Annals of Pediatric Cardiology最新文献

{"title":"Neuroprotective strategies for atrial myxoma resection surgery in a child with cerebral infarction from embolic stroke.","authors":"Sue-Anne Han Jia Chyn, Joyce Darshinee Sirisani, Kok Wai Soo, Khairul Anuar Abdul Aziz","doi":"10.4103/apc.apc_144_25","DOIUrl":"https://doi.org/10.4103/apc.apc_144_25","url":null,"abstract":"<p><p>Cardiac myxoma is a rare benign primary cardiac tumor in children with a high risk of cerebral embolization due to its friable and mobile nature. We present a child who developed an acute left middle cerebral artery infarct from embolization from a left atrial myxoma. He underwent decompressive craniectomy followed by myxoma resection 5 days later. Perioperative management focused on neuroprotection, including mild hypothermia, cerebral oximetry monitoring, and optimized hemodynamic and metabolic parameters. No hemorrhagic complications occurred, and the patient had a favorable neurological recovery without tumor recurrence. In myxoma-related embolic stroke, surgical resection remains the definitive treatment. Although the timing of surgery remains debated, delaying surgery even with antithrombotic bridging still poses a risk of recurrent embolism. With multidisciplinary coordination to balance the risks of hemorrhagic transformation and further embolization, early surgery can be both safe and effective.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"620-623"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodality imaging in a child with complete atrioventricular canal defect, left superior vena cava, and airway compression: Echocardiography, bronchoscopy, and lung ultrasound insights.","authors":"Rajesh Madavathazathil Gopalakrishnan, Shashikapoor Yadav, Ashish Katewa","doi":"10.4103/apc.apc_261_25","DOIUrl":"https://doi.org/10.4103/apc.apc_261_25","url":null,"abstract":"<p><p>Congenital heart disease may coexist with airway abnormalities, increasing perioperative risk. We report a 2-year-old girl with a complete atrioventricular canal defect (CAVCD), left superior vena cava (LSVC), and severe pulmonary hypertension, in whom multimodality imaging was pivotal for diagnosis and management. Transthoracic echocardiography confirmed CAVCD, LSVC, and severe pulmonary hypertension. Preoperative computed tomography demonstrated left pulmonary artery compression of the left main bronchus and a suspected cor triatriatum. Intraoperative bronchoscopy revealed left bronchomalacia, while transesophageal echocardiography identified a dilated coronary sinus as the cause of left atrial inflow turbulence, excluding cor triatriatum. Surgical management included CAVCD repair and LSVC anastomosis to the right atrial appendage. Post-cardiopulmonary bypass echocardiography showed no residual atrioventricular valve regurgitation or inflow gradient. Lung ultrasound prior to extubation excluded left lung collapse. This case highlights the role of multimodality imaging in guiding diagnosis, surgical planning, and safe perioperative management.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"628-631"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in neonatal ductal stenting: When to avoid tortuous ducts and pulmonary artery stenosis.","authors":"Sakthi Saravanan, Navaneetha Sasikumar, Raman Krishna Kumar","doi":"10.4103/apc.apc_148_25","DOIUrl":"https://doi.org/10.4103/apc.apc_148_25","url":null,"abstract":"<p><p>Ductal stenting (DS) is the preferred palliative approach to the Blalock-Thomas-Taussig shunt (BTTS) for neonates with duct-dependent pulmonary circulation. However, appropriate case selection remains a critical challenge. This report explores the limitations of DS through illustrative examples and defines the subset in which neonatal DS is better avoided. Tortuous ducts increase the risk of procedural failure, ductal spasm, and pulmonary artery (PA) jailing. These can generally be managed with wire techniques and stiff wires. If extreme curvature persists despite these measures, it is best to abandon the procedure. Bilateral PA stenosis needs careful strategic planning and is often better managed surgically. Procedural risk is significantly high when both branch PA stenosis and tortuosity coexist, necessitating a BTTS. This pictorial report specifies anatomical substrates that are unsuitable for neonatal DS to improve safety and efficacy. It is intended as a visual reference for interventionists facing comparable clinical scenarios, particularly in early career.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"586-589"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of pediatric heart transplantation in single-ventricle heart disease: A single-center analysis.","authors":"L Lily Rosenthal, Heinrich Netz, Nikolaus A Haas, Carola Grinninger, Jörgen Hörer, Sebastian Michel, Christian Hagl, Marcus Fischer","doi":"10.4103/apc.apc_209_25","DOIUrl":"https://doi.org/10.4103/apc.apc_209_25","url":null,"abstract":"<p><strong>Objective and aims: </strong>Pediatric heart transplantation (HTx) for children with single-ventricle (SV) physiology remains a complex and high-risk procedure. This study aimed to retrospectively evaluate long-term outcomes in patients with SV undergoing primary HTx versus HTx after failed staged palliation.</p><p><strong>Methods: </strong>Between 1991 and 2025, 22 pediatric patients (aged ≤ 18 years) with SV physiology underwent orthotopic HTx. Thirteen received primary HTx (Group 1), and nine had HTx after failed staged palliation (Group 2), including two post-Norwood, three post-Glenn, and four post-Fontan procedures.</p><p><strong>Results: </strong>The 10-year survival rate was 71.6%, with similar re-transplant-free survival. The median transplant age was 0.22 years (interquartile range [IQR], 0.08-0.49) for Group 1 and 15.1 years (IQR, 3.0-16.5) for Group 2. Posttransplant extracorporeal membrane oxygenation was needed in three patients in Group 1 and six patients in Group 2. Coronary vasculopathy (grades I-III) occurred in eight patients in Group 1 and 5 patients in Group 2; one patient in each group underwent re-HTx. Cytomegalovirus positivity was found in three and one patients; Epstein-Barr virus positivity in six and two patients (Groups 1 and 2, respectively). Rejection (grades 0-II) occurred in 7 and 2 patients, respectively. Posttransplant lymphatic disorder developed in four patients (Group 1). Immunosuppression was changed in 10 patients (Group 1) and 6 patients (Group 2). Three patients in Group 1 required pacemakers.