International journal of cardiology. Congenital heart disease最新文献

{"title":"Thrombus formation in neonates and early infants undergoing congenital heart surgery","authors":"Muneaki Matsubara ,&nbsp;Alessandra Poppe ,&nbsp;Thibault Schaeffer ,&nbsp;Jonas Palm ,&nbsp;Teresa Lemmen ,&nbsp;Paul Philipp Heinisch ,&nbsp;Nicole Piber ,&nbsp;Andrea Amici ,&nbsp;Alfred Hager ,&nbsp;Peter Ewert ,&nbsp;Jürgen Hörer ,&nbsp;Masamichi Ono","doi":"10.1016/j.ijcchd.2025.100617","DOIUrl":"10.1016/j.ijcchd.2025.100617","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated thrombus formation and its impact on outcomes in neonates and early infants undergoing congenital heart surgery.</div></div><div><h3>Methods</h3><div>Neonates and early infants (≤90 days) undergoing congenital heart surgery with cardiopulmonary bypass from 2001 to 2024 were analyzed. Thrombi were detected by transthoracic echocardiography and cardiac catheterization.</div></div><div><h3>Results</h3><div>Among 2331 patients, 170 (7.3 %) developed thrombi during hospitalization. Median age at surgery and time to thrombus detection in affected patients were 12 (interquartile range: 7–34) and 7 (interquartile range: 3–15) days, respectively. Among surgical procedures performed in at least 10 patients, thrombi were most frequently observed following tricuspid valve repair (28.6 %), followed by arterial switch operation, ventricular septal defect closure, and aortic arch repair (15.8 %). The most common thrombus location was the superior vena cava in 61 patients, followed by the inferior vena cava in 33, the aorta in 31, and the right atrium in 21 patients. Additional surgical interventions were required in 28 patients. The length of hospital stay was significantly longer in patients with thrombi (27 vs. 15 days, p &lt; 0.001). Independent risk factors for thrombus formation included preoperative cardiopulmonary resuscitation (odds ratio: 2.037, p = 0.001), tricuspid valve repair (odds ratio: 6.206, p &lt; 0.001), and Norwood procedure (odds ratio: 1.558, p = 0.027).</div></div><div><h3>Conclusions</h3><div>The incidence of thrombus formation was 7.3 % in neonates and early infants undergoing congenital heart surgery. Thrombus was most frequently observed in the superior vena cava and resulted in prolonged hospitalization. Preoperative cardiopulmonary resuscitation, tricuspid valve repair, and Norwood procedures carried the highest thrombotic risk.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100617"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital uterine anomalies and congenital heart disease: An underappreciated association?","authors":"Harrison J. VanDolah ,&nbsp;Kathy Mostajeran ,&nbsp;Luis Goncalves ,&nbsp;Wayne J. Franklin ,&nbsp;Melissa Parks ,&nbsp;Tabitha G. Moe","doi":"10.1016/j.ijcchd.2025.100634","DOIUrl":"10.1016/j.ijcchd.2025.100634","url":null,"abstract":"<div><h3>Background</h3><div>Congenital uterine anomalies (CUAs), also known as Müllerian duct anomalies, can have an impact on gynecological care, pre-pregnancy counseling, and obstetrical outcomes. Patients with congenital heart disease (CHD), particularly of higher complexity, often have extracardiac manifestations. The relationship between CUAs and CHD is not well-described in the currently available literature.</div></div><div><h3>Methods</h3><div>A single center retrospective cohort study was performed of all patients born female with ICD-10 codes corresponding to congenital heart disease and a completed pelvic MRI or ultrasound. CT imaging was not included given the known shortcomings of CUA detection and classification with CT. CHD diagnoses were confirmed with echocardiography and were classified into “simple”, “moderate”, or “complex” per the 2018 ACHD guidelines. CUAs were categorized based on the 2021 American Society of Reproductive Medicine Guidelines for classification of Müllerian anomalies.</div></div><div><h3>Results</h3><div>197 patients met inclusion criteria. 33 (16.7 %) were found to have a CUA. 17 (20 %) patients with moderate or complex CHD had a CUA. Notable associations include VACTERL and partial anomalous pulmonary venous return. More complex CHD was associated with more complex CUA.</div></div><div><h3>Conclusions</h3><div>Within the limitations of a single center retrospective study, our data suggests there is an underappreciated association between CUA and CHD that requires further prospective multicenter study to assess prevalence data. There may ultimately be a role for targeted screening for CUA in patients with CHD, particularly those with genetic syndromes or moderate or complex CHD who are considering pregnancy or gynecologic intervention.