Archives of Cardiovascular Diseases最新文献

{"title":"Mapping the care pathways during the final year of life for patients with complex chronic heart conditions, whether congenital or acquired: A paediatric observational study","authors":"Ashley Ridley, Fanny Bajolle, Sophie-Guiti Malekzadeh Milani, Olivier Raisky, Diala Khraiche, Daphne Madec, Damien Bonnet, Neil Derridj","doi":"10.1016/j.acvd.2026.06.025","DOIUrl":"10.1016/j.acvd.2026.06.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Complex chronic conditions (CCC) represent an increasing burden in pediatrics, reflecting both clinical progress and limits of curative care. Those with congenital or acquired heart disease (CAHD) account for the largest subgroup of CCC inpatient deaths. This study aimed to characterize healthcare utilization over the last year of life management and circumstances of death among children with CAHD.</div></div><div>Complex chronic conditions (CCC) represent an increasing burden in pediatrics, reflecting both clinical progress and limits of curative care. Those with congenital or acquired heart disease (CAHD) account for the largest subgroup of CCC inpatient deaths. This study aimed to characterize healthcare utilization over the last year of life management and circumstances of death among children with CAHD.</div><div><h3>Methods</h3><div>We conducted an observational study at Necker Children's Hospital (Paris, France). Patients aged 1–18 years with CAHD meeting criteria for CCC, with at least one year of follow-up after diagnosis, who died between 2013 and 2023 were included. Data were extracted from a prospectively maintained mortality database and electronic medical records. Collected variables included diagnostic categories, genetic and extracardiac comorbidities, healthcare utilization during the last year of life, end-of-life care, and circumstances of death.</div></div><div>We conducted an observational study at Necker Children's Hospital (Paris, France). Patients aged 1–18 years with CAHD meeting criteria for CCC, with at least one year of follow-up after diagnosis, who died between 2013 and 2023 were included. Data were extracted from a prospectively maintained mortality database and electronic medical records. Collected variables included diagnostic categories, genetic and extracardiac comorbidities, healthcare utilization during the last year of life, end-of-life care, and circumstances of death.</div><div><h3>Results</h3><div>A total of 190 patients were included. Congenital heart disease (CHD) accounted for 57.8% of diagnoses, followed by cardiomyopathies (18.8%), pulmonary arterial hypertension–related disease (10.9%), and rhythm disorders (12.5%). A prenatal diagnosis was documented in 45.3% of patients, predominantly in CHD (70.3%). Genetic syndromes or extracardiac anomaly were reported in 68.8%. During the last year of life, 86% were hospitalized (median cumulative stay 13 days), mainly for acute symptoms (45%) or scheduled procedures (48%). Catheterization (34%) and cardiac surgery (41%) were performed at a median of 38 days before death, with 52% intended to be curative. Care intensity increased markedly in the final two weeks, and 70% of deaths occurred in the ICU following active resuscitation (40%), withdrawal (13%), or non-escalation (12%) of life-sustaining treatment. At death, 41% were intubated, 11% received non-invasive ventilation, 33% inotropes, and 14% were supported with ECMO. Overall","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S251"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815828","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":"Thromboembolic and bleeding events in patients with Fontan circulation: A long-term follow-up study","authors":"Mathieu Albertini, Candice Oger, Pauline David, Caroline Ghanime, Alexis Barat, Antoine Legendre, Anne-Solene Chaussade, Pascal Lim, Laurence Iserin, Victor Waldmann","doi":"10.1016/j.acvd.2026.06.010","DOIUrl":"10.1016/j.acvd.2026.06.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Thrombosis and bleeding are specific risks in patients with a Fontan circulation, related to its unique physiology. The optimal thromboprophylaxis strategy in these patients remains debated throughout life. The aim of our study was to describe thromboembolic and major bleeding events and to identify risk factors and high-risk periods across the lifespan.</div></div><div>Thrombosis and bleeding are specific risks in patients with a Fontan circulation, related to its unique physiology. The optimal thromboprophylaxis strategy in these patients remains debated throughout life. The aim of our study was to describe thromboembolic and major bleeding events and to identify risk factors and high-risk periods across the lifespan.