Pediatric Cardiology最新文献

{"title":"Correction: Pulmonary Valve Aneurysm Associated with a Patent Ductus Arteriosus.","authors":"W Wyatt Lindsey, Catherine E Tomasulo, Alan E Benheim","doi":"10.1007/s00246-024-03715-2","DOIUrl":"https://doi.org/10.1007/s00246-024-03715-2","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716836","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":"Percutaneous Device Closure of Perimembranous Ventricular Septal Defects Associated with Aortic Valve Prolapse and Aortic Regurgitation.","authors":"Ilker Kemal Yucel, Ibrahim Halil Demir, Murat Kardas, M Orhan Bulut, Murat Surucu, E Hekim Yilmaz, R Irem Yekeler, Ahmet Celebi","doi":"10.1007/s00246-024-03725-0","DOIUrl":"https://doi.org/10.1007/s00246-024-03725-0","url":null,"abstract":"<p><p>The progression of aortic regurgitation (AR) in perimembranous ventricular septal defects (pVSD) remains uncertain; research indicates that the accompanying AR tends to worsen over time. There is controversy surrounding the percutaneous closure of defects in patients with pVSD associated with aortic valve prolapse (AVP) and AR. Our research focused on transcatheter closure for pVSD accompanied by AVP, AR, and septal aneurysm, with the aim of addressing challenges through device placement in aneurysmal tissue to eliminate the Venturi effect. We studied 44 patients with AVP, AR, and septal aneurysm who underwent transcatheter device closure. The mean age and weight were 10.5 ± 4.0 years and 36.0 ± 15.1 kg, respectively. Transcatheter closure was attempted in 44 patients. One case (2.3%) was referred to surgery, while the procedure was successfully completed in 43 out of 44 patients (97.7%). Early complications were minimal. Embolization of the device to the pulmonary artery was observed in one patient; upon re-evaluation, significant aneurysm tissue damage was detected, leading to a referral for surgery. Additionally, three patients (6.9%) developed permanent incomplete right bundle branch block (iRBBB). The median follow-up time was 43 months. During the follow-up period, AR progressed in only 1(2.3%) patient, while AR in 7(16.3%) patients regressed markedly. Follow-up assessments demonstrated high rates of complete occlusion; the rates at immediate, 24 h, 6 months, and 1 year were assessed as 72, 83.7, 93, and 95.3%, respectively. Transcatheter device closure of pVSD offers a minimally invasive, safe, effective, and alternative treatment option for patients with pVSD associated with AVP and AR.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731458","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":"Provider Perceptions of Outcomes in the Pediatric Cardiac Intensive Care Unit.","authors":"Preston J Boyer, Kurt R Schumacher, Kate Thornsberry, Sunkyung Yu, Ray Lowery, Nathaniel R Sznycer-Taub","doi":"10.1007/s00246-024-03717-0","DOIUrl":"https://doi.org/10.1007/s00246-024-03717-0","url":null,"abstract":"<p><p>In the pediatric cardiac intensive care unit (PCICU), predicting the complications and long-term impact of extracorporeal membrane oxygenation (ECMO) and cardiopulmonary resuscitation (CPR) is influenced by the providers' perceptions. Little is understood about such perceptions as they relate to provider role and experience. A multi-disciplinary group in the PCICU of a single center was surveyed regarding two patient scenarios: (1) ECMO after cardiac surgery, and (2) cardiac arrest with need for CPR. Respondents indicated their risk tolerance for potential complications of these interventions, and the impact on patient health-related quality of life (HRQoL). Responses were compared based on providers' role and experience. 101 providers were surveyed and were willing to tolerate a 50% risk of death with ECMO or continued CPR but had less tolerance for the risk of other long-term morbidities. For most potential complications, nurses had the lowest risk tolerance and attending physicians the highest. Provider experience had no impact on risk tolerance. All providers underestimated HRQoL scores compared to previously published scores of patients who survived the surveyed scenarios. This survey is one of the first to explore providers' perceptions of ECMO and CPR. PCICU providers are more willing to accept the risk of death than other morbid complications, and poorly predict HRQoL outcomes. Team members have varied risk tolerance for complications and predict their impact differently. Understanding the variability of and influences on perceptions of patient outcomes could help improve communication with patients and families, team dynamics, and decision-making in the PCICU.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731500","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":"PDA Stenting for Ductal-Dependent Cyanotic Congenital Heart Disease: History and View From 10,000 Feet.","authors":"John W Moore","doi":"10.1007/s00246-024-03714-3","DOIUrl":"https://doi.org/10.1007/s00246-024-03714-3","url":null,"abstract":"<p><p>This article provides a historical review and a current perspective on the procedures used to palliate cyanosis in ductal-dependent infants. Eighty years ago, Helen Taussig, Alfred Blalock and Vivien Thomas developed the first effective treatment. The Blalock-Taussig-Thomas (BTT) shunt is the historical predecessor of both the contemporary modified BTT shunt and interventional stenting of the Patent Ductus Arteriosus (PDA). The surgical shunt was firmly established therapy before catheterization was born, and PDA stenting was not possible until the technologies designed to address coronary heart disease were developed. The momentum of long-established surgical therapy inhibited clinical development of PDA stenting. Nevertheless, available clinical outcomes, though limited, appear to favor PDA stenting, and first-line therapy may be shifting from the modified BTT shunt to PDA stenting. More definitive data should arise from a randomized controlled trial.