Archives of Cardiovascular Diseases最新文献

{"title":"Transcatheter closure of ostium secundum atrial septal defects in 2253 children and adults: Early outcomes.","authors":"Grégoire Albenque, Estibaliz Valdeolmillos, Claire Foray, Marine Cachanado, Philippe Brenot, Benoît Gerardin, Lisa Guirgis, Emmanuelle Fournier, Sarah Cohen, Florence Lecerf, Mohamed Jaber, Joy Zoghbi, Bastien Provost, Régine Roussin, Emre Belli, Clément Batteux, Jérôme Petit, Sébastien Hascoët","doi":"10.1016/j.acvd.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.07.010","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter closure of ostium secundum atrial septal defect (osASD) has been the first-line treatment in most children and adults since the 2000s. Some major adverse events (MAE), such as aortic erosion, have been infrequently reported.</p><p><strong>Aims: </strong>To report early outcomes in different subgroups by age and investigate risk factors associated with MAE.</p><p><strong>Methods: </strong>This prospective, single-centre, cohort study included 2253 consecutive patients referred for transcatheter osASD with Amplatzer Septal Occluder (ASO) (Abbott®) between May 1998 and December 2021. Peri-procedural data associated with MAE at 1 month were investigated.</p><p><strong>Results: </strong>Of 2253 patients, 1388 (61.6%) were adults and 865 (38.4%) were children, including 38 (1.7%) who weighed<15kg. Mean±standard deviation osASD diameter was 18±7mm, 22.7% of patients had a deficient aortic rim and 0.9% had a deficient inferior vena cava rim. Procedural success was achieved in 98.1% (95% confidence interval [CI] 97.4-98.6%). A total of 32 peri-procedural MAE occurred in 31 patients (1.4%, 95% CI 0.9--1.9%) including 19 device embolizations (0.8%) and two cardiac erosions (0.1%). No peri-procedural deaths were reported. There were no significant differences in the incidence of MAE between age and weight subgroups. In univariate analysis, MAE were significantly associated with atrial arrhythmia history before the intervention (P=0.013), inferior vena cava rim deficiency (P<0.001), antero-inferior rim deficiency (P=0.004), absence of balloon sizing (P=0.026), larger prosthesis size (P=0.017), maximal atrial septal defect size/body surface area≥20mm/m² (P=0.008).</p><p><strong>Conclusion: </strong>Transcatheter osASD closure using ASO has a high procedural success rate across a broad population of children and adults, reinforcing that transcatheter osASD closure is the intervention of choice for a wide range of patients and osASD morphologies.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overall safety evaluation of the risk signals of sacubitril/valsartan: A postmarketing pharmacoepidemiology study from 2015 to 2024.","authors":"Xiangyu Li, Fang Yang, Lingjing Yuan, Tao Dong","doi":"10.1016/j.acvd.2025.06.077","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.077","url":null,"abstract":"<p><strong>Background: </strong>Sacubitril/valsartan is a widely used cardiovascular agent characterized by its dual inhibition of the renin-angiotensin-aldosterone system and neprilysin. However, existing evidence on the safety of sacubitril/valsartan is primarily limited to clinical studies; this results in an inability to provide a timely update on associated adverse events.</p><p><strong>Aim: </strong>To mine and systematically describe adverse events related to sacubitril/valsartan from September 2015 to June 2024 using the Food and Drug Administration Adverse Event Reporting System (FAERS) database.</p><p><strong>Methods: </strong>The reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network and multi-item gamma poisson shrinker methods were combined to detect risk signals in the FAERS database to identify potential associations between sacubitril/valsartan and adverse events.