Pediatric Cardiology最新文献

{"title":"Neonatal Transcatheter Closure of a Large Pulmonary Arteriovenous Fistula with a KONAR-MF™ VSD Occluder.","authors":"Alessia Callegari, Damien Bonnet, Sophie Malekzadeh-Milani","doi":"10.1007/s00246-025-03830-8","DOIUrl":"https://doi.org/10.1007/s00246-025-03830-8","url":null,"abstract":"<p><p>Pulmonary arteriovenous fistulas (PAVFs) are rare congenital anomalies characterized by abnormal vascular connections that bypass the capillary bed, causing hypoxemia, cyanosis, and systemic embolic risks. Early diagnosis and intervention are critical to prevent complications, particularly in neonates with severe right-to-left shunts. This report describes the first documented case of neonatal transcatheter closure of a large PAVF using a KONAR-MF™ VSD Occluder (MFO). A 1-day-old neonate with a prenatally diagnosed PAVF presented with oxygen saturation of 82%. Angiographic and echocardiographic assessments confirmed the presence of a large PAVF between the right pulmonary artery and right inferior pulmonary vein. The fistula was successfully closed using an 8 × 6 mm MFO device, with no complications. Post-procedure, oxygen saturation improved to 100%, and follow-up at 5 months demonstrated sustained closure. This report highlights the safety and versatility of the MFO occluder in complex cardiac cases, offering a minimally invasive alternative to surgical intervention.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649900","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":"Correction: Atrioventricular Area Difference Aids Diastolic Filling in Patients with Repaired Tetralogy of Fallot.","authors":"Martin Johansson, Erik Hedström, Katarina Steding-Ehrenborg, Misha Bhat, Petru Liuba, Håkan Arheden, Pia Sjöberg","doi":"10.1007/s00246-025-03811-x","DOIUrl":"https://doi.org/10.1007/s00246-025-03811-x","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649898","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":"Echocardiographic Predictors and Incidence of Left Ventricular Dysfunction Following Transcatheter Patent Ductus Arteriosus Closure in Extremely Premature Infants.","authors":"Marissa E Adamson, R Allen Ligon, Shannon Hamrick, Marcos Mills, Shazia Bhombal, Sarah Hash, Erik Michelfelder","doi":"10.1007/s00246-025-03829-1","DOIUrl":"https://doi.org/10.1007/s00246-025-03829-1","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular (LV) dysfunction is a known complication after ligation of patent ductus arteriosus (PDA). An increasing number of premature and extremely low birth weight (ELBW) infants undergo transcatheter closure of PDAs. The aim of this study was to evaluate incidence and predictors of LV dysfunction after transcatheter PDA closure in ELBW infants.</p><p><strong>Methods: </strong>Subjects undergoing PDA closure from 2020 to 2022 who were ELBW (< 1 kg) and extremely premature (gestational age < 29 weeks) at birth were included. A single cardiologist reviewed each pre- and post-intervention echocardiogram and calculated LVEF.</p><p><strong>Results: </strong>67 subjects were included with a mean gestational age of 24.8 weeks and birth weight of 648.2 g. Mean age and weight at time of procedure were 7.9 weeks and 1722.4 g, respectively. All patients had normal LVEF pre-procedure (mean LVEF 67.0%) with a significant decline post-procedure to 60.3% (p < 0.001). Post-procedure, 81% of subjects maintained normal LVEF (> 53%). 55% of patients did have a decline in EF > 5%. There was no significant difference in post-procedure LV dysfunction in relation to pre-procedural PDA size, left atrial or LV dilation. All subjects recovered function with a variable time to observed normal LVEF of 3-30 days.</p><p><strong>Conclusions: </strong>LV dysfunction develops in 19% of ELBW infants undergoing PDA device occlusion, is usually mild in severity, and normalizes in all subjects. The size of PDA, degree of left heart dilation does not predict LV dysfunction in this population.