Archives of Cardiovascular Diseases最新文献

{"title":"Catheter Ablation of Ventricular Arrhythmias in Patients with Congenital Heart Diseases: A Nationwide Prospective Study","authors":"Francis Bessière ,&nbsp;Jean-Luc Pasquié ,&nbsp;Guillaume Duthoit ,&nbsp;Raphaël Martins ,&nbsp;Laure Champ-Rigot ,&nbsp;Frédéric Sacher ,&nbsp;Stefano Bartoletti ,&nbsp;Charlene Bredy ,&nbsp;Sok-Sithikun Bun ,&nbsp;Antoine Da Costa ,&nbsp;Christian De Chillou ,&nbsp;Pascal Defaye ,&nbsp;Nicolas Derval ,&nbsp;Marie Wilkin ,&nbsp;Eloi Marijon ,&nbsp;Nicolas Combes ,&nbsp;Victor Waldmann","doi":"10.1016/j.acvd.2025.06.007","DOIUrl":"10.1016/j.acvd.2025.06.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Sudden death and ventricular arrhythmias (VA) remain a significant concern among patients with congenital heart disease (CHD). While catheter ablation techniques have improved dramatically over the last decade, current evidence in this specific population is derived from small, retrospective studies. We aimed to describe the burden and characteristics of VAs targeted by catheter ablation in CHDs, as well as associated outcomes and emerging preventive ablative strategies.</div></div><div><h3>Method</h3><div>This prospective nationwide study included all CHD patients referred for catheter ablation of a VA from 2020 to 2024 in France. The primary outcome was the rate of per-procedural acute success. Secondary outcomes included complications as well as freedom from arrhythmia recurrence.</div></div><div><h3>Results</h3><div>Among a total of 1,192 consecutive catheter ablation procedures, 210 (17.6%) VA catheter ablations were performed in 190 patients (mean age 43.8<!--> <!-->±<!--> <!-->15.5 years, 63.8% males): ventricular tachycardia (VT) was targeted in 164 (78.1%) procedures and premature ventricular complex (PVC) in 53 (25.2%) (both VT and PVC targeted in 7). Fourteen (6.7%) patients had a simple CHD, 161 (76.7%) a moderate CHD, and 35 (16.7%) a complex CHD. In patients with tetralogy of Fallot (n<!--> <!-->=<!--> <!-->126), catheter ablation was performed without clinically documented VA in 46 (36.5%), mainly before transcatheter or surgical intervention. Overall, the clinical arrhythmia was successfully ablated in 182 (86.7%) patients. An acute complication was reported in 6 (2.9%) procedures, with no related death. The overall 1-year and 2-year rates of freedom from recurrence were 81.5% (95% CI 75.3<!--> <!-->−<!--> <!-->88.4%) and 78.2% (95% CI 71.2<!--> <!-->−<!--> <!-->85.8%). The presence of anatomical isthmuses related to prior cardiac surgeries was associated with lower recurrence rates (HR 0.30, 95% CI 0.14<!--> <!-->−<!--> <!-->0.64, <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>Ventricular arrhythmias represent approximately 20% of catheter ablation procedures performed in CHD patients. This large cohort provides key insights into the effectiveness of catheter ablation and the main mechanisms of VAs in patients with CHD. The significant differences in outcomes demonstrated depending on underlying substrate are important to consider to inform the benefit/risk assessment.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S250"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934282","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":"Integrating artificial intelligence into an echocardiography department: Feasibility and comparative study of automated versus human measurements in a high-volume clinical setting","authors":"Stéphane Lafitte ,&nbsp;Louis Lafitte ,&nbsp;Melchior Jonveaux ,&nbsp;Zoe Pascual ,&nbsp;Julien Ternacle ,&nbsp;Marina Dijos ,&nbsp;Guillaume Bonnet ,&nbsp;Patricia Reant ,&nbsp;Anne Bernard","doi":"10.1016/j.acvd.2025.04.051","DOIUrl":"10.1016/j.acvd.2025.04.051","url":null,"abstract":"<div><h3>Background</h3><div>Echocardiography is an important diagnostic tool in cardiology as it is essential for heart disease treatment. However, its time-consuming nature and reliance on user expertise constitutes a challenge for its use in high-volume clinics. Artificial intelligence (AI) offers the potential to automate tasks performed manually by echocardiographers and promises to improve efficiency and diagnostic consistency.