Pediatric Cardiology最新文献

{"title":"Health-Related Quality of Life in Adolescents and Young Adults with Congenital Heart Disease and Its Predictors, Including Subjective Transition Readiness to Adulthood.","authors":"Kazuteru Niinomi, Shoji Yoshikawa, Toshiaki Sato, Hiroko Omori, Kayoko Miyashita","doi":"10.1007/s00246-025-04033-x","DOIUrl":"https://doi.org/10.1007/s00246-025-04033-x","url":null,"abstract":"<p><p>Although international studies have examined the health-related quality of life (HRQoL) of adolescents and young adults (AYAs) with congenital heart disease (CHD), those focusing specifically on predictors including transition readiness to adulthood remain limited, particularly in Japan. This study aimed to evaluate HRQoL among AYAs with CHD and its predictors. This cross-sectional survey included 86 participants with CHD from 4 outpatient pediatric cardiology clinics and a parents' peer support group in Japan. The MOS Short-Form 36-Item Health Survey (SF-36) was conducted, and information was obtained on demographics, physical conditions, and participants' transition readiness assessment. The three SF-36 component summary scores as dependent variables were compared against standard values and analyzed using multiple linear regression analyses. Participants' mean age was 21.3 years (standard deviation = 3.6). Compared to national standard values, component scores showed no apparent differences, except in a lower role/social component summary in females. The presence of arrhythmia and cyanosis, New York Heart Association (NYHA) functional classification, physical disability certification grade, and a transition readiness item together accounted for 36.1% of the variance in the physical component summary. Families living together, CHD-related surgery experience within the last 3 years, and one transition readiness item explained 19.8% of the variance in the mental component summary. Participants' sex and NYHA explained 13.6% of the variance in RCS. Physical conditions and subjective transition readiness partially predicted the HRQoL of AYAs with CHD. Females may be aware that being unable to fulfill expected social roles may prevent them from achieving optimum HRQoL.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092231","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 and Outcomes for Post-operative Arrhythmias Following the Norwood Operation.","authors":"Michael J Lin, Emma Kate Costanza, Ryan Masotti, Pranay Nayi, Robert Whitehill, Asaad G Beshish","doi":"10.1007/s00246-025-04024-y","DOIUrl":"https://doi.org/10.1007/s00246-025-04024-y","url":null,"abstract":"<p><p>Despite improvements in survival following staged surgical palliation for single ventricle heart disease, morbidity and mortality remain substantial, particularly during the interstage period following the Norwood operation. Post-operative arrhythmias are common in this population, yet their risk factors and impact on outcomes are not well defined. This study aims to characterize the risk factors and clinical outcomes of arrhythmias following the Norwood operation. We conducted a retrospective cohort study of neonates who underwent the Norwood operation between January 2010 and December 2023 at a quaternary care children's hospital. Clinically significant arrhythmias requiring pharmacologic or electrical intervention were identified. Demographic, intra-, and post-operative variables were collected, along with arrhythmia characteristics. Multivariable logistic regression was used to assess associations with arrhythmias and operative mortality. Among 322 patients, post-operative arrhythmias occurred in 107 (33.2%), with supraventricular tachycardias being most common. Bradyarrhythmias occurred in 3.7% of patients, with 58.3% requiring permanent pacemaker placement. Patients with arrhythmias were younger at surgery and had a higher incidence of acute kidney injury. Arrhythmias were associated with longer ICU (p = 0.003) and hospital stays (p = 0.001). Operative mortality was 18.3%, and while associated with arrhythmias in univariate analysis, only cardiac arrest, higher vasoactive-inotropic scores, and prolonged cardiopulmonary bypass time remained independently associated with mortality. Clinically significant arrhythmias are common following the Norwood operation, particularly supraventricular tachyarrhythmias. Younger age at surgery and post-operative acute kidney injury were associated with arrhythmias. Although arrhythmias were associated with increased morbidity, they were not independent predictors of operative mortality.