Pediatric Cardiology最新文献

{"title":"Methodological and Reporting Concerns Regarding the Manuscript on Double Aortic Arch and Tracheal Morphology.","authors":"Cem Doğan","doi":"10.1007/s00246-026-04221-3","DOIUrl":"10.1007/s00246-026-04221-3","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3611-3612"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434601","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":"Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery in the United States.","authors":"Grant Chappell, Darren Turner, Amir Mehdizadeh-Shrifi, David Lehenbauer, Marco Ricci, Meghan M Chlebowski, Stuart L Goldstein, Awais Ashfaq, David L S Morales","doi":"10.1007/s00246-025-04144-5","DOIUrl":"10.1007/s00246-025-04144-5","url":null,"abstract":"<p><p>Hemodialysis after infant congenital heart surgery (CHS) for acute kidney injury (AKI) presents a major challenge due to relatively low utilization, difficult vascular access and small patient size. Therefore, we performed a multi-institutional analysis for infants requiring hemodialysis post-CHS. The Pediatric Health Information System (PHIS) was queried for infants undergoing CHS from 2004 to 2024. Intermittent hemodialysis (iHD) and continuous renal replacement therapy (CRRT) were included, patients undergoing pre-CHS dialysis or post-CHS peritoneal dialysis during admission were excluded. High HD use centers were in the top 10% of HD usage while low HD use centers were all other centers. After CHS, 1% (332/31,634) of infants received a form of hemodialysis (HD); 61% (204/332) received CRRT, 11% (37/332) received iHD, 11% (36/332) received both, and 17% (55/332) had an unknown type. HD was provided in 2% (220/12,898) of neonates (< 31days-old at CHS) vs. 1% (112/18,736) of infants 31-365 days old (p < 0.001). One-year survival was lower in the dialysis vs. non-dialysis cohort (46% vs. 94%, p < 0.0001). CRRT patients had higher one-year survival vs. iHD (50% vs. 25%, weighted log-rank; p = 0.01), although there was no difference after adjustment upon multivariate analysis. HD infants at high HD use centers had improved hospital and 1-year survival vs. low HD use (66% vs. 23%; 67% vs. 28%, p < 0.0001). Infants requiring hemodialysis (iHD or CRRT) post-CHS suffer from poor outcomes with < 50% 1-year survival, with high HD use centers having triple the hospital survival and double the 1-year survival, suggesting modifiable factors may mitigate poor outcomes.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3450-3458"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934595","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":"Systemic-Pulmonary Collaterals in KCNT1-Related Disorders: Precise Nomenclature and Management.","authors":"Jeffery Delaney, Utkarsh Kohli, Yuki Kawasaki, Casey Burg, Ponghatai Boonsimma, Azusa Ikeda, Tanitnun Paprad, David Bearden, Justin West, Sarah Drislane, Brad Bryan, Amanda Abuhl","doi":"10.1007/s00246-025-04131-w","DOIUrl":"10.1007/s00246-025-04131-w","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3258-3264"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743713","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":"Evaluating the Impact of an Institutional Practice Change from Warfarin to Therapeutic Rivaroxaban Post-Fontan Operation.","authors":"Joel Livingston, Leanne Meakins, Jennifer Conway, Alanna Ash, Luke Eckersley, Mary Bauman","doi":"10.1007/s00246-025-04137-4","DOIUrl":"10.1007/s00246-025-04137-4","url":null,"abstract":"<p><p>Thrombotic complications post-Fontan operation remain a significant clinical concern and preventing these events is critical to improve patient outcomes. While the optimal strategy for thromboprophylaxis post-Fontan is unclear, recent randomized studies have shown comparable outcomes in patients started on Direct Oral Anticoagulants (DOACs) as compared to either antiplatelet medications (e.g. aspirin) or anticoagulants (e.g. warfarin). Based on this increasing data, the Stollery Children's Hospital (primary pediatric cardiac surgical site for Western Canada) changed the standard thromboprophylaxis strategy in May 2024 from anticoagulation with warfarin (target international normalized ratio (INR) 2-3) to treatment dose rivaroxaban (adult equivalent dose 20 mg daily). The goal of this pilot study was to compare outcomes of the first 20 patients during the rivaroxaban period to the most recent 20 patients prior to the practice change. All patients who underwent Fontan procedure March/2023-April/2024 (warfarin cohort) and May/2024-September/2025 (rivaroxaban cohort) were identified and data on bleeding/thrombotic outcomes, length of hospital stay, and laboratory monitoring was collected through retrospective review of the electronic medical record including from surgical admission until 30 days post-discharge. All patients started on rivaroxaban had peak-rivaroxaban-calibrated-anti-Xa used to monitor dosing. During the study period, no significant bleeding or thrombotic events occurred post initiation of rivaroxaban, in the warfarin cohort there was one episode of clinically relevant non-major bleeding. Results suggest that thromboprophylaxis post-Fontan procedure with treatment dose rivaroxaban had similar early outcomes to warfarin. Future work is needed to validate these results in a larger cohort and include longer-term patient outcomes.