</div></div><div><h3>Aims</h3><div>To evaluate the integration of AI-based tools in a high-volume echocardiography department and assess the concordance of AI-generated measurements with manually-performed measurements.</div></div><div><h3>Methods</h3><div>The study was conducted in the echocardiography department of Bordeaux University Hospital. Over 2<!--> <!-->months, 894 echocardiograms were performed by operators with three experience levels (nurses, residents and experts), with measurements performed by AI and humans. The statistical analyses assessed measurement agreement between both.</div></div><div><h3>Results</h3><div>The AI system was successfully integrated into the hospital's infrastructure within 6<!--> <!-->weeks. Concordance analysis revealed good to very good agreement between AI and human measurements for most parameters, especially for ejection fraction (intraclass correlation coefficient [ICC]: 0.81, 95% confidence interval [95% CI]: 0.78–0.85) and Doppler-based flow measurements (mitral E wave velocity: ICC 0.97, 95% CI 0.95–0.98). Bland-Altman analysis showed a global mean difference of −4% with a standard deviation of 15%. Subgroup analysis revealed higher concordance for experts and residents compared with nurses (mean ICCs: 0.78 and 0.79 vs. 0.72, respectively).</div></div><div><h3>Conclusion</h3><div>AI can be effectively integrated into clinical echocardiography practice, with high agreement between AI and human measurements. Further research is needed to investigate the long-term impact on clinical outcomes and efficiency.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages 477-488"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055801","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":"Reevaluating the role of left atrial strain in systemic cardiomyopathies: A call for nuanced metrics and broader inclusion","authors":"Gaurav Sharma ,&nbsp;Saman Javid ,&nbsp;Saad Jamil","doi":"10.1016/j.acvd.2025.05.002","DOIUrl":"10.1016/j.acvd.2025.05.002","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page 508"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251003","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":"Real-world use of rivaroxaban for the thromboprophylaxis in Congenital and Acquired Heart Disease: A Prospective Cohort Study","authors":"Fanny Bajolle ,&nbsp;Neil Derridj ,&nbsp;Dominique Lasne ,&nbsp;Sabrina Da Costa ,&nbsp;Diala Khraiche ,&nbsp;Hugues Ndjoli ,&nbsp;Damien Bonnet","doi":"10.1016/j.acvd.2025.06.015","DOIUrl":"10.1016/j.acvd.2025.06.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Direct oral anticoagulants (DOACs) offer advantages over conventional anticoagulants, including fewer drug-drug interactions, no dietary restrictions, and less monitoring. While recent trials suggest promise for their use in children with congenital or acquired heart disease (CAHD), real-life data in this heterogenous and high-risk population remain scarce. This study aimed to evaluate the real-life efficacy and safety of Rivaroxaban and to identify associated risk factors.</div></div><div><h3>Method</h3><div>This prospective study included all children enrolled in the DOACs educational program between September 2023 and November 2024. Serious adverse events were defined according to the International Society on Thrombosis and Haemostasis (ISTH) criteria, including thrombotic events, major bleeding events, and clinically relevant non-major bleeding events (CRNM). Statistical analysis was conducted using Cox proportional hazard models.</div></div><div><h3>Results</h3><div>A total of 105 patients were included, of whom 65 (61.9%) were male. Diagnoses included 74 (70.4%) with Fontan physiology, 18 (17.1%) with cardiomyopathy, 7 (6.8%) with Kawasaki disease and giant aneurysms, and 6 (5.7%) with other conditions (arrhythmia, stroke, coronary fistulae, mitral annulus). The median age at initiation was 9.3 years (IQR: 5.7–13.8), with a median follow-up duration of 6.2 months (IQR: 3.5–9.4). A total of 8 serious adverse events were recorded: one thrombotic event (left pulmonary artery thrombosis) in an adolescent with tetralogy of Fallot following surgical replacement of the right ventricular outflow tract, and one major bleeding event in an adolescent with acute anemia secondary to profuse menometrorrhagia. At 6 months, 91.1% (95% CI [82.9%–95.5%]) of patients remained free of any serious adverse events. Univariate analysis identified female gender as the only risk factor for serious adverse events (HR<!