</p><p><strong>Results: </strong>A total of 95,132 adverse event reports with sacubitril/valsartan as the \"primary suspect\" were collected. A total of 588 preferred terms and 27 system organ categories were obtained. The proportion of serious adverse events was 49.11%. Notably, hypotension (n=10,338, reporting odds ratio 13.71, proportional reporting ratio 13.23, information component 3.60, empirical Bayes geometric mean 12.08) and throat clearing (n=1495, reporting odds ratio 132.46, proportional reporting ratio 131.75, information component 6.03, empirical Bayes geometric mean 65.44) exhibited the highest incidence and signal intensity, respectively. In addition, uncommon, but apparently strong adverse event signals were observed, such as dyspnoea paroxysmal nocturnal and brain natriuretic peptide decreased. Cardiac dysfunction (n=444, reporting odds ratio 26.55, proportional reporting ratio 26.50, information component 4.47, empirical Bayes geometric mean 22.13) and memory impairment (n=2134, reporting odds ratio 3.35, proportional reporting ratio 3.33, information component 1.71, empirical Bayes geometric mean 3.27) also showed strong adverse event signals, which were not included in the instructions.</p><p><strong>Conclusions: </strong>Psychiatric and neurological disorders, especially cardiac dysfunction and memory impairment, should be closely monitored in the clinical application of sacubitril/valsartan. At the same time, clinical professionals should be alert to the occurrence of adverse event signals not mentioned in the instructions, and take preventive measures to ensure the safety of clinical use.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic stenosis and peripheral artery disease: Impact on mortality following transcatheter aortic valve replacement.","authors":"Martin Faure, Louis Le Bivic, Marouane Boukhris, Andrea Cianci, Jean-David Blossier, Dounia Meddad, Lucie Chastaingt, Philippe Lacroix, Jérôme Jouan, Pierre-Marie Preux, Nicole Darodes, Victor Aboyans, Julien Magne","doi":"10.1016/j.acvd.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.07.009","url":null,"abstract":"<p><strong>Background: </strong>Due to common pathophysiology and shared risk factors, peripheral artery disease (PAD) is frequently present in patients with calcific aortic stenosis (AS). However, the prevalence of PAD in calcific AS and its prognostic impact require further investigation.</p><p><strong>Aims: </strong>To describe the prevalence of PAD in patients with advanced AS requiring intervention and assess the impact of PAD on overall long-term mortality among patients undergoing transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>All patients who underwent TAVR between 2014 and 2023 in our tertiary care centre were enrolled in a retrospective cohort. PAD was defined by the mention of a clinical diagnosis in medical records, significant arterial stenosis observed on the pre-procedural angio-computed tomography scan or a history of lower-limb revascularization.</p><p><strong>Results: </strong>Among the 904 included patients (median [interquartile range] age 84.2 (79.9-87.4) years, 54.4% male), 212 (23.5%) had PAD. Patients with PAD had a significantly higher risk of mortality compared to patients without PAD (mean 5-year survival 40.0%, 95% confidence interval [CI] 32.2-49.6 vs. 52.7%, 95% CI 47.8-58.1; P=0.008; adjusted hazard ratio [aHR] 1.31, 95% confidence interval [CI] 1.03-1.66; P=0.029). Among patients without coronary artery disease (CAD), those with PAD alone had an increased risk of mortality (aHR 1.50, 95% CI 1.03-2.21; P=0.037). Importantly, patients with PAD alone had significantly reduced survival compared to those with CAD alone (i.e. without PAD) (aHR 1.49, 95% CI 1.02-2.19; P=0.040). However, the survival of patients with both PAD and CAD did not significantly differ from those with CAD without PAD.</p><p><strong>Conclusion: </strong>PAD was independently associated with increased mortality in severe calcific AS. Importantly, this excess mortality among patients with PAD was not affected by the simultaneous presence of CAD. Similarly to patients with CAD, patients with AS and concomitant PAD should be considered at high risk of mortality.