Pediatric Cardiology最新文献

{"title":"The Influence of Arrhythmia on the Outcomes of Pediatric Patients with Idiopathic Dilated Cardiomyopathy.","authors":"Mohammad Dalili, Marieh Dastafshan, Mohammad Mahdavi, Hossein Shahzadi, Golnar Mortaz Hejri, Fariba Rashidighader, Pedro Brugada","doi":"10.1007/s00246-024-03684-6","DOIUrl":"10.1007/s00246-024-03684-6","url":null,"abstract":"<p><p>Children diagnosed with dilated cardiomyopathy (DCM) are at an increased risk of developing arrhythmias, which can significantly affect their overall prognosis. However, the implantation and effectiveness of implantable cardioverter-defibrillators (ICDs) pose challenges in the pediatric population. Therefore, it is crucial to determine the prevalence of arrhythmia-related death in pediatric patients with DCM. This study investigated the correlation between arrhythmias and mortality in pediatric patients with DCM. This retrospective cohort study examined children with idiopathic DCM referred to Rajaie Cardiovascular, Medical, and Research Institute in Tehran, Iran, from 2017 to 2023. All patients underwent a standard 12-lead electrocardiogram, 24-h Holter monitoring, cardiac magnetic resonance imaging, and echocardiography. Patient outcomes, including death, heart transplantation, and survival, were evaluated within one year of Holter monitoring. A total of 178 children (79 males) with a mean age of 83.06 ± 56.41 months were included in the study. Overall, 72 deaths (40.4%) and 46 heart transplants (25.8%) were recorded and 60 patients (33.7%) survived. There was no significant association between patients' outcomes with ventricular arrhythmias, late gadolinium enhancement, corrected QT interval, and QRS interval prolongation; however, a significantly higher proportion of dead patients had abnormal heart rate variability (P = 0.034). Heart failure was the leading cause of death, with ventricular arrhythmia accounting for two out of 72 deaths. Both cases of ventricular arrhythmia were associated with severe cardiac dysfunction. Arrhythmia-related mortality is rare in children with idiopathic DCM, with severe heart failure being the primary cause of death in this population. Life-threatening arrhythmias primarily occur in DCM children with more compromised cardiac function.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1842-1847"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472016","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":"Patient Driven EKG Device Performance in Adults with Fontan Palliation.","authors":"Matthew Laubham, Anudeep K Dodeja, Rohan Kumthekar, Victoria Shay, Nathan D'Emilio, Sara Conroy, May Ling Mah, Chance Alvarado, Anna Kamp","doi":"10.1007/s00246-024-03614-6","DOIUrl":"10.1007/s00246-024-03614-6","url":null,"abstract":"<p><p>The aim of this study was to evaluate the accuracy of the KardiaMobile (KM) device in adults with a Fontan palliation, and to assess the KM function as a screening tool for atrial arrhythmias. While patient driven electrocardiogram (EKG) devices are becoming a validated way to evaluate cardiac arrhythmias, their role for patients with congenital heart disease is less clear. Patients with single ventricle Fontan palliation have a high prevalence of atrial arrhythmias and represent a unique cohort that could benefit from early detection of atrial arrhythmias. This single center prospective study enrolled adult patients with Fontan palliation to use the KM heart rhythm monitoring device for both symptomatic episodes and asymptomatic weekly screening over a 1-year period. Accuracy was assessed by comparing the automatic KM interpretation (KM-auto) to an electrophysiologist overread (KM-EP) and traditional EKG. Fifty patients were enrolled and 510 follow-up transmissions were received. The sensitivity and specificity of enrollment KM-auto compared to EKG was 65% and 100%, respectively. The sensitivity and specificity of enrollment KM-auto compared to the KM-EP was 75% and 96%, respectively. In the adult Fontan palliation, the accuracy of the KM device to detect a normal rhythm was reliable and best with a physician overread. Abnormal or uninterpretable KM-auto device interpretations, symptomatic transmissions, and any transmissions with a high heart rate compared to a patient's normal baseline should warrant further review.