Archives of Cardiovascular Diseases最新文献

{"title":"Long-term follow-up of adults with Fontan circulation: Predictors of death or transplantation","authors":"Candice Oger, Ghita Afilal, Gilles Soulat, Pauline David, Caroline Ghanime, Alexis Barat, Antoine Legendre, Anne-Solene Chaussade, Elie Mousseaux, Victor Waldmann, Laurence Iserin, Mathieu Albertini","doi":"10.1016/j.acvd.2026.06.013","DOIUrl":"10.1016/j.acvd.2026.06.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Adults with congenital heart disease who underwent Fontan palliation are at increased risk of premature death and heart transplantation. Identifying factors associated with these events is essential to improve risk stratification and guide timely referral for advanced heart failure management. The Brompton score has been proposed as a risk stratification tool in Fontan patients, but its external validity remains uncertain.</div></div><div>Adults with congenital heart disease who underwent Fontan palliation are at increased risk of premature death and heart transplantation. Identifying factors associated with these events is essential to improve risk stratification and guide timely referral for advanced heart failure management. The Brompton score has been proposed as a risk stratification tool in Fontan patients, but its external validity remains uncertain.</div><div><h3>Methods</h3><div>We conducted a retrospective, observational, single-center study including all consecutive patients with a Fontan circulation followed at a tertiary referral center. The primary endpoint was a composite of all-cause death and heart transplantation. Event-free survival was assessed using Kaplan–Meier analysis, and factors associated with the primary endpoint were evaluated using Cox proportional hazards models. The secondary objective was to assess the external validity of the Brompton score through calibration analyses.</div></div><div>We conducted a retrospective, observational, single-center study including all consecutive patients with a Fontan circulation followed at a tertiary referral center. The primary endpoint was a composite of all-cause death and heart transplantation. Event-free survival was assessed using Kaplan–Meier analysis, and factors associated with the primary endpoint were evaluated using Cox proportional hazards models. The secondary objective was to assess the external validity of the Brompton score through calibration analyses.</div><div><h3>Results</h3><div>A total of 163 patients were included. Median age at baseline was 25 years (IQR 21–30), and median follow-up in the validation cohort was 7.40 years (IQR 3.60–13.59). Thirty-one patients reached the primary endpoint. Freedom from death or transplantation was 88.6% (95% CI 83.5–94.1) at 5 years, 78.7% (95% CI 71.6–86.6) at 10 years, and 77.0% (95% CI 69.4–85.5) at 15 years (<span><span>Fig. 1</span></span>). In univariable analysis, age<!--> <!-->><!--> <!-->30 years (HR 3.23; 95% CI 1.57–6.62; <em>P</em> <!-->=<!--> <!-->0.0014), history of supraventricular tachycardia (HR 2.57; 95% CI 1.27–5.22; <em>P</em> <!-->=<!--> <!-->0.0086), history of heart failure requiring chronic diuretic therapy (HR 3.68; 95% CI 1.78–7.61; <em>P</em> <!-->=<!--> <!-->0.00045), severe ventricular dysfunction (HR 35.25; 95% CI 10.10–123.01; <em>P</em> <!--><<!--> <!-->0.001), moderate-to-severe atrioventricular valve regurgitation, reduced peak VO<sub>2</sub>, and abnorma","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages S244-S245"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816003","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":"Assessment of aortic isthmus flow as a prenatal predictor of severity in tricuspid valve abnormalities","authors":"Chloé Wanert, Marie-Josée Raboisson, Imen Ben Ali, Camilo Lopez Ibarra","doi":"10.1016/j.acvd.2026.06.068","DOIUrl":"10.1016/j.acvd.2026.06.068","url":null,"abstract":"<div><h3>Introduction</h3><div>Tricuspid valve (TV) abnormalities, including Ebstein's anomaly and TV dysplasia, are rare congenital heart deseases (< 1% of CHD). Tricuspid regurgitation (TR) often worsens in the second trimester due to increased fetal cardiac output and right heart dominance and postnatal prognosis remains challenging. The Isthmic Systolic Index (ISI), reflecting right- and left-heart contributions in the aortic isthmus, may indicate disease progression. ISI was derived from the ratio Ns (Systolic Nadir)/PSV (Peak Systolic Velocity). In severe TR, reduced right ventricular output lowers the systolic nadir, leading to increased ISI as TR severity advances.