</div><div><h3>Methods</h3><div>We conducted a retrospective, observational, single-center study including the entire cohort of Fontan patients followed at a tertiary care center. All patients with a Fontan circulation under follow-up were included, and all relevant clinical events occurring throughout their lives were collected. The primary endpoint was a thromboembolic event. The secondary endpoint was a major bleeding event.</div></div><div>We conducted a retrospective, observational, single-center study including the entire cohort of Fontan patients followed at a tertiary care center. All patients with a Fontan circulation under follow-up were included, and all relevant clinical events occurring throughout their lives were collected. The primary endpoint was a thromboembolic event. The secondary endpoint was a major bleeding event.</div><div><h3>Results</h3><div>A total of 163 patients were included, with a median age of 33.47 years [28.01–41.66]; 96 (58.9%) were women. During follow-up, 24 thromboembolic events were recorded, including 12 thromboembolic events and 12 ischemic strokes, with a median age at event of 23.70 years [15.85–32.44]. No risk factors were identified other than the absence of thromboprophylactic treatment with vitamin K antagonists (<em>P</em> <!--><<!--> <!-->0.001) or aspirin (<em>P</em> <!--><<!--> <!-->0.001). Twenty-two major bleeding events occurred during follow-up, most commonly hemoptysis (8 events, 36.4%), with a median age at event of 27.40 years [24.11–33.40]. No significant increase in bleeding risk was observed with aspirin (<em>P</em> <!-->=<!--> <!-->0.55) or vitamin K antagonists (<em>P</em> <!-->=<!--> <!-->0.46) compared with no treatment (<span><span>Fig. 1</span></span>).</div></div><div>A total of 163 patients were included, with a median age of 33.47 years [28.01–41.66]; 96 (58.9%) were women. During follow-up, 24 thromboembolic events were recorded, including 12 thromboembolic events and 12 ischemic strokes, with a median age at event of 23.70 years [15.85–32.44]. No risk factors were identified other than the absence of thromboprophylactic treatment with vitamin K antagonists (<em>P</em> <!--><<!--> <!-->0.001) or aspirin (<em>P</em> <!-->&l","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages S242-S243"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815863","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":"Neurodevelopmental and mental health outcomes in congenital long QT syndrome","authors":"Sylvie Martins, Grégoire de La Villéon, Julie Deninotti, Helena Huguet, Marie-Christine Picot, Marie Vincenti, Luc Souilla, Damien Bonnet, Pascal Amédro, Johanna Calderon","doi":"10.1016/j.acvd.2026.06.072","DOIUrl":"10.1016/j.acvd.2026.06.072","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital long QT syndrome (LQTS) is a potentially life-threatening inherited heart rhythm disorder. Neuropsychiatric disorders are described in adults, but outcomes in children remain unknown. We investigated neurodevelopmental and mental health outcomes and their risk factors in children with LQTS.</div></div><div>Congenital long QT syndrome (LQTS) is a potentially life-threatening inherited heart rhythm disorder. Neuropsychiatric disorders are described in adults, but outcomes in children remain unknown. We investigated neurodevelopmental and mental health outcomes and their risk factors in children with LQTS.</div><div><h3>Methods</h3><div>This is a cross-sectional multicenter study. Mean scores for neuropsychological assessment (Full-Scale IQ, verbal comprehension, visual-spatial reasoning, working memory, fluid reasoning and processing speed), executive function, and symptoms of anxiety and depression were compared to normative values. The proportions with scores at-risk (<em>i.e.</em>, 1SD from the mean) were analyzed. Multivariate regression was applied to identify risk factors.</div></div><div>This is a cross-sectional multicenter study. Mean scores for neuropsychological assessment (Full-Scale IQ, verbal comprehension, visual-spatial reasoning, working memory, fluid reasoning and processing speed), executive function, and symptoms of anxiety and depression were compared to normative values. The proportions with scores at-risk (<em>i.e.</em>, 1SD from the mean) were analyzed. Multivariate regression was applied to identify risk factors.</div><div><h3>Results</h3><div>Twenty-three children with LQTS (mean age<!--> <!-->=<!--> <!