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of intensive cardiac care units over the past decade: A France nationwide observational database study comparing recent trends (2014–2023)","authors":"Hugo Guillermou ,&nbsp;Grégoire Mercier ,&nbsp;Eric Bonnefoy-Cudraz ,&nbsp;Clément Delmas ,&nbsp;François Roubille","doi":"10.1016/j.acvd.2025.02.013","DOIUrl":"10.1016/j.acvd.2025.02.013","url":null,"abstract":"<div><h3>Background</h3><div>The landscape of intensive cardiac care units has transformed greatly over recent decades, reflecting shifts in patient demographics, treatment modalities and healthcare practices. However, data characterizing these changes over time are limited.</div></div><div><h3>Aim</h3><div>To provide a detailed nationwide analysis of intensive cardiac care unit utilization in France.</div></div><div><h3>Methods</h3><div>This observational study analysed all intensive cardiac care unit admissions in France from 2014 to 2023, using data from the French national hospital discharge database (PMSI). Patient characteristics, admission patterns, procedures and outcomes were compared across years, contextualizing long-term changes in cardiac care.</div></div><div><h3>Results</h3><div>The study included 2,731,925 intensive cardiac care unit stays from 2014 to 2023. Long-term trends from 2014 showed a shift towards younger patients, shorter overall hospital stays (from 7.6 to 6.6<!--> <!-->days) and an increase in non-surgical interventions (from 41.4% to 49.0%). Heart failure prevalence increased slightly (from 27.9% to 31.9%), whereas acute coronary artery disease remained stable (39.4% in 2014 and 38.3% in 2023). The in-hospital death rate was consistent at around 4%.</div></div><div><h3>Conclusions</h3><div>This comprehensive analysis highlights important long-term shifts in patient profiles and treatment approaches over the past decade. These findings provide crucial data for optimizing acute cardiac care delivery and resource allocation in the evolving landscape of intensive cardiac care.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages 457-463"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of findings suspicious for severe congenital heart defects on fetal echocardiograms by an artificial intelligence-based software","authors":"Marilyne Levy ,&nbsp;Chloé Crosby ,&nbsp;Alisa Arunamata ,&nbsp;Jennifer Lam-Rachlin ,&nbsp;Miwa Geiger ,&nbsp;Bertrand Stos ,&nbsp;Malo de Boisredon ,&nbsp;Eric Askinazi ,&nbsp;Valentin Thorey ,&nbsp;Christophe Gardella ,&nbsp;Sheetal Patel","doi":"10.1016/j.acvd.2025.06.057","DOIUrl":"10.1016/j.acvd.2025.06.057","url":null,"abstract":"<div><h3>Introduction</h3><div>Prenatal detection of severe congenital heart defects (CHDs) is crucial for improving neonatal outcomes. However, identifying cardiac anomalies on prenatal ultrasounds remains challenging, contributing to consistently low detection rates globally.</div><div>We aim to evaluate the efficacy of an artificial intelligence (AI) software to detect examinations suspicious for severe CHD based on eight ultrasound findings during fetal echocardiography.</div></div><div><h3>Method</h3><div>We retrospectively included 193 fetal echocardiography examinations from singleton pregnancies, performed between 18 and 24 weeks of gestation at one pediatric cardiology center in the United States. The dataset included 84 exams with various forms of severe CHD confirmed postnatally and 108 exams without any cardiac abnormalities.</div><div>The AI-based software analyzes 4-chamber, LVOT and RVOT standard views on all grayscale 2D ultrasound clips to determine the presence of eight findings that may be associated with severe CHD: overriding artery, septal defect at the cardiac crux, abnormal relationship of the outflow tracts, enlarged cardiothoracic ratio, right-to-left ventricular size discrepancy, tricuspid-to-mitral valve annular size discrepancy, pulmonary-to-aortic valve annular size discrepancy and cardiac axis deviation. The presence of any of these findings would warrant increased attention by a fetal heart specialist.</div></div><div><h3>Results</h3><div>The AI detected on average 3.9 (95% CI, 3.5; 4.2) suspicious findings per case with severe CHD, significantly more than for cases with no cardiac abnormalities (0.02, 95% CI: 0; 0.04, <em>p</em> <!-->&lt;<!--> <!