</div></div><div>Tricuspid valve (TV) abnormalities, including Ebstein's anomaly and TV dysplasia, are rare congenital heart deseases (< 1% of CHD). Tricuspid regurgitation (TR) often worsens in the second trimester due to increased fetal cardiac output and right heart dominance and postnatal prognosis remains challenging. The Isthmic Systolic Index (ISI), reflecting right- and left-heart contributions in the aortic isthmus, may indicate disease progression. ISI was derived from the ratio Ns (Systolic Nadir)/PSV (Peak Systolic Velocity). In severe TR, reduced right ventricular output lowers the systolic nadir, leading to increased ISI as TR severity advances.</div><div><h3>Objective</h3><div>To demonstrate a difference in the ISI between fetuses with TV abnormalities associated with poor prognosis versus those with a more favorable outcome.</div></div><div>To demonstrate a difference in the ISI between fetuses with TV abnormalities associated with poor prognosis versus those with a more favorable outcome.</div><div><h3>Methods</h3><div>This multicenter retrospective study in Québec, Canada (13 years) includes all fetuses with TV abnormalities, excluding those with major CHD, extracardiac malformations, or any fetal conditions affecting isthmic flow. Fetal echocardiography, maternal records, and postnatal outcomes will be reviewed to assess prognostic factors for TV disease severity. Severe or poor prognosis will be defined in utero by hydrops, intrauterine death, or medical termination of pregnancy, and postnatally by neonatal death, univentricular physiology, or subsequent mortality.</div></div><div>This multicenter retrospective study in Québec, Canada (13 years) includes all fetuses with TV abnormalities, excluding those with major CHD, extracardiac malformations, or any fetal conditions affecting isthmic flow. Fetal echocardiography, maternal records, and postnatal outcomes will be reviewed to assess prognostic factors for TV disease severity. Severe or poor prognosis will be defined in utero by hydrops, intrauterine death, or medical termination of pregnancy, and postnatally by neonatal death, univentricular physiology, or subsequent mortality.</div><div><h3>Expected results</h3><div>Approximately 60 patients will be included across three centers, with 1–3 echocardiog","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S272"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816057","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":"Tele-proctoring for device closure of patent ductus arteriosus in extremely low-birth-weight infants","authors":"Alban-Elouen Baruteau, Gérald Laforest, Jean-Bernard Selly, Nadir Benbrik, Pierre Bourgoin, Yael Lévy","doi":"10.1016/j.acvd.2026.06.053","DOIUrl":"10.1016/j.acvd.2026.06.053","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcatheter closure of patent ductus arteriosus (TC-PDA) has become a safe alternative to surgical ligation in premature infants. Current guidelines recommend an experienced onsite physician proctoring initial cases, as procedural complications may have catastrophic consequences. Appropriate onsite mentoring is difficult in remote centers.</div></div><div>Transcatheter closure of patent ductus arteriosus (TC-PDA) has become a safe alternative to surgical ligation in premature infants. Current guidelines recommend an experienced onsite physician proctoring initial cases, as procedural complications may have catastrophic consequences. Appropriate onsite mentoring is difficult in remote centers.