-->11 years, 3.5 mo; 70% male) were enrolled. Despite normal cognitive scores including IQ (98.4<!--> <!-->±<!--> <!-->12.2, <em>p</em> <!-->=<!--> <!-->0.55) and executive functions, verbal skills were lower than expected (<em>i.e.</em>, Vocabulary, 8.9<!--> <!-->±<!--> <!-->2.2, <em>p</em> <!-->=<!--> <!-->0.02), with 26% of patients scoring at least 1SD below expected norms for verbal comprehension, and 31% for executive functioning. Anxiety and depression were frequent, particularly among females. Multivariable analyses showed that early age at LQTS diagnosis was related to higher cognitive risk (ORadj [95% CI]<!--> <!-->=<!--> <!-->0.98 [0.95;1.00]) and that older age at assessment was linked to higher executive function risks (ORadj [95% CI]<!--> <!-->=<!--> <!-->1.45 [0.99;2.12]). Finally, females were particularly vulnerable regarding mental health for both anxiety (54.7<!--> <!-->±<!--> <!-->8.5 <em>versus</em> 44.7<!--> <!-->±<!--> <!-->10.0, <em>p</em> <!-->=<!--> <!-->0.04) and depression (55.8<!--> <!-->±<!--> <!-->11.5 <em>versus</em> 41.9<!--> <!-->±<!--> <!-->10.3, <em>p</em> <!-->=<!--> <!-->0.04).</div></div><div>Twenty-three children with LQTS (mean age<!--> <!-->=<!--> <!-->11 years, 3.5 mo; 70% male) were enrolled. Despite normal cognitive scores including IQ (98","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S274"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816041","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":"Electrocardiographic phenotypes of a representative subset of the French general population: ECGs at inclusion in the CONSTANCES cohort","authors":"Fabrice Extramiana,&nbsp;Thien Vu Nguyen Minh Tuan,&nbsp;Martino Vaglio,&nbsp;Anna Ozguler,&nbsp;Peter W. Macfarlane,&nbsp;Pierre Maison-Blanche,&nbsp;Fabio Badilini","doi":"10.1016/j.acvd.2025.12.013","DOIUrl":"10.1016/j.acvd.2025.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Large electrocardiogram (ECG) dataset analyses have emerged as potential game-changers in the field of personalized predictive medicine. ECG parameters have been described in cohorts of apparently healthy subjects and from primary care but seldom in community-based representative populations.</div></div><div><h3>Aims</h3><div>To describe the ECG phenotypes of a representative subset of the adult French general population.</div></div><div><h3>Methods</h3><div>ECGs recorded at inclusion in the CONSTANCES cohort were automatically analysed using the Glasgow diagnostic algorithm. Extreme values and abnormal statements were adjudicated to detect false positives. A subset of ECGs that were classified as normal were also adjudicated to estimate false negative statements. The data obtained were used to describe the prevalence and distribution of quantitative parameters and diagnostic statements.</div></div><div><h3>Results</h3><div>We automatically analysed the ECGs of 143,763 subjects (54% female; mean<!--> <!-->±<!--> <!-->standard deviation age 47.0<!--> <!-->±<!--> <!-->13.5 years in females and 46.9<!--> <!-->±<!--> <!-->13.5 years in males; <em>P</em> <!-->=<!--> <!-->0.44) and adjudicated<!--> <!-->&gt;<!--> <!-->10,000 ECGs. We describe the distribution of automatic ECG interval measurements and the prevalence of different ECG statements provided by the automatic analysis, before and after adjudication. Heart rate and interval durations were dependent on both sex and age (ANOVA <em>P</em> <!-->&lt;<!--> <!-->0.0001). At the population level, the Fridericia formula appeared to be less biased than that of Bazett.</div></div><div><h3>Conclusions</h3><div>We describe the adjudicated ECG phenotypes of a representative subset of the adult French general population. The automated measurement and interpretation provided by the Glasgow algorithm proved highly efficient for epidemiological evaluation. This ECG phenotype characterization will open up the possibilities for cross-analyses, for artificial intelligence-based algorithm development and will serve as a reference to evaluate serial ECG changes during extended follow-up.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages 545-553"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576614","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":"Parental experience and perception of the neurodevelopmental risk and care in congenital heart disease","authors":"Marie Soulard,&nbsp;Oscar Werner,&nbsp;Olivier Cadeau,&nbsp;Amanda Guerra,&nbsp;Gaëlle Marguin,&nbsp;Nathalie Lucas,&nbsp;Astrid Monier,&nbsp;Jihed Laribi,&nbsp;Paul Padovani,&nbsp;Arnaud Roy,&nbsp;Alban-Elouen Baruteau","doi":"10.1016/j.acvd.2026.06.023","DOIUrl":"10.1016/j.acvd.2026.06.023","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Congenital heart disease (CHD) is a critical healthcare issue and the primary cause of birth defects. Neurodevelopmental disorders (NDD) are increasingly recognized as the main extra cardiac comorbidity, with significant practice variations in NDD screening and care across centers. We aimed to assess parental experience, which remains understudied.