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092272","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":"Pediatric Cross-Sectional Cardiac Imaging in Europe: Current Status, Disparities, and Potential Solutions: A Survey from the Association for European Pediatric and Congenital Cardiology (AEPC) Imaging Working Group.","authors":"Tristan Ramcharan, Arno Roest, Inga Voges, Massimiliano Cantinotti, Heynric Grotenhuis, Almudena Ortiz Garrido, Giulia Pasqualin, Giovanni Di Salvo, Sylvia Krupickova, György Róth, Antonis Jossif, Thomas Salaets, Henrik Brun, Brian Grant, Carl Glessgen, Andreas Petropoulos, Gabriela Doros, Helen Pärna, Karel Koubsky, Peter Olejnik, Inguna Lubaua, Ulrike Herberg, Lars Idorn, Anna Sabaté Rotés, Diala Khraiche, Rui Anjos, Tara Bharucha, Beatrice Bonello, Jan Marek, Emanuela Valsangiacomo, Franz Gerald Greil, Owen Miller, Francesca Raimondi, Colin J McMahon","doi":"10.1007/s00246-025-04027-9","DOIUrl":"https://doi.org/10.1007/s00246-025-04027-9","url":null,"abstract":"<p><p>Cross-sectional cardiac imaging including cardiac computed tomography (CCT) and cardiac magnetic resonance imaging (CMR) allows three-dimensional imaging of intracardiac and extracardiac structures. This study was undertaken to better understand current European practice of pediatric cardiology cross-sectional imaging, in addition to how training is undertaken in different centers. A structured detailed 64-question survey focusing on cross-sectional imaging was circulated to all Imaging Working Group members of the 95 AEPC affiliated centers. Consultants from 42 centers (44%) from 25 different European countries completed the survey, between 7th July 2024 and 28th October 2024. Ninety percent of centers have been performing pediatric CCT for > 10 years, with median 135 scans/year. Comparatively, 84% of centers have been performing CMR for > 10 years, with a median 200 scans/year. CCT was performed by a pediatric radiologist, whereas CMR was more often performed by a pediatric cardiologist, but frequently both modalities were undertaken by a combination of pediatric cardiologists and radiologists. Less than two-third of centers surveyed train fellows in CMR or CCT. Many fellows travel abroad to obtain specialist training. Just over half of the centers surveyed have institutional guidelines for pediatric CCT/CMR, with the majority agreeing that provision of European (AEPC-led) guidelines for pediatric CCT/CMR would be helpful. Across Europe there is significant variation in how CCT/CMR is performed and how pediatric cardiologists are trained in cross-sectional imaging. This survey highlights the current state of cross-sectional imaging in Europe, challenges faced, but also explores potential solutions to standardize European cross-sectional imaging.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092215","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":"Severe Ascending Aortic Aneurysm in a Preschool Age Child.","authors":"Filippos-Paschalis Rorris, Meletios Kanakis, Maria Kontou, Dimitrios Bobos, Martin Kostolny","doi":"10.1007/s00246-025-04028-8","DOIUrl":"https://doi.org/10.1007/s00246-025-04028-8","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086577","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":"Influence of Heart Rate on Hemodynamics in Fontan Circulation.","authors":"Aya Miyazaki, Yoshifumi Fujimoto, Yasumi Nakashima, Junji Sakata, Yasuyo Takeuchi, Makoto Motooka, Yasuhiko Tanaka, Nao Inoue, Hideki Saito, Yasuo Ono, Hiroki Sakamoto, Hisashi Sugiyama","doi":"10.1007/s00246-025-04003-3","DOIUrl":"https://doi.org/10.1007/s00246-025-04003-3","url":null,"abstract":"<p><p>The standard value of heart rate (HR) and the effect of HR on Fontan circulation remain unclear. HRs and hemodynamic parameters were evaluated in 59 adults with Fontan circulation without pacemaker (PM) and then compared with those of 15 patients with PM. The minimum HR in Holter monitoring, HR in resting electrogram, resting HR in cardiopulmonary exercise (CPX), maximum HR in Holter, and peak HR in CPX were observed during sleep, supine, sitting, maximum daily activity, and exercise, respectively. HRs in 15 patients with excellent status of Fontan circulation were 50 ± 6, 75 ± 15, 81 ± 7, 86 ± 11, 141 ± 19, and 165 ± 17 bpm in sleep, in supine, Holter mean, in sitting, during maximum daily activity, and during exercise, respectively. Among 59 patients, the higher HR during exercise and higher ΔHR between exercise and sleep were associated with favorable values of hemodynamics. The PM group had higher HR during sleep and lower HR during the activities above the sitting position, compared with the non-PM group. The standard values for adults with Fontan circulation would be approximately 50, 75, 80, 85, 140, and 165 bpm during sleep, in the supine position, Holter mean, in the sitting position, during maximum daily activity, and during exercise, respectively. The higher HR during activities may facilitate the maintenance of good Fontan circulation. After PM implantation for Fontan circulation, the setting of increased HR during activities as well as the efforts to maintain narrow QRS duration and atrioventricular synchrony should be kept in mind.