</div><div><h3>Methods</h3><div>La Réunion University Hospital is a French congenital heart disease (CHD) center located 10.000-km away from mainland France, without expert TC-PDA proctor within close distance. Cases were performed with the remote mentoring of an echographer and an interventionist proctor who were conferenced into the operating room using Medinbox, a secure platform allowing bidirectional audio communication and real-time high-quality streaming of imaging guidance modalities (<span><span>Fig. 1</span></span>). A retrospective study was conducted to report our experience in tele-proctored TC-PDA in<!--> <!--><<!--> <!-->2000-grams infants between 2022 and 2025.</div></div><div>La Réunion University Hospital is a French congenital heart disease (CHD) center located 10.000-km away from mainland France, without expert TC-PDA proctor within close distance. Cases were performed with the remote mentoring of an echographer and an interventionist proctor who were conferenced into the operating room using Medinbox, a secure platform allowing bidirectional audio communication and real-time high-quality streaming of imaging guidance modalities (<span><span>Fig. 1</span></span>). A retrospective study was conducted to report our experience in tele-proctored TC-PDA in<!--> <!--><<!--> <!-->2000-grams infants between 2022 and 2025.</div><div><h3>Results</h3><div>Tele-proctored TC-PDA was performed in 11 symptomatic infants (median gestational age: 26 weeks [Q1–Q3: 25–27], birth weight: 850 grams [Q1–Q3: 715–920]), at a procedural age of 25 days [Q1–Q3: 22–27] and weight of 1200 grams [Q1–Q3: 1000–1450], including an 880-grams and a 950-grams infant under high-frequency jet ventilation. PDAs were large (diameter: 3.6<!--> <!-->mm [Q1–Q3: 2.9–3.8]), with a length of 7<!--> <!-->mm [Q1–Q3: 6–9], and hemodynamically significant according to clinical and echocardiographic criteria. They were closed using an 4/2 Amplatzer Piccolo Occluder (APO, Abbott, USA) in 5 patients, a 5/2 APO in 5, and a 6-mm Amplatzer Vascular Plug-II (Abbott, USA) in 1.Procedural success was achieved in 11/11 cases. Postprocedural echocardiography showed non-increased LPA and DAo flow velocities (Vmax: 1.6<!--> <!-->m/s [Q1–Q3: 1.4–1.8] and 1.1<!--> ","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S264"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815847","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":"Outcomes of transcatheter patent ductus arteriosus closure in infants weighing 2 to 6 kg","authors":"Paul Padovani, Sophie Malekzadeh-Milani, Kothandam Sivakumar, Thomas Goronflot, Mathilde Méot, Matthew Jones, Caroline Ovaert, Sebastien Hascoet, Zakaria Jalal, Carles Bautista-Rodriguez, Gianfranco Butera, Shak Qureshi, Alain Fraisse, Gareth Morgan, Alban-Elouen Baruteau","doi":"10.1016/j.acvd.2026.06.047","DOIUrl":"10.1016/j.acvd.2026.06.047","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcatheter patent ductus arteriosus (PDA) closure is safe in<!--> <!--><<!--> <!-->2<!--> <!-->kg infants and in<!--> <!-->≥<!--> <!-->6<!--> <!-->kg patients, but major safety concerns remain when applied to the intermediate weight range. We aimed to assess outcomes of transcatheter PDA closure in 2 to 6<!--> <!-->kg infants.</div></div><div>Transcatheter patent ductus arteriosus (PDA) closure is safe in<!--> <!--><<!--> <!-->2<!--> <!-->kg infants and in<!--> <!-->≥<!--> <!-->6<!--> <!-->kg patients, but major safety concerns remain when applied to the intermediate weight range. We aimed to assess outcomes of transcatheter PDA closure in 2 to 6<!--> <!-->kg infants.</div><div><h3>Methods</h3><div>An international, multicentre, retrospective cohort study was conducted in 31 tertiary hospitals in 17 countries between 2000 and 2023, investigating all infants who underwent attempted transcatheter PDA closure with a procedural weight of 2 to 6<!--> <!-->kg.</div></div><div>An international, multicentre, retrospective cohort study was conducted in 31 tertiary hospitals in 17 countries between 2000 and 2023, investigating all infants who underwent attempted transcatheter PDA closure with a procedural weight of 2 to 6<!--> <!-->kg.</div><div><h3>Results</h3><div>Attempted transcatheter PDA closure was performed in 1231 infants (median weight: 4747 grams Q1–Q3 [3700–5300]; median age: 132 days Q1–Q3 [83–194]; ex-preterm: <em>n</em> <!-->=<!--> <!