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634333","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":"Mitral Valve Leaflet Repair with Autologous Saphenous Vein in a Child with Infective Endocarditis.","authors":"Jacques T Janson, Barend Fourie, Pierre Goussard, Helena Rabie, Jinyong Kim","doi":"10.1007/s00246-025-03826-4","DOIUrl":"https://doi.org/10.1007/s00246-025-03826-4","url":null,"abstract":"<p><p>Saphenous vein has been used successfully to repair the mitral valve in adults. We describe the use of a saphenous vein patch to repair a large defect in the anterior mitral valve leaflet in a child with infective endocarditis to avoid a mechanical mitral valve replacement.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634334","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":"Fontan-Associated Liver Disease (FALD) in the EUROFontan Experience. An Insight into European Awareness.","authors":"Anna Gozzi, Luca Vedovelli, Emma Bergonzoni, Irene Cao, Emanuela Angeli, Rossana Zanoni, Roberta Biffanti, Gianfranco Butera, Kostantinos Dimopoulos, Alvaro Gonzalez Rocafort, Mark G Hazekamp, Andrzej Kansky, Marien Lenoir, Thomas Martens, Giovanni Meliota, Bart Meyns, Matej Nosal, Carlo Pace Napoleone, Friso M Rijnberg, Eva Sames Dolzer, Giuseppe Scrascia, Ugo Vairo, Joeri Van Puyvelde, Giovanni Di Salvo, Claudia Montanaro, Massimo A Padalino","doi":"10.1007/s00246-025-03781-0","DOIUrl":"https://doi.org/10.1007/s00246-025-03781-0","url":null,"abstract":"<p><p>Fontan-Associated Liver Disease (FALD) is a dramatically emerging problem even if not precisely defined in term of debated diagnosis and surveillance protocols. We analyze FALD prevalence, clinical impact and implications in a European cohort of patients. It's a retrospective observational multicenter study including Fontan patients operated between 1990 and 2022. Anatomical, clinical, surgical and liver-related data were collected, defining FALD as a spectrum of time-related structural-functional liver modifications due to congestive hepatopathy (from mild liver fibrosis to liver cirrhosis and hepatocellular carcinoma) diagnosed through multiparametric evaluations. 14 centers routinely conducted liver assessment after Fontan completion. Out of 2141 patients, 343 (16%) were diagnosed with FALD (M/F = 198/145; median age 18 years, IQR 15-26) with a median follow-up time of 14 years (IQR 9-20) from Fontan surgery. Among these, there were 19 (5.5%) deaths, 5 (26.3%) of whom related to advanced liver disease/cancer. FALD showed no significant association with gender (p = 0.4, adjusted p-value = 0.5), dominant ventricular morphology (p = 0.060, adjusted p-value = 0.086) nor surgery type (p = 0.3, adjusted p-value = 0.4). Significant association emerged between FALD and fenestration absence (p < 0.001, adjusted p-value < 0.001), systemic ventricular (p < 0.001, adjusted p-value < 0.001) and atrio-ventricular valve (p < 0.001) dysfunction, III-IV NYHA classes (p < 0.001, adjusted p-value < 0.001), tachyarrhythmias (p < 0.001) and liver stiffness ≥ 22 kPa on transient elastography (p < 0.001, adjusted p-value < 0.001). The analysis demonstrated no significant association between FALD and abnormal liver function tests (p = 0.2), heart transplantation (p = 0.6, adjusted p-value = 0.6), worse survival (p = 0.38). This study shows significant mortality related to FALD, which is also associated to clinical signs of failing Fontan circulation, stressing the pressing need of universally shared diagnostic criteria and surveillance protocols, to prevent and/or early-identify FALD and its more lethal complications.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625212","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":"Cardiogenic Shock Risk Score at Diagnosis of Multisystem Inflammatory Syndrome in Children: A Multicenter Study.","authors":"Saïd Bichali, Naïm Ouldali, Michaël Génin, Julie Toubiana, Alexandre Belot, Corinne Levy, Alexis Rybak, Nathan Giroux, Stéphane Béchet, Etienne Javouhey, François Angoulvant, François Godart, Ali Houeijeh, Stéphane Leteurtre","doi":"10.1007/s00246-025-03823-7","DOIUrl":"https://doi.org/10.1007/s00246-025-03823-7","url":null,"abstract":"<p><p>Severe cardiovascular involvement is associated with mortality in multisystem inflammatory syndrome in children (MIS-C). This study aimed to test a previously published cardiogenic shock risk score at diagnosis of MIS-C and build a new screening tool in a larger pediatric cohort. The first score published in a single-center cohort (age > 8 years, time to diagnosis ≥ 6 days, and NT-proBNP at