International journal of cardiology. Congenital heart disease最新文献

{"title":"How to set up a pregnancy heart team","authors":"K. Rijs ,&nbsp;C.D. van der Marel ,&nbsp;A.L.M.J. van der Knijff-van Dortmont ,&nbsp;I.J.J. Dons-Sinke ,&nbsp;V.F.R. Adriaens ,&nbsp;J.M.J. Cornette ,&nbsp;A.G.M.G.J. Mulders ,&nbsp;J.J. Duvekot ,&nbsp;M.M.P. Driessen ,&nbsp;A.E. van den Bosch ,&nbsp;J.A.A.E. Cuypers ,&nbsp;R.M. Kauling ,&nbsp;J.W. Roos-Hesselink","doi":"10.1016/j.ijcchd.2025.100635","DOIUrl":"10.1016/j.ijcchd.2025.100635","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) is the leading cause of maternal morbidity and mortality in developed countries, complicating 4–11 % of pregnancies. Women with CVD are at increased risk of maternal complications, including heart failure and arrhythmias, as well as adverse fetal outcomes such as preterm birth and perinatal mortality. Traditionally, care for pregnant women with CVD has been fragmented across specialties, leading to discontinuity and missed opportunities for optimization. To address this, recent European Society of Cardiology (ESC) guidelines strongly recommend the implementation of a pregnancy heart team: a dedicated multidisciplinary team providing integrated care for this high-risk population.</div><div>We describe the implementation and organization of a pregnancy heart team in our academic tertiary hospital. The core team consists of a cardiologist specialized in cardio-obstetrics, a maternal-fetal medicine specialist, and an obstetric anesthesiologist, with additional experts consulted as required. Patients are discussed at predefined time points: preconception, during pregnancy, and postpartum. Standardized risk assessment using the modified World Health Organization (mWHO) classification guides counseling, management, and delivery planning. Shared decision-making is central, balancing maternal and fetal risks with patient preferences. The team establishes individualized peripartum care plans covering timing, mode, and location of delivery, anesthesia strategies, anticoagulation management, and postpartum monitoring.</div><div>This structured, multidisciplinary model ensures continuity of care and offers a practical framework to improve outcomes in women with CVD during pregnancy.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100635"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528526","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":"Percutaneous closure of perimembranous and infundibular ventricular septal defects: single-center experience in 203 patients with medium- and long-term follow-up","authors":"Nataliia Yashchuk ,&nbsp;Igor Ditkivskyy ,&nbsp;Denys Voloshyn ,&nbsp;Bogdan Cherpak ,&nbsp;Yuliia Yermolovych","doi":"10.1016/j.ijcchd.2025.100641","DOIUrl":"10.1016/j.ijcchd.2025.100641","url":null,"abstract":"","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100641"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623322","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 implications of progressive systemic ventricular dysfunction in adults with Fontan palliation","authors":"Meena Bai,&nbsp;Ahmed Bahnasy,&nbsp;Sara Aboelmaaty,&nbsp;Mohamed Ellabbad,&nbsp;Ahmed Ali,&nbsp;Alexander C. Egbe","doi":"10.1016/j.ijcchd.2025.100620","DOIUrl":"10.1016/j.ijcchd.2025.100620","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to determine the clinical implications of progressive systemic ventricular (SV) systolic dysfunction in adults with Fontan palliation.</div></div><div><h3>Methods</h3><div>Retrospective study of Fontan patients with ≥2 echocardiograms at Mayo Clinic. SV systolic function was assessed using echo-derived ejection fraction (Echo_EF) at baseline, and annually for 3 years. Temporal decline in SV systolic function was estimated as relative change (relative Δ_Echo_EF)/year. Exploratory analysis was performed to assess the effect of guideline-directed medical therapy (GDMT) on Echo_EF.</div></div><div><h3>Results</h3><div>Of 414 patients (age 27 ± 9 years; males 228 [55 %]), 287 (69 %) and 127 (31 %) had dominant morphologic left ventricle (LV) and right ventricle (RV), respectively. Assessment of Echo_EF was feasible in 1464 of 1603 echocardiograms (91 %). The baseline Echo_EF was 54 % (48–58), and the relative Δ_Echo_EF was −3.9 % (95 %CI -6.3 to −2.5 %)/year. The predictors of progressive SV systolic dysfunction were older age, morphologic RV, ≥moderate atrioventricular valve regurgitation, cardiac implantable electronic devices, and atrial fibrillation. Progressive SV systolic dysfunction was associated with an approximately 2-fold increase in death/transplant (hazard ratio 1.92, p = 0.009), independent of baseline Echo_EF and comorbidities. GDMT was associated with improvement in Echo_EF in patients with morphologic LV.