Annals of Pediatric Cardiology最新文献

{"title":"Utility of lidocaine in reducing pain of intramuscular benzathine penicillin G in children with rheumatic heart disease: A randomized, double-blind crossover study.","authors":"Ni Putu Veny Kartika Yantie, Eka Gunawijaya","doi":"10.4103/apc.apc_161_24","DOIUrl":"https://doi.org/10.4103/apc.apc_161_24","url":null,"abstract":"<p><strong>Background: </strong>The current recommended secondary prevention of rheumatic fever (RF)/rheumatic heart disease (RHD) includes every 21-28 days injection of benzathine penicillin G (BPG), which causes pain. We evaluated the effect of the coadministration of lidocaine on reducing the pain of BPG injections in children with RF/RHD.</p><p><strong>Patients and methods: </strong>Children aged 7-18 years who received BPG were eligible for a randomized crossover study. Participants received a secondary prophylaxis dose of intramuscular (IM) BPG with and without additional lidocaine as a diluent (0.2-0.4 mg/kg) and were randomized to the intervention (as a sequence). Participants and staff completing the evaluation were blinded to the sequence. Pain scales were assessed by participants using a Visual Analog Scale (VAS) and staff using the Wong-Baker Faces Pain Scale (WBFPS) at 5 and 60 min after injection.</p><p><strong>Results: </strong>Forty-two children were included in the study. Both lidocaine and aquadest sterile water groups were well matched in baseline characteristics. The pain scores at 5 min after BPG injection were lower when lidocaine was coadministrated: 2 (min-max 1-9) in lidocaine versus 5 (min-max 1-9) in sterile water (<i>P</i> = 0.001) using VAS score and 2 (min-max 0-10) in lidocaine versus 4 (1-8) in sterile water (<i>P</i> = 0.002) using WBFPS. Scores at 60 min after BPG injection showed no differences between treatments with <i>P</i> = 0.551 and <i>P</i> = 0.167, respectively, using VAS and WBFPS. No adverse event was observed.</p><p><strong>Conclusion: </strong>The coadministration of lidocaine as diluent resulted in reduced pain 5 min after IM injection of BPG.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"420-424"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962881","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":"Congenital cardiac surgery: Innovations from India.","authors":"Debasis Das","doi":"10.4103/apc.apc_22_25","DOIUrl":"https://doi.org/10.4103/apc.apc_22_25","url":null,"abstract":"<p><p>Innovation in congenital cardiac surgery took its roots in the 1960s with the development of indigenous heart-lung machines. Over the years, many pioneering advancements showcasing solutions that combine cutting-edge technology with cost-effective approaches have happened in India. Indian surgeons have made significant contributions, including developing tissue-engineered patches, handmade conduits, and indigenous devices for surgical closure of multiple ventricular septal defects. Several new surgical techniques have been described, and Indian surgeons have described some new anatomical entities. Development of frugal technologies has been the game-changer for resource-limited environments. Innovations in imaging, including three-dimensional printing and virtual reality, are transforming preoperative planning and surgical education. Artificial intelligence and machine learning are beginning to influence decision-making and predictive modeling in pediatric cardiac care. Funding initiatives, including government support, public-private partnerships, and philanthropic funding, are making congenital heart disease surgery accessible to a broader population. India's contributions to innovations in congenital cardiac surgery exemplify the spirit of resilience and ingenuity, offering solutions that are impactful locally and inspiring globally.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"389-400"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967387","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":"ThoroughFare atrial pressure controller device to create a controlled interatrial right-to-left shunt in advanced pulmonary arterial hypertension - A pilot study.","authors":"Bojja Venkata Satya Roopesh, Girija Haritha, S V Kishore, Muthukumaran Chinnasamy Sivaprakasam, Shreesha Maiya, Saileela Rajan, Pramod Sagar, Kothandam Sivakumar","doi":"10.4103/apc.apc_209_24","DOIUrl":"https://doi.org/10.4103/apc.apc_209_24","url":null,"abstract":"<p><strong>Background: </strong>Atrial flow regulators are used in patients with pulmonary arterial hypertension (PAH) who present with syncope or advanced heart failure. The ThoroughFare atrial pressure controller (Meril Life Sciences, Vapi, India) is a new device for similar use. The differences in structural design include a cable-screw release mechanism and a low profile.