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086629","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":"Transcatheter Ventricular Septal Defect Closure in Children < 10 kg: Anatomical Challenges, and Outcomes with the Konar MFO Device.","authors":"Utku Pamuk, Hazım Alper Gursu, Emine Azak, İbrahim İlker Çetin","doi":"10.1007/s00246-025-04018-w","DOIUrl":"https://doi.org/10.1007/s00246-025-04018-w","url":null,"abstract":"<p><p>This study evaluated the feasibility, safety, and mid-term outcomes of transcatheter ventricular septal defect (VSD) closure using the Konar MFO device in infants weighing < 10 kg, focusing on procedural challenges and anatomical complexities. A retrospective single-center analysis included 34 consecutive patients (mean age: 14.8 months; mean weight: 7.4 kg) who underwent transcatheter VSD closure between January 2022 and December 2024 via transfemoral or transjugular approaches. Technical success was achieved in 94.1% (32/34) of cases. Major complications were rare (5.9%), with no device embolization, arrhythmias, or new-onset valvular regurgitation. The Konar MFO device was successfully deployed across diverse VSD morphologies, including perimembranous, muscular outlet, mid-muscular, and apical-muscular defects, as well as cases with aortic override or multifocal defects requiring dual-device implantation. Procedural challenges, such as papillary muscle knotting during wire manipulation, were managed with tailored strategies, enabling safe device placement in all patients. Individualized procedural modifications, including novel dual-device and access strategies, enabled safe closure even in anatomically complex cases. At a median follow-up of 17 months, all patients demonstrated sustained defect closure, hemodynamic improvement, and resolution of symptoms. In conclusion, transcatheter VSD closure with the Konar MFO device provides high procedural success and favorable mid-term outcomes in infants < 10 kg, including those with challenging anatomies. Unlike previous reports focusing mainly on procedural success, this study systematically addresses anatomical complexities and mid-term outcomes in infants < 10 kg. Larger multicenter studies with extended follow-up are needed to confirm long-term safety and standardize procedural strategies.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069943","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":"Genetic Health Education in Adolescents with Congenital Heart Disease: A Patient, Parent, and Clinician Perspective.","authors":"Bridget R O'Malley, Janine Smith, Gary F Sholler, Julian Ayer, Gillian M Blue","doi":"10.1007/s00246-025-04010-4","DOIUrl":"https://doi.org/10.1007/s00246-025-04010-4","url":null,"abstract":"<p><p>Improvements in outcomes for congenital heart disease (CHD) have resulted in a growing adolescent/adult CHD population. Subsequently, education on CHD causes and inheritance has been identified as important. This study aimed to determine population-specific understanding and preferences of CHD causes and inheritance education. CHD adolescents aged 13-18 years, their parent, and clinicians involved in the care of patients with CHD completed a purpose-designed, online survey outlining their current understanding of CHD genetics and inheritance and their preferences for education content and delivery. Approximately 50% of participants were unsure if CHD was caused by genetic factors, and 25% believed CHD was not genetic. Many participants (63% (19/30) adolescents, 81% (26/32) parents) wanted to know more about CHD causes, with most considering this important. Over 60% of participants indicated that CHD causes had not been discussed with them, despite 74% of clinicians (17/23) indicating they discuss this. Information on genetic causes of CHD and recurrence risks, delivered in-person with parents present, was the preferred option for the content and delivery of this information. Most clinicians indicated genetics education should be introduced between 12 and 14 years, whereas adolescents and parents preferred this to occur between 14 and 16 years. Participants want to know more about CHD causes and inheritance, in an outpatient setting with parents in attendance. The findings of this study support the development of a specialized genetics education program about CHD causes and inheritance for adolescents with CHD. Further, it provides important insight into the content, timing, and delivery of this information.