</div></div><div><h3>Conclusions</h3><div>The current study underscores the importance of longitudinal echocardiographic monitoring of SV systolic function, and the potential clinical benefits of GDMT in patients with morphologic LV. Further studies are required to determine whether interventions such as valve surgery, rhythm control strategy, and physiologic pacing would prevent or reverse SV systolic dysfunction.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100620"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106097","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":"Long-term outcome after surgical ventricular septal defect closure: Longitudinal follow-up into the fifth decade","authors":"Sahra Ünlütürk ,&nbsp;Robert M. Kauling ,&nbsp;Judith A.A.E. Cuypers ,&nbsp;Annemien E. van den Bosch ,&nbsp;Alexander Hirsch ,&nbsp;Chiara Pelosi ,&nbsp;Daniel J. Bowen ,&nbsp;Raluca G. Chelu ,&nbsp;Ad J.J.C. Bogers ,&nbsp;Willem A. Helbing ,&nbsp;Isabella Kardys ,&nbsp;Jolien W. Roos-Hesselink","doi":"10.1016/j.ijcchd.2025.100624","DOIUrl":"10.1016/j.ijcchd.2025.100624","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate survival, clinical outcome and quality of life (QoL) of patients up to 49 years after surgical ventricular septal defect (VSD) closure.</div></div><div><h3>Methods</h3><div>Single-center, longitudinal cohort study evaluating consecutive patients with surgical VSD closure between 1968 and 1980 with extensive cardiac and QoL evaluation every decade.</div></div><div><h3>Results</h3><div>Of the original cohort of 174 patients, 39 died (22 %), 8 were lost to follow-up and 38 had not participated previously. Survival rate at 49 years follow-up was 77 % and 86 % when excluding early postoperative mortality. Of the 89 eligible survivors, 76 (85 %) were evaluated (59 % male, median age 49 [44–54] years) with a median follow-up of 44 (range 40–49) years after surgery. Event-free survival at 49 years was 50 %, with symptomatic arrhythmias (10 %), pacemaker implantation (8 %) and VSD-related interventions (3 %) being common complications. At last follow-up, 58 % had left atrial dilation, 25 % had aortic regurgitation and 5 patients (7 %) had a residual VSD. Early postoperative arrhythmias predicted mortality. Both left ventricular (LV) and right ventricular ejection fraction remained stable, with only 1 % having an LV ejection fraction below 45 % at last follow-up. Exercise capacity and VO₂max were mildly reduced in 33 % and 49 % of the patients while self-perceived QoL was stable and comparable with the general Dutch population.</div></div><div><h3>Conclusion</h3><div>Half of the patients with surgical VSD closure had an event-free survival at 49 years. Pacemaker implantation was often needed. Early postoperative arrhythmias predicted mortality. QoL was good and remained stable over time.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100624"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361636","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":"Physical fitness in adults with isolated secundum atrial septal defects","authors":"Linda Ashman Kröönström ,&nbsp;Anna-Klara Zetterström ,&nbsp;Mikael Dellborg ,&nbsp;Åsa Cider ,&nbsp;Peter Eriksson ,&nbsp;Emelie Dahlin ,&nbsp;Zacharias Mandalenakis","doi":"10.1016/j.ijcchd.2025.100632","DOIUrl":"10.1016/j.ijcchd.2025.100632","url":null,"abstract":"<div><h3>Background</h3><div>Atrial septal defect (ASD) is one of the most common diagnoses in patients with adult congenital heart disease (ACHD). However, recent studies indicate that ASD is not so benign and may impede physical fitness. We aimed to assess physical fitness in patients with isolated secundum ASD compared with healthy reference values and to evaluate the results according to the absence or presence of repair.</div></div><div><h3>Methods</h3><div>Between April 2009 and March 2025, patients with ACHD performed physical fitness tests comprising five muscular fitness tests and one cardiorespiratory endurance test. Data were stored in a registry at the Physical Therapy Department, Sahlgrenska University Hospital/Östra. In total, 102 adults with isolated secundum ASD were included in this descriptive, register-based cohort study.</div></div><div><h3>Results</h3><div>Both women and men with ASD showed significantly lower isoinertial muscular fitness test results (heel lifts: p &lt; 0.001 and shoulder flexions: p &lt; 0.001) and maximal exercise capacity (p &lt; 0.001) compared with healthy reference values. The shoulder flexion test revealed the lowest percentage of reference values for women and men with ASD (58.3 % and 53.3 %, respectively). Women who had undergone surgical procedures performed the timed-stands test significantly faster when compared with women who had undergone device procedures (13.0 s [10.2, 16.0] vs. 19.1 s [15.1, 26.2]; p = 0.014).