</p><p><strong>Methods: </strong>A multi-institutional study assessed the feasibility and safety of this device and reported short-term follow-up. This device, with an 8-mm fenestration diameter, was deployed after transseptal puncture using a 12F sheath.</p><p><strong>Results: </strong>Between April 2023 and June 2024, 15 symptomatic patients aged 5-39 years, including four children, received this implant after dual pulmonary vasodilator pharmacotherapy for at least 2 years. Etiology included idiopathic PAH in eight patients, hereditary PAH in two, operated shunt lesions in four, and human immunodeficiency virus-associated PAH in one patient. The key indication was recurrent syncope in 11 and right heart failure in the rest. The mean N-terminal pro-brain natriuretic peptide was 2414 ± 2046 pg/mL. The hemodynamic assessment revealed high right atrial pressures in 80% of patients, low cardiac index in half, and suprasystemic pulmonary pressures in four patients. The procedure was completed in all patients without any complications. Pulse oximeter saturations dropped from 98% ±2% to 92% ±4%. Symptoms improved over a median follow-up of 8 months, and the device patency was confirmed in all patients except one patient who died 5 months postprocedure after a heart-lung transplantation.</p><p><strong>Conclusion: </strong>ThoroughFare atrial pressure controller implantation was feasible and safe for all patients with severe PAH without any complications. Longer follow-up with more patients is needed to ascertain the functional improvements.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"408-414"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959861","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":"Rome was not built in a day!","authors":"Sataroopa Mishra, Avinash Anantharaj, Santhosh Satheesh","doi":"10.4103/apc.apc_41_25","DOIUrl":"https://doi.org/10.4103/apc.apc_41_25","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"471-472"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960153","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":"Pheochromocytoma presenting with recurrent syncope, prolonged QT interval and macroscopic T-wave alternans.","authors":"Raghav Bansal, Bhavik Dhirawani, Chetan Rathi, Yash Lokhandwala","doi":"10.4103/apc.apc_215_24","DOIUrl":"https://doi.org/10.4103/apc.apc_215_24","url":null,"abstract":"<p><p>An 11-year-old boy presented with recurrent exertional syncope for 1 month. The baseline electrocardiogram (ECG) suggested a diagnosis of long QT syndrome with macroscopic T-wave alternans. Volatility of blood pressure and left ventricular hypertrophy triggered further investigations, revealing pheochromocytoma as the primary cause. The child underwent laparoscopic resection of the tumor with subsequent resolution of ECG changes and symptoms. The genetic testing was negative for known mutations implicated with prolonged QT interval.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"455-458"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966714","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":"Evaluating the functional and genomic analysis of pathogenic junctophilin-2 variants and their association with the pathogenesis of cardiomyopathy to understand their molecular impact on cardiac calcium homeostasis and disease phenotypes.","authors":"Muhammed Ali Siham","doi":"10.4103/apc.apc_173_24","DOIUrl":"https://doi.org/10.4103/apc.apc_173_24","url":null,"abstract":"<p><p>The growing body of evidence suggests that junctophilin-2 (JPH2) variants hold significant potential for diagnostic and therapeutic interventions, particularly within the framework of personalized medicine and genetic screening across diverse populations. Mutations in JPH2 have been associated with a range of clinical phenotypes including early-onset heart failure and cardiomyopathies, a diverse group of diseases affecting heart muscle structure and function that contribute to heart failure and sudden cardiac death. While traditional understanding has centered on sarcomeric gene mutations, recent studies have shifted attention toward calcium-handling genes such as JPH2. This study consolidates insights from original research, preclinical studies, case reports, and editorials to highlight JPH2's impact on cardiomyopathies and associated disease phenotypes.