-->581 [56.8%]) with a 95.0% success rate. A composite outcome of procedural failure or major adverse events was observed in 173 (14%) patients, including device embolization in 64 (3.7%), device-induced left pulmonary artery stenosis in 47 (2.7%) and procedural death in 2 (0.2%). Logistic regression model analysis identified a 2-to 3.9-kg procedural weight, increased pulmonary artery pressure, and window-type or tubular ductal morphologies as independent predictors of the composite outcome. Based on propensity score matching analysis, 2 to 3.9<!--> <!-->kg infants had a risk ratio of 2.19 (95%CI, 1.25–3.83) for experiencing the composite outcome, as compared to 4 to 5.9<!--> <!-->kg infants.</div></div><div>Attempted transcatheter PDA closure was performed in 1231 infants (median weight: 4747 grams Q1–Q3 [3700–5300]; median age: 132 days Q1–Q3 [83–194]; ex-preterm: <em>n</em> <!-->=<!--> <!-->581 [56.8%]) with a 95.0% success rate. A composite outcome of procedural failure or major adverse events was observed in 173 (14%) patients, including device embolization in 64 (3.7%), device-induced left pulmonary artery stenosis in 47 (2.7%) and procedural death in 2 (0.2%). Logistic regression model analysis identified a 2-to 3.9-kg procedural weight, increased pulmonary artery pressure, and window-type or tubular ductal morphologies as independent predictors of the composite outcome. Based on propensity score matching analysis, 2 to 3.9<!--> <!-->kg infants had a risk ratio of 2","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S261"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815925","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":"Very large devices for transcatheter closure of ostium secundum atrial septal defect: Higher procedural risk but comparable long-term outcomes","authors":"Grégoire Albenque, Mohamed Jaber, Estíbaliz Valdeolmillos, Jerome Petit, Clément Batteux, Sebastien Hascoet","doi":"10.1016/j.acvd.2026.06.055","DOIUrl":"10.1016/j.acvd.2026.06.055","url":null,"abstract":"<div><h3>Introduction</h3><div>Percutaneous closure of ostium secundum atrial septal defect (ASD) has become the standard of care for this condition. However, the management of very large ASDs remains less extensively studied, particularly regarding long-term outcomes. We aimed to assess peri-procedural and long-term outcomes following implantation of very large closure devices compared with smaller devices.</div></div><div>Percutaneous closure of ostium secundum atrial septal defect (ASD) has become the standard of care for this condition. However, the management of very large ASDs remains less extensively studied, particularly regarding long-term outcomes. We aimed to assess peri-procedural and long-term outcomes following implantation of very large closure devices compared with smaller devices.</div><div><h3>Methods</h3><div>We conducted a prospective, single-center cohort study including consecutive patients aged<!--> <!-->≥<!--> <!-->15<!--> <!-->years who underwent percutaneous ostium secundum ASD closure at Marie Lannelongue Hospital between 1998 and 2021. Peri-procedural and long-term outcomes were systematically collected. Patients were categorized according to implanted device size:<!--> <!-->≥<!--> <!-->34<!--> <!-->mm (very large device group) versus<!--> <!--><<!--> <!-->34<!--> <!-->mm. Comparative analyses were performed between groups.</div></div><div>We conducted a prospective, single-center cohort study including consecutive patients aged<!--> <!-->≥<!--> <!-->15<!--> <!-->years who underwent percutaneous ostium secundum ASD closure at Marie Lannelongue Hospital between 1998 and 2021. Peri-procedural and long-term outcomes were systematically collected. Patients were categorized according to implanted device size:<!--> <!-->≥<!--> <!-->34<!--> <!-->mm (very large device group) versus<!--> <!--><<!--> <!-->34<!--> <!-->mm. Comparative analyses were performed between groups.</div><div><h3>Results</h3><div>A total of 1497 patients were included, of whom 257 (17.1%) received a device<!--> <!-->≥<!--> <!-->34<!--> <!-->mm. Baseline clinical characteristics were similar between groups, except for a prior history of stroke/TIA, which was more frequent in the<!