-->0.001). This difference was consistent across all major types of severe CHD (<span><span>Figure 1</span></span>). The software detected at least one suspicious finding in 82 of 84 cases with severe CHD. Among the 108 exams with no cardiac abnormalities, the AI identified 106 as having no findings present, while 2 cases were flagged with abnormal cardiac axis deviation. This resulted in a sensitivity for detecting severe CHD of 0.98 (95% CI, 0.92; 0.99) and a specificity of 0.98 (95% CI, 0.93; 0.99).</div></div><div><h3>Conclusion</h3><div>The AI software shows strong potential in distinguishing between severe CHD cases and cases with no cardiac abnormalities. Ultimately, AI assistance in detecting fetal ultrasounds at risk of severe CHD could enhance prenatal detection rates.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S278"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial strain abnormalities and history of life-threatening arrhythmia in corrected tetralogy of Fallot : A cardiac MRI analysis","authors":"Arthur Missana ,&nbsp;Nunes Ferreira ,&nbsp;Thomas Foulon ,&nbsp;Pascale Maragnes ,&nbsp;Cynthia Cousergue ,&nbsp;Michèle Hamon ,&nbsp;Fabien Labombarda","doi":"10.1016/j.acvd.2025.06.061","DOIUrl":"10.1016/j.acvd.2025.06.061","url":null,"abstract":"<div><h3>Introduction</h3><div>The objectives of this study were to examine left atrial (LA) function using cardiac MRI analysis in adult patients with corrected Tetralogy of Fallot (c-ToF) and to investigate the relationships between LA reservoir function and patient characteristics, especially history of life-threatening arrhythmia ((h-LTA) including sustained and non sustained ventricular tachycardia.</div></div><div><h3>Method</h3><div>39 c-ToF patients (27 males; age: 39<!--> <!-->±<!--> <!-->15 years; h-LTA, n<!--> <!-->=<!--> <!-->10) were included in this retrospective monocenter study. In addition to a standard cardiac MRI examination, LA strain analysis was performed to assess LA volume and function, including peak-positive LA strain (LAS-reservoir function).</div></div><div><h3>Results</h3><div>Patients with h-LTA tend to be older (46<!--> <!-->±<!--> <!-->17years <em>vs.</em> 39<!--> <!-->±<!--> <!-->13 years; <em>p</em> <!-->=<!--> <!-->0.06); had more history of pulmonary valve replacement (40% <em>vs.</em> 24%; <em>p</em> <!-->=<!--> <!-->0.03) and exhibited a significant longer QRS duration (167<!--> <!-->±<!--> <!-->19<!--> <!-->ms <em>vs.</em> 142<!--> <!-->±<!--> <!-->25<!--> <!-->ms; <em>p</em> <!-->&lt;<!--> <!-->0.001).</div><div>LAS was significantly lower in the group of patients with h-LTA (12.9<!--> <!-->±<!--> <!-->4% <em>vs.</em> 17.9<!--> <!-->±<!--> <!-->4.6%; <em>p</em> <!-->=<!--> <!-->0.01) while others MRI parameters, including left/right ventricular function and volumes, right atrial volumes and late gadolinium enhancement, did not differed between two groups.</div><div>Moderate inverted correlation was found between LAS and QRS duration (−0.43; <em>p</em> <!-->=<!--> <!-->0.005). Among tested parameters, LAS was the best predictor for h-LTA (AUC: 0.838; <em>p</em> <!-->&lt;<!--> <!-->0.001) especially best than QRS duration.</div><div>Analysis of intraobserver and interobserver variability demonstrated good agreement between observations for the LAS [ICC (95% confidence interval): 0.97 (0.94–0.98) and 0.84 (0.44–0.96), respectively]</div></div><div><h3>Conclusion</h3><div>Using cardiac MRI, we documented abnormal LA reservoir function in adult c-ToF patients. Further study is needed to determine how best to incorporate LAS reservoir function assessed by MRI, into multiparametric predictive models for LTA in c-ToF patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S280"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Index","authors":"","doi":"10.1016/S1875-2136(25)00421-8","DOIUrl":"10.1016/S1875-2136(25)00421-8","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages I16-I18"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing outcomes of active closure versus natural evolution in hemodynamically significant restrictive PmVSDs: Insights from the FRANCISCO cohort","authors":"Camille Gery ,&nbsp;Lisa Guirgis ,&nbsp;Jean-Benoît