Pediatric Cardiology最新文献_第5页

Echocardiogram-Guided Balloon Valvuloplasty of the Aortic Valve in Neonates and Infants Reduces Contrast Exposure with Maintained Efficacy and Less Aortic Regurgitation. 超声心动图引导下的新生儿和婴儿主动脉瓣球囊瓣膜成形术可减少对比剂暴露，保持疗效并减少主动脉瓣反流。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-07-01 DOI: 10.1007/s00246-023-03188-9

Conor P O'Halloran, Sandhya Ramlogan, Nazia Husain, Jeremy Fox, Alan W Nugent, Paul Tannous

{"title":"Echocardiogram-Guided Balloon Valvuloplasty of the Aortic Valve in Neonates and Infants Reduces Contrast Exposure with Maintained Efficacy and Less Aortic Regurgitation.","authors":"Conor P O'Halloran, Sandhya Ramlogan, Nazia Husain, Jeremy Fox, Alan W Nugent, Paul Tannous","doi":"10.1007/s00246-023-03188-9","DOIUrl":"10.1007/s00246-023-03188-9","url":null,"abstract":"Balloon aortic valvuloplasty (BAV) is performed in children with significant aortic stenosis (AS). Traditionally, contrast angiography measures the annulus and assesses aortic regurgitation (AR) after each dilation. Echocardiographic guidance is hypothesized to reduce contrast and radiation exposure, without compromising efficacy or safety. Patients < 10 kg undergoing BAV from 2013 to 2022 were retrospectively investigated. Agreement between echocardiographic and angiographic annulus measurements was assessed. Echocardiogram-guided (eBAV) and traditional angiogram-guided (tBAV) outcomes were compared controlling for weight, critical AS, and other congenital heart disease (CHD). Twelve eBAV and 19 tBAV procedures were performed. The median age was 33 days, median weight was 4.3 kg, 7 patients (23%) had critical AS, and 9 patients (29%) had other CHD. Annulus measurements by intraprocedural echocardiography and angiography displayed excellent correlation (ICC 0.95, p < 0.001). eBAV patients received less contrast (0.5 vs 3.5 ml/kg, p < 0.01). Five recent eBAV procedures were performed contrast free. Radiation exposure was not statistically different between the eBAV and tBAV groups (155 vs 313 µGy·M2, p = 0.12). One eBAV patient (8%) and 3 tBAV patients (16%, p = 0.62) experienced serious adverse events. Technical success (gradient < 35 mmHg and increase in AR by ≤ 1 grade) occurred in 11 eBAV patients (92%) and 16 tBAV patients (84%, p = 0.22). AR increased in 2 eBAV patients (17%) and 8 tBAV patients (44%, p = 0.02). eBAV was associated with similar efficacy and significantly lower contrast exposure and risk of aortic regurgitation. There was strong agreement between aortic valve annulus measurements by intraprocedural echocardiography and angiography, ultimately permitting contrast free BAV.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9726891","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

Facility-Based and Virtual Cardiac Rehabilitation in Young Patients with Heart Disease During the COVID-19 Era. COVID-19 时代年轻心脏病患者的设施式和虚拟心脏康复治疗。

IF 1.5 4区医学

Pediatric Cardiology Pub Date : 2024-10-01 Epub Date: 2023-06-09 DOI: 10.1007/s00246-023-03202-0

Elizabeth B Aronoff, Clifford Chin, Alexander R Opotowsky, Wayne A Mays, Sandra K Knecht, Jennah Goessling, Malloree Rice, Justine Shertzer, Samuel G Wittekind, Adam W Powell

{"title":"Facility-Based and Virtual Cardiac Rehabilitation in Young Patients with Heart Disease During the COVID-19 Era.","authors":"Elizabeth B Aronoff, Clifford Chin, Alexander R Opotowsky, Wayne A Mays, Sandra K Knecht, Jennah Goessling, Malloree Rice, Justine Shertzer, Samuel G Wittekind, Adam W Powell","doi":"10.1007/s00246-023-03202-0","DOIUrl":"10.1007/s00246-023-03202-0","url":null,"abstract":"Cardiac rehabilitation (CR) is an important tool for improving fitness and quality of life in those with heart disease (HD). Few pediatric centers use CR to care for these patients, and virtual CR is rarely used. In addition, it is unclear how the COVID-19 era has changed CR outcomes. This study assessed fitness improvements in young HD patients participating in both facility-based and virtual CR during the COVID-19 pandemic. This retrospective single-center cohort study included new patients who completed CR from March 2020 through July 2022. CR outcomes included physical, performance, and psychosocial measures. Comparison between serial testing was performed with a paired t test with P < 0.05 was considered significant. Data are reported as mean ± standard deviation. There were 47 patients (19 ± 7.3 years old; 49% male) who completed CR. Improvements were seen in peak oxygen consumption (VO2, 62.3 ± 16.1 v 71 ± 18.2% of predicted, p = 0.0007), 6-min walk (6 MW) distance (401 ± 163.8 v 480.7 ± 119.2 m, p = < 0.0001), sit to stand (16.2 ± 4.9 v 22.1 ± 6.6 repetitions; p = < 0.0001), Patient Health Questionnaire-9 (PHQ-9) (5.9 ± 4.3 v 4.4 ± 4.2; p = 0.002), and Physical Component Score (39.9 ± 10.1 v 44.9 ± 8.8; p = 0.002). Facility-based CR enrollees were less likely to complete CR than virtual patients (60%, 33/55 v 80%, 12/15; p = 0.005). Increases in peak VO2 (60 ± 15.3 v 70.2 ± 17.8% of predicted; p = 0.002) were seen among those that completed facility-based CR; this was not observed in the virtual group. Both groups demonstrated improvement in 6 MW distance, sit-to-stand repetitions, and sit-and-reach distance. Completion of a CR program resulted in fitness improvements during the COVID-19 era regardless of location, although peak VO2 improved more for the in-person group.","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10251322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9618459","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

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":null,"pages":null},"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

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":null,"pages":null},"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":null,"pages":null},"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

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":null,"pages":null},"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":null,"pages":null},"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

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

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":null,"pages":null},"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