Pediatric Cardiology最新文献_第10页

Referral Order Placement Decreases Time to Transfer to Adult Congenital Heart Disease Care. 转诊单的下达缩短了转入成人先天性心脏病治疗的时间。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-04-27 DOI: 10.1007/s00246-023-03164-3

Debora Burger, Quin E Denfeld, Patrick D Evers, Pam Ward, Patricia Woods, Reem Hasan

{"title":"Referral Order Placement Decreases Time to Transfer to Adult Congenital Heart Disease Care.","authors":"Debora Burger, Quin E Denfeld, Patrick D Evers, Pam Ward, Patricia Woods, Reem Hasan","doi":"10.1007/s00246-023-03164-3","DOIUrl":"10.1007/s00246-023-03164-3","url":null,"abstract":"Pediatric patients with moderate and great complexity congenital heart disease (CHD) may benefit from coordinated transfer to adult congenital heart disease (ACHD) centers to reduce the risk of complications; however, there are a variety of transfer practices. We examined the impact of referral order placement at the last pediatric cardiology visit on time to transfer to an ACHD center. We analyzed data collected from pediatric patients with moderate and great complexity CHD who were eligible to transfer to our tertiary center's accredited ACHD center. We examined transfer outcomes and time-to-transfer between those with a referral order placed at the last pediatric cardiology visit and those without using Cox proportional hazards modeling. The sample (n = 65) was 44.6% female and mean age at study start was 19.5 years (± 2.2). Referral orders were placed for 32.3% of patients at the last pediatric cardiology visit. Those who had a referral order placed at the last visit had significantly higher number of successful transfers to the ACHD center compared to those who did not (95% vs 25%, p < 0.001). In a Cox regression model, placement of a referral order at the last pediatric cardiology visit was associated significantly with a sooner time to transfer (HR 6.0; 95% CI 2.2-16.2, p > 0.001), adjusting for age, sex, complexity, living location, and pediatric cardiology visit location. Placement of a referral order at the last pediatric cardiology visit may improve transfer occurrence and time to transfer to accredited ACHD centers.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1424-1429"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9351876","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}

引用次数: 0

Cardiovascular Manifestations of Turner Syndrome: Phenotypic Differences Between Karyotype Subtypes. 特纳综合征的心血管表现：核型亚型之间的表型差异

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-05-05 DOI: 10.1007/s00246-023-03159-0

Alona Birjiniuk, Allison Goetsch Weisman, Christina Laternser, Joseph Camarda, Wendy J Brickman, Reema Habiby, Sheetal R Patel

{"title":"Cardiovascular Manifestations of Turner Syndrome: Phenotypic Differences Between Karyotype Subtypes.","authors":"Alona Birjiniuk, Allison Goetsch Weisman, Christina Laternser, Joseph Camarda, Wendy J Brickman, Reema Habiby, Sheetal R Patel","doi":"10.1007/s00246-023-03159-0","DOIUrl":"10.1007/s00246-023-03159-0","url":null,"abstract":"Turner syndrome (TS) is a genetic disorder presenting in phenotypic females with total or partial monosomy of the X chromosome. Cardiovascular abnormalities are common, including congenital heart defects (CHD) and aortic dilation. Although mosaic TS is suspected to have less severe phenotype as compared to non-mosaic TS, differences in cardiovascular manifestations between karyotypes are not well studied. This is a single-center retrospective cohort study including patients with TS seen from 2000 to 2022. Demographic data, chromosomal analysis, and imaging were reviewed. Karyotypes were categorized as monosomy X (45X), 45X mosaicism, isochromosome Xq, partial X deletions, ring X (r(X)), TS with Y material, and others. Prevalence of CHD and aortic dilation were compared between monosomy X and other subtypes using Pearson's chi-square test and Welch two-sample t-test. We included 182 TS patients with median age 18 (range 4-33) years. CHD was more common in monosomy X as compared with others (61.4% vs. 26.8%, p < 0.001), including bicuspid aortic valve (44.3% vs. 16.1%, p < 0.001), partial anomalous pulmonary venous return (12.9% vs. 2.7%, p = 0.023), persistent left superior vena cava (12.9% vs. 1.8%, p = 0.008), and coarctation of the aorta (20.0% vs. 4.5%, p = 0.003). Cardiac surgery (24.3% vs. 8.9%, p = 0.017) was more prevalent in the monosomy X group. There was no statistically significant difference for presence of aortic dilation (7.1% vs 1.8%, p = 0.187). Although CHD and need for cardiac surgery are more common in TS with monosomy X as compared to others, all TS subtypes may have similar risk of developing aortic dilation. All TS patients should have similar cardiovascular surveillance testing to monitor for aortic dilation.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1407-1414"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9413929","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}