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Congenital heart disease (CHD) is a critical healthcare issue and the primary cause of birth defects. Neurodevelopmental disorders (NDD) are increasingly recognized as the main extra cardiac comorbidity, with significant practice variations in NDD screening and care across centers. We aimed to assess parental experience, which remains understudied.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A French nationwide, cross-sectional online survey was e-mailed to parents of CHD children in May–June 2025, exploring modalities and timing of disclosure of the neurodevelopmental risk, access to appropriate resources, care pathways, and parental perceptions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A French nationwide, cross-sectional online survey was e-mailed to parents of CHD children in May–June 2025, exploring modalities and timing of disclosure of the neurodevelopmental risk, access to appropriate resources, care pathways, and parental perceptions.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 293 parents who replied, 184 (62.3%) had a prenatal diagnosis, 189 (64.5%) a child with critical CHD and with an associated extra cardiac anomaly in 153 (52%). Most parents (56.3%; parents of critical CHD kids: 49.7%) declared being unaware of the NDD risk, whilst an appropriate information had been delivered by healthcare providers in 127 (43.3%), although 83% of them never received documentation, guidance or contact of patients’ advocacy work. Of the 290 (99%) parents who would have liked to be informed on the neurodevelopmental risk, 37.5% would have liked receiving this information antenatally, 25.6% postnatally but preoperatively, 27.3% postoperatively and 28% later on along the follow-up. Neurodevelopmental delay or NDD was diagnosed in 120/210 (44%) CHD children aged 3 years-old, including 77/189 (40.7%) critical CHD children; 11/120 (9.2%) were actually followed in a multidisciplinary perinatal healthcare network; 75% reported that their child's NDD care was not coordinated by a given healthcare provider, although 48% believed this role should remain to their referring pediatric cardiologist. Overall, 71% parents felt the quality of the delivered information was insufficient, whilst 54% disclosed this announcement has had a major/massive impact on their daily life.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Of the 293 parents who replied, 184 (62.3%) had a prenatal diagnosis, 189 (64.5%) a child with critical CHD and with an associated extra cardiac anomaly in 153 (52%). Most parents (56.3%; parents of critical CHD kids: 49.7%) declared being unaware of the NDD risk, whilst an appropriate information had been delivered by healthcare pr","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S250"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815638","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":"Percutaneous atrial septal defect closure using a modified guidewire-free technique at bedside in preterm and infants under 5 kg with pulmonary hypertension","authors":"Florence Mycinski,&nbsp;Kevin Leduc,&nbsp;Mona Kettroussi,&nbsp;Olivia Domanski,&nbsp;Gaelle Mazeau,&nbsp;Alexandre Delarue,&nbsp;Maxime Lemaitre,&nbsp;Laurent Storme,&nbsp;François Godart,&nbsp;Ali Houeijeh","doi":"10.1016/j.acvd.2026.06.052","DOIUrl":"10.1016/j.acvd.2026.06.052","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Atrial septal defect (ASD) incidence is more frequent in preterm infants and is associated with an increased risk of bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH). In this population, ASD closure is controversial because of high procedural risks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Atrial septal defect (ASD) incidence is more frequent in preterm infants and is associated with an increased risk of bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH). In this population, ASD closure is controversial because of high procedural risks.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;To describe a novel modified percutaneous technique for ASD closure at bedside in preterm infants with BPD and PH presenting with a significant left-to-right shunt.