</div></div><div><h3>Conclusion</h3><div>Patients with less complex ACHD, such as secundum ASD, may have impaired muscular fitness and cardiorespiratory endurance. Therefore, all patients with ACHD could be offered tests of physical fitness. These tests are necessary when prescribing individualized exercise, as suggested by guidelines.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100632"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578754","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":"Pregnancy outcomes and effects on cardiac function among patients with Tetralogy of Fallot: A single-center cohort study","authors":"Ohad Houri ,&nbsp;Noam Shasho-Peres ,&nbsp;Eran Hadar ,&nbsp;Sharon Orbach Zinger ,&nbsp;Ran Kornowski ,&nbsp;Anat Pardo ,&nbsp;Shimon Kolker ,&nbsp;Shahar Vig ,&nbsp;Asnat Walfisch ,&nbsp;Bar Narkis ,&nbsp;Nili Schamroth Pravda","doi":"10.1016/j.ijcchd.2025.100613","DOIUrl":"10.1016/j.ijcchd.2025.100613","url":null,"abstract":"<div><h3>Background</h3><div>Data on the characteristics and outcomes of pregnancy amongst patients with Tetralogy of Fallot (TOF) is limited. Depending on the hemodynamic status of the patient, the risk of maternal and fetal complications during pregnancy can be considerable.</div></div><div><h3>Objectives</h3><div>We aimed to systematically evaluate maternal, obstetric, and fetal outcomes, and assess longitudinal changes in cardiac function among women with TOF using serial imaging.</div></div><div><h3>Methods</h3><div>Pregnant adult patients with TOF between 2014 and 2022 were included. We examined maternal and obstetric outcomes during pregnancy. We assessed serial imaging to evaluate the temporal effects of pregnancy on cardiac function.</div></div><div><h3>Results</h3><div>Our cohort included 50 patients. There were 85 pregnancies overall with 79 live births (92.9 %). The median gestational age at delivery was 38.3 [37.0–39.1] gestational weeks (GW), nine deliveries (11.3 %) occurred before 37 GW, but only one before 34 GW. The median birthweight at delivery was 2850 [2450–3048] grams. The main fetal complication was small for gestational age (n = 16,22 %). There were no deaths in the peripartum period or the year following pregnancy. There were no significant valvular or ventricular functional differences when comparing pre-conception to post-conception echocardiogram data. In the subgroup with availability of MRI data, the Right ventricular end-diastolic volume index increased significantly post-pregnancy (109 ± 37.9 ml/m² vs 117 ± 25.0 ml/m², p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Maternal and obstetric complications are rare among patients with TOF. Our initial findings suggest that pregnancy does influence cardiac dimensions on serial long-term imaging follow-up but further, expanded long-term data is needed.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100613"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922015","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 role of artificial intelligence and mobile health in diagnosis and management of pulmonary arterial hypertension","authors":"Maria Luisa Benesch Vidal ,&nbsp;Alexandra Arvanitaki ,&nbsp;Gerhard-Paul Diller","doi":"10.1016/j.ijcchd.2025.100622","DOIUrl":"10.1016/j.ijcchd.2025.100622","url":null,"abstract":"<div><div>Pulmonary arterial hypertension (PAH) is a rare, progressive disorder characterized by pulmonary vascular remodeling, increased pulmonary vascular resistance, and ultimately right ventricular failure. Despite therapeutic advances, delayed diagnosis and imprecise risk stratification remain key challenges. Artificial intelligence (AI) and machine learning (ML) offer opportunities across the care continuum. This includes early detection from electronic health records, electrocardiography and imaging, automated, standardized interpretation of echocardiography, computed tomography (CT), and cardiac magnetic resonance (CMR) potentially expediting referral and final diagnosis. Deep learning applied to echocardiography achieves expert-level PAH classification and provides automated right-heart quantification while CT/CMR-based models segment the heart and great vessels, quantify lung disease radiomics, and infer hemodynamics, supporting noninvasive triage and prognostication. In future, remote monitoring with wearables and telemedicine, coupled with AI analytics, promises to enable proactive management and potentially reduce hospitalizations. While early studies are promising, translation to practice requires rigorous external validation, prospective studies, bias auditing and seamless integration into guideline-aligned workflows. Overall, AI stands to augment expert clinical judgement by converting high-dimensional, multimodal data into actionable insights. With careful governance and evidence generation, AI has the potential to shorten time-to-diagnosis, refine risk stratification, and personalize therapy in PAH, ultimately improving outcomes for this high-risk population.