Thambo ,&nbsp;Ivan Bouzguenda ,&nbsp;Damien Bonnet ,&nbsp;Nadir Benbrik ,&nbsp;Laurence Cohen ,&nbsp;Charlotte Denis ,&nbsp;Stéphanie Douchin ,&nbsp;Samir Harchaoui ,&nbsp;Hadeed Khaled ,&nbsp;Eric Hery ,&nbsp;Ali Houeijeh ,&nbsp;Zakaria Jalal ,&nbsp;Diala Kraiche ,&nbsp;Bruno Lefort ,&nbsp;Nicolas Pangaud ,&nbsp;Clement Karsenty ,&nbsp;Raymond Haddad ,&nbsp;Sebastien Hascoet","doi":"10.1016/j.acvd.2025.06.050","DOIUrl":"10.1016/j.acvd.2025.06.050","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemodynamically significant restrictive perimembranous ventricular septal defects (PmVSDs) present management challenges, requiring a choice between active closure or watchful waiting. This study evaluates the early impact of these strategies on left ventricular (LV) dimensions, growth, functional status, and cardiovascular events.</div></div><div><h3>Method</h3><div>In the multicenter, prospective nationwide FRANCISCO cohort, 206 patients (aged<!--> <!-->&gt;<!--> <!-->1 year) with hemodynamically significant (LV end-diastolic diameter (LVEDD) z-score<!--> <!-->≥<!--> <!-->2), restrictive (without pulmonary arterial hypertension) PmVSDs were assigned to active shunt closure or natural evolution. LVEDD z-scores, body mass index (BMI) z-scores, NYHA/ROSS class, and cardiovascular events were collected over a 9 to 36-month follow-up period.</div></div><div><h3>Results</h3><div>Overall, 30.1% underwent active PmVSD closure while 69.9% followed natural evolution. Closed defects averaged 7.8<!--> <!-->mm, while those evolving naturally averaged 5.1<!--> <!-->mm (<em>p</em> <!-->&lt;<!--> <!-->0.001). Active shunt closure significantly reduced LVEDD z-scores from 3.3 to 1.1 (<em>p</em> <!-->&lt;<!--> <!-->0.001), and improved BMI z-scores and NYHA/ROSS class (both <em>p</em> <!-->&lt;<!--> <!-->0.001). In children under 3 years, BMI z-scores improved from −2.0 to −0.3 (<em>p</em> <!-->&lt;<!--> <!-->0.001) and NYHA/ROSS class from 1.5 to 1.0 (<em>p</em> <!-->=<!--> <!-->0.002). Natural evolution group saw a significant reduction in LVEDD z-scores from 2.7 to 2.0 (<em>p</em> <!-->&lt;<!--> <!-->0.001) without significant changes in BMI z-scores (<em>p</em> <!-->=<!--> <!-->0.384) or NYHA/ROSS class (<em>p</em> <!-->=<!--> <!-->0.332). Cardiovascular events occurred in 7.3% of patients (4.8% in the active closure group versus 8.3% in the natural evolution group, <em>p</em> <!-->=<!--> <!-->0.560) (<span><span>Figure 1</span></span>).</div></div><div><h3>Conclusion</h3><div>On early follow-up, active shunt closure significantly improves clinical outcomes, especially in larger defects and younger children, compared to natural evolution, with no significant difference in cardiovascular event incidence between the two strategies.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S274-S275"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis of operated truncus: A single-center experience","authors":"Chaima Ghorbel ,&nbsp;Kaouthar Hakim ,&nbsp;Rania Gargouri","doi":"10.1016/j.acvd.2025.06.013","DOIUrl":"10.1016/j.acvd.2025.06.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Common arterial trunk (CAT), a rare congenital cardiovascular anomaly characterized by a single arterial vessel originating from the heart that supplies systemic, pulmonary, and coronary circulations, accounts for 0.3–1% of congenital heart defects. Without early surgical correction, this lesion leads to progressive heart failure and irreversible pulmonary hypertension.</div></div><div><h3>Method</h3><div>A retrospective, longitudinal cohort analysis was conducted on 25 patients who underwent CAT repair at La Rabta University Hospital's Pediatric Cardiology Department (1983–2016). Data included preoperative diagnostics (transthoracic echocardiography, cardiac catheterization, CT angiography), surgical details, and postoperative follow-up (median: 16 years). Outcomes were analyzed using Kaplan-Meier survival curves and descriptive statistics.