--> <!-->=<!--> <!-->5.8; 95% CI [1.2–28.9]; <em>p</em> <!-->=<!--> <!-->0.03), with the majority of CRNM events corresponding to severe menometrorrhagia.</div></div><div><h3>Conclusion</h3><div>DOACs appears to be a feasible and safe therapeutic option for children with CAHD. However, particular attention should be paid to young girls, who exhibit an increased risk of bleeding associated with menstruation. Targeted therapeutic education and specific preventive measures should be incorporated for this subgroup.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S255"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933748","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":"Short-term outcomes of aortic neocuspidization using autologous pericardium: An anticoagulant-free surgical solution","authors":"Marien Lenoir ,&nbsp;Anne-Claire Casalta ,&nbsp;Philippe Aldebert ,&nbsp;Fanny Dion ,&nbsp;Bruno Lefort ,&nbsp;Paul Neville ,&nbsp;Thierry Bourguignon ,&nbsp;Loïc Mace ,&nbsp;Jean Marc El Arid","doi":"10.1016/j.acvd.2025.06.052","DOIUrl":"10.1016/j.acvd.2025.06.052","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortic valve neocuspidization using autologous pericardium is an anticoagulant-free surgical alternative for aortic valve disease, but data on its short- and mid-term durability remain limited.</div></div><div><h3>Method</h3><div>This study includes all patients who underwent aortic neocuspidization between November 2018 and January 2025 in two centers. Analyses focused on structural valve degeneration, survival, reoperations, and hemodynamic performance assessed by echocardiographic measurements preoperatively, at discharge, and annually thereafter.</div></div><div><h3>Results</h3><div>Fifty-three patients underwent surgery (mean age 40<!--> <!-->±<!--> <!-->20 years, range 7–74 years), including 15 minors (28%) and 39 males (76%). Among them, 26 (49%) had a unicuspid valve, 21 (39%) bicuspid, 5 (10%) tricuspid, and 1 (2%) quadricuspid. Aortic stenosis was present in 30 patients (56%) and severe aortic regurgitation in 23 (44%). Concomitant procedures were performed in 17 patients (32%). The mean follow-up was 2.0<!--> <!-->±<!--> <!-->1.4 years. At hospital discharge, the peak and mean pressure gradients were 13<!--> <!-->±<!--> <!-->8<!--> <!-->mmHg and 8<!--> <!-->±<!--> <!-->5<!--> <!-->mmHg, respectively. At the end of follow-up, the peak and mean pressure gradients were 13<!--> <!-->±<!--> <!-->10<!--> <!-->mmHg and 7<!--> <!-->±<!--> <!-->5<!--> <!-->mmHg, respectively, and 96% of patients had less than grade 2 aortic regurgitation (<span><span>Figure 1</span></span>). Two reinterventions were necessary: an early failure in a 39-year-old patient due to aortic leakage requiring a Ross procedure at 48<!--> <!-->hours, and a cusp perforation at 2.9 years in a 47-year-old patient, resulting in the only death in the cohort.</div></div><div><h3>Conclusion</h3><div>Aortic neocuspidization provides low pressure gradients and the absence of significant regurgitation both immediately after surgery and at mid-term follow-up. The survival of young patients is excellent, suggesting that this approach may delay the need for a Ross procedure.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S275-S276"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934166","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":"Management of Children in Shock with Cardiac Dysfunction: A Descriptive Study in the Pediatric Intensive Care Unit","authors":"Simon Anquetil ,&nbsp;Marion Delaye ,&nbsp;Matthieu Devred ,&nbsp;David Brossier","doi":"10.1016/j.acvd.2025.06.028","DOIUrl":"10.1016/j.acvd.2025.06.028","url":null,"abstract":"<div><h3>Introduction</h3><div>This study analyzes the management of pediatric cardiogenic shock following the recommendations of Brissaud et al. (2016), focusing on epidemiology, clinical practices, mortality rates, and associated risk factors.