Annals of Pediatric Cardiology最新文献

{"title":"Cardiac magnetic resonance imaging in Holmes' heart: Decoding a rare variant of double-inlet left ventricle.","authors":"Lucas Rodrigues Araújo, Vitor Iglesias Mangolini, Marcos Torres de Brito Filho, André Vaz","doi":"10.4103/apc.apc_259_25","DOIUrl":"https://doi.org/10.4103/apc.apc_259_25","url":null,"abstract":"<p><p>Holmes' heart, a rare variant of double-inlet left ventricle with rudimentary right ventricle and ventriculoarterial concordance, predisposes to pulmonary overcirculation and heart failure due to unrestricted shunting. We report the case of a 32-year-old male, in whom cardiac magnetic resonance (CMR) revealed Holmes' heart with marked pulmonary artery dilation and advanced heart failure after long-term clinical management. This case highlights the value of CMR in characterizing complex anatomy and reinforces the importance of early surgical palliation to prevent late decompensation.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"638-640"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621735","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":"Cardiac surgery in Jehovah's Witness children: Clinical characteristics and outcomes from a limited single-center cohort.","authors":"Nikita Panigrahi, Harohalli Aswathanarayana Venkatesh, Manas Ranjan Mishra, Lalchand H Bandagi, Jyoti Thadlani, Ramesh Reddy, Nijagal Shivanna Devananda","doi":"10.4103/apc.apc_165_25","DOIUrl":"https://doi.org/10.4103/apc.apc_165_25","url":null,"abstract":"<p><strong>Background: </strong>Jehovah's Witnesses (JWs), a religious group with over 9 million members globally, refuse allogeneic blood transfusions on religious grounds. Awareness of this population and their unique medical needs remains limited in India, particularly within the pediatric cardiac surgical context. Managing such patients poses legal, ethical, and clinical challenges. This study aims to describe the clinical profile, perioperative management, and outcomes of JW children undergoing cardiac surgery at a tertiary center.</p><p><strong>Methodology: </strong>A retrospective cohort study was conducted at a tertiary care hospital in Bangalore, India, including all pediatric JW patients who underwent cardiac surgery between 2019 and 2024. Data were collected on demographics, diagnoses, perioperative hemoglobin levels, blood-conservation strategies, postoperative complications, and outcomes.</p><p><strong>Results: </strong>Ten JW pediatric patients underwent cardiac surgery during the study period, including six infants. Seven had acyanotic congenital heart disease, whereas three had cyanotic defects. The mean preoperative hemoglobin and hematocrit were 13.1 ± 2.3 g/dL and 36.7% ± 5.2%, respectively; postoperative values were 10.3 ± 1.2 g/dL and 28.6% ± 3.9%. Blood conservation measures included postoperative recombinant erythropoietin in five patients and tranexamic acid in seven. There were no mortalities, and most patients had an uneventful recovery.</p><p><strong>Conclusions: </strong>Pediatric cardiac surgery in JW patients can be performed safely and effectively when a structured, multimodal blood conservation strategy is meticulously applied. Increased awareness and preparedness among clinicians are essential for optimizing outcomes in this unique population.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"565-570"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621746","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":"A one-and-a-half repair in a pulmonary atresia intact ventricular septum: A more appropriate final repair strategy.","authors":"Katsuo Tao, Yuichi Ishikawa, Koichi Sagawa","doi":"10.4103/apc.apc_147_25","DOIUrl":"https://doi.org/10.4103/apc.apc_147_25","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary atresia with intact ventricular septum (PAIVS) may be unable to compensate for right heart failure in the remote period due to inadequate right ventricular function, even if both ventricular circulations are maintained in the short term. One-and-a-half repairs may have a lower risk of remote right heart failure and severe complications than biventricular repair (BVR). We compared complications and hemodynamics during the medium term for each type of circulatory repair, estimated the risk of right heart failure, and discussed the PAIVS strategy, considering the remote prognosis.</p><p><strong>Materials and methods: </strong>Of 105 PAIVS patients who underwent surgical intervention at our hospital, we excluded patients who died (<i>n</i> = 8) and those with Glenn circulation awaiting Fontan repair (<i>n</i> = 3). Ninety-four patients were analyzed (BVR, <i>n</i> = 16; one-and-a-half, <i>n</i> = 6; Fontan, <i>n</i> = 72). Hemodynamics and complications in the medium term were compared among groups according to the final repair.</p><p><strong>Results: </strong>The mean age (range) at the last evaluation was as follows: BVR, 17.5 (2-39) years; one-and-a-half, 28.5 (6-34) years; and Fontan, 14 (3-36) years. The New York Heart Association (NYHA) classification was lowest in the one-and-a-half group (P = 0.06) (NYHA I/II/III: BVR, 11/5/0; one-and-a-half, 6/0/0; Fontan, 65/7/0). The central venous pressure was the lowest in the one-and-a-half group: one-and-a-half, 4 (1-14) mmHg; BVR, 4.5 (1-10) mmHg; and Fontan, 8 [5-15] mmHg.