</p><p><strong>Conclusions: </strong>HTx is feasible for pediatric SV patients. Primary Tx in infancy may involve shorter operative times, whereas HTx after failed palliation, especially post-Fontan, is more complex and associated with higher morbidity. Early referral and tailored treatment are essential. Multicenter prospective studies are needed to improve patient selection and address donor availability.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"541-550"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular mid-cavity obstruction: A novel cause of duct-dependent systemic circulation in a newborn.","authors":"Salim Nasser Al-Maskari, Madan Mohan Maddali, Ghida Mubarak Al-Muzaini, Halima Adam Al-Hashmi","doi":"10.4103/apc.apc_167_25","DOIUrl":"https://doi.org/10.4103/apc.apc_167_25","url":null,"abstract":"<p><p>Accessory mitral valve tissue is a rare congenital anomaly that may cause left ventricular outflow tract obstruction. This may be the first case report in a neonate, describing accessory mitral valve tissue producing a significant left ventricular outflow tract obstruction, resulting in a duct-dependent systemic circulation perfusing the neck and head vessels. This report also discusses why a hybrid palliative strategy was adopted.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"609-612"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biallelic truncating variants in the myosin-binding protein C3 result in a fatal form of cardiomyopathy in Indian infants.","authors":"Mani Ram Krishna, Usha Nandhini Sennaiyan, Shruti Irene Varghese, Sivalingam Devaprasath","doi":"10.4103/apc.apc_119_25","DOIUrl":"https://doi.org/10.4103/apc.apc_119_25","url":null,"abstract":"<p><p>As the genetic basis of pediatric cardiomyopathies is widely understood, it is hoped that the genotype would provide prognostic information about the course of the disease. We report four Indian infants with a fatal form of cardiomyopathy due to biallelic truncating variants in the Myosin-Binding Protein C3 gene.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"632-634"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic survey versus systematic review: Clarifying the methodology of a systematic survey on breastfeeding practices in infants with congenital heart disease.","authors":"Naimisha Yenduri, Perraju Bendapudi, Abish Sudhakar, Raman Krishna Kumar","doi":"10.4103/apc.apc_14_26","DOIUrl":"https://doi.org/10.4103/apc.apc_14_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"646"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unresolved questions in atrial septal defect pathophysiology: Shunt dynamics, exercise physiology, and pulmonary vascular disease risk.","authors":"Ashish H Shah","doi":"10.4103/apc.apc_164_25","DOIUrl":"https://doi.org/10.4103/apc.apc_164_25","url":null,"abstract":"<p><p>Despite advancements in the diagnosis and management of atrial septal defect (ASD), key hemodynamic aspects remain poorly understood. This review explores limitations of the pulmonary-to-systemic flow ratio (Qp:Qs), the impact of exercise on shunt volume, and predictors of pulmonary arterial hypertension. We highlight that Qp:Qs may not reflect true pulmonary blood flow, particularly during exertion, and that exercise-induced augmentation of shunt flow could predispose to right heart overload. Future studies integrating advanced imaging and hemodynamic measures are essential to refine risk stratification and management in patients with ASD.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"594-597"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic management of left brachiocephalic artery reimplantation in an infant: Role of cerebral oximetry in guiding ventilation, perfusion, and cannulation decisions.","authors":"Rajesh Madavathazathil Gopalakrishnan, Sakthi Saravanan, Balaji Srimurugan, Alakkaparambil Ramachandran Meghalakshmi, Raman Krishna Kumar","doi":"10.4103/apc.apc_183_25","DOIUrl":"https://doi.org/10.4103/apc.apc_183_25","url":null,"abstract":"<p><p>Isolated left brachiocephalic artery (ILBA) is a rarely reported congenital anomaly in which the left brachiocephalic artery (LBA) is connected to the pulmonary artery. Repair of this condition is challenging due to cerebral perfusion being dependent on the circle of Willis and the direct connection between the pulmonary artery and the systemic circulation. We report the case of a 9-month-old female diagnosed with type II ILBA, who underwent elective reimplantation of the LBA into the aorta. The anesthetic goals were to optimize cerebral circulation and prevent pulmonary overflow. Near-infrared spectroscopy (NIRS) was employed to monitor cerebral oxygenation. Major intraoperative decisions such as adjusting ventilation to induce hypercapnia, systemic cooling, optimizing cannula positioning, employing selective antegrade cerebral perfusion, deep hypothermic arrest, and gradual rewarming were all guided by NIRS monitoring. Postoperative recovery was uneventful, with extubation performed on the same day. This case highlights the importance of cerebral oximetry and emphasizes the critical role of NIRS as an indispensable tool for guiding ventilation, cerebral perfusion, and cannulation decisions, which should be the standard of care during complex aortic arch repairs.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"616-619"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics of congenital heart disease interventions: \"Can do versus ought to do\"dilemma.","authors":"Anita Saxena, Raman Krishna Kumar","doi":"10.4103/apc.apc_13_26","DOIUrl":"https://doi.org/10.4103/apc.apc_13_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"527-530"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}