</div></div><div><h3>Objective</h3><div>The primary objective of this study was to describe the epidemiology and management practices of patients admitted to pediatric intensive care for cardiogenic or septic shock with cardiac dysfunction. The secondary objective was to assess the mortality rate and identify risk factors associated with mortality.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study, based on CRH data, includes children (&gt;<!--> <!-->5 days and &lt;<!--> <!-->18 years old) with septic or cardiogenic shock associated with cardiac dysfunction. Epidemiological, clinical, therapeutic, and biological data, along with results from complementary investigations, were collected. Patients were classified into two groups: “deceased” and “survivors”.</div></div><div><h3>Expected results</h3><div>Among the 249 children included, the overall mortality rate was 24.9%. The leading cause of cardiac dysfunction was sepsis, with no statistically significant difference between the two groups (<em>p</em> <!-->=<!--> <!-->0.145). The primary cause of cardiogenic shock was post-cardiac arrest myocardial dysfunction (24.8%), across all etiologies. Dobutamine was the first-line inotropic agent (62.6%) (<span><span>Figure 1</span></span>), with no significant difference between groups. Milrinone use was more frequent among survivors (<em>p</em> <!-->=<!--> <!-->0.036), whereas adrenaline was more commonly administered in the deceased group (<em>p</em> <!-->&lt;<!--> <!-->0.001). Invasive ventilation was more prevalent in the deceased group (<em>p</em> <!-->&lt;<!--> <!-->0.001), whereas non-invasive ventilation was more frequent among survivors (<em>p</em> <!-->=<!--> <!-->0.002). Mortality was associated with a higher PIM3 score, invasive ventilation, neurological distress, adrenaline administration, and renal replacement therapy. A protective trend for milrinone was observed, although not statistically significant.</div></div><div><h3>Perspectives</h3><div>Management primarily relies on mechanical ventilation and first-line dobutamine administration. This interim analysis highlighted limitations in data collection methods, necessitating adjustments for the next phase of the study, which aims to compare milrinone and dobutamine.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S262"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934222","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 in patients with pulmonary arterial hypertension","authors":"Annabel Sudaka ,&nbsp;Estíbaliz Valdeolmillos ,&nbsp;Grégoire Albenque ,&nbsp;clement Batteux ,&nbsp;Olivier Sitbon ,&nbsp;Laurent Savale ,&nbsp;David Montani ,&nbsp;Sébastien Hascoët","doi":"10.1016/j.acvd.2025.06.018","DOIUrl":"10.1016/j.acvd.2025.06.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcatheter atrial septal defect (ASD) closure may be feasible in selected patients with pulmonary arterial hypertension (PAH) and elevated pulmonary vascular resistance (PVR<!--> <!-->&gt;<!--> <!-->5 Wood units, WU), particularly following PAH-specific therapy (PAHST) within a treat-and-repair strategy. This study aimed to evaluate clinical and hemodynamic outcomes of patients with PAH and persistent left-to-right shunting who underwent transcatheter ASD closure.</div></div><div><h3>Method</h3><div>We retrospectively analyzed 30 patients (77% female) with PAH—defined by mean pulmonary arterial pressure (mPAP)<!--> <!-->&gt;<!--> <!-->20<!--> <!-->mmHg, PVR<!--> <!-->&gt;<!--> <!-->2 WU, and pulmonary arterial wedge pressure (PAWP)<!--> <!-->≤<!--> <!-->15 mmHg—who underwent percutaneous ASD closure between 2008 and 2024.</div></div><div><h3>Results</h3><div>Median age at PAH diagnosis was 42 [30–54] years and 49 [36–58] years at ASD closure. At baseline, 60% of patients were in NYHA functional class III–IV. Eleven patients (37%) received pre-closure PAHST (monotherapy: n<!--> <!-->=<!--> <!-->4; dual therapy: n<!--> <!-->=<!--> <!-->6). All patients had left-to-right shunting without evidence of right-to-left flow. Median Qp/Qs was 2.0 [1.5–2.3] (range 1.2–3.0), median PVR 5.8 [4.1–6.3] WU (max 9.1), and median mPAP 39.0 [33.0–46.0] mmHg (max 56). Median ASD diameter was 28.0 [22.5–34.0] mm. No major adverse events were reported. Five patients initiated PAHST post-closure due to PAH risk factors (portal hypertension, BMPR2 mutation, family history of idiopathic PAH, or HIV).