Methodist DeBakey cardiovascular journal最新文献_第3页

Severe Trileaflet Aortic Stenosis Without Significant Valve Calcification in an Older Adult. 老年人严重三瓣主动脉狭窄无明显瓣膜钙化。

Methodist DeBakey cardiovascular journal Pub Date : 2026-07-21 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1819

Mahshad Razaghi, Juan M Farina, Laureve Chollet, Chadi Ayoub, Reza Arsanjani, Kristen A Sell-Dottin

引用次数: 0

Surgical Reconstruction of a Suprahepatic Inferior Vena Cava Aneurysm Using a Tubularized Bovine Pericardial Patch. 用管状牛心包贴片重建肝上下腔静脉动脉瘤。

Methodist DeBakey cardiovascular journal Pub Date : 2026-07-21 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1841

Laasya Achanta, Bright Benfor, Dylan E Brooks, Michael J Reardon, Alan B Lumsden

引用次数: 0

Adult Congenital Heart Disease at the Crossroads of Innovation. 成人先天性心脏病在创新的十字路口。

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1881

Valeria E Duarte, Andrea Giulio Quarti

引用次数: 0

Single Ventricle Fontan: The Basics for General Cardiologists. 单心室Fontan：普通心脏病专家的基础知识。

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1816

Berardo Sarubbi, Flavia Fusco, Michela Palma, Rosaria Barracano, Giovanni Domenico Ciriello, Nunzia Borrelli, Giancarlo Scognamiglio

{"title":"Single Ventricle Fontan: The Basics for General Cardiologists.","authors":"Berardo Sarubbi, Flavia Fusco, Michela Palma, Rosaria Barracano, Giovanni Domenico Ciriello, Nunzia Borrelli, Giancarlo Scognamiglio","doi":"10.14797/mdcvj.1816","DOIUrl":"10.14797/mdcvj.1816","url":null,"abstract":"Single-ventricle physiology encompasses a heterogeneous spectrum of congenital cardiac malformations in which a single dominant ventricle supports both pulmonary and systemic circulation. Advances in staged surgical palliation culminating in the Fontan procedure have transformed survival, allowing most patients to reach adulthood. Consequently, general cardiologists increasingly encounter adults with Fontan circulation and its long-term cardiac and extracardiac complications. Although life-saving, Fontan circulation is a palliative physiology characterized by passive pulmonary blood flow, limited preload reserve, and chronic systemic venous hypertension. Over time, patients are at risk for progressive complications including arrhythmias, thromboembolism, ventricular dysfunction, Fontan pathway obstruction, lymphatic disorders including protein-losing enteropathy, hepatic disease, and reduced exercise capacity. This review provides general cardiologists with a practical, physiology-based overview of single-ventricle anatomy, the surgical pathway to Fontan circulation, common late complications, and principles of lifelong surveillance. Early recognition of deterioration and timely referral to specialized adult congenital heart disease centers are essential to improving outcomes in this growing patient population.","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"22 3","pages":"54-66"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Box: A Message from the Heart in 55 Words. 《盒子：55个字的心声》

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1656

Justin C Cordova, James B Young, James S Huntley

引用次数: 0

Lifelong Management of Right Ventricular Outflow Tract Dysfunction in Adults with Congenital Heart Disease. 成人先天性心脏病右心室流出道功能障碍的终身治疗。