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100634"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based predictive model for atrial arrhythmia following transcatheter atrial septal defect closure","authors":"Xander Jacquemyn ,&nbsp;Alexander Van De Bruaene ,&nbsp;Joris Ector ,&nbsp;Peter Haemers ,&nbsp;Pieter De Meester ,&nbsp;Cedric Manlhiot ,&nbsp;Werner Budts ,&nbsp;Bert Vandenberk","doi":"10.1016/j.ijcchd.2025.100639","DOIUrl":"10.1016/j.ijcchd.2025.100639","url":null,"abstract":"<div><h3>Background</h3><div>Atrial septal defects (ASDs) are frequently closed percutaneously. Despite successful closure, many patients still develop atrial arrhythmias. There is inconsistent data on the risk factors associated with these atrial arrhythmias. As such, we aimed to develop a machine learning (ML) model predicting atrial arrhythmias following transcatheter ASD closure in adolescents and adults.</div></div><div><h3>Methods</h3><div>Patients with secundum-type ASDs undergoing transcatheter closure between 2008 and 2024 at a single center were retrospectively analyzed. Patients with prior atrial arrhythmias were excluded. A deep neural network, adapted via transfer learning from a large external ECG dataset, was used to extract predictive features from preprocedural 12-lead ECGs. These features were combined with clinical, demographic, biochemical and hemodynamic variables in ensemble survival models. Model performance was assessed using the integrated Brier scores and the area under the receiver operating curve (AUC).</div></div><div><h3>Results</h3><div>A total of 148 adult patients (median 44.4 years [30.6–57.8], 105 females [70.9 %]) were eligible for included. There were a total of 1055 person-years of follow-up (median follow-up 7.3 [3.1–11.3]), during which 28 patients (18.9 %) developed atrial arrhythmias. The final ensemble ML model incorporating ECG-derived features demonstrated strong predictive performance (integrated Brier score 0.044, mean AUC 0.823). Subgroup and sensitivity analyses confirmed the robustness of the model across various patient profiles.</div></div><div><h3>Conclusions</h3><div>We developed a novel ML-based risk model using a transfer learning approach to predict atrial arrhythmias after transcatheter ASD closure. Further research and external validation are needed to refine the proposed risk stratification prior to clinical implementation.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100639"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcomes of cardiovascular surgery and transcatheter procedures in adults with Down syndrome and congenital heart disease","authors":"Takumi Osawa ,&nbsp;Tomoko Machino-Ohtsuka ,&nbsp;Keitaro Kume ,&nbsp;Takahiro Yano ,&nbsp;Koshiro Kanaoka ,&nbsp;Yoko Sumita ,&nbsp;Yusuke Yano ,&nbsp;Ruriko Numata ,&nbsp;Naoto Kawamatsu ,&nbsp;Hideyuki Kato ,&nbsp;Yuji Hiramatsu ,&nbsp;Tomoko Ishizu","doi":"10.1016/j.ijcchd.2025.100638","DOIUrl":"10.1016/j.ijcchd.2025.100638","url":null,"abstract":"<div><h3>Background</h3><div>Advances in medical care have increased the number of adults with Down syndrome and congenital heart disease (CHD), including those with residual or unrepaired lesions. However, clinical outcomes following invasive cardiovascular procedures in this population remain poorly understood.</div></div><div><h3>Methods</h3><div>We extracted data on patients with Down syndrome aged ≥16 years and diagnosed with CHD from the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination (JROAD-DPC), covering the period from April 1, 2013, to March 31, 2023. Patients who underwent cardiovascular surgery or transcatheter procedures were included in the analysis.</div></div><div><h3>Results</h3><div>The study included 115 patients (median age: 21 [17–33] years; 47.8 % female), of whom 72 underwent surgery and 43 underwent transcatheter intervention. Procedures were most common among those aged 16–29 years. The main CHD subtypes were tetralogy of Fallot, atrial septal defects, and atrioventricular septal defects. Catheter-based interventions were associated with shorter hospital stay and no in-hospital mortality. In contrast, all three deaths (4.2 %) occurred in the surgical group, with pulmonary hypertension medications used in two of these patients. Among surgical patients receiving pulmonary hypertension medications, the in-hospital mortality rate reached 25 %. In multivariate analysis, emergency admission and the use of pulmonary hypertension medications were independently associated with longer hospital stays after surgery.