引用次数: 0

Pre-Fontan Assessment Utilizing Combined Cardiac Catheterization and Cardiac MRI: Comparison to the Pre-Fontan Catheterization. 利用联合心导管检查和心脏磁共振成像进行芳坦前评估：与超声心动图前导管检查的比较

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-05-21 DOI: 10.1007/s00246-023-03178-x

Lindsay F Eilers, Jolie J Britt, Justin Weigand, Daniel J Penny, Srinath T Gowda, Athar M Qureshi, Gary E Stapleton, Asra Khan, Melissa K Webb, Manish Bansal

{"title":"Pre-Fontan Assessment Utilizing Combined Cardiac Catheterization and Cardiac MRI: Comparison to the Pre-Fontan Catheterization.","authors":"Lindsay F Eilers, Jolie J Britt, Justin Weigand, Daniel J Penny, Srinath T Gowda, Athar M Qureshi, Gary E Stapleton, Asra Khan, Melissa K Webb, Manish Bansal","doi":"10.1007/s00246-023-03178-x","DOIUrl":"10.1007/s00246-023-03178-x","url":null,"abstract":"Single ventricle patients eligible for Fontan completion undergo pre-Fontan catheterization for hemodynamic and anatomic assessment prior to surgery. Cardiac magnetic resonance imaging may be used to evaluate pre-Fontan anatomy, physiology, and collateral burden. We describe our center's outcomes in patients undergoing pre-Fontan catheterization combined with cardiac magnetic resonance imaging. A retrospective review of patients undergoing pre-Fontan catheterization from 10/2018 to 04/2022 at Texas Children's Hospital was performed. Patients were divided into 2 groups: combined cardiac magnetic resonance imaging and catheterization (combined group) and those who underwent catheterization only (catheterization only group). There were 37 patients in the combined group and 40 in the catheterization only group. Both groups were similar in age and weight. Patients undergoing combined procedures received less contrast, and experienced less in-lab time, fluoroscopy time and catheterization procedure time. Median radiation exposure was lower in the combined procedure group but was not statistically significant. Intubation and total anesthesia times were higher in the combined procedure group. Patients undergoing a combined procedure were less likely to have collateral occlusion performed than in the catheterization only group. Bypass time, intensive care unit length of stay, and chest tube duration were similar in both groups at the time of Fontan completion. Combined pre-Fontan assessment decreases catheterization procedure and fluoroscopy time associated with cardiac catheterization at the expense of longer anesthetic times, and results in similar Fontan outcomes compared to when cardiac catheterization alone is utilized.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1448-1454"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9484884","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}

引用次数: 0

Evaluating How Physician Attitudes May Affect Practice in Fetal Cardiac Counseling. 评估医生的态度如何影响胎儿心脏咨询的实践。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-06-19 DOI: 10.1007/s00246-023-03210-0

Anna M Martens, Chelsey C Lim, Michael Kelly, Caitlin S Haxel, Christina Ronai, Joanne S Chiu

{"title":"Evaluating How Physician Attitudes May Affect Practice in Fetal Cardiac Counseling.","authors":"Anna M Martens, Chelsey C Lim, Michael Kelly, Caitlin S Haxel, Christina Ronai, Joanne S Chiu","doi":"10.1007/s00246-023-03210-0","DOIUrl":"10.1007/s00246-023-03210-0","url":null,"abstract":"Advances in fetal cardiac imaging over the last few decades have allowed for increased prenatal detection and detailed counseling of congenital heart disease (CHD). When CHD is detected, fetal cardiologists are faced with the challenge of providing nuanced prenatal counseling. Studies in other specialties have shown that differences in physician attitudes exist around termination of pregnancy and correlate with variations in the counseling provided to parents. We conducted an anonymous cross-sectional survey of fetal cardiologists in New England (n = 36) regarding attitudes toward termination of pregnancy and the counseling provided to parents with a fetal diagnosis of hypoplastic left heart syndrome. Using a screening questionnaire, there was no significant difference in the counseling provided to parents regardless of the physician's personal or professional views on termination of pregnancy, age, gender, location, type of practice, or years of experience. There were, however, differences among physicians on reasons to consider termination and their perceived professional responsibility to the fetus or mother. Further investigation on a larger geographic scale may reveal additional insights on variations in physician beliefs and whether such beliefs affect variability in counseling practices.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1550-1558"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667332","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}