diagnosis ≥ 11.10³ ng/L) was tested in a multicenter cohort of pediatric patients diagnosed with MIS-C from 2020 to 2023. In the multicenter cohort, the factors associated with the occurrence of cardiogenic shock were determined and a new score was built using a multivariate regression model. In 127 children with MIS-C, (median age [interquartile range] 8.6 [5.2; 11.5] years, 67 (53%) patients with cardiogenic shock), age > 8 years, time to treatment ≥ 6 days, dyspnea, altered mental status, general deterioration, gastrointestinal symptoms, ≤ 1 Kawasaki sign, absence of rhinopharyngitis signs, NT-proBNP ≥ 11.10³ ng/L, high C-Reactive Protein (CRP), and high leucocytes at diagnosis of MIS-C were associated with a high risk of cardiogenic shock. The new score was 0.128*Age(year) + 1.195*(1 if dyspnea, 0 otherwise) + 0.007*CRP(mg/L) - 2.6732. The sensitivity was 0.88 and negative likelihood ratio 0.23 (cutoff - 0.4761). The score correlated with the minimal left ventricular ejection fraction (ρ = 0.51, p < 0.001). In a multicenter cohort, each item of the previous score was associated with the occurrence of cardiogenic shock. The new score, combining age, dyspnea, and CRP at diagnosis of MIS-C, had a high sensitivity.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606085","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":"Evaluating Hospital Resource Utilization for Hypoplastic Left Heart Syndrome Through Linkage of a Clinical Registry and an Administrative Database.","authors":"Katherine E Bates, Li Huang, Colleen Mangeot, Jeffrey B Anderson, Samuel P Hanke, Sara K Pasquali, Kim Dalziel","doi":"10.1007/s00246-025-03814-8","DOIUrl":"https://doi.org/10.1007/s00246-025-03814-8","url":null,"abstract":"<p><p>Resource utilization estimates for hypoplastic left heart syndrome (HLHS) in early childhood are lacking. We linked the National Pediatric Cardiology Quality Improvement (NPC-QIC) clinical registry to the Pediatric Health Information Systems (PHIS) database to estimate hospital resource utilization for a contemporary HLHS cohort. All hospitals with both PHIS and NPC-QIC data available were eligible for inclusion. Patients discharged from their Norwood procedure 10/1/2009-9/30/2015 were linked using indirect identifiers. Estimated cost and length-of-stay data for all inpatient episodes across the first six years of life were calculated and reported per year of life. We linked 973/1175 (82.8%) unique patients from 33 centers. Complete costing records from birth to Fontan, transplant, or inpatient death < 6 years of age were available for 38%. For patients with complete cost estimate data, resource use was highest in the first year of life with an average cost of $450,124 (95% CI $397,094-$503,154) which corresponded to an average of 79 days (95% CI 72-86) in hospital. The total average cost in the first 6 years was $651,006 ($518,819-$783,193), with an average of 110 days (93-128) in hospital. Average hospitalization costs associated with each staged surgical procedure were $239,936 ($229,649-$250,223) for Norwood procedure, $143,292 ($126,383-$160,200) for stage 2 procedure, and $77,198 ($70,471-$83,925) for Fontan. Linking NPC-QIC clinical registry data to PHIS data to evaluate resource utilization is feasible. Resource utilization in HLHS is highest in the first year of life and remains high over the first six years of life.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606091","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":"Heart Rate Control with Landiolol Hydrochloride in Infants and Neonates During Cardiac Surgery.","authors":"Matthias Müller, Lukas Andreas Puschmann, Thomas Zajonz, Martin Unger, Jakob Ackerl, Olga Shatilova","doi":"10.1007/s00246-025-03824-6","DOIUrl":"https://doi.org/10.1007/s00246-025-03824-6","url":null,"abstract":"<p><p>Perioperative tachyarrhythmias are common in children undergoing cardiac surgery, contributing to significant mortality and morbidity. Landiolol, an ultrashort-acting beta-blocker, offers selective heart rate (HR) control in pediatric patients with tachycardia during cardiac surgery. The LANDI-cardioPed study assessed landiolol's safety and efficacy in children during cardiac surgery. The retrospective review included patients under 1 year of age with intraoperative