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100622"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361706","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 course of severe congenital aortic valve stenosis in children","authors":"Maximiliaan L. Notenboom ,&nbsp;Sencer Albayrak ,&nbsp;Kevin M. Veen ,&nbsp;Ingrid van Beynum ,&nbsp;Rebecca Swens ,&nbsp;Jolien W. Roos-Hesselink ,&nbsp;Pieter C. van de Woestijne ,&nbsp;Jonathan R.G. Etnel ,&nbsp;Willem A. Helbing ,&nbsp;Johanna J.M. Takkenberg ,&nbsp;Ad J.J.C. Bogers","doi":"10.1016/j.ijcchd.2025.100626","DOIUrl":"10.1016/j.ijcchd.2025.100626","url":null,"abstract":"<div><h3>Background</h3><div>Congenital valvular aortic stenosis (VAS) in children requires lifelong follow-up. An overview of age-specific treatment pathways from first diagnosis of severe VAS is lacking.</div></div><div><h3>Objectives</h3><div>To assess patient journeys and outcomes after severe pediatric VAS diagnosis, by describing its clinical course and treatment trajectories based on a 37-year single-center experience.</div></div><div><h3>Methods</h3><div>Baseline and time-related data of children diagnosed with severe congenital VAS between 1985 and 2022 were retrospectively collected. Time-related death (Kaplan-Meier estimator) and intervention occurrence (Aalen-Johansen estimator) were analyzed.</div></div><div><h3>Results</h3><div>245 children (73.1 % male, median age: 1.2 years (IQR:0.1–7.0)) were diagnosed with severe VAS (53 aged &lt;30 days, 74 between 30d-1y, 84 between 1y-12y, 34 between 12y-18y). Median survival follow-up was 23.3 years (IQR:10.3–31.2) (99.0 % complete). Thirty-five-year incidence of death after diagnosis was 16.2 %(95 %CI:9.7–22.2 %). Of 245 patients, 211 patients (86.1 %) underwent an intervention and 34 (13.9 %) did not undergo an intervention. Of these 34 children, 7 children showed time-related Doppler gradient regression to mild-or-moderate VAS and 17 had stable severe VAS. These 24 children experienced a 6.0 % incidence of death at 30-years after diagnosis. The most common intervention over time (47.5 %) was balloon valvuloplasty, especially in neonates and infants, followed by aortic valve replacement (37.5 %), especially in older children.</div></div><div><h3>Conclusions</h3><div>This study highlights the vast heterogeneity of treatment pathways and outcomes in children diagnosed with severe VAS at different ages. The observed stabilization of severe VAS or regression of the serial peak Doppler gradient to mild-or-moderate VAS without symptoms in 24 children highlights the need for better insight into determinants of disease course.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100626"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361707","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":"Prognostic implications of heart failure rehospitalization in adults with CHD & clinical benefits of medical therapy","authors":"Emili P. Rosado Rodriguez,&nbsp;Cynthia S. Crowson,&nbsp;Alexander C. Egbe","doi":"10.1016/j.ijcchd.2025.100640","DOIUrl":"10.1016/j.ijcchd.2025.100640","url":null,"abstract":"<div><h3>Background</h3><div>The risk factors for heart failure (HF) rehospitalization, and the effect of guideline directed medical therapy (GDMT) are poorly understood in adults with congenital heart disease (ACHD). We aimed to describe the outcomes of HF hospitalization and to assess the clinical benefits of GDMT for HF.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of ACHD hospitalized for HF at Mayo Clinic from 2003 to 2023. Cox proportional hazard models were used to determine the predictors of HF rehospitalization and all-cause mortality, and to assess the association between death and GDMT, as measured by the Heart Failure Collaborative score.