Annals of Pediatric Cardiology最新文献

{"title":"Electrosurgery in pediatric catheter interventions.","authors":"Kothandam Sivakumar","doi":"10.4103/apc.apc_116_26","DOIUrl":"https://doi.org/10.4103/apc.apc_116_26","url":null,"abstract":"<p><p>Electrosurgery refers to the use of high-frequency alternating current in continuous mode to cut tissues by generating heat through vaporization of water molecules to hydrogen and hydroxide ions. This aids in transcatheter procedures to open atretic valves or atretic vessels, recanalize occluded blood vessels and conduits, and create new communication between adjacent cardiac chambers that have wide application in different structural and congenital heart diseases. This review aims to provide information on the physics behind electrosurgery, terminology used, and different clinical applications and finally details the practical techniques to be followed in the catheterization laboratory using the commonly available gadgets and catheters.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"553-563"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103143","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 catheter ablation for arrhythmia in adults with congenital heart disease: A meta-analysis of clinical outcomes.","authors":"Imke Maria Puling, Sebastian Willyanto, Nyoman Deva Giri, Jesphine Arbi Wijaya, Liliana Dewi, Derren Dch Rampengan, Valerinna Yogibuana Swastika Putri, Starry Homenta Rampengan","doi":"10.4103/apc.apc_134_25","DOIUrl":"https://doi.org/10.4103/apc.apc_134_25","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmias remain a major clinical challenge in adult congenital heart disease (aCHD), contributing significantly to increased hospitalization rates and cardiac complications, affecting over 50% of aCHD patients. Catheter ablation (CA) is regarded as a first-line therapeutic modality due to its potential for disease modification. However, concerns persist regarding its long-term efficacy and safety. Thus, a comprehensive evaluation of CA outcomes in this population is warranted.</p><p><strong>Methods: </strong>The outcomes of interest were the success rate, secondary ablation rate, complication rates, and recurrence of arrhythmias. Quality assessment was done using the Risk of Bias in Non-randomized Studies of Interventions tool, and meta-analysis was performed using RStudio.</p><p><strong>Results: </strong>A comprehensive search of seven databases yielded 15 articles for analysis, among which 10 were categorized as low-risk, four as moderate-risk, and one lacked information regarding bias. The single-arm meta-analysis, examining events per 100 observations, revealed a success rate of 85.37 (95% confidence interval [CI] =78.50, 92.24). Moreover, the secondary ablation rate was determined to be 29.29 (95% CI = 16.92, 41.66), while major complications occurred at a rate of 2.81 (95% CI = 0.89, 4.73) and minor complications at a rate of 5.29 (95% CI = 1.88, 8.70). The overall recurrence rate of arrhythmias was found to be 40.33 (95% CI = 28.37, 52.29), with specific rates for intra-atrial reentrant tachycardia at 20.33 (95% CI = 11.24, 29.43), atrial fibrillation at 14.25 (95% CI = 3.46, 25.05), and atrioventricular nodal reentrant tachycardia at 9.70 (95% CI = 0.00, 19.56). Lastly, the implantation rate of implantable cardioverter defibrilators (ICDs) was found to be 1.05 (95% CI = 0.12, 1.99).</p><p><strong>Conclusion: </strong>CA for arrhythmias in aCHD patients demonstrates high success rates with minimal procedural complications. However, the substantial recurrence rates highlight the need for ongoing monitoring and proactive strategies to optimize long-term outcomes.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"475-489"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103132","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":"Sildenafil and fetomaternal outcomes in pregnancy-associated pulmonary hypertension.","authors":"Thirunavukkarasu Arun Babu, Vijayan Sharmila","doi":"10.4103/apc.apc_218_26","DOIUrl":"https://doi.org/10.4103/apc.apc_218_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"623-624"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102903","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":"Assessment of cardiac function in children with tuberculosis.","authors":"Waizungla Longkumer, Shaad Abqari, Mohammad Shameem","doi":"10.4103/apc.apc_59_26","DOIUrl":"https://doi.org/10.4103/apc.apc_59_26","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) continues to be a major global health concern, emerging evidence suggests that both pulmonary and extrapulmonary TB can cause subclinical or overt cardiac dysfunction, particularly in children. Echocardiography is a sensitive tool for early detection of myocardial, pericardial, and functional abnormalities. Early recognition of cardiac involvement and its reversibility with anti-tubercular therapy (ATT) may significantly influence clinical outcomes in paediatric population.