--> <!--><<!--> <!-->34<!--> <!-->mm group (OR 0.38 [0.18–0.80]; <em>P</em> <!-->=<!--> <!-->0.01). There were no significant differences in baseline electrocardiographic characteristics, including history of atrial arrhythmia (OR 1.15 [0.77–1.70]; <em>P</em> <!-->=<!--> <!-->0.50). During the peri-procedural period, patients receiving devices<!--> <!-->≥<!--> <!-->34<!--> <!-->mm had a significantly higher incidence of intra-procedural atrial arrhythmias (OR 5.90 [1.79–19.50]; <em>P</em> <!-->=<!--> <!-->0.003) and device embolization (OR 3.68 [1.25–10.70]; <em>P</em> <!-->=<!--> <!-->0.021). Over a mean follow-up of 10.0 years, no statistically significant differences were observed between groups in all-cause mortality (OR 0.97 [0.52–1.85]; <em>P</em> <!-->=<!--> <!-->1","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S265"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815927","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":"Optimizing the transfusion strategy in acute type A aortic dissection: A call for precision haemostasis","authors":"Brijesh Sathian, Javed Iqbal, Syed Muhammad Ali","doi":"10.1016/j.acvd.2025.07.008","DOIUrl":"10.1016/j.acvd.2025.07.008","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page 618"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008557","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":"Pulmonary valve–sparing repair of tetralogy of fallot with T-shaped infundibulotomy: Five-year follow-up results","authors":"Ramona Ghenghea, Yasmine Boumzebra, Paul Vignaud, Aitor Guitarte, Yves Dulac, Philippe Acar, Khaled Hadeed, Clement Karsenty, Bertrand Léobon","doi":"10.1016/j.acvd.2026.06.065","DOIUrl":"10.1016/j.acvd.2026.06.065","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulmonary valve (PV) preservation during Tetralogy of Fallot (TOF) repair remains challenging, particularly in patients with small pulmonary annuli. We previously described a standardized and reproducible pulmonary valve–sparing technique based on conservative management of the native valve to preserve its growth potential. We report the mid-term outcomes of the same cohort with extended follow-up.</div></div><div>Pulmonary valve (PV) preservation during Tetralogy of Fallot (TOF) repair remains challenging, particularly in patients with small pulmonary annuli. We previously described a standardized and reproducible pulmonary valve–sparing technique based on conservative management of the native valve to preserve its growth potential. We report the mid-term outcomes of the same cohort with extended follow-up.</div><div><h3>Methods</h3><div>Between July 2015 and December 2019, 23 consecutive children with regular TOF underwent repair using this technique in a single centre. Median age at surgery was 7 months (range: 4.5–150.4; IQR: 4.3) and median weight was 6.7<!--> <!-->kg (range: 4.8–24.0; IQR: 2.5). Nineteen patients (82%) had a bicuspid pulmonary valve. Median pulmonary annulus diameter was 7.0<!--> <!-->mm (range: 5.0–14.0; IQR: 2.5), with a median z-score of −2.5 (range: −4.9 to −0.02; IQR: −1.6). The technique combines T-shaped infundibulotomy to release the anterior annulus, extensive commissurotomy following ventricular septal defect closure, and right ventricular outflow tract (RVOT) remodeling using a shield-shaped bovine patch attached to the annulus, creating systolic traction.</div></div><div>Between July 2015 and December 2019, 23 consecutive children with regular TOF underwent repair using this technique in a single centre. Median age at surgery was 7 months (range: 4.5–150.4; IQR: 4.3) and median weight was 6.7<!--> <!-->kg (range: 4.8–24.0; IQR: 2.5). Nineteen patients (82%) had a bicuspid pulmonary valve. Median pulmonary annulus diameter was 7.0<!--> <!-->mm (range: 5.0–14.0; IQR: 2.5), with a median z-score of −2.5 (range: −4.9 to −0.02; IQR: −1.6). The technique combines T-shaped infundibulotomy to release the anterior annulus, extensive commissurotomy following ventricular septal defect closure, and right ventricular outflow tract (RVOT) remodeling using a shield-shaped bovine patch attached to the annulus, creating systolic traction.