</div></div><div><h3>Results</h3><div>Of the 324 patients, 164 were rehospitalized for HF and 149 died. The 10-year cumulative incidence of rehospitalization was 75.8 % (95 % CI 70.1 %–81.5 %), and the 10-year survival rate from mortality was 47.3 % (95 % CI 40.9 %–54.7 %). Chronic kidney disease (HR 1.46, 95 % CI 1.06–2.01, p = 0.021) and Fontan physiology (HR 1.59, 95 % CI 1.02–2.49, p = 0.043) were associated with HF rehospitalization. HF rehospitalization within 1 year was associated with nearly a 3-fold increased risk of mortality (HR 2.88, 95 % CI 2.00–4.15, p &lt; 0.001). The HFC score was associated with a lower risk of all-cause mortality (HR 0.77, 95 % CI 0.62–0.95, p = 0.016) in the subgroup of patients with reduced ejection fraction.</div></div><div><h3>Conclusions</h3><div>Among adults with CHD hospitalized for HF, half of the patients were rehospitalized for HF. Rehospitalization within 1 year of the index HF hospitalization was associated with mortality. The use of GDMT for HF was associated with improved survival in patients with reduced ejection fraction.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100640"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623321","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":"Patient-specific mixed reality for venus P-valve implantation: A novel approach to procedural planning","authors":"Angelo Fabio d’Aiello ,&nbsp;Francesca Bevilacqua ,&nbsp;Angelo Micheletti ,&nbsp;Diana Gabriela Negura ,&nbsp;Giulia Pasqualin ,&nbsp;Luca Giugno ,&nbsp;Luciane Piazza ,&nbsp;Laura Schianchi ,&nbsp;Sara Boveri ,&nbsp;Alessandro Giamberti ,&nbsp;Massimo Chessa","doi":"10.1016/j.ijcchd.2025.100614","DOIUrl":"10.1016/j.ijcchd.2025.100614","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Survival rates for patients with congenital heart disease (CHD) have improved, but complications like pulmonary regurgitation (PR) often require re-interventions. Transcatheter pulmonary valve implantation (TPVI) with self-expandable valves, such as the Venus P-Valve, has broadened treatment options. Accurate procedural planning, particularly valve sizing, remains a significant challenge. Mixed Reality (MxR) technology enables a patient-specific approach that enhances procedural planning accuracy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;To evaluate the use of MxR in planning Venus-P valve implantation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This study included patients undergoing Venus P-Valve implantation with holographic models generated from CT data using ARTICOR® software from January 2023 to June 2024. Two independent operators used these models for procedural planning. Concordance between operators was assessed. Predictions were compared with implanted valve dimensions to evaluate concordance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 29 eligible patients, 26 underwent successful Venus-P valve implantation. Concordance between the operators reached 60 % (n = 15/26) for valve diameter and over 88 % (n = 23/26) for valve length. Holographic models achieved 96 % (n = 25/26) concordance in predicting valve length, type of the approach (92 %) and 50 % (n = 13/26) concordance for diameter.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Holographic models enhanced procedural planning, enabling better visualization and collaborative decision-making. While highly effective for valve length predictions, and type of the approach limitations in predicting valve diameter highlight the need for improved methods, such as computational modelling or machine learning.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Patient-specific holographic models are promising tools for TPVI planning. Advancements in technology and interdisciplinary collaboration are critical to overcoming current limitations and advancing procedural planning and related outcomes in interventional cardiology.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Condensed abstract&lt;/h3&gt;&lt;div&gt;This study assesses the use of mixed reality (MxR) technology for procedural planning in transcatheter pulmonary valve implantation (TPVI) with the Venus P-Valve. Holographic models were created from CT data to aid in valve sizing and implantation strategies, with two operators comparing measurements for valve diameter and length. Among 26 patients who underwent successful implantation, concordance between operators was 60 % for valve diameter and 88 % for valve length. Predictions using holographic models showed 96 % concordance for implanted valve length, type of the approach (92 %) and 50 % concordance for valve diameter. These results highlight the potential of MxR for improving TPVI planning, though the limited accuracy for valve diameter suggests a need for further advancements, such as computational modeling or ","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100614"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106151","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}