</p><p><strong>Methods: </strong>This observational study included 50 children diagnosed with pulmonary or extrapulmonary TB. Detailed clinical evaluation, laboratory investigations (including Troponin I and Pro-BNP), and baseline echocardiographic assessment were performed using M-mode, pulsed and tissue Doppler and 2-D speckle tracking imaging. Repeat echocardiography was done after completion of ATT to assess improvement in cardiac parameters.</p><p><strong>Results: </strong>Of the 50 enrolled children, 16 (32%) demonstrated cardiac dysfunction on initial echocardiography. The most common abnormalities included impaired diastolic parameters on Doppler imaging and reduced global longitudinal strain (GLS). Elevated cardiac biomarkers was also associated with diastolic dysfunction. Post-ATT follow-up was available for 47 children. Among the 14 who initially had cardiac dysfunction, 12 (85.7%) showed significant improvement after treatment, while 2 had persistent dysfunction. No new dysfunction developed in children with normal baseline echocardiography.</p><p><strong>Conclusions: </strong>A considerable proportion of children with tuberculosis exhibit subclinical cardiac dysfunction detectable on echocardiography. Most abnormalities showed improvement following completion of ATT, underscoring the reversible nature of of TB-related cardiac involvement. Routine echocardiographic screening, should be considered in Pediatric TB to facilitate early diagnosis, timely intervention, and monitoring of treatment response.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"520-526"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103035","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":"Severe underweight status predicts adverse postoperative outcomes after congenital heart surgery in children.","authors":"Bana Nasser Agha, Usama Hagag Elsaedy, Basel Harahsheh, Marwan Al Hobani, Khalid Al Hawri, Abdu Rahman Al Mesned, Mohmad Salim Kabbani","doi":"10.4103/apc.apc_10_26","DOIUrl":"https://doi.org/10.4103/apc.apc_10_26","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition significantly affects children with congenital heart disease (CHD). Severe underweight status may prolong postoperative recovery and increase complications after cardiac surgery. Identifying modifiable risk factors may help improve outcomes.</p><p><strong>Patients and methods: </strong>Between January 2022 and December 2024, we included all children with a weight-for-age <i>Z</i> score (WAZ) <-3 who underwent palliative or corrective cardiac surgery (group 1). Demographic, laboratory, physiological, and clinical parameters were collected. Outcomes were compared with age- and risk-adjustment for congenital heart surgery-matched controls (group 2) with a normal WAZ (>-2). The severely underweight group was subdivided into two subgroups, complicated (1a) and noncomplicated (1b), to analyze potential risk factors.</p><p><strong>Results: </strong>A total of 170 children were included; 86 were severely underweight. Means WAZ and weight-for-height <i>Z</i> scores for group 1 were -4.4 ± 0.16 and -3.75 ± 0.43, respectively. The total complication rate was more in group (1), although it was not statistically different; cardiac and respiratory complications were higher in the severely underweight group. There were no differences in major cardiac events, unplanned interventions, or mortality. Severely underweight children had longer mechanical ventilation (MV), longer ICU and hospital stays, and more feeding difficulties.</p><p><strong>Conclusions: </strong>Severe underweight significantly increases postoperative morbidity after congenital heart surgery. Factors that elevate oxidative stress in this fragile population may further amplify surgical risk. Large-scale studies are essential to better identify and understand the contributing risk factors.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"497-502"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102875","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":"Cytokine-driven recurrent pericarditis in Down syndrome: Role of pericardial fluid analysis and cardiac magnetic resonance imaging.","authors":"Masaki Sato, Sayo Suzuki, Motoshi Sonoda, Ayako Kuraoka, Koichi Sagawa","doi":"10.4103/apc.apc_83_26","DOIUrl":"https://doi.org/10.4103/apc.apc_83_26","url":null,"abstract":"<p><p>Recurrent pericarditis is uncommon in children with Down syndrome (DS) and may present diagnostic challenges. We report the case of a child with DS who developed massive pericardial effusion with minimal systemic inflammatory markers. Pericardial fluid analysis revealed markedly elevated interleukin-6 levels, suggesting localized cytokine-driven inflammation. Cardiac magnetic resonance (CMR) imaging revealed limited subepicardial enhancement with preserved ventricular function, findings consistent with pericarditis and secondary myocardial involvement rather than primary myocarditis. Combination therapy with ibuprofen and colchicine resulted in sustained remission without recurrence. This case highlights that significant pericardial inflammation may occur in patients with DS despite minimal systemic inflammation, and CMR imaging may assist in disease activity assessment and therapeutic decision-making.