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"401-407"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957738","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":"Re; Mantoo, Mohsin Raj; Ramakrishnan, Sivasubramanian - Pediatric cardiac interventions: Innovations from India.","authors":"Maitri Chaudhuri, Munesh Tomar","doi":"10.4103/apc.apc_242_24","DOIUrl":"https://doi.org/10.4103/apc.apc_242_24","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"470"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967595","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":"Hemodynamic rounds: Transcatheter creation of ventricular septal defect in pulmonary arterial hypertension with suprasystemic pressures.","authors":"Kothandam Sivakumar","doi":"10.4103/apc.apc_211_24","DOIUrl":"https://doi.org/10.4103/apc.apc_211_24","url":null,"abstract":"<p><p>This hemodynamic round section deals with severe pulmonary arterial hypertension with suprasystemic pulmonary artery pressures in a patient who underwent delayed surgical correction of the double-outlet right ventricle with a large subaortic ventricular septal defect (VSD). Recreation of a moderate-sized VSD by electrocautery-aided fenestration of the surgical patch resulted in effective right ventricular decompression. The changes in the hemodynamics are illustrated in the pressure traces and Doppler echocardiographic images. The changes in cardiac events on the right and left heart due to the right bundle branch block are also illustrated in the manuscript.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"448-454"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959240","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":"Immediate and short-term outcome of balloon pulmonary valvuloplasty in neonatal critical pulmonary stenosis.","authors":"Neeraj Aggarwal, Mridul Agarwal, Praneet Lale, Jay Relan, Siddartha Rudrappa, Anil Kumar, Reena Khantwal Joshi, Raja Joshi","doi":"10.4103/apc.apc_162_24","DOIUrl":"https://doi.org/10.4103/apc.apc_162_24","url":null,"abstract":"<p><strong>Introduction: </strong>Balloon pulmonary valvuloplasty (BPV) is the treatment of choice for valvular pulmonary stenosis (PS) in all age groups. However, there are limited data regarding its outcomes in newborns with critical PS in the current era. We are reporting the immediate and short-term outcomes of BPV in this population.</p><p><strong>Materials and methods: </strong>The study population comprised of all neonates with critical valvular PS who underwent BPV at our center between January 2015 and December 2022. The clinical and echocardiographic data were collected retrospectively and stratified as preintervention, intervention, and follow-up.</p><p><strong>Results: </strong>Twenty-four neonates with critical PS underwent BPV at a mean age of 7.0 ± 6.8 days. The median pulmonary and tricuspid valve (TV) Z-scores were - 0.49 and - 1.50, respectively. The procedure was performed through the femoral and jugular veins in 15 (62.5%) and 4 (16.7%) patients, respectively. The pulmonary valve could be crossed only through the retrograde route (patent ductus arteriosus) in 5 (20.8%) patients. The mean balloon annulus ratio was 1.02 ± 0.12. Eleven (45.8%) patients required graded balloon dilatation. The procedure was successful in 22/24 patients. There was a significant reduction in the pulmonary peak transvalvular gradient (83.9 ± 14.4 mmHg to 18.2 ± 7.6 mmHg; P < 0.05). Follow-up showed a progressive increase in Z-scores of pulmonary and tricuspid valve. Two patients who developed restenosis had dysplastic pulmonary valves.</p><p><strong>Conclusion: </strong>Neonates undergoing BPV have good short-term outcomes with a low restenosis rate. In patients with small TV and severe regurgitation, crossing the pulmonary valve by retrograde approach (through ductus arteriosus) is an effective method.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"425-430"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971002","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":"Management dilemma of a child with long-segment tracheal stenosis, double outlet right ventricle, and left pulmonary artery sling: For single or staged repair?","authors":"Gurpreet Singh, Anna Marie Nathan, Norazah Zahari, Khairul Anuar Bin Abdul Aziz","doi":"10.4103/apc.apc_199_24","DOIUrl":"https://doi.org/10.4103/apc.apc_199_24","url":null,"abstract":"<p><p>This is a case of a 3-year-old child who presented with long-segment tracheal stenosis (LSTS) and complex congenital cardiovascular disease for surgical intervention. The ideal operation for this child will include slide tracheoplasty and multiple cardiac lesion repairs. However, the low birth weight and extremely young age present a dilemma as to whether to perform total repair simultaneously or in stages. Age and weight by which the first surgical procedure was done, cardiovascular abnormality details, preoperative respiratory support, preoperative tracheobronchomalacia, cardiopulmonary bypass, the complexity of the surgery, and preoperative extracorporeal membrane oxygenation support are known to be predictive factors of long-term outcomes. Comparative studies between simultaneous and staged operations have shown that it is best to manage children with LSTS and complex cardiovascular anomalies in stages.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"17 6","pages":"444-447"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960152","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}