</div></div><div><h3>Conclusions</h3><div>In adults with Down syndrome and CHD, invasive cardiovascular procedures had relatively acceptable in-hospital outcomes. Careful patient selection and perioperative management are crucial when planning cardiac surgery, especially in patients taking medication for pulmonary hypertension.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100638"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac autonomic function in patients with single ventricle physiology after Fontan palliation: A literature review","authors":"Elizaveta Polyakova ,&nbsp;Marieke Nederend ,&nbsp;Philippine Kies ,&nbsp;Anastasia D. Egorova ,&nbsp;Monique R.M. Jongbloed","doi":"10.1016/j.ijcchd.2025.100636","DOIUrl":"10.1016/j.ijcchd.2025.100636","url":null,"abstract":"<div><h3>Background</h3><div>The Fontan operation has significantly improved survival in patients with single ventricle physiology. This comes at a price of highly prevalent long-term complications. Autonomic dysfunction has been documented in patients after Fontan palliation. Although autonomic dysfunction is associated with a range of adverse outcomes, the exact clinical implications in patients with a Fontan circulation remain unclear.</div></div><div><h3>Aims</h3><div>The aims of this review are to address (1) the extent and characteristics of autonomic dysfunction in Fontan patients; (2) its association with clinical short- and long-term outcomes, and (3) identify key gaps in the literature.</div></div><div><h3>Methods</h3><div>A literature search was performed in PubMed using a dedicated query for single ventricle disease and cardiac autonomic (dys)function.</div></div><div><h3>Results</h3><div>Data from the literature consistently indicated overt autonomic dysfunction in patients after Fontan operation versus controls, marked by reduced heart rate variability and impaired parasympathetic tone. However, autonomic dysfunction showed different associations with clinical outcomes in Fontan patients. Several studies reported an association with diminished exercise capacity, arrhythmias, organ function markers, while other studies found no clear predictive value. Gaps in literature include data on adult patients, the influence of anatomical substrate, sex and lifestyle, as well as specific “driving” factors for the development of cardiac autonomic dysfunction.</div></div><div><h3>Conclusion</h3><div>Autonomic dysfunction in Fontan patients is a persistent and potentially progressive condition, characterized by reduced heart rate variability and reduced parasympathetic tone. Long-term studies are needed to clarify its clinical significance and address gaps in literature relating to contributing factors like sex, anatomy, and underlying mechanisms.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100636"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the imaging of pulmonary hypertension","authors":"Polona Kačar ,&nbsp;Katja Prokšelj ,&nbsp;Sarah Ghonim ,&nbsp;Thomas Semple ,&nbsp;Sonya V. Babu-Narayan ,&nbsp;Heba Nashat ,&nbsp;Stephen J. Wort ,&nbsp;Michael A. Gatzoulis ,&nbsp;Margarita Brida","doi":"10.1016/j.ijcchd.2025.100619","DOIUrl":"10.1016/j.ijcchd.2025.100619","url":null,"abstract":"<div><div>Pulmonary hypertension (PH) is a complex and progressive disorder characterized by elevated pulmonary arterial pressures leading to right ventricular dysfunction and increased morbidity and mortality. Non-invasive imaging, including echocardiography, computed tomography (CT) and cardiovascular magnetic resonance (CMR), plays a crucial role in the diagnosis, risk stratification, and management of PH. The integration of these imaging modalities facilitates a multimodal approach to PH evaluation, enabling more precise diagnosis, improved phenotyping, and better-guided therapeutic decision-making. Echocardiography remains the first-line modality, offering valuable insights into pulmonary artery pressures, right ventricular size and function, and associated cardiac anomalies. Recent developments in speckle-tracking echocardiography and 3D imaging have enhanced its diagnostic and prognostic utility. CT imaging provides detailed evaluation of the pulmonary vasculature, parenchyma, and perfusion, which is essential in distinguishing PH subtypes. CMR is non-invasive, radiation free, and highly sensitive to changes in anatomy and function making it ideal for the long-term follow up of patients with PH. It offers in-depth evaluation of all cardiac chambers as well as pulmonary blood flow assessment and tissue characterisation. In this work we discuss current strengths, limitations, and future directions in these key imaging modalities used for the comprehensive assessment of PH.