</div><div>Median follow-up was 6.0 [2.6–9.7] years. Right heart catheterization (RHC) was performed post-closure in 21 patients (70%). In this subgroup, mPAP and PVR significantly decreased (ΔmPAP–13.5 [–7.5 to–18.5] mmHg; ΔPVR–2.0 [–0.9 to–3.4] WU). PVR moderately increased in 4/21 patients (19%), including one aged over 50 at closure. Three patients without post-closure RHC died from unrelated causes.</div></div><div><h3>Conclusion</h3><div>This study supports transcatheter ASD closure as a safe and effective intervention in selected patients with moderate-to-severe PAH and persistent left-to-right shunting, offering durable hemodynamic and clinical improvement.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S257"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934236","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":"Cardiotoxicity of Anticancer Drugs in Pediatric Patients: Insights from the WHO Pharmacovigilance Database","authors":"Fabien Labombarda ,&nbsp;Jérémie Rouger ,&nbsp;Damien Legallois ,&nbsp;Joachim Alexandre ,&nbsp;Basile Chrétien","doi":"10.1016/j.acvd.2025.06.017","DOIUrl":"10.1016/j.acvd.2025.06.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiovascular toxicities associated with anticancer drugs are a major problem for pediatric patients treated for cancer. Reliable data concerning the burden of acute cancer-therapy related cardiac dysfunction (CTRCD) are scarce in this specific population at high risk of myocardial toxicity. Using the World Health Organization individual case safety report database, VigiBase®, we aimed to determine the association between anticancer drugs and acute CTRCD in children.</div></div><div><h3>Method</h3><div>A disproportionality analysis evaluating the multivariable adjusted reporting odd-ratios (aROR) for CTRCD reporting with their 95% confidence intervals (CI) was performed for 249 FDA- or EMA-labeled anticancer drugs in VigiBase® in 4 pediatric age classes (0–27 days, 28 days–23 months, 2–11 years, 12–17 years), followed by a descriptive analysis of the time to CTRCD onset for the anticancer drugs identified in VigiBase®.</div></div><div><h3>Results</h3><div>A total of 796 CTRCD cases associated with at least one anticancer drug were identified in VigiBase® In the multivariate analysis on the whole pediatric population, 16 anticancer drugs were significantly associated with CTRCD reporting of which 10 (63%) are mainly used in hematologic malignancies and 2 represented new CTRCD associations not previously reported in literature including topo-isomerase 1 inhibitor (Topotecan) and cytotoxics antibiobics (Dactinomycine) (<span><span>Figure 1</span></span>).</div></div><div><h3>Conclusion</h3><div>We identified in Vigibase® 16 anticancer drugs significantly associated with CTRCD reporting in pediatrics. Our analysis confirmed some of associations that were extensively previously reported in children (as for anthracyclines), and found new signals such as systemic exposure to Topotecan and Dactinomycin. Dedicated prospective clinical trials are now required to confirm these results.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S256-S257"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934237","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":"Characterization of language profile in children with critical congenital heart disease","authors":"Magali Faria ,&nbsp;Caroline Hurtrel ,&nbsp;Elodie Garnier ,&nbsp;Anne Gaelle Piller ,&nbsp;Bruno Lefort","doi":"10.1016/j.acvd.2025.06.025","DOIUrl":"10.1016/j.acvd.2025.06.025","url":null,"abstract":"<div><h3>Introduction</h3><div>While motor and cognitive development have been extensively studied in children with heart defects in recent decades, language has been much less so, and rarely in French. The aim of our study was to describe the language profile of children with critical congenital heart disease using standardized speech therapy batteries, and to identify associated vulnerability factors.