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3418-3423"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820341","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":"Access to Care and Therapy for Kawasaki Disease in Morocco: A Kawasaki Disease Arab Initiative (Kawarabi) Multicenter Survey.","authors":"Kenza Bouayed, Sara Ahchouch, Maryam Jalal, Bouchra Chkirate, Nadia Mebrouk, Noureddine Rada, Mohamed Bouskraoui, Abdenasser Drighil, Hamza Benjelloun, Hafsa Moukhane, Moustapha Hida, Safaa Hajjaj, Abdellatif Daoudi, Sifeddine Nejmi, Said Chraibi, Amine Essaidi, Myriam Bensemlali, Dalal Ansar El Hamraoui, Amal Fadil, Kaoutar Khabbache, Abdeladim Babakhouya, Nadia El Idrissi Slitine, Raed Alzyoud, Ashraf Harahsheh, Nadine Choueiter, Nagib Dahdah","doi":"10.1007/s00246-026-04158-7","DOIUrl":"10.1007/s00246-026-04158-7","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3541-3550"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998693","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":"Neural Changes in Adolescents with Single Ventricle Congenital Heart Disease.","authors":"Kamal R Singh, Nancy A Pike, Diana E Kosoyan, Dineth R Karunamuni, Nancy J Halnon, Alan B Lewis, Rajesh Kumar","doi":"10.1007/s00246-025-04141-8","DOIUrl":"10.1007/s00246-025-04141-8","url":null,"abstract":"<p><p>Single ventricle heart disease (SVHD) adolescents show brain tissue injury in sites that mediate autonomic, mood, and cognition functions deficient in the condition, which may result from impaired neural interactions at resting state. However, it is unclear whether SVHD subjects have aberrant neural activities in those areas that can be examined with regional homogeneity (ReHo) measures, assessing local neural synchronization. We aimed to examine regional brain neural activity changes in SVHD compared to healthy controls using functional magnetic resonance imaging (fMRI). Resting fMRI data were collected from 27 SVHD and 31 controls using a 3.0-Tesla MRI scanner. Using the standard pre-processing steps, ReHo maps were calculated and transformed to z-scored maps, normalized to a common space, smoothed, and compared between groups (ANCOVA; qFDR corrected p ≤ 0.05; covariates: age and sex). Reduced ReHo appeared in brain sites, including the caudate, parietal cortex, frontal cortex, and amygdala, and increased ReHo emerged in the parietal cortex, insula, cerebellar vermis, hippocampus, para-hippocampal gyrus, cerebellar peduncles, and cerebellar cortex in SVHD over controls. SVHD adolescents show impaired neural synchronization at resting in areas involved in neurobehavior and cognition. The findings indicate the widespread impact on brain functional organization and may explain functional deficits observed in SVHD.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3440-3449"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912619","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":"Cardiovascular Manifestations and Interventions in Children Living in a Histoplasmosis Endemic Region.","authors":"Cassandra Campbell, Sandra Arnold, Mario Briceno-Medina, Michael Perez, Shyam Sathanandam","doi":"10.1007/s00246-025-04123-w","DOIUrl":"10.1007/s00246-025-04123-w","url":null,"abstract":"<p><p>Histoplasmosis in children remains understudied, drawing most clinical understanding from adult populations. Located in a histoplasmosis-hyperendemic region, our institution aimed to characterize the cardiovascular manifestations and interventional treatments in children diagnosed with histoplasmosis. We conducted a retrospective cohort study of 160 patients under 18 years of age diagnosed with histoplasmosis between January 2009 and March 2023 at a tertiary-care children's hospital. Data reviewed included clinical presentation, imaging, electrocardiograms, echocardiograms, and catheter-based or surgical interventions. Of the 160 patients, 65 (41%) demonstrated cardiovascular involvement from mediastinal manifestations of histoplasmosis (mediastinal lymphadenopathy, mediastinal granuloma, and fibrosing mediastinitis) including all 8 patients with fibrosing mediastinitis. Among these 65 children, pericarditis with pericardial effusion was the most common (58%), 30 patients requiring urgent intervention. Other manifestations from mass effect included pulmonary artery stenosis (34%), superior vena cava (SVC) stenosis (15%), pulmonary vein stenosis (8%), inferior vena cava (IVC) stenosis (3%), and aortic arch obstruction (2%). Fourteen patients underwent catheter-based stenting procedures with a total of 22 stents placed (17 in pulmonary artery branches, 4 in pulmonary veins, and 1 in the SVC), typically not performed during the initial presentation. Five patients underwent mass resection for cardiac indications. Cardiovascular complications from histoplasmosis-related mediastinal lymphadenopathy in children are significant, presenting with pericarditis or compression of central vascular structures. Fibrosing mediastinitis was consistently associated with cardiac involvement, frequently necessitating intervention. Surgical repair is challenging due to extensive fibrosis. However, percutaneous vascular interventions are feasible and effective in managing vascular obstructions. Early recognition and timely intervention are critical to prevent irreversible vascular atresia.