</p><p><strong>Conclusions: </strong>A one-and-a-half repair is a final repair because it offers a safer hemodynamic margin and may also carry a lower risk of long-term right ventricle failure than BVR.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"557-564"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621756","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":"Beyond the operating room: Integrating pediatric cardiac anesthesiology and critical care in India - Towards a collaborative model.","authors":"Rajesh Madavathazathil Gopalakrishnan","doi":"10.4103/apc.apc_294_25","DOIUrl":"https://doi.org/10.4103/apc.apc_294_25","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"647-648"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621659","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":"Detection of streptococcal deoxyribonucleic acid with polymerase chain reaction in excised valvular tissue of rheumatic heart disease patients.","authors":"Nitin Kumar Parashar, Mohsin Raj Mantoo, Sudheer Arava, Sivasubramanian Ramakrishnan, Palleti Rajashekar, Mumun Sinha, Sandeep Seth, Balram Bhargava","doi":"10.4103/apc.apc_225_25","DOIUrl":"https://doi.org/10.4103/apc.apc_225_25","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatic heart disease (RHD) is traditionally attributed to cumulative valvular injury from the recurrent episodes of acute rheumatic fever. An alternative hypothesis is that streptococcal antigenic material may persist within cardiac valves, perpetuating chronic inflammation. This study aimed to test this by detecting streptococcal deoxyribonucleic acid (DNA) in excised rheumatic valvular tissue.</p><p><strong>Methods: </strong>We prospectively included 15 patients with RHD and 5 non-RHD controls undergoing valve replacement surgery. Patients with active rheumatic activity or infective endocarditis were excluded. Valvular tissue was subjected to nucleic acid extraction and polymerase chain reaction using universal 16S ribosomal ribonucleic acid primers, with glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as an internal control.</p><p><strong>Results: </strong>All the samples amplified with GAPDH primers, confirming DNA integrity. However, no bacterial DNA was detected in RHD or control valves. Histopathology consistently revealed chronic inflammation, fibrosis, hyalinization, and dystrophic calcification in RHD valves.</p><p><strong>Conclusions: </strong>Streptococcal bacterial DNA was not detected in the excised cardiac valvular tissues of RHD patients, suggesting that chronic bacterial persistence is unlikely to be the cause of ongoing valvular inflammation. The study, however, is limited by its small sample size.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"580-585"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621677","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":"Efficacy of thromboprophylaxis following stage II surgical palliation for single-ventricle physiology: A systematic review and meta-analysis.","authors":"Dicky Fakhri, Maura Andini Setiabudi, Ketut Shri Satya Yogananda","doi":"10.4103/apc.apc_196_25","DOIUrl":"https://doi.org/10.4103/apc.apc_196_25","url":null,"abstract":"<p><strong>Background: </strong>Postoperative thrombosis remains a significant cause of mortality and morbidity, especially in patients with single-ventricle physiology (SVP). The standard management plan for SVP consists of a three-stage surgical palliation, with widely varying thromboprophylaxis strategies. While routine thromboprophylaxis is standard after stages I and III, its role for stage II palliation remains controversial. This study aims to evaluate the impact of routine thromboprophylaxis in patients undergoing stage II palliation, with particular attention to cases involving pulmonary artery (PA) reconstruction, where the risk-to-benefit ratio of therapy may differ from routine stage II procedures.</p><p><strong>Methods and results: </strong>Analyses were conducted across 15 studies published between 1981 and 2021 (<i>n</i> = 1682), assessing the impact of routine thromboprophylaxis on thromboembolic events, mortality, and major adverse events (MAEs). A significant potential benefit of thromboprophylaxis use was observed only in the subgroup of patients undergoing PA reconstruction (14% in the thromboprophylaxis group versus 6% in the no-thromboprophylaxis group; <i>P</i> = 0.01). The prevalence of thromboembolic events in the overall population was 5% (95% confidence interval [CI]: 3%-8%) without a significant difference between the two groups (<i>P</i> = 0.88). The pooled odds ratio (OR) showed a nonsignificant effect of thromboprophylaxis in reducing thrombotic events (OR = 0.35, 95% CI: 0.02-7.81). No significant differences were observed in thromboembolic events, MAEs, and mortality rates between the groups receiving thromboprophylaxis or no thromboprophylaxis (<i>P</i> = 0.88, 0.29, 0.45, respectively).</p><p><strong>Conclusions: </strong>This study supports the use of routine thromboprophylaxis following second-stage palliation of SVP, particularly in patients undergoing PA reconstruction. However, the evidence is limited by observational study designs, heterogeneity among studies, and the lack of recent high-quality data. Further well-designed studies are warranted to confirm these findings and to identify the optimal antithrombotic agent.