tachycardia during cardiac surgery treated with landiolol hydrochloride (Rapibloc®) at the Pediatric Heart Center Giessen, Germany (June 2017-October 2022). The primary endpoint was the proportion of patients achieving a target HR (< 160 bpm) by surgery end. Among 24 patients (46% neonates, 54% infants; mean weight: 4.8 kg; preexisting heart failure in 71%), 83% achieved the target HR by surgery's end, with all patients reaching it during treatment. Median HR normalization time was 4.0 min and 75% of children reached it within 18.5 min. Landiolol demonstrated good hemodynamic stability. It reduced HR by 6% from baseline while maintaining stable blood pressure and HR/BP ratios, with no increased vasopressor use. The drug was titrated individually, with a mean initial dose of 23 µg/kg/min, the dose was 26 µg/kg/min upon reaching target HR, and the maximum dose of 49 µg/kg/min. The treatment duration averaged 10.5 h. Safety was favorable; three adverse events unrelated to landiolol were reported, and no dose interruptions occurred. Landiolol was effective and safe for HR control in neonates and infants with tachycardia during cardiac surgery, which aligns with current knowledge on its use in children.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597480","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":"Preoperative Oral Feeding in Infants with Congenital Heart Disease Within the First Month of Life is Associated with a Higher Likelihood of Freedom from Tube Feeding at Time of Postoperative Discharge.","authors":"Muhammad Irfan, Fatima Fazal","doi":"10.1007/s00246-025-03805-9","DOIUrl":"https://doi.org/10.1007/s00246-025-03805-9","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586644","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":"Incidence and Risk Factors of Pulmonary Vein Stenosis After Orthotopic Heart Transplantation in Pediatric Patients.","authors":"Daiji Takajo, Paul J Critser, Benjamin S Mantell, Russel Hirsch","doi":"10.1007/s00246-025-03828-2","DOIUrl":"10.1007/s00246-025-03828-2","url":null,"abstract":"<p><p>Pulmonary vein stenosis (PVS) is a rare yet critical condition in children with a poor prognosis. The incidence and underlying risk factors of PVS following orthotopic heart transplantation (OHT) remain unclear. This study aimed to investigate the occurrence and predictors of PVS development post-OHT among pediatric recipients. This retrospective, single-center study was conducted at Cincinnati Children's Hospital Medical Center included patients who underwent OHT between 2014 and 2023. Demographics were compared between patients who developed PVS after OHT and those who did not. Cox regression analyses was used to identify predictors of PVS development. Among 114 patients (70 males, 61%) who underwent OHT at a median age of 11 years (IQR: 2-15), 12 were diagnosed with PVS (6 males, 50%) during a median follow-up of 29 months (IQR: 14-63). The median interval between OHT and diagnosis of PVS was 2 months (IQR: 1-8). All 12 PVS cases were associated with underlying congenital heart disease (12/69, 17.4%) including 2 patients with history of PVS at time of transplant. No patients with history of cardiomyopathy or myocarditis developed PVS. Among the 12 PVS patients, 3 (25%) had multivessel pulmonary vein disease and 4 patients (33%) died. Cox regression analysis, after excluding 2 patients with a prior history of PVS, identified age at OHT (Hazard ratio 0.86, p = 0.027) and partial or total anomalous pulmonary venous return (Hazard ratio 9.0, p = 0.002) as significant predictors of PVS development post-OHT. Prematurity, chronic lung disease, single ventricle physiology and donor-recipient size mismatch were not significantly associated with development of PVS post-OHT. The patients with PVS had significantly higher mortality compared to those without PVS (p = 0.025). This study highlights a low risk of PVS post-OHT in children with cardiomyopathy or myocarditis. PVS post-transplant is linked to congenital heart disease and early post-transplant period. Monitoring for PVS during the first year post-OHT is crucial, especially in children with congenital heart disease.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582359","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}