressure, and left ventricular function and hypertrophy at the last follow-up were analyzed, and possible prognostic factors were examined. Except for one patient, all individuals exhibited a z-score below - 2 at the level corresponding to stenosis. Left ventricular dysfunction occurred more frequently in patients aged < 5 years (p = 0.024). Patients with idiopathic MAS showed a better prognosis in terms of blood pressure and follow-up aortic size (p = 0.051 and 0.048, respectively). CT-measured aortic z-scores may be useful for the diagnosis and follow-up of MAS.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"312-323"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139570674","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}