引用次数: 0

Longitudinal Assessment of Left Ventricular Function in Patients with Myopericarditis After mRNA COVID-19 Vaccination. mRNA COVID-19 疫苗接种后心肌炎患者左心室功能的纵向评估

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-06-09 DOI: 10.1007/s00246-023-03200-2

Barresi Nv, S McCollum, E Faherty, J M Steele, R Karnik

{"title":"Longitudinal Assessment of Left Ventricular Function in Patients with Myopericarditis After mRNA COVID-19 Vaccination.","authors":"Barresi Nv, S McCollum, E Faherty, J M Steele, R Karnik","doi":"10.1007/s00246-023-03200-2","DOIUrl":"10.1007/s00246-023-03200-2","url":null,"abstract":"Background: Multiple reports have described myopericarditis following mRNA COVID-19 vaccination. However, data on the persistence of subclinical myocardial injury assessed by left ventricular (LV) longitudinal strain (LVLS) is limited.Objectives: Our aim was to assess LV function longitudinally in our cohort of COVID-19 vaccine-related myopericarditis using ejection fraction (EF), fractional shortening (FS), LVLS, and diastolic parameters.Methods: Retrospective, single-center review of demographic, laboratory, and management data was performed on 20 patients meeting diagnostic criteria for myopericarditis after mRNA COVID-19 vaccination. Echocardiographic images were obtained on initial presentation (time 0), at a median of 12 days (7.5, 18.5; time 1), and at a median of 44 days (29.5, 83.5; time 2). FS was calculated by M-mode, EF by 5/6 area-length methods, LVLS by utilization of TOMTEC software, and diastolic function by tissue Doppler. All parameters were compared across pairs of these time points using Wilcoxon signed-rank test.Results: Our cohort consisted predominantly of adolescent males (85%) with mild presentation of myopericarditis. The median EF was 61.6% (54.6, 68.0), 63.8% (60.7, 68.3), 61.4% (60.1, 64.6) at times 0, 1, and 2, respectively. Upon initial presentation, 47% of our cohort had LVLS < -18%. The median LVLS was -18.6% (-16.9, -21.0) at time 0, -21.2% at time 1 (-19.4, -23.5) (p = 0.004) and -20.8% (-18.7, -21.7) at time 2 (p = 0.004, as compared to time 0).Conclusions: Though many of our patients had abnormal strain during acute illness, LVLS improved longitudinally, indicating myocardial recovery. LVLS can be used as marker of subclinical myocardial injury and risk stratification in this population.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1524-1532"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10251331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10036502","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}

引用次数: 0

Transcatheter Ductus Arteriosus Stenting for Acute Pediatric Pulmonary Arterial Hypertension is Associated with Improved Right Ventricular Echocardiography Strain. 经导管动脉导管支架植入术治疗急性小儿肺动脉高压与右心室超声心动图应变的改善有关。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-07-13 DOI: 10.1007/s00246-023-03233-7

Jason S Kerstein, Eleonore Valencia, Shane Collins, Alessandra M Ferraro, David M Harrild, Kimberlee Gauvreau, Ryan Callahan, Mary P Mullen

{"title":"Transcatheter Ductus Arteriosus Stenting for Acute Pediatric Pulmonary Arterial Hypertension is Associated with Improved Right Ventricular Echocardiography Strain.","authors":"Jason S Kerstein, Eleonore Valencia, Shane Collins, Alessandra M Ferraro, David M Harrild, Kimberlee Gauvreau, Ryan Callahan, Mary P Mullen","doi":"10.1007/s00246-023-03233-7","DOIUrl":"10.1007/s00246-023-03233-7","url":null,"abstract":"Background: Interventional therapies for severe pulmonary arterial hypertension (PAH) can provide right ventricular (RV) decompression and preserve cardiac output. Transcatheter stent placement in a residual ductus arteriosus (PDA) is one potentially effective option in critically ill infants and young children with PAH. We sought to assess recovery of RV function by echocardiographic strain in infants and young children following PDA stenting for acute PAH.Methods: Retrospective review of patients < 2 years old who underwent PDA stenting for acute PAH. Clinical data were abstracted from the electronic medical record. RV strain (both total and free wall components) was assessed from echocardiographic images at baseline and 3, 6, and 12 months post-intervention, as well as at last echocardiogram.Results: Nine patients underwent attempted ductal stenting for PAH. The median age at intervention was 38 days and median weight 3.7 kg. One-third (3of 9) of patients had PAH associated with a congenital diaphragmatic hernia. PDA stents were successfully deployed in eight patients. Mean RV total strain was - 14.9 ± 5.6% at baseline and improved to - 23.8 ± 2.2% at 6 months post-procedure (p < 0.001). Mean free wall RV strain was - 19.5 ± 5.4% at baseline and improved to - 27.7 ± 4.1% at 6 months (p = 0.002). Five patients survived to discharge, and four patients survived 1 year post-discharge.Conclusion: PDA stenting for severe, acute PAH can improve RV function as assessed by strain echocardiography. The quantitative improvement is more prominent in the first 6 months post-procedure and stabilizes thereafter.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1573-1580"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9777326","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}

