Annals of Pediatric Cardiology最新文献

{"title":"Amiodarone-induced acute liver failure in an infant with paroxysmal supraventricular tachycardia.","authors":"Aditi Gupta, Neethu Ravi, R Dhinaharan, Mansingh Parihar, Sarthak Chakrabarti, Yash Shrivastava, Lokesh Kumar Tiwari","doi":"10.4103/apc.apc_335_25","DOIUrl":"10.4103/apc.apc_335_25","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"356-358"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583440","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":"The Fontan circulation: Arrhythmia is just one price we have to pay.","authors":"Jack Rychik","doi":"10.4103/apc.apc_229_26","DOIUrl":"10.4103/apc.apc_229_26","url":null,"abstract":"<p><p>The Fontan circulation has transformed the outlook for patients with single-ventricle congenital heart disease, allowing survival into adolescence and adulthood for thousands who would otherwise not have survived. However, this success comes at the cost of a unique and complex physiology associated with multiple long-term complications, among which arrhythmia remains a major concern. In this invited commentary, the findings of a recent systematic review and meta-analysis comparing arrhythmia outcomes after extracardiac and intracardiac Fontan completion are discussed in the broader context of Fontan physiology. While extracardiac Fontan appears to be associated with a lower arrhythmia risk, the clinical significance of different rhythm disturbances and their impact on overall outcomes requires careful interpretation. Exercise limitation, hepatic issues, and quality of life are among the other important effects of Fontan circulation that should be taken into account in addition to arrhythmia. Ultimately, the choice of Fontan pathway should be guided by overall long-term benefits rather than arrhythmia risk alone, emphasizing the need for robust longitudinal data and collaborative registries to help future decision-making.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"267-269"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583438","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":"Refractory ventricular tachycardia requiring radiofrequency ablation following surgical closure of ventricular septal defect: A rare occurrence.","authors":"Sayantika Saha, Satarupa Mukherjee, Subhendu Mandal, Kuntal Roychowdhuri, Rakesh Sarkar, Manoj Kumar Daga","doi":"10.4103/apc.apc_80_26","DOIUrl":"10.4103/apc.apc_80_26","url":null,"abstract":"<p><p>Arrhythmia is known complication in postoperative period of congenital heart disease among which ventricular tachycardia is one of the major causes of morbidity and mortality. Here we present an unique case of eleven month old baby managed by radiofrequency ablation for refractory ventricular tachycardia in postoperative VSD closure in view of doubly committed VSD with outlet extension due to refractory hypotension and non response to medical therapy and cardioversion. Although VT is mostly managed by medical treatment conservatively in postoperative period, this patient didn't respond to either medical treatment or cardioversion requiring RFA as bailout strategy. Radiofrequency ablation can be adopted as one of the bailout strategy for the postoperative VT storm even in pediatric population.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"324-327"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583299","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":"Intraoperative hypotension is associated with postoperative acute kidney injury in infants undergoing cardiac surgery.","authors":"Mudit Sharma, Tanvir Samra, Rajarajan Ganesan, Karalanglin Tiewsoh, Goverdhan Dutt Puri, Manoj Kumar Rohit, Vivek Jaswal","doi":"10.4103/apc.apc_64_26","DOIUrl":"10.4103/apc.apc_64_26","url":null,"abstract":"<p><strong>Background: </strong>Pediatric cardiac surgery is associated with a 3%-40% incidence of acute kidney injury (AKI). We aimed to study the contribution of intraoperative hypotension to the development of AKI in this population.</p><p><strong>Methods: </strong>In this prospective single-center observational study, patients aged 1 month-18 years undergoing cardiac surgery with cardiopulmonary bypass (CPB) were included. The incidence of AKI, defined by the Kidney Disease Improving Global Outcomes criteria, was calculated. Intraoperative hypotension was defined as a value below the age and height-adjusted 5^th centile for the patient. The relationship of AKI to patient demographics, Risk adjustment in congenital heart surgery (RACHS)-1 score, CPB duration, cumulative hypotension, duration of hypotension, time-weighted cumulative hypotension, and intensive care unit (ICU) outcomes were assessed. Subgroup analysis was performed for infants.</p><p><strong>Results: </strong>In the 150 patients included in the study, the incidence of AKI was 34% (<i>n</i> = 51), of which 63% (<i>n</i> = 32) had stage 1 AKI and 72.5% (<i>n</i> = 37) had transient AKI. The age, height, and weight were lesser in patients who developed AKI. The RACHS-1 score, peak intraoperative lactate, first ICU lactate, intraoperative blood transfusion volume, postoperative mechanical ventilation duration, ICU stay, and mortality were higher in patients who