</div><div><h3>Results</h3><div>At discharge, all patients had pulmonary regurgitation (PR) less than moderate. After a median follow-up of 60.9 months (range: 8.4–105.1; IQR: 32.6), the median maximal gradient was 21.0<!--> <!-->mmHg (range: 9.0–46.2; IQR: 11.0), with only one patient having a gradient above 31.0<!--> <!-->mmHg (46.2<!--> <!-->mmHg), and all others below 31.0<!--> <!-->mmHg. At the latest follow-up, severe PR was observed in 4 patients (17%) and moderate PR in 2 patients (8%), while the remaining patients had PR less than moderate. No patient requ","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages S270-S271"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816046","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":"Atrial strain: An early marker of diastolic impairment in severe pediatric obesity","authors":"Ramona Ghenghea, Béatrice Jouret, Maité Tauber, Paul Vignaud, Philippe Acar, Khaled Hadeed, Céline Galès, Clement Karsenty","doi":"10.1016/j.acvd.2026.06.039","DOIUrl":"10.1016/j.acvd.2026.06.039","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiovascular diseases are the leading cause of death in Europe. Heart failure (HF) with preserved ejection fraction accounts for up to 50% of cases and is characterized by diastolic dysfunction despite preserved systolic function. Pediatric data on early diastolic alterations in high-risk populations, such as obese children and adolescents, remain limited.</div></div><div>Cardiovascular diseases are the leading cause of death in Europe. Heart failure (HF) with preserved ejection fraction accounts for up to 50% of cases and is characterized by diastolic dysfunction despite preserved systolic function. Pediatric data on early diastolic alterations in high-risk populations, such as obese children and adolescents, remain limited.</div><div><h3>Methods</h3><div>We analyzed transthoracic echocardiograms from 76 severe obese adolescents, including 27 girls (7 prepubertal and 20 pubertal) and 49 boys (18 prepubertal and 31 pubertal), from the OBEPEDIA cohort, France. The median age was 12.5 years (range: 3.9–16.9; IQR: 5). The median body mass index was 33.4<!--> <!-->kg/m<sup>2</sup> (range: 21.4–60.6; IQR: 8.3) with a <em>Z</em>-score of +4.7 (range: 2.0–10.9; IQR: 1.1). Systolic and diastolic ventricular and atrial function were assessed using two-dimensional transthoracic echocardiography.</div></div><div>We analyzed transthoracic echocardiograms from 76 severe obese adolescents, including 27 girls (7 prepubertal and 20 pubertal) and 49 boys (18 prepubertal and 31 pubertal), from the OBEPEDIA cohort, France. The median age was 12.5 years (range: 3.9–16.9; IQR: 5). The median body mass index was 33.4<!--> <!-->kg/m<sup>2</sup> (range: 21.4–60.6; IQR: 8.3) with a <em>Z</em>-score of +4.7 (range: 2.0–10.9; IQR: 1.1). Systolic and diastolic ventricular and atrial function were assessed using two-dimensional transthoracic echocardiography.</div><div><h3>Results</h3><div>Systolic function was preserved in both ventricles. The left ventricle (LV) showed a median ejection fraction of 64.0% (range: 50.0–73.0; IQR: 7.0) and a median end-diastolic volume of 47.6<!--> <!-->ml/m<sup>2</sup> (range: 6.5–78.8; IQR: 16.6). The right ventricle (RV) had a median S′ of 15.0<!--> <!-->cm/s (range: 10.0–23.0; IQR: 2.3). Conventional LV diastolic parameters were within normal ranges, with a median E/A of 1.7 (range: 0.8–3.1; IQR: 0.5), lateral E/e′ of 5.4 (range: 3.3–9.9; IQR: 1.9), and septal E/e′ of 6.9 (range: 3.9–11.6; IQR: 1.8). Atrial strain showed early diastolic dysfunction, with median values for the left atrium of LAS reservoir 35.0% (range: 20.0–43.0; IQR: 6.8), LAS conduit −24.9% (range: −9.0 to −36.0; IQR: −6.0), and LAS contractile −10% (range: −8.0 to −36.0; IQR: −5.0). RV and atrial strain were also reduced, with median RV GLS −19.8% (range: −16.2 to −21.3; IQR: −2.9), RV FWS −27.9% (range: −22.2 to −39.2; IQR: −4.1), RAS reservoir 32.0% (range: 14.0–48.0; IQR: 12.0), RAS conduit −23.0% (range: −10.0 to −39.0; IQR: −9.0), a","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S257"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816047","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":"Off-label use of the multifunctional occluder for transcatheter patent ductus arteriosus closure: An international experience","authors":"Alban-Elouen Baruteau, Caroline Ovaert, Sophie Malekzadeh-Milani, Thomas Krasemann, Stanimir Georgiev, Ali Houeijeh, Stéphanie Douchin, Peter Kramer, Céline Grunenwald, Sebastien Hascoet, Zakaria Jalal, Bruno Lefort, Inaki Navarro Castellanos, Stefan Schubert, Alain Fraisse","doi":"10.1016/j.acvd.2026.06.050","DOIUrl":"10.1016/j.acvd.2026.06.050","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcatheter patent ductus arteriosus (PDA) closure can be challenging in cases of large PDA, complex anatomy, and small patient size. We aimed to assess the feasibility, efficacy and safety of the off-label use of the multifunctional occluder (MFO) in transcatheter PDA closure.</div></div><div>Transcatheter patent ductus arteriosus (PDA) closure can be challenging in cases of large PDA, complex anatomy, and small patient size. We aimed to assess the feasibility, efficacy and safety of the off-label use of the multifunctional occluder (MFO) in transcatheter PDA closure.</div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients who underwent transcatheter PDA closure with the MFO in 14 pediatric cardiology centers (5 countries) from 2018 to 2025.</div></div><div>A retrospective analysis was conducted on patients who underwent transcatheter PDA closure with the MFO in 14 pediatric cardiology centers (5 countries) from 2018 to 2025.</div><div><h3>Results</h3><div>A total of 77 procedures were performed on 75 patients, including 5 adults (6.7%). Among the 70 children (93.3%) [median age: 0.8 years (range: 0.1–10 years), median procedural weight: 6.9<!--> <!-->kg (range: 2.1–32.0<!--> <!-->kg)], 35 (50.0%) weighed 6<!--> <!-->kg or less [median procedural weight: 4.0<!--> <!-->kg (range: 2.1–5.9<!--> <!-->kg)]. The PDA was large, with a minimal ductal diameter of 3.8<!--> <!-->mm (range: 1.5–7.0<!--> <!-->mm), short in 54.5%, and unrestrictive with increased pulmonary artery pressures in 51.6% patients. The morphology was predominantly conical (Krichenko type A: 51.9%), with window-type or complex morphologies representing 26.7% (Type B: 18.2%, Type D: 7.8%). Both arterial and venous femoral accesses were obtained in 87.0% cases, with deployment being antegrade in 77.9% and retrograde in 22.1%. Successful device deployment and release were achieved in 74 cases (96.1%). The rate of major adverse events was 5.2% including 1 early (1.3%) and 3 late complications (3.9%). No other adverse events were reported.</div></div><div>A total of 77 procedures were performed on 75 patients, including 5 adults (6.7%). Among the 70 children (93.3%) [median age: 0.8 years (range: 0.1–10 years), median procedural weight: 6.9<!--> <!-->kg (range: 2.1–32.0<!--> <!-->kg)], 35 (50.0%) weighed 6<!--> <!-->kg or less [median procedural weight: 4.0<!--> <!-->kg (range: 2.1–5.9<!--> <!-->kg)]. The PDA was large, with a minimal ductal diameter of 3.8<!--> <!-->mm (range: 1.5–7.0<!--> <!-->mm), short in 54.5%, and unrestrictive with increased pulmonary artery pressures in 51.6% patients. The morphology was predominantly conical (Krichenko type A: 51.9%), with window-type or complex morphologies representing 26.7% (Type B: 18.2%, Type D: 7.8%). Both arterial and venous femoral accesses were obtained in 87.0% cases, with deployment being antegrade in 77.9% and retrograde in 22.1%. Successful device deployment and release were ","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages S262-S263"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816094","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":"Can machine-learning algorithms replace clinical prediction rules for deep vein thrombosis diagnosis?","authors":"Elena-Mihaela Cordeanu, Dominique Stephan","doi":"10.1016/j.acvd.2026.03.119","DOIUrl":"10.1016/j.acvd.2026.03.119","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages 615-617"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724768","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}