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1932-1940"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996246","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":"Electrocardiographic Changes in Acute Kawasaki Disease in the Era of Immunoglobulin Therapy.","authors":"Ryo Nakanishi, Toshiki Nakamura, Yutaro Koyama, Shogo Akahoshi, Hiroshi Hataya, Masaru Miura","doi":"10.1007/s00246-024-03648-w","DOIUrl":"10.1007/s00246-024-03648-w","url":null,"abstract":"<p><p>Kawasaki disease (KD), an acute, febrile, self-limiting, multisystem vasculitis of unknown etiology, often involves the cardiac complications of coronary artery aneurysm development, myocarditis, pericarditis, and valvulitis. However, there are insufficient epidemiological data on electrocardiographic (ECG) changes in acute KD in the IVIG era, and little is known about the association between ECG changes and the prognosis. The present study aimed to determine the type of ECG changes found in acute KD and to clarify the course of these changes as well as their relationship to disease severity. The present, retrospective, observational study analyzed 201 patients aged < 15 years with Kawasaki disease who received IVIG from April 2021 to March 2023. In the 156 eligible patients analyzed (male: 62.8%; median age on admission: 24 months), the most common abnormalities were T wave changes (n = 141; 90.4%) on any lead followed by T wave inversions (n = 63; 40.4%), tachycardia (n = 36; 23.1%), and a prolonged PR interval (n = 23; 14.7%). PR prolongation, abnormal Q wave, QTc prolongation, and ST changes were less common in the present cohort, and arrhythmia occurred less frequently than in previous studies. No significant association was found between T wave inversion and disease severity. T wave changes occurred frequently in the acute phase ECG in KD but were not associated with clinical features, such as unresponsiveness to IVIG therapy or coronary artery abnormalities.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1862-1867"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351621","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":"Efficacy and Safety of Esmolol in Neonatal Cardiac Surgery with Cardiopulmonary Bypass (CPB) for d-Transposition of the Great Arteries (d-TGA).","authors":"Anna-Eva Blank, Thomas Zajonz, Inga Gruschwitz, Christoph Neuhäuser, Hakan Akintürk, Christian Jux, David Backhoff","doi":"10.1007/s00246-024-03671-x","DOIUrl":"10.1007/s00246-024-03671-x","url":null,"abstract":"<p><strong>Objective: </strong>D-Transposition of the great arteries (d-TGA) is the most common congenital heart disease requiring surgical correction within the neonatal period. Sinus tachycardia often persists postoperatively, potentially affecting cardiac function. This study aimed to investigate the efficacy and safety of the short-acting beta-1-selective beta-blocker esmolol in controlling heart rate in neonatal cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on neonates undergoing surgery for d-TGA. The study cohort included 112 patients, divided into an esmolol intervention group (n = 57) and a control group (n = 55). Baseline characteristics, hemodynamic parameters and outcome measures were assessed.</p><p><strong>Results: </strong>In the esmolol group, median heart rate at ICU admission was significantly higher compared to the control group (155 vs. 147 bpm, p = 0.018). After a median time of 11 h, heart rate was lower among the esmolol patients (135 vs. 144 bpm, p < 0.001). There were no differences in other hemodynamic parameters between the two groups. Patients treated with esmolol required longer catecholamine support while no difference regarding survival, duration of invasive ventilation and ICU stay were noticed.</p><p><strong>Conclusion: </strong>No relevant hemodynamic difference was seen between neonates treated with perioperative esmolol and the control group and outcome did not differ. This indicates non-inferiority of perioperative betablocker therapy in young age. Prospective and placebo-controlled assessment of perioperative esmolol therapy in neonates is needed.