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To describe a novel modified percutaneous technique for ASD closure at bedside in preterm infants with BPD and PH presenting with a significant left-to-right shunt.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective monocentric study included infants with PH who underwent percutaneous ASD closure with the modified technique. Device size was selected before the intervention according to the largest ASD transthoracic echocardiographic diameter plus 1&lt;!--&gt; &lt;!--&gt;mm. Four interventions were performed in the cathlab and three in the NICU under mobile Fluoroscopy. Through the femoral vein, a 45-cm, 45°, 6-Fr Destination sheath (Terumo, Japan) was advanced into the inferior vena cava to its junction to the right atrium. A 60-cm, 4-Fr multipurpose catheter was then advanced under echocardiographic and fluoroscopic guidance into the left atrium. The sheath was subsequently advanced over the catheter, avoiding intracardiac use of a 0.035-inch guidewire in these fragile patients. The device was deployed in the standard technique under echocardiographic guidance mainly.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A retrospective monocentric study included infants with PH who underwent percutaneous ASD closure with the modified technique. Device size was selected before the intervention according to the largest ASD transthoracic echocardiographic diameter plus 1&lt;!--&gt; &lt;!--&gt;mm. Four interventions were performed in the cathlab and three in the NICU under mobile Fluoroscopy. Through the femoral vein, a 45-cm, 45°, 6-Fr Destination sheath (Terumo, Japan) was advanced into the inferior vena cava to its junction to the right atrium. A 60-cm, 4-Fr multipurpose catheter was then advanced under echocardiographic and fluoroscopic guidance into the left atrium. The sheath was subsequently advanced over the catheter, avoiding intracardiac use of a 0.035-inch guidewire in these fragile patients. The device was deployed in the standard technique under echocardiographic guidance mainly.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Seven infants were included between 2020 and 2026. Median age at intervention was 104 days (36–214) and median weight 3.8&lt;!--&gt; &lt;!--&gt;kg (2.7–5.0). Median ASD diameter was 7&lt;!--&gt; &lt;!--&gt;mm (6–9). Procedural success was 100%. N","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages S263-S264"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815846","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":"Optivenosus study: 6 months follow up comparing transcatheter and surgical therapy of sinus venosus defects","authors":"Clement Batteux,&nbsp;Grégoire Albenque,&nbsp;Nicolas Combes,&nbsp;Philippe Aldebert,&nbsp;Clement Karsenty,&nbsp;Bruno Lefort,&nbsp;Ali Houeijeh,&nbsp;François Godart,&nbsp;Roland Henaine,&nbsp;Ivan Bouzguenda,&nbsp;Hélène Bouvaist,&nbsp;Marien Lenoir,&nbsp;Vlad Ciobotaru,&nbsp;Damien Bonnet,&nbsp;Alain Fraisse,&nbsp;Jurgen Hoerer,&nbsp;Guillaume Reverdito,&nbsp;Régine Roussin,&nbsp;Sebastien Hascoet","doi":"10.1016/j.acvd.2026.06.009","DOIUrl":"10.1016/j.acvd.2026.06.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The OPTIVENOSUS study evaluates the efficacy and safety of percutaneous correction of sinus venosus defects (SVD) using covered stents compared with the surgical gold standard. The primary objective was to assess a composite endpoint combining complete shunt closure and absence of major adverse events.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;The OPTIVENOSUS study evaluates the efficacy and safety of percutaneous correction of sinus venosus defects (SVD) using covered stents compared with the surgical gold standard. The primary objective was to assess a composite endpoint combining complete shunt closure and absence of major adverse events.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This is a prospective, multicenter, comparative study. Surgery was considered first-line treatment, while catheter-based intervention was proposed for patients deemed ineligible for surgery and with favorable anatomy. The primary endpoint at 6 months combined efficacy (complete shunt closure) and safety (absence of death or surgical conversion). Secondary endpoints included reduction in right ventricular end-diastolic volume (RVEDV) and absence of major complications (reintervention, stroke, or conduction disorders requiring pacemaker implantation).