</div></div><div><h3>Results</h3><div>Cohort characteristics: Median age at admission: 60 days (IQR: 185 days; range: 1 day–6 years). Diagnostic concordance: Echocardiography confirmed CAT in 100% of cases, with anatomical subtype identification in 64% (16/25); advanced imaging (CT/catheterization) was required for 36% (9/25). Surgical intervention: Median age at repair: 14.16 months (range: 1–108 months). Anatomical concordance between imaging and intraoperative findings: 80%. Early outcomes: In-hospital mortality: 4% (1/25; septic shock). Major complications included truncal valve insufficiency (80%), cardiogenic shock (40%), nosocomial infection (40%), and severe pulmonary hypertension (28%). Long-term survival: Overall survival at 5 years: 87.5%. Late mortality: 24% (6/25; mean age: 9.5 years), predominantly cardiac-related (66.7%). Reinterventions: 44% (11/25) required reoperations (median follow-up: 16 years). Freedom from reintervention: 50% at 10 years. Primary indications: right ventricle-pulmonary artery conduit degeneration (44%), severe pulmonary insufficiency (16%), aortic valve dysfunction (11%), and infective endocarditis (5%).</div></div><div><h3>Conclusion</h3><div>Complete CAT repair confers excellent medium- and long-term survival, yet reinterventions—primarily for conduit degeneration and valvular dysfunction—remain inevitable. These findings underscore the necessity for lifelong surveillance and highlight the durability challenges of current surgical conduits.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S253-S254"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Infarction in a 17-Year-Old Patient diagnosed with MPOD II syndrome","authors":"Julie Karila Cohen ,&nbsp;Cecilia Clarac ,&nbsp;Damien Bonnet","doi":"10.1016/j.acvd.2025.06.038","DOIUrl":"10.1016/j.acvd.2025.06.038","url":null,"abstract":"<div><h3>Introduction</h3><div>Microcephalic Osteodysplastic Primordial Dwarfism (MOPD) syndrome type 2, caused by a mutation in the PCNT gene (21q22.3), is a rare autosomal recessive disorder. Patients often present with bone dysplasia, dental anomalies, insulin resistance leading to diabetes, chronic kidney diseases, and cardiac malformations, making them prone to vascular diseases. Cardiomyopathy, hypertension, and coronary diseases are documented. The prognosis is strongly associated with cerebrovascular complications.</div></div><div><h3>Method</h3><div>We report case of a patient with MOPD type II who suffered an inferior myocardial infarction hospitalized in our institution. Informed consent for publishing patient information and images was obtained from the patient's parents.</div></div><div><h3>Results</h3><div>A 17-year-old female with MPOD II syndrome, weighing 20 kilograms and with a height of 86 centimeters, was referred for chest pain. She exhibited typical disease-related features. Thoracic pains had been occurring for over a month, increasing in intensity, with an episode prompting emergency consultation. Initial tests revealed elevated troponin and an inflammatory response. ECG showed ST-segment depression and elevation. Echocardiography revealed hypokinetic inferior walls with moderate concentric hypertrophy. Coronary CT scan showed subendocardial hypodensity. Diagnostic coronary angiography revealed tri-branch lesions and almost complete stenoses or occlusions on the circumflex artery (<span><span>Figure 1</span></span>). No indication for interventional treatment due to diffuse atheromatous lesions. Exclusive medical treatment was initiated.</div></div><div><h3>Conclusion</h3><div>MPOD II syndrome is associated with cardiac malformations and neurovascular complications, including myocardial infarction. Despite the infrequency of coronary syndrome at this age, regular electrocardiogram monitoring is advisable. Active surveillance for coronary diseases is necessary from adolescence onward. Recognizing this complication allows for prompt intervention at the onset of initial clinical signs. This case highlights the need for specific monitoring and prompt management of chest pain in patients with MPOD II syndrome. Primary prevention could mitigate the occurrence of coronary events in this high-risk population.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S267-S268"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}