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075922","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":"Delirium in the Pediatric Cardiac Intensive Care Unit and Use of a Language Other than English.","authors":"Mary S Pilarz, Cara M Pritchett, Quinn Tentinger, Jiafeng Li, Adrian D Zurca","doi":"10.1007/s00246-025-04016-y","DOIUrl":"10.1007/s00246-025-04016-y","url":null,"abstract":"<p><p>This study aimed to characterize the relationship between the use of a language other than English (LOE) and the prevalence of delirium in the pediatric cardiac intensive care unit (CICU), hypothesizing that patients from families who use an LOE would have a higher prevalence of delirium compared to those from English-speaking families. This was a retrospective cohort study at a quaternary-care, free-standing children's hospital CICU. Children admitted to the CICU between January 1, 2017, and July 31, 2023 with documented delirium screening scores were included. The primary outcome was the presence of delirium, assessed using the Cornell Assessment of Pediatric Delirium (CAP-D) score, with scores ≥ 9 indicating delirium. Language was recorded in the electronic health record and categorized as English, Spanish, or language other than English or Spanish (LOES). Covariates included age, sex, length of stay, developmental delay, use of mechanical ventilation, use of physical restraints, receipt of vasoactive medications, and caregiver presence. Among 1865 patients with CAP-D scores, 25.6% (477 patients) experienced delirium. Neither Spanish-speaking [adjusted OR (aOR) 1.43, 95% CI 0.92-2.22] nor LOES patients (aOR 0.73, 95% CI 0.33-1.60) demonstrated higher odds of delirium. Established risk factors for delirium, including age, length of stay, and mechanical ventilation, were associated with increased delirium risk. Inconsistent caregiver presence at bedside was associated with higher odds of delirium (aOR 2.37, 95% CI 1.76-3.18). In this CICU cohort, there was no significant association between the use of an LOE and delirium in the CICU. There is a strong, independent relationship between inconsistent caregiver presence and delirium.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069589","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: Survey of Pediatric Cardiologists on Screening for Conditions Associated with Sudden Cardiac Death.","authors":"Jenna L Schlondrop, Nicholas H Von Bergen, Xiao Zhang, John S Hokanson","doi":"10.1007/s00246-025-04011-3","DOIUrl":"10.1007/s00246-025-04011-3","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040746","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":"Cardiac Resynchronization Therapy to Aid Ventricular Assist Device Explantation in Infants with Cardiomyopathy and Left Bundle Branch Block.","authors":"Anila A Chaudhary, Chandra Srinivasan, Katsuhide Maeda, Aaron G DeWitt, Catherine Montgomery, Radhika Rastogi, Matthew J O'Connor, Jonathan J Edwards, Humera Ahmed, Kimberly Y Lin, Joseph W Rossano, Carol Wittlieb-Weber, Jonathan B Edelson","doi":"10.1007/s00246-025-04022-0","DOIUrl":"https://doi.org/10.1007/s00246-025-04022-0","url":null,"abstract":"<p><p>Two previously healthy infants presented with severely dilated left ventricles (LV) and severely diminished left ventricular function. Their initial ECGs demonstrated a left bundle branch block (LBBB) with evidence of dyskinetic septal wall motion on serial echocardiograms. Both were supported with a Berlin Heart EXCOR left ventricular assist device (LVAD). Serial LVAD turn down trials demonstrated improvement in LV function, though with ongoing pronounced septal dyskinesis due to the LBBB. Both underwent successful LVAD explantation with simultaneous epicardial lead placement for biventricular cardiac resynchronization therapy (CRT) given the ongoing dyssynchrony. LVAD explantation in this age group is rare. These cases highlight CRT as a strategy which may aid in the successful explant of ventricular assist devices in select patients who have LBBB and evidence of dyssynchrony by echocardiogram.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033850","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}