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 6","pages":"598-608"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621680","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":"Fontan circulation versus cirrhotic cardiomyopathy: A comparative overview.","authors":"Ashish H Shah","doi":"10.4103/apc.apc_222_25","DOIUrl":"https://doi.org/10.4103/apc.apc_222_25","url":null,"abstract":"<p><p>Fontan circulation and cirrhotic cardiomyopathy (CCM) represent distinct but overlapping entities characterized by concomitant hepatic and cardiac dysfunction. Fontan patients exhibit chronically elevated central venous pressure (CVP), impaired preload, limited cardiac reserve, systolic-diastolic dysfunction, and frequent arrhythmias, while CCM arises in cirrhosis with blunted stress response, diastolic dysfunction, and electrophysiologic abnormalities despite preserved resting ejection fraction. Both share exercise intolerance and stress-induced contractile failure but differ in underlying hemodynamics: Low-output, high-CVP Fontan physiology versus hyperdynamic, low-resistance CCM. We highlight mechanistic links, including inflammation, nitric oxide, and bile acid-mediated cardiotoxicity, by which Fontan-associated cirrhosis may induce a CCM-like phenotype, with implications for surveillance and management.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 5","pages":"487-489"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147301235","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":"Transcatheter closure of ostium secundum atrial septal defect in congenitally corrected transposition of great arteries with visceral situs inversus and dextrocardia: Rationale and technical challenges.","authors":"Sabyasachi Pandey, Chetan Kumar Nanjegowda, Anand P Subramanian, Jayanth Kumar Honnakere Venkataiya","doi":"10.4103/apc.apc_221_25","DOIUrl":"https://doi.org/10.4103/apc.apc_221_25","url":null,"abstract":"<p><p>Congenitally corrected transposition of the great arteries (CC-TGA) may occur in isolation or may be associated with defects in the ventricular septum and stenosis of the pulmonary outflow tract. A large ostium secundum atrial septal defect (ASD) as the only other anomaly is rare in CC-TGA. We report successful use of an Amplatzer septal occluder to close an ASD in a patient with visceral situs inversus, dextrocardia, and CC-TGA.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 5","pages":"504-508"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289263","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":"Serum procalcitonin as a predictor of intravenous immunoglobulin resistance and coronary artery lesions in Kawasaki disease.","authors":"Jae Sung Son","doi":"10.4103/apc.apc_104_25","DOIUrl":"https://doi.org/10.4103/apc.apc_104_25","url":null,"abstract":"<p><strong>Background: </strong>Procalcitonin (PCT) has emerged as a potential biomarker for predicting resistance to intravenous immunoglobulin (IVIG) treatment and coronary artery abnormalities in Kawasaki disease (KD). This study aimed to evaluate the clinical utility of serum PCT in the management of KD.</p><p><strong>Materials and methods: </strong>A retrospective analysis was performed on 170 patients with KD treated at a single center. Serum PCT levels were measured along with clinical and laboratory data. Patients were categorized as responders or nonresponders to IVIG treatment based on the resolution of fever following treatment. Logistic regression and receiver operating characteristic curve analysis were used to assess the predictive value of serum PCT.</p><p><strong>Results: </strong>Serum PCT levels were significantly higher in nonresponders compared to responders (1.40 ng/mL versus 0.32 ng/mL, <i>P</i> < 0.001). Logistic regression analysis identified serum PCT as an independent predictor of IVIG resistance (odds ratio - 1.385; 95% confidence interval, 1.071-1.791; <i>P</i> = 0.013). A cutoff value of 1.80 ng/mL yielded a sensitivity of 71.4% and specificity of 86.6%, with an area under the curve of 0.838. Although elevated serum PCT levels were observed in patients with coronary artery abnormalities, it was not an independent predictor in logistic regression analysis.</p><p><strong>Conclusions: </strong>Serum PCT is a useful biomarker for predicting resistance to IVIG treatment in KD. However, its utility for predicting coronary artery lesions is limited. Further multicenter studies are needed to validate these findings and standardize methodologies for clinical application.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 5","pages":"447-454"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289280","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":"From closure to catastrophe: Pneumonectomy following missed aortic pseudoaneurysm after transcatheter closure of patent ductus arteriosus.","authors":"Amit Kumar, Anita Saxena, Krishna Subramony Iyer, Soumyaranjan Das, Sumir Girotra, Parvathi Iyer","doi":"10.4103/apc.apc_207_25","DOIUrl":"https://doi.org/10.4103/apc.apc_207_25","url":null,"abstract":"<p><p>We describe the case of a large pseudoaneurysm developing after percutaneous closure of patent ductus arteriosus in a 2-year-old girl, which went undiagnosed in time, leading to destruction of the left lung necessitating left pneumonectomy along with resection of the pseudoaneurysm.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"18 5","pages":"493-495"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147301240","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}