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1901-1905"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392285","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":"Prolonged Inotrope Use After Surgery for Congenital Heart Disease: A Common Occurrence with a High Burden of Mortality.","authors":"Alicia M Kamsheh, Warren B Bilker, Yuan-Shung Huang, Oluwatimilehin Okunowo, Danielle S Burstein, Jonathan B Edelson, Kimberly Y Lin, Katsuhide Maeda, Constantine D Mavroudis, Matthew J O'Connor, Carol A Wittlieb-Weber, Hillary R Bogner, Joseph W Rossano","doi":"10.1007/s00246-024-03619-1","DOIUrl":"10.1007/s00246-024-03619-1","url":null,"abstract":"<p><p>Outcomes in patients requiring prolonged inotropes (PI) following surgery for congenital heart disease (CHD) have not been well studied. We aimed to describe the burden of PI use in the immediate postoperative period after CHD surgery and identify risk factors for in-hospital mortality. We conducted a retrospective cohort study using the Pediatric Health Information System® (PHIS) database. Patients 0-18 years with CHD who underwent cardiovascular surgery from 2010 to 2020 were included. Patients who received inotropic medications for > 7 consecutive days after surgery were in the PI group and all others in the control group. Patients who died before 7 days were excluded. Multivariable mixed-effect logistic regression was used to examine risk factors for in-hospital mortality. There were 110,271 patients from 48 centers included, 10,292 in the PI group and 99,979 in the control group. In-hospital mortality was significantly higher in the PI group (24.9% vs. 4.6%, p < 0.001). Ventricular assist device use was rare (1.6%). After adjustment, odds of in-hospital mortality in the PI group was 3.5 (95% CI 3.3-3.8) times higher than in controls. Independent risk factors for in-hospital mortality were age, non-White race, class of CHD, number of complex chronic conditions, preoperative inotrope, preoperative extracorporeal membrane oxygenation, sepsis, stroke, renal failure, number of inotropes at 7 days, and discharge year (p < 0.01 for all). Postoperative PI use in CHD is common and carries a considerable burden of mortality. Additional work is needed to understand which risk factors are modifiable and which patients may benefit from reintervention or advanced heart failure therapies.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2037-2046"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976309","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":"Neighborhood Income Disparities in Unplanned Hospital Admission and In-Hospital Outcomes Among Children with Congenital Heart Disease.","authors":"Laxmi V Ghimire, Sagya Khanal, Zareh Torabyan, Hiba El-Rahi, Catherine Cong, Fu-Sheng Chou, Othman A Aljohani, Anita J Moon-Grady","doi":"10.1007/s00246-024-03755-8","DOIUrl":"10.1007/s00246-024-03755-8","url":null,"abstract":"<p><p>Unplanned admissions are associated with worse clinical outcomes and increased hospital resource utilization. We hypothesized that children with congenital heart disease (CHD) from lower-income neighborhoods have higher rates of unplanned hospital admissions and greater resource utilization. Utilizing the Kids' Inpatient Database (2016 and 2019), we included children under 21 years of age with CHD, excluding newborn hospitalizations. CHD cases were categorized into simple lesions, complex biventricular lesions, and single ventricle lesions. Admissions were classified as surgical or non-surgical. A logistic regression model assessed the risk of unplanned hospital admission, mortality, and resource utilization across different neighborhood income levels. Out of 4,722,684 admitted children (excluding newborn hospitalizations), 199,757 had CHD and met the study criteria: 121,626 with mild CHD, 61,639 with complex biventricular lesions, and 16,462 with single ventricle lesions. Surgical admissions comprised 20% (n = 39,694). In the CHD cohort, 27% had planned admissions, while 73% were unplanned. Mortality was higher in unplanned admissions compared to planned admissions (3.0 vs. 0.93%, P < 0.001). Unplanned admissions were more common in the lowest-income neighborhoods compared to the highest-income neighborhoods (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.3-1.5; P < 0.001), consistent across different age groups. Higher rates of unplanned admissions in the lowest-income neighborhoods were observed for each CHD category and for both medical and surgical admissions. Median hospitalization length was longer in the poorest neighborhoods compared to the wealthiest (7 days [IQR 3-21] vs. 6 days [IQR 3-17], P < 0.001). In conclusion, children with CHD residing in the lowest-income neighborhoods have increased odds of unplanned hospitalization for both surgical and non-surgical admissions, along with higher mortality and resource utilization.