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100619"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Congenital Cardiac Diagnosis Translator (CCDT): Enhancing interoperability in congenital cardiac diagnosis terminology","authors":"Sarah Kübler,&nbsp;Ely Erez,&nbsp;Justin Cohen,&nbsp;Peter J. Gruber","doi":"10.1016/j.ijcchd.2025.100628","DOIUrl":"10.1016/j.ijcchd.2025.100628","url":null,"abstract":"<div><h3>Objectives</h3><div>Congenital heart diseases (CHDs) are classified using diverse terminologies worldwide, creating barriers to effective communication and collaboration in both clinical practice and research. This project aimed to develop a tool to improve interoperability between commonly used CHD classification systems.</div></div><div><h3>Methods and results</h3><div>The Congenital Cardiac Diagnosis Translator (CCDT) was developed by manually cross-matching diagnostic terms across six coding systems: Fyler, HPO, IPCCC, STS, ICD-10, and ICD-11. Terms were reviewed one system at a time. When an exact match was unavailable, the most specific encompassing diagnosis was selected; in cases where no suitable match existed, no translation was provided. Mappings were consolidated into a curated master lookup table. The CCDT was implemented as a web-based tool with a graphical user interface, enabling term-specific searches. Translations were qualitatively validated by clinical experts in congenital cardiology to ensure accuracy and relevance. The CCDT includes 505 unique congenital heart diagnoses cross-mapped across six coding systems. Qualitative feedback indicated that the translator is intuitive, accurate, and easy to use.</div></div><div><h3>Conclusions</h3><div>The CCDT provides a scalable, expert-informed solution for improving interoperability across CHD classification systems. By standardizing diagnostic terminology, it supports global collaboration and data sharing in congenital cardiology. The translator is freely accessible and will continue to evolve alongside diagnostic systems.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100628"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular pressure-volume loop analysis in congenital heart disease","authors":"Renée S. Joosen ,&nbsp;Michael G. Dickinson ,&nbsp;Marielle C. van de Veerdonk ,&nbsp;Rahi S. Alipour Symakani ,&nbsp;Daphne Merkus ,&nbsp;Michiel Voskuil ,&nbsp;Gregor J. Krings ,&nbsp;Johannes M.P.J. Breur","doi":"10.1016/j.ijcchd.2025.100625","DOIUrl":"10.1016/j.ijcchd.2025.100625","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular (RV) function is an independent predictor of prognosis in patients with congenital heart disease (CHD). Early detection is therefore crucial but current methods to assess RV function are highly load-dependent. RV pressure-volume (PV) loop analysis is an invasive technique which is load-independent and considered the gold standard for evaluating RV adaptation in relation to its load. However, RV PV loop analysis can be time consuming and prone to inter-operator variability.</div></div><div><h3>Methods</h3><div>This article provides a comprehensive guide on performing RV PV loop analysis using the multi-beat method in pediatric and adult patients with complex CHD.</div></div><div><h3>Results</h3><div>RV PV loop analysis using the multi-beat method can be safely and reliably applied in children and adults with complex CHD.</div></div><div><h3>Conclusion</h3><div>RV PV loop analysis offers a valuable tool for advanced insight into RV adaptation and a deeper understanding of cardiac physiology in complex CHD patients with RV pressure and/or volume overload. By enhancing our understanding of RV adaptation, this approach holds great potential for improving patient management and optimizing treatment strategies.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100625"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of priority practice areas for evidence-based care in congenital heart Disease: An exploratory Survey of non-medical healthcare professionals affiliated with the Italian Society of Pediatric Cardiology","authors":"Arianna Magon ,&nbsp;Serena Francesca Flocco ,&nbsp;Samantha Scolari ,&nbsp;Gianluca Conte ,&nbsp;Cristina Arrigoni ,&nbsp;Greta Ghizzardi ,&nbsp;Giovanna Campioni ,&nbsp;Raluca-Bianca Nedesca ,&nbsp;Enrico Gambirasi ,&nbsp;Floriana Di Iorio ,&nbsp;Rossella Orlando ,&nbsp;Mariassunta Castaldi ,&nbsp;Chiara Gatti ,&nbsp;Paola Claudia Fazio ,&nbsp;Mariella Rubin ,&nbsp;Cinzia Pirti ,&nbsp;Stefania Baratta ,&nbsp;Assunta Carandente ,&nbsp;Salvatore Angileri ,&nbsp;Rosario Caruso","doi":"10.1016/j.ijcchd.2025.100616","DOIUrl":"10.1016/j.ijcchd.2025.100616","url":null,"abstract":"<div><h3>Introduction</h3><div>s Identifying priority areas of nursing practice for individuals with congenital heart disease (CHD) is essential to address evolving care needs and support professional development. However, standardized criteria to guide such prioritization remain limited.