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3362-3373"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655034","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":"Efficacy and Tolerability of Selexipag in Pediatric Patients with Pulmonary Arterial Hypertension: An Updated Systematic Review and Meta-analysis.","authors":"Vasiliki Patsiou, Triantafyllia Grantza, Thomas Chrysochoidis-Trantas, Maria Kavga, Nikolaos Fragakis, Antonios Ziakas, Alexandra Arvanitaki, George Giannakoulas","doi":"10.1007/s00246-025-04094-y","DOIUrl":"10.1007/s00246-025-04094-y","url":null,"abstract":"<p><p>Evidence supporting selexipag in pediatric pulmonary arterial hypertension (PAH) is sparse, mainly from small, heterogeneous studies. This meta-analysis assessed its efficacy and tolerability in this population. A systematic search of PubMed, Embase, Web of Science, Cochrane Library, and Scopus was conducted until April 2025. Eligible studies included patients under 18 years diagnosed with PAH and treated with selexipag, reporting clinical outcomes. Two reviewers independently screened, extracted data, and evaluated study quality. Pooled analyses of efficacy and safety outcomes were performed, with subgroup comparisons for add-on therapy versus transition from parenteral prostacyclin analogs. Twelve studies involving 344 pediatric patients (90.6% diagnosed with PAH) were included. Selexipag significantly improved 6-minute walk distance (SMD: - 0.75; 95% CI: - 1.22 to - 0.29; P = 0.002), but did not affect pulmonary vascular resistance index, mean pulmonary artery pressure (mPAP), or NT-proBNP. Sensitivity analysis revealed reduced mPAP in PAH-only studies (SMD: - 0.30; P = 0.03). Adverse events occurred in 62.8%, predominantly mild. Functional improvement was greater in the add-on therapy group, which also experienced more adverse events. Selexipag improved functional capacity and mPAP in pediatric PAH and was generally well tolerated. Further prospective studies are needed to confirm long-term benefits.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3233-3243"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541613","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":"Coronary Anomalies and Early Surgical Outcomes in Transposition of the Great Arteries and Taussig-Bing Anomaly: Insights from 251 Consecutive Arterial Switch Cases.","authors":"Ensar Duras, Samet Paksoy, Okan Yildiz, Hacer Kamali, Aslihan Karaman, Ismihan Selen Onan, Alper Guzeltas, Sertac Haydin","doi":"10.1007/s00246-025-04119-6","DOIUrl":"10.1007/s00246-025-04119-6","url":null,"abstract":"<p><p>Coronary artery anomalies (CAAs) are a critical factor in the arterial switch operation (ASO), yet their prognostic significance remains a matter of debate. This study aimed to evaluate the impact of CAAs on early outcomes, including mortality and postoperative recovery, in patients with transposition of the great arteries (TGA) and Taussig-Bing anomaly (TBA). We retrospectively analyzed 251 consecutive patients who underwent an ASO between 2010 and 2022. Coronary anatomy was classified intraoperatively according to the Leiden convention: Group I (usual, n = 181) and Group II (anomalous, n = 70). Preoperative, operative, and postoperative variables were compared. The primary outcome was early mortality (≤ 30 days or during hospitalization), and secondary outcomes included intensive care unit (ICU) and hospital stay, need for extracorporeal membrane oxygenation (ECMO), and major complications. Statistical analysis involved the Mann-Whitney U and Chi-squared tests; logistic regression was used to identify predictors of mortality. Coronary anomalies were identified in 70 patients (27.9%). Group II had higher median age (17.5 vs. 8 days, p = 0.003) and more associated anomalies (17.1% vs. 6.1%, p = 0.008), but mortality (11.4% vs. 8.3%, p = 0.43), ICU stay (11.5 vs. 11 days, p = 0.90), and hospital stay (21.5 vs. 20 days, p = 0.94) were comparable. In multivariable analysis, ECMO requirement (OR 31.0; 95% CI 10.0-95.9, p < 0.01) and prolonged ICU stay (OR 0.94; 95% CI 0.90-0.99, p = 0.04) were independent predictors of mortality, while CAAs were not. These findings suggest that coronary anatomy does not independently affect early outcomes after ASO, although complex variants may still increase technical difficulty and require individualized surgical strategies.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3323-3331"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582434","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":"Transapical Mitral Valve-in-Valve Implantation in Less than 10 kg Children.","authors":"Lisa Bianco, Celine Grunenwald, Guido Michielon, Mohamed Ly, Alban-Elouen Baruteau, Alain Fraisse","doi":"10.1007/s00246-025-04142-7","DOIUrl":"10.1007/s00246-025-04142-7","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"3589-3592"},"PeriodicalIF":1.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857459","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}