</div></div><div><h3>Method</h3><div>33 children aged 5 to 6.5 years at the time of the study, who had undergone cardiac surgery or catheterization before the age of 6 months and had no diagnosed neurodevelopmental disorders, were assessed using 7 tests, on the receptive and expressive language skills of phonology, lexicon and morphosyntax, as well as in articulation.</div></div><div><h3>Results</h3><div>Language performance was below the population average in all subtests, but only lexical comprehension scores were significantly below the population average. Nevertheless, the proportion of children with a pathological language profile (at least 2 subtests<!--> <!-->≤<!--> <!-->−<!--> <!-->1.65 Z Score) was 4 times higher than in the general population. Phonology, morphosyntax and expressive lexicon were particularly affected when the profile was severe. Length of hospitalization and intubation, 1-minute APGAR score and parents’ level of education were significantly associated with the pathological language profile.</div></div><div><h3>Conclusion</h3><div>Our study confirms that language is an area of development at high risk of vulnerability. Early detection and referral to speech therapy are necessary.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S260"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934284","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":"Venus-P in Large Right Ventricular Outflow Tracts: Procedural and Early Safety Profile","authors":"Raymond Haddad ,&nbsp;Grégoire Albenque ,&nbsp;Cohen Sarah ,&nbsp;Jelena Radojevic ,&nbsp;Estíbaliz Valdeolmillos ,&nbsp;Lisa Guirgis ,&nbsp;Fournier Emmanuelle ,&nbsp;Belli Emre ,&nbsp;Jerome Petit ,&nbsp;Magalie Ladouceur ,&nbsp;clement Batteux ,&nbsp;Sebastien Hascoet","doi":"10.1016/j.acvd.2025.06.044","DOIUrl":"10.1016/j.acvd.2025.06.044","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-expandable valves (SEVs) are emerging complements to balloon-expandable valves for transcatheter pulmonary valve replacement (TPVR) in large dysfunctional right ventricular outflow tracts (RVOTs), though their safety and efficacy remain underexplored. We aim to describe our experience with Venus-P SEVs in TPVR.</div></div><div><h3>Method</h3><div>Baseline and early follow-up data were prospectively analyzed for 52 patients who underwent TPVR with Venus-P SEVs (Jan 2022–Dec 2024).</div></div><div><h3>Results</h3><div>Cohort: 53.8% male; median age 43 years (IQR: 30.6–52.0); median weight 68<!--> <!-->kg (IQR: 58.3–85.2). Tetralogy of Fallot was present in 63.5%. RVOTs were native in 30.8% and patched in 69.2%, all with severe pulmonary regurgitation. Multiplanar CT analysis classified RVOT anatomy as green in 17 (32.7%), Amber 1 in 17 (32.7%), Amber 2 in 12 (23.1%), and red in 6 (11.5%) cases. The median valve diameter was 36<!--> <!-->mm (IQR: 32–36); valve length was 25<!--> <!-->mm in 86.5%. All implantations were successful. Postoperative median RVOT velocity was 1.6<!--> <!-->m/s (IQR: 1.1–1.8). Moderate procedural or vascular access AEs occurred in 4 patients. Non-sustained VT occurred in 5 patients (9.6%), all with negative preoperative EPS. One symptomatic case received IV amiodarone followed by beta-blockers; another symptomatic and two asymptomatic patients were treated with oral amiodarone; one was already on beta-blockers. Antiarrhythmic therapy was discontinued within 6 weeks in 4/5 patients, with no recurrence on follow-up Holter monitoring. Six patients (11.5%) had ventricular premature beats: five Grade II (one symptomatic) and one Grade IV (asymptomatic). Beta-blockers were initiated in four, and two were already on treatment. Hypoattenuated leaflet thickening (HALT) was detected in 7 patients on follow-up CT scans; 4 had impaired valve mobility without any echocardiographic gradient increase. One asymptomatic patient had the proximal stent part of the valve protruding at the level of the left PA without bleeding.</div></div><div><h3>Conclusion</h3><div>Venus-P SEVs are effective for TPVR but are associated with a high rate of early postoperative arrhythmic adverse events and HALT, both appearing to have no immediate clinical impact.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S270"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934321","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}