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1797

Maurizio Brighenti, Gabriele Egidy Assenza, Elisabetta Mariucci, Andrea Donti

{"title":"Lifelong Management of Right Ventricular Outflow Tract Dysfunction in Adults with Congenital Heart Disease.","authors":"Maurizio Brighenti, Gabriele Egidy Assenza, Elisabetta Mariucci, Andrea Donti","doi":"10.14797/mdcvj.1797","DOIUrl":"10.14797/mdcvj.1797","url":null,"abstract":"Right ventricular outflow tract (RVOT) dysfunction is a common and clinically significant late complication in adults with congenital heart disease (ACHD), often after repair of conotruncal anomalies, Ross intervention, or isolated pulmonary valve disease. Pulmonary regurgitation, stenosis, or mixed lesions can result in RV dilation, dysfunction, arrhythmias, and exercise limitation. RVOT dysfunction often requires either surgical or transcatheter intervention, with careful patient selection, imaging, and planning. Surgical pulmonary valve replacement remains the reference standard for complex anatomies, whereas transcatheter pulmonary valve replacement offers a less invasive, repeatable solution in suitable conduits, bioprostheses, and increasingly often in patched RVOTs. Long-term outcomes have improved with advances in imaging, device technology, and perioperative care; however, complications such as valve degeneration, infective endocarditis, and arrhythmias persist. This review provides a comprehensive synthesis of epidemiology, pathophysiology, indications, surgical and transcatheter management strategies, and lifelong complications after RVOT reintervention in ACHD patients.","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"22 3","pages":"67-77"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endocarditis in Adults with Congenital Heart Disease. 成人先天性心脏病的心内膜炎

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1799

Andrea Busti, Giuseppe Annoni, Carlo Pace Napoleone

{"title":"Endocarditis in Adults with Congenital Heart Disease.","authors":"Andrea Busti, Giuseppe Annoni, Carlo Pace Napoleone","doi":"10.14797/mdcvj.1799","DOIUrl":"10.14797/mdcvj.1799","url":null,"abstract":"Infective endocarditis (IE) remains a major cause of morbidity and mortality in patients with congenital heart disease (CHD). Advances in medical and surgical care have led to a growing population of adults with CHD who carry a substantially higher lifetime risk of IE than the general population. This increased susceptibility reflects the combined effects of abnormal intracardiac flow patterns, the frequent presence of prosthetic material or intracardiac devices, and repeated surgical and transcatheter interventions. The epidemiology, microbiology, clinical presentation, and management of IE in CHD differ in several important aspects from those observed in patients without CHD. Streptococcal species and Staphylococcus aureus account for the majority of IE cases. Diagnosis is often challenging due to complex cardiac anatomy and the presence of prosthetic material, and therefore it requires a high index of suspicion and multimodality imaging. Medical therapy usually requires prolonged antimicrobial therapy. Surgical intervention is more frequently required than in non-CHD populations, reflecting both the burden of prosthetic material and the higher rate of complications at presentation. Preventive strategies, including meticulous dental and skin hygiene and appropriate antibiotic prophylaxis, remain the cornerstone of IE management in this high-risk population.","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"22 3","pages":"136-149"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary Tricuspid Regurgitation in ACHD: Diagnosis and Treatment. ACHD原发性三尖瓣反流的诊断和治疗。

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1813

Luciana Da Fonseca Da Silva

{"title":"Primary Tricuspid Regurgitation in ACHD: Diagnosis and Treatment.","authors":"Luciana Da Fonseca Da Silva","doi":"10.14797/mdcvj.1813","DOIUrl":"10.14797/mdcvj.1813","url":null,"abstract":"Primary tricuspid valve regurgitation includes congenital and acquired disorders, especially Ebstein anomaly and tricuspid valve dysplasia. Severe tricuspid regurgitation causes progressive right atrial and ventricular dilation, arrhythmias, exercise intolerance, impaired left ventricular filling, and eventual biventricular dysfunction. Some patients remain minimally symptomatic for decades despite progressive disease. Poor prognostic factors include severe cardiomegaly, ventricular dysfunction, cyanosis, and arrhythmias. Surgical indications include symptoms, declining exercise capacity, cyanosis, progressive right ventricular enlargement or dysfunction, recurrent arrhythmias, and, in selected asymptomatic patients, severe regurgitation with right ventricular dilation. The Cone repair procedure restores native valve competence, improves right and left ventricular interaction, promotes reverse remodeling, and has low operative risk in experienced centers. Current evidence supports individualized and earlier surgical repair, preferably during childhood and in specialized centers, to improve ventricular function, quality of life, and long-term survival.","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"22 3","pages":"88-97"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Innovative Management of Rhythm Disorders in Adults with Congenital Heart Disease. 成人先天性心脏病心律失常的创新管理。