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;This is a prospective, multicenter, comparative study. Surgery was considered first-line treatment, while catheter-based intervention was proposed for patients deemed ineligible for surgery and with favorable anatomy. The primary endpoint at 6 months combined efficacy (complete shunt closure) and safety (absence of death or surgical conversion). Secondary endpoints included reduction in right ventricular end-diastolic volume (RVEDV) and absence of major complications (reintervention, stroke, or conduction disorders requiring pacemaker implantation).&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;At 6 months postoperative, fifty-eight patients were analyzed (30 catheter-based, 28 surgical). The primary endpoint was achieved in 93.1% of the catheter group versus 100% of the surgical group, with no significant difference (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.49). After adjustment for age, oxygen saturation, arrhythmia history, pulmonary hypertension, and heart failure, no significant difference was observed (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;0.99). Complete shunt closure was obtained in 27 patients in the catheter group and in all patients in the surgical group. A&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;20% reduction in RVEDV was observed in 92.6% and 96.2% of patients, respectively (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;0.99). No reintervention, stroke, or conduction disorder requiring pacemaker implantation occurred in 100% of the catheter group and 96.4% of the surgical group (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.49), with one reintervention reported in the surgical arm. No death or surgical conversion occurred in the percutaneous group. Residual shunts in the catheter group were infrequent and were related to anatomical constraints at the cavo-atrial junction.&lt;/div&gt;&lt;/d","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S242"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815862","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":"Systematic review and meta-analysis of clinical scientific evidences on self-expanding percutaneous pulmonary valve implantation","authors":"Carlo Barsali,&nbsp;Chinali Marcello,&nbsp;Mara Pilati,&nbsp;Claudia Montanaro,&nbsp;Micol Rebonato,&nbsp;Enrico Piccinelli,&nbsp;Gianfranco Butera","doi":"10.1016/j.acvd.2026.06.058","DOIUrl":"10.1016/j.acvd.2026.06.058","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Percutaneous pulmonary valve implantation (PPVI) is an option for dysfunctional right ventricular outflow tract (RVOT) in patients with native or surgically repaired anatomies. Several self-expanding valve platforms, including Venus-P-Valve, Alterra Harmony and Pulsta, all with different frame geometries and anchoring strategies are now available. But nowadays comparative data remain limited. The aim of the study is to systematically evaluate procedural success, early, mid-term, and late outcomes of self-expanding PPVI systems and to explore differences in complication profiles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Percutaneous pulmonary valve implantation (PPVI) is an option for dysfunctional right ventricular outflow tract (RVOT) in patients with native or surgically repaired anatomies. Several self-expanding valve platforms, including Venus-P-Valve, Alterra Harmony and Pulsta, all with different frame geometries and anchoring strategies are now available. But nowadays comparative data remain limited. The aim of the study is to systematically evaluate procedural success, early, mid-term, and late outcomes of self-expanding PPVI systems and to explore differences in complication profiles.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A systematic review and meta-analysis was conducted including clinical studies reporting outcomes of self-expanding PPVI. Articles published between 2000 and 2025 were identified through database searches. Patients with congenital heart disease undergoing PPVI for regurgitation and/or stenosis of the RVOT were eligible. Primary endpoints were procedural success and major complications rate. Secondary endpoints included total complications. The complications were stratified as early (&lt;&lt;!--&gt; &lt;!--&gt;30 days), mid-term (30 days–1&lt;!--&gt; &lt;!--&gt;year) and late (&gt;&lt;!--&gt; &lt;!