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716837","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":"Response to \"Health-Related Quality of Life After Neonatal Treatment of Symptomatic Tetralogy of Fallot: Insights from the Congenital Cardiac Research Collaborative\".","authors":"Zainab Muhammad Hanif, Muzna Murtaza, Syeda Zuha Sami, Ariba Nazir, Fnu Venjhraj","doi":"10.1007/s00246-024-03721-4","DOIUrl":"https://doi.org/10.1007/s00246-024-03721-4","url":null,"abstract":"<p><p>This piece of writing commends the article \"Health Related Quality of Life After Neonatal Treatment of Symptomatic Tetralogy of Fallot\" for its contributions to pediatric cardiology while noting key limitations. The limited sample size may limit generalizability, and further investigation of comorbidities is required to understand their influence on health-related quality of life (HRQOL). The lack of a control group limits interpretation, and longer follow-up periods are required to capture the changing obstacles experienced by children after therapy. Addressing these challenges will provide better insights into HRQOL for children with symptomatic Tetralogy of Fallot and improve treatment procedures.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709523","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":"Left Atrial Size and Strain in Hypertensive Children Compared to Age-, Sex-, and Race/Ethnicity-Matched Controls.","authors":"Michelle Kaplinski, Heather Griffis, Yan Wang, Laura Mercer-Rosa, Anirban Banerjee, Michael D Quartermain, Shobha S Natarajan","doi":"10.1007/s00246-024-03719-y","DOIUrl":"https://doi.org/10.1007/s00246-024-03719-y","url":null,"abstract":"<p><p>Left atrial (LA) volume and peak longitudinal strain (LA strain) are indicators of left ventricular (LV) diastolic function in adults, but little is known about LA volume and strain in pediatric patients with hypertension (HTN). We evaluated LA volume and strain in pediatric cases with HTN compared to age-, sex-, and race/ethnicity-matched controls. This was a retrospective matched case-control study of patients who presented to the HTN clinic at CHOP from 12/2011 to 9/2018. Coarctation of the aorta, cardiomyopathy or heart transplantation cases were excluded. HTN was defined by an abnormal ambulatory blood pressure result. LA volume was measured by biplane area-length method and indexed to body surface area (BSA). LA strain and strain rate were measured using TOMTEC® software. Left ventricular mass index (LVMI) was measured by M-mode and the 5/6 area-length method indexed to height^2.7. LV global longitudinal strain (LV GLS) was measured during the echocardiographic examination on the GE ultrasound machine for cases and offline using TOMTEC® software for controls. Measurements were compared using Chi-square, McNemar, or Wilcoxon signed rank tests. We included 47 cases and 47 controls. There was no difference in LA volume z-scores (- 1.9 vs. - 0.9, p = 0.068), LA strain (37.8% vs. 38.0%, p = 0.735) or LA strain rate (1.4 vs. 1.5, p = 0.852) in cases compared to controls. LVMI by M-mode and 5/6 area-length method was higher in cases compared to controls (40.0 vs. 33.7 g/m^2.7, p < 0.001 and 29.9 vs 24.4 g/m^2.7, p =  < 0.001, respectively). LV GLS was decreased (less negative) in cases compared to controls. In summary there was no difference in LA volume or LA strain in cases compared to controls. In cases, LVMI was significantly elevated and LV GLS was significantly decreased, which may be the first response to HTN, prior to affecting LA size.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710887","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 Role of Nt-Pro-Bnp in Predicting Outcome in Pediatric Hypertrophic Cardiomyopathy.","authors":"Nicoletta Cantarutti, Rachele Adorisio, Sara Di Marzio, Marianna Cicenia, Irma Battipaglia, Erica Mencarelli, Massimo Stefano Silvetti, Antonio Amodeo, Fabrizio Drago","doi":"10.1007/s00246-024-03702-7","DOIUrl":"https://doi.org/10.1007/s00246-024-03702-7","url":null,"abstract":"<p><strong>Hypothesis: </strong>The aim of the study was to evaluate the correlation between NTproBNP and left ventricular mass (LVM) in children affected by hypertrophic cardiomyopathy (HCM), both asymptomatic, symptomatic, and with implantable cardioverter-defibrillator (ICD).</p><p><strong>Methods: </strong>A total of 225 pediatric patients were evaluated and 45 were enrolled in the study because met inclusion criteria (age < 18 years; diagnosis of hypertrophic cardiomyopathy; NTproBNP > 600 pg/ml).</p><p><strong>Results: </strong>The analysis showed a significant correlation between NTproBNP level and LVM (p = 0.024). ANOVA test showed that high level of NTproBNP and LVM were significantly correlated to ICD implantation (p = 0.001; p = 0.003). Multivariate analysis showed NTproBNP as an independent risk factor for ICD implantation (p = 0.035).