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"576-580"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103021","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 test-taking to test-building: Using artificial intelligence to strengthen board examination preparation.","authors":"Mohammed Abdulrasak, Sohail Hootak","doi":"10.4103/apc.apc_159_26","DOIUrl":"https://doi.org/10.4103/apc.apc_159_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"616"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103212","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":"Millimeters from catastrophe: The pericardium as a lifesaving shield.","authors":"Konark Thakkar, Anurag Garg, Ashish Dolas, Shweta Tyagi, Shriya Haval, Ankur Dhameliya, Vipul Sharma, Ranjit Pawar, Tanushree Kar, Kishore Babu","doi":"10.4103/apc.apc_157_26","DOIUrl":"https://doi.org/10.4103/apc.apc_157_26","url":null,"abstract":"<p><p>We report a rare case of a 2-year-old child presenting 48 h after accidental penetrating chest trauma due to a fall from a motorcycle, with a retained foreign body lodged within the pericardial sac. Imaging revealed an opaque object overlying the cardiac silhouette. On median sternotomy, approximately 50 mL of pericardial blood was evacuated, and a piece of metallic debris was found resting beneath the left atrial appendage without injury to cardiac structures. The foreign body was successfully removed without cardiopulmonary bypass, and the child had an uneventful recovery. Retained foreign bodies in the pericardium following blunt-penetrating trauma in pediatrics are exceedingly rare and require a high index of suspicion and appropriate imaging. Surgical exploration remains the definitive treatment when pericardial injury or cardiac tamponade is suspected.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"608-611"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103119","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":"Favorable outcome of fetal bradyarrhythmia: Two case reports and literature review.","authors":"He Hong-Ju","doi":"10.4103/apc.apc_112_26","DOIUrl":"https://doi.org/10.4103/apc.apc_112_26","url":null,"abstract":"<p><p>Fetal bradycardia is primarily a symptom of fetal distress or intrauterine injury. This can result in fetal cardiac insufficiency, fetal edema, or even fetal death. This condition once perplexed doctors and often resulted in the induction of labor, breaking the hearts of many families. Here, we present two cases of fetal bradycardia with favorable outcomes, offering hope for the survival of affected babies.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"597-601"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103181","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":"Simultaneous transcatheter management of incidental critical left main coronary artery disease in a young woman undergoing atrial septal defect device closure.","authors":"Anil Kumar Singhi, Dilip Kumar, Arnab De, Somnath Dey, Kaushik Mukherjee","doi":"10.4103/apc.apc_186_26","DOIUrl":"https://doi.org/10.4103/apc.apc_186_26","url":null,"abstract":"<p><p>Transcatheter device closure is the preferred treatment for secundum atrial septal defect (ASD) in young adults with suitable anatomy. In this population, routine coronary angiography is generally not recommended in the absence of ischemic symptoms or conventional cardiovascular risk factors. However, coronary imaging is selectively performed during ASD intervention to delineate anomalous coronary anatomy at risk of device-related compression, and emerging evidence indicates that clinically significant coronary artery disease may occasionally coexist silently in younger adults. We report the case of a 28-year-old asymptomatic woman undergoing transcatheter closure of a large secundum ASD with deficient rims, in whom coronary angiography performed during invasive catheterization unexpectedly revealed critical left main coronary artery stenosis. Intravascular ultrasound (IVUS) confirmed severe luminal compromise, and successful IVUS-guided left main coronary stenting was performed, followed by device-assisted ASD closure in the same procedural session. Retrospective clinical assessment revealed a history of premature sudden cardiac death in a first-degree relative. This case illustrates the potential for occult yet prognostically significant coronary artery disease in young adults undergoing congenital heart interventions and supports a selective, individualized, and context-driven approach to coronary evaluation, consistent with contemporary adult congenital heart disease guidelines.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 4","pages":"437-442"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760582","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}