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2116-2123"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896591","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":"Ectopic Calcification in Congenital Heart Surgery: A Material-Centric Review.","authors":"Tatsuya Watanabe, Satoshi Yuhara, Joseph T Leland, J Logan Spiess, Aditya Thodla, Raghav Ramachandiran, John M Kelly, Toshiharu Shinoka, Christopher K Breuer","doi":"10.1007/s00246-024-03622-6","DOIUrl":"10.1007/s00246-024-03622-6","url":null,"abstract":"<p><p>The modern congenital heart surgeon has an array of materials available for cardiovascular repair. With advancements in the surgical outcomes for pediatric cardiac defects, choice of material has become increasingly dependent on late-term complications associated with each material. Calcification is a leading long-term complication and is increasing in prevalence with materials lasting longer in patients. Material calcification can impair functionality, lead to subsequent complications, and require additional interventions. A comprehensive literature review was conducted to investigate ectopic calcification of commonly used materials for congenital heart defect repair. Mechanisms of ectopic calcification among commonly used materials were investigated. Ectopic calcification is initiated by material-specific immunological reactions. Recent efforts have focused on developing new materials that are not prone to calcification. ePTFE was widely used in cardiovascular applications but still has reported instances of calcification in various situations, such as long-term use. Tissue engineering techniques have shown reduced calcification in reports. Calcification can occur in all conventional materials we reviewed and, in some cases, has led to life-threatening complications. Favorable outcomes have been reported with tissue-engineered materials, with the expectation of continued positive results in future reports. With an array of synthetic and biological materials now displaying acceptable surgical and short-term outcomes, there is a pressing need to review the long-term viability of these materials, especially considering improved patient survival to adulthood. Furthermore, developing new materials to mitigate calcification remains a promising avenue of research in this field.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1771-1789"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562906","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":"Postmortem Identification of a Foreign Body in the Heart: A Case Report.","authors":"Kamil Şahin, Adem Tartıcı, Bora Özdemir, Murat Elevli, Özge Demir","doi":"10.1007/s00246-024-03672-w","DOIUrl":"10.1007/s00246-024-03672-w","url":null,"abstract":"<p><p>The presence of a foreign body in the heart have been reported, mostly in adults. Deaths and injuries can result from the breakage or rupture of angiography catheters. We present a case in which an angiocath tip was identified in the right ventricle of a pediatric patient, and the patient died as a result thereof. As no similar cases have been reported, we would like to draw attention to this subject. A 4.5-month-old female patient who was hospitalized 3 times during her life had a history of peripheral venous access establishment in the extremities with angiocatheters. During these hospital admissions, a central catheter was not inserted, and no additional problems were identified. Emergency personnel responded and found the patient at home, experiencing bradycardia and arrhythmia. She was resuscitated and taken to the hospital, where she died. The autopsy revealed, the tip of a 1.5 cm long, 1 mm wide lumen catheter had penetrated the right ventricular wall (Fig. 1) (Fig. 2), thus her death was attributed to complications that developed as a result of the peripheral vascular access catheter tip breaking and migrating to the right ventricle. Although the patient did not have an ECG, physical examination by the emergency ambulance personnel revealed an irregular and bradycardic heartbeat, suggesting that the child may have developed arrhythmia and atrioventricular conduction block. Health care professionals must check upon removal of peripheral intravenous access, and record whether the integrity of the peripheral catheter tip was compromised to prevent similar events in future. Fig. 1 Angiocath tip piercing the right ventricular wall and exiting the heart Fig. 2 a A 1.5 cm long, b 1 mm wide lumen catheter tip penetrating the right ventricular wall.