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1736

Stephanie Fuentes Rojas, Paul Khairy

{"title":"Innovative Management of Rhythm Disorders in Adults with Congenital Heart Disease.","authors":"Stephanie Fuentes Rojas, Paul Khairy","doi":"10.14797/mdcvj.1736","DOIUrl":"10.14797/mdcvj.1736","url":null,"abstract":"Adults with congenital heart disease (ACHD) represent a rapidly growing patient population that is uniquely predisposed to rhythm disturbances. Arrhythmia mechanisms are shaped by congenital anatomy, prior surgical repairs, and progressive chamber remodeling, necessitating lesion-specific strategies. Intra-atrial reentrant tachycardia remains the dominant atrial rhythm disturbance in repaired or surgically modified atria, whereas atrial fibrillation is increasingly encountered with advancing age. While pulmonary vein isolation using pulsed field ablation has entered clinical practice, extra-pulmonary triggers and extensive atrial disease pose unique challenges in ACHD. Ventricular tachycardia in repaired tetralogy of Fallot predominantly arises from slow-conducting anatomical isthmuses. Ongoing studies are evaluating whether preventive isthmus ablation at the time of pulmonary valve replacement reduces subsequent arrhythmic risk. Intraoperative conduction mapping has emerged as a powerful tool to identify the His-Purkinje system in real-time during congenital surgery, reducing postoperative atrioventricular block. Device therapy is evolving toward conduction system pacing as a physiologic strategy across a broader spectrum of congenital heart disease subtypes, along with selective use of subcutaneous defibrillators and leadless devices. Risk prediction and sudden death prevention are being refined by the integration of genetics, application of artificial intelligence, and personalized digital twin models. Together, these innovations herald a future of substrate-guided and mechanism-based arrhythmia management in ACHD. This review synthesizes the evidence underpinning these advances, outlines their clinical applications, and identifies priorities for future research aimed at reducing arrhythmia burden, sudden death risk, and long-term morbidity in this complex population.","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"22 3","pages":"108-123"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transcatheter Edge-to-Edge Repair in Adult Congenital Heart Disease: Anatomic Challenges, Device Adaptations, and Emerging Evidence. 成人先天性心脏病的经导管边缘到边缘修复：解剖学挑战，设备适应和新证据。

Methodist DeBakey cardiovascular journal Pub Date : 2026-06-30 eCollection Date: 2026-01-01 DOI: 10.14797/mdcvj.1840

Dhaval R Parekh

{"title":"Transcatheter Edge-to-Edge Repair in Adult Congenital Heart Disease: Anatomic Challenges, Device Adaptations, and Emerging Evidence.","authors":"Dhaval R Parekh","doi":"10.14797/mdcvj.1840","DOIUrl":"10.14797/mdcvj.1840","url":null,"abstract":"Atrioventricular valvular regurgitation (AVVR) is a principal determinant of morbidity and mortality in adults with congenital heart disease (ACHD), and surgical management carries substantial operative risk owing to prior sternotomies, distorted intracardiac anatomy, impaired ventricular function, and lesion-specific hemodynamic fragility. Transcatheter edge-to-edge repair (TEER)-using MitraClip or TriClip (Abbott) or PASCAL/PASCAL ACE (Edwards Lifesciences)-has emerged as a compelling alternative in high-surgical-risk acquired valvular disease and is rapidly expanding into ACHD. We review the anatomic substrate, device-specific technical considerations, preprocedural imaging requirements, and clinical evidence supporting TEER across the principal ACHD substrates: congenitally corrected transposition of the great arteries (TGA) with systemic tricuspid regurgitation, atrial switch repairs for dextro-TGA, atrioventricular septal defects, and single-ventricle Fontan circulations. We also address procedural challenges unique to ACHD, including venous access anomalies, altered transseptal geometry, absent conventional echocardiographic windows, and iatrogenic stenosis risk in morphologically abnormal valves. Multidisciplinary selection integrating ACHD structural expertise, advanced imaging, and procedural TEER experience is requisite for safe outcomes.","PeriodicalId":39207,"journal":{"name":"Methodist DeBakey cardiovascular journal","volume":"22 3","pages":"98-107"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0