</p><p><strong>Conclusion: </strong>Our study showed that NTproBNP levels directly correlated to LVM and disease progression and it was found to be predictive, together with LVM, of ICD implantation.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709651","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":"Evaluation of Cardiac Function in Children Undergoing Liver Transplantation.","authors":"Neha Bansal, Joseph Mahgerefteh, Jacqueline M Lamour, Debora Kogan-Liberman, Michelle Ovchinsky, Kayla Ganzburg, Nadine Choueiter","doi":"10.1007/s00246-024-03673-9","DOIUrl":"https://doi.org/10.1007/s00246-024-03673-9","url":null,"abstract":"<p><p>Cirrhotic cardiomyopathy is a complication of cirrhosis resulting in cardiac dysfunction. It remains poorly characterized in children. The aim of this study was to assess relationship of pre-liver transplant (LT) conventional and novel parameters of biventricular function with post-LT clinical course. This is a retrospective study of pre-LT echocardiograms performed on patients < 18 years of age with cirrhosis at a single center, who received a LT. Demographic, clinical, and echocardiographic data were collected. Speckle tracking echocardiography (STE) analysis was performed by a single observer using TomTec system. Descriptive data were expressed as mean (SD) and number (%). The relationship between clinical data and echocardiographic variables were assessed using Spearman correlation coefficient. Significance was set at < 0.05. Thirty-five patients (median age 6.5; IQR 14.2 years) underwent LT between 2010 and 2020. Pre-LT diagnosis was biliary atresia in 14 (40%) patients and 7 (20%) patients were listed as status 1A/1B. Their median natural pediatric/model end-stage liver disease score was 13 (IQR 9). Their pre-LT echocardiogram showed normal left ventricular systolic (LV) function by ejection fraction and strain parameters. Right ventricular (RV) function was abnormal in 74% of patients as measured by RV GLS (23 ± 3%). There was correlation between echocardiographic parameters with pre-transplant clinical disease and post-operative LT course (length of stay and duration of mechanical ventilation). Children undergoing liver transplant have RV dysfunction as evidenced by abnormal RV GLS on STE. There is echocardiographic parameter correlation between clinical liver disease and post-LT clinical course. This evidence highlights the importance of using novel technology like STE in assessment of children undergoing evaluation for liver transplant.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688495","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":"Acute Patent Ductus Arteriosus Stent Occlusion: A Unique Perspective.","authors":"Jesse Lee, Shireen Mukadam, Randall Fortuna, Anees Razzouk, Stephen Nageotte","doi":"10.1007/s00246-024-03713-4","DOIUrl":"https://doi.org/10.1007/s00246-024-03713-4","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688494","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":"Left-Sided Atrioventricular Valve Regurgitation After the Repair of Complete Atrioventricular Septal Defect.","authors":"Takaya Hoashi, Akinori Hirano, Ryusuke Hosoda, Haruhiro Nagase, Yuji Fuchigami, Yukino Iijima, Takaaki Suzuki","doi":"10.1007/s00246-024-03707-2","DOIUrl":"https://doi.org/10.1007/s00246-024-03707-2","url":null,"abstract":"<p><p>This study aimed to investigate left-sided atrioventricular valve outcome after the repair of complete atrioventricular septal defect from single-institutional retrospective chart review. From 1998 to 2022, 55 patients with complete atrioventricular septal defect and balanced 2 ventricles underwent biventricular repair. Median age and weight at repair were 5.5 months old [interquartile range, 3.4-9.1] and 4.6 kg [3.9-5.9]. Analyzed possible risk factors were Rastelli classification, low birth weight < 2.5 kg, preterm < 37 weeks, proceeding pulmonary artery banding, Down syndrome, persistent left superior vena cava, tetralogy of Fallot, early surgical era < 2010, preoperative left-sided atrioventricular valve regurgitation > mild, modified single-patch repair, small left mural leaflet, and complete left-sided atrioventricular valve cleft closure. No patients underwent left-sided atrioventricular valve replacement at the timing of repair. No patient required subsequent single ventricular conversion. The median follow-up period in survivors was 11.0 years. The survival rate at 15 years from repair was 96.4%. Freedom from moderate or greater left-sided atrioventricular valve regurgitation rate at 10 years was 58.4%. After elimination of 3 patients undergone complete closure then experienced tone of closed cleft, complete cleft closure was significant inhibitor for moderate or greater left-sided atrioventricular valve regurgitation (p = 0.034, Odds ratio: 0.36, 95% Confidence intervals: 0.14-0.93). Twelve patients underwent 15 reoperations for left-sided atrioventricular valve. All 4 patients who developed left-sided atrioventricular valve stenosis and backward pulmonary hypertension required prosthetic valve replacement. Incomplete cleft closure was the only risk factor for significant postoperative left-sided atrioventricular valve regurgitation. Already small left-sided atrioventricular valve by previous repair developed significant regurgitation, it is no longer repairable therefore required to be replaced.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693267","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}