引用次数: 0

Role of Cardiac CTA to Evaluate Branch Pulmonary Artery Stenosis and Ductal Insertion Pattern in Right-Sided Congenital Heart Defects. 心脏 CTA 在评估右侧先天性心脏病肺动脉分支狭窄和导管插入模式中的作用

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-07-21 DOI: 10.1007/s00246-023-03234-6

Ana L Vasquez Choy, Rafael Zonana Amkie, Dilachew A Adebo

{"title":"Role of Cardiac CTA to Evaluate Branch Pulmonary Artery Stenosis and Ductal Insertion Pattern in Right-Sided Congenital Heart Defects.","authors":"Ana L Vasquez Choy, Rafael Zonana Amkie, Dilachew A Adebo","doi":"10.1007/s00246-023-03234-6","DOIUrl":"10.1007/s00246-023-03234-6","url":null,"abstract":"There is limited experience in evaluating abnormal ductus arteriosus (DA) insertion pattern by contrast-enhanced cardiac computed tomography (cardiac CT) in patients with right-sided obstructive cardiac defects. Retrospective review of 38 infants with right-sided obstructive cardiac defects who underwent a preoperative cardiac CT between 2016 and 2021. We reviewed the types of cardiac lesions, patterns of ductal insertion, frequency of pulmonary artery (PA) stenosis requiring intervention, total dose length product (DLP), and effective radiation dose. Of 38 infants, 45% were female, the median gestational age and weight were 37 (range 34-40) weeks and 2.95 (range 2-4) kg. The most common pathologies were pulmonary atresia with ventricular septal defect (24%) and tetralogy of Fallot (24%). The abnormal ductal insertion patterns were DA inserting into the left PA in 39%, DA bifurcating into branch PA in 32%, and DA inserting into the right PA in 13%. Of the 38 infants, 76% developed branch PA stenosis requiring intervention. Among patients with abnormal DA insertion, 44% required branch PA arterioplasty during their index surgery compared to 17% without abnormal DA insertion. Regardless of the type of abnormal DA insertion, 67% developed bilateral branch PA stenosis over time. The mean DLP was 8 mGy-cm and the mean calculated effective radiation dose was 0.312 mSv. The utilization of contrast-enhanced cardiac CT in infants with right-sided obstructive heart defects can offer crucial insights into abnormal ductus arteriosus insertion patterns. This information is valuable for effective procedure planning and for monitoring the development of branch pulmonary artery stenosis.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1581-1587"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223218","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}

引用次数: 0

Response to the Letter Titled "Same Entity, Different Hemodynamics: Residual VSD After TOF Repair and Isolated VSD Closure" From Dr. Safak ALPAT. 对 Safak ALPAT 博士题为 "相同的实体，不同的血流动力学：Safak ALPAT 博士题为 "相同的实体，不同的血流动力学：TOF 修复术后残留的 VSD 和孤立的 VSD 关闭术 "的回信。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2024-07-19 DOI: 10.1007/s00246-024-03595-6

Yuki Nakayama, Takeshi Shinkawa

引用次数: 0

Comment on: Fate After the Mustard Procedure for d-Transposition of the Great Arteries: Impact of Age, Complexity, and Atrial Tachyarrhythmias: A Single Center Experience. 评论大动脉d-横位芥末手术后的命运：年龄、复杂性和房性心动过速的影响：单中心经验。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2024-07-27 DOI: 10.1007/s00246-024-03594-7

Iman Akram, F N U Samiullah

引用次数: 0

Acute Kidney Injury and Mid-term Outcomes After Extra-Cardiac Fontan Conversion. 心外丰坦转换术后的急性肾损伤和中期预后。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-06-24 DOI: 10.1007/s00246-023-03220-y

Tatsuya Kunigo, Risa Oikawa, Minoru Nomura

引用次数: 0