--&gt;1 year). Pooled proportions were calculated using a random-effects model with logit transformation and continuity correction for rare events. Heterogeneity was assessed using &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; and &lt;em&gt;τ&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A systematic review and meta-analysis was conducted including clinical studies reporting outcomes of self-expanding PPVI. Articles published between 2000 and 2025 were identified through database searches. Patients with congenital heart disease undergoing PPVI for regurgitation and/or stenosis of the RVOT were eligible. Primary endpoints were procedural success and major complications rate. Secondary endpoints included total complications. The complications were stratified as early (&lt;&lt;!--&gt; &lt;!--&gt;30 days), mid-term (30 days–1&lt;!--&gt; &lt;!--&gt;year) and late (&gt;&lt;!--&gt; &lt;!--&gt;1 year). Pooled proportions were calculated using a random-effects model with logit transformation and continuity correction for rare events. Heterogeneity was assessed using &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; and &lt;em&gt;τ&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Fifty-two studies comprising 1404 patients were included. Most patients were repaired Tetralogy of Fall","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S266"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815931","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":"Predictors of late atrial arrhythmia after transcatheter osASD closure","authors":"Grégoire Albenque,&nbsp;Mohamed Jaber,&nbsp;Marine Cachanado,&nbsp;Clément Batteux,&nbsp;Stefano Bartoletti,&nbsp;Alice Maltret,&nbsp;Magalie Ladouceur,&nbsp;Nicolas Combes,&nbsp;Sebastien Hascoet","doi":"10.1016/j.acvd.2026.06.070","DOIUrl":"10.1016/j.acvd.2026.06.070","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Percutaneous closure of ostium secundum atrial septal defect (ASD) has become the standard of care for this condition. However the occurrence of supraventricular arrhythmias remain insufficiently studied. We conducted this study to identify predictors of long-term supraventricular arrhythmias following percutaneous ASD closure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Percutaneous closure of ostium secundum atrial septal defect (ASD) has become the standard of care for this condition. However the occurrence of supraventricular arrhythmias remain insufficiently studied. We conducted this study to identify predictors of long-term supraventricular arrhythmias following percutaneous ASD closure.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a retrospective single-center study including patients who underwent percutaneous ostium secundum ASD closure at Marie Lannelongue Hospital between 1998 and 2021. Procedural and long-term follow-up data were systematically collected. Patients with a prior history of supraventricular arrhythmia were excluded from the main analysis. A comparative analysis was then performed between patients who developed new-onset supraventricular arrhythmia during long-term follow-up and those who did not.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We performed a retrospective single-center study including patients who underwent percutaneous ostium secundum ASD closure at Marie Lannelongue Hospital between 1998 and 2021. Procedural and long-term follow-up data were systematically collected. Patients with a prior history of supraventricular arrhythmia were excluded from the main analysis. A comparative analysis was then performed between patients who developed new-onset supraventricular arrhythmia during long-term follow-up and those who did not.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among the 1,495 patients without pre-procedural atrial arrhythmia, 98 (6.5%) developed atrial arrhythmia during long-term follow-up (median follow-up: 10.0 years). In univariate analysis, patients who developed post-procedural arrhythmias were significantly older (48.5 &lt;em&gt;vs.&lt;/em&gt; 18.0 years, &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), more frequently had a body mass index&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;30&lt;!--&gt; &lt;!