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted between April and September 2024 using an online survey distributed to all nurse members of the Italian Society of Pediatric Cardiology and Congenital Heart Diseases (SICPED). Sixteen CHD-related practice areas and five prioritization criteria were defined through literature review and expert consultation. Participants rated each area on a 5-point Likert scale according to the five criteria.</div></div><div><h3>Results</h3><div>A total of 78 nurses completed the survey. Among the criteria, the absence of clinical guidelines (mean = 4.04 ± 0.98) and the required level of professional competence (mean = 3.95 ± 1.24) received the highest scores. Mixed ANOVA revealed significant variability in scores across practice areas and criteria (F(48) = 2.385, p &lt; .001). Four areas emerged as priority domains across multiple criteria: psychosocial and emotional support for individuals with CHD and their families, management of neonatal opioid withdrawal, palliative and end-of-life care, and the transition of adolescents with CHD to adult services.</div></div><div><h3>Conclusions</h3><div>This study provides a structured foundation for identifying nursing practice priorities in the care of individuals with CHD. These findings may guide the development of interdisciplinary strategies, clinical guidelines, and professional training initiatives within communities of practice.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100616"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of balloon pulmonary valvuloplasty in symptomatic infants with tetralogy of Fallot awaiting intracardiac repair","authors":"Sanjeev Hanumantacharya Naganur,&nbsp;Abhishek Mallick,&nbsp;Manoj Kumar Rohit,&nbsp;Parag Barwad,&nbsp;Vinothkumar S.P.","doi":"10.1016/j.ijcchd.2025.100621","DOIUrl":"10.1016/j.ijcchd.2025.100621","url":null,"abstract":"<div><h3>Background and aim</h3><div>Mortality risk in tetralogy of Fallot (TOF) is highest in infancy, predominantly due to hypercyanotic spells. Timing of corrective surgery is centre/expertise dependent and surgical shunt procedures carry high mortality risk. We aimed to study the efficacy and feasibility of balloon pulmonary valvuloplasty (BPV) in TOF physiology children, as an alternative to surgical shunt, in those infants who were severely cyanosed (saturation &lt;75 %) or having recurrent spells and who were still awaiting intracardiac repair (ICR). The primary objective was to assess the following parameters pre and post BPV: resting saturation, Z score of pulmonary annuli by 2D Echocardiography, right ventricular outflow tract (RVOT) gradient, hypercyanotic spell frequency. Secondarily we looked at the modified Nakata index (MNI), any procedural complications, requirement of early shunt or ICR (within study period).</div></div><div><h3>Materials and methods</h3><div>This was a single arm interventional study done over a period of one year. Values pre and post intervention were compared using Wilcoxon matched pair signed rank test and Chi-square test for categorical variables as appropriate. Independent groups were compared using Mann Whitney <em>U</em> test. The children were followed up for a period of 6 months post procedure.</div></div><div><h3>Results</h3><div>After enrolling 10 infants, data could be studied in 9 of them. 1 child was lost to follow up. Significant improvement was noted in saturation, size of PA annulus, RVOT gradient, MNI (p value &lt; 0.05 each). 2 patients had access site thrombosis which resolved with heparin. 1 had transient complete heart block which resolved within 24 h but required temporary pacing. There was no mortality and none had more than mild pulmonary regurgitation. Out of 5 children who presented with recurrent spells, 2 were completely free of spells after BPV, 2 had spells with reduced frequency/duration, 1 continued to have spells needing surgical intervention. (p = 0.36). Apart from this child who needed surgery, one other patient remained severely cyanotic and had to undergo a shunt procedure.</div></div><div><h3>Conclusion</h3><div>To conclude, BPV seems like a safe and cost-effective alternative to high-risk surgical shunt palliation in symptomatic TOF infants, in resource constrained regions.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100621"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}