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2133-2136"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472004","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":"Risk Factors for low Cardiac Output Syndrome in Children less than 6 years old Undergoing Ventricular Septal Defect Closure: a Retrospective Cohort Study.","authors":"Takumi Yamaguchi, Yuri Tomonari, Shiori Utsunomiya, Nakako Fujioka, Takahiro Asano","doi":"10.1007/s00246-025-04041-x","DOIUrl":"https://doi.org/10.1007/s00246-025-04041-x","url":null,"abstract":"<p><p>Low cardiac output syndrome (LCOS) is a critical complication following ventricular septal defect (VSD) closure in children. Despite its clinical importance, the risk factors specific to LCOS in VSD cases are underexplored. This study investigated the risk factors and clinical outcomes associated with LCOS in children aged < 6 years who underwent VSD closure.We conducted a retrospective cohort study and analyzed 266 patients who underwent VSD closure between January 2014 and December 2023. Patients with other complex congenital heart anomalies requiring surgical repair, except for atrial septal defects, patent ductus arteriosus, mild valve stenosis, or regurgitation, were excluded. LCOS was diagnosed based on hemodynamic and metabolic criteria. The LCOS observation window included both the intraoperative and early postoperative phases. Univariate and multivariate logistic regression analyses were performed to identify risk factors for LCOS. Among the 266 patients, 46 (17.3%) developed LCOS. Independent risk factors for LCOS included age < 3 months (adjusted odds ratio [aOR]: 4.72, 95% confidence interval [CI]: 2.20-10.2, p < 0.001), preoperative pulmonary hypertension (defined using echocardiography as the qualitative presence of interventricular septal flattening) (aOR: 2.17, 95% CI: 1.03-4.58, p < 0.05), and cardiopulmonary bypass duration > 120 min (aOR, 2.92; 95% CI: 1.41-6.07, p < 0.01). LCOS was associated with prolonged mechanical ventilation, intensive care unit stay, and hospital stay but did not significantly affect mortality. This study identified risk factors for LCOS that contribute to safe intraoperative and postoperative management in pediatric patients undergoing VSD closure.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200534","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":"Right Ventricular Outflow Tract and Pulmonary Artery Strains During the Cardiac Cycle Prior to Pulmonary Valve Replacement.","authors":"Liam Swanson, Raphael Sivera, Nicholas M Jacobson, Claudio Capelli, Lorna P Browne, Catalina Vargas-Acevedo, Gareth J Morgan, Silvia Schievano","doi":"10.1007/s00246-025-04034-w","DOIUrl":"https://doi.org/10.1007/s00246-025-04034-w","url":null,"abstract":"<p><p>Right ventricular outflow tract and pulmonary arteries (RVOT/PAs) in surgically repaired congenital heart disease are highly dynamic structures, dilating in systole to accommodate the ejected blood volume while also elongating due to the ventricular contraction. In this study, we aim to quantify RVOT/PA circumferential and axial strains in a population of patients assessed for transcatheter pulmonary valve replacement (TPVR). 3D RVOT/PA geometries at end diastole and systole were reconstructed from 4D computed tomography images of 20 patients (35% female; 34 ± 15 years; 50% pulmonary stenosis, 40% Tetralogy of Fallot). A deformable shape model (DSM) was built to establish point-correspondence between subjects at end diastole and measure the RVOT/PA deformations of each subject to systole. The strain components were averaged over RVOT, pulmonary valve, and pulmonary trunk, and the strain ratio, describing the simultaneous deformations in the two main loading directions, was calculated. Overall, circumferential strains were smaller (range: - 0.28-0.30; area-weighted average 0.09), than axial strains (range: - 0.16-0.95; area-weighted average 0.28). Axial strains were high in the RVOT and progressively decreased toward the PA bifurcation, while circumferential strains increased instead. 90% of RVOT/PA showed positive strain ratios (0.13 ± 0.31, 0.25 ± 0.20, and 1.04 ± 0.52 in the RVOT, pulmonary valve, and pulmonary trunk, respectively). The RVOT/PA DSM computed in TPVR patients confirmed the macroscopic positive strain ratio observed during the cardiac cycle, with overall greater axial strains compared to circumferential strains. This may have implications in device/patient selection for TPVR.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200562","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}