--&gt;kg/m&lt;sup&gt;2&lt;/sup&gt; (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.003), and had higher CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc scores (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). On baseline electrocardiography, complete right bundle branch block (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.04) and atrial premature beats (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.009) were more frequent. Echocardiographic features associated with arrhythmia included interatrial septal aneurysm (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.008) and left ventricular dysfunction (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.01). Hemodynamic data showed significantly higher pulmonary artery pressures (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), and larger device size was also associated with arrhythmia occurrence (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). During long-term follow-up, patients wh","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S273"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816058","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":"Dapagliflozin in adult patients with failing Fontan (DAPA-FONTAN): A prospective multicentre study","authors":"Mathieu Albertini,&nbsp;Fabien Labombarda,&nbsp;Elise Barre,&nbsp;Valentin Baland,&nbsp;Jelena Radojevic,&nbsp;Fanny Dion,&nbsp;Sylvie Falcon-Eicher,&nbsp;Charlotte Denis,&nbsp;Pauline David,&nbsp;Alexis Barat,&nbsp;Antoine Legendre,&nbsp;Anne-Solene Chaussade,&nbsp;Elie Mousseaux,&nbsp;Sebastien Hascoet,&nbsp;Gilles Soulat,&nbsp;Victor Waldmann,&nbsp;Laurence Iserin","doi":"10.1016/j.acvd.2026.06.007","DOIUrl":"10.1016/j.acvd.2026.06.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Heart failure (HF) is the leading cause of mortality in adults with congenital heart disease, particularly in patients with a univentricular heart and Fontan circulation. This physiology is associated with progressive morbidity and the development of a failing Fontan (FF), most often related to systolic or diastolic ventricular dysfunction. Therapeutic options remain limited. Dapagliflozin, a sodium–glucose cotransporter 2 inhibitor recommended for left-sided HF, may provide functional benefits in this population. We aimed to evaluate the impact of dapagliflozin on functional capacity in adults with FF related to ventricular dysfunction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Heart failure (HF) is the leading cause of mortality in adults with congenital heart disease, particularly in patients with a univentricular heart and Fontan circulation. This physiology is associated with progressive morbidity and the development of a failing Fontan (FF), most often related to systolic or diastolic ventricular dysfunction. Therapeutic options remain limited. Dapagliflozin, a sodium–glucose cotransporter 2 inhibitor recommended for left-sided HF, may provide functional benefits in this population. We aimed to evaluate the impact of dapagliflozin on functional capacity in adults with FF related to ventricular dysfunction.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a 6-month prospective, multicenter, observational study including adults (&gt;&lt;!--&gt; &lt;!--&gt;18 years) with FF confirmed by right heart catheterization within the previous 6 months. FF was defined by elevated ventricular filling pressures (ventricular end-diastolic pressure or pulmonary artery wedge pressure&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;15&lt;!--&gt; &lt;!--&gt;mmHg) associated with systolic dysfunction (ejection fraction&lt;!--&gt; &lt;!--&gt;≤&lt;!--&gt; &lt;!--&gt;40%) or diastolic dysfunction (ejection fraction&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;41%). Patients with severe atrioventricular valve regurgitation, elevated pulmonary vascular resistance, Fontan circuit obstruction, pregnancy, or systolic blood pressure&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;95&lt;!--&gt; &lt;!--&gt;mmHg were excluded. The primary endpoint was change in peak oxygen consumption (VO&lt;sub&gt;2max&lt;/sub&gt;) assessed by cardiopulmonary exercise testing between baseline and 6 months. Secondary endpoints included NYHA class, quality of life (KCCQ-12), oxygen saturation, NT-proBNP, ventricular function, HF hospitalizations, diuretic dose, biological parameters, blood pressure, and safety.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We conducted a 6-month prospective, multicenter, observational study including adults (&gt;&lt;!--&gt; &lt;!--&gt;18 years) with FF confirmed by right heart catheterization within the previous 6 months. FF was defined by elevated ventricular filling pressures (ventricular end-diastolic pressure or pulmonary artery wedge pressure&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;15&lt;!--&gt; &lt;!--&gt;mmHg) associated with systolic dysfunction (ejection fraction&lt;!--&gt; &lt;!--&gt;≤&lt;!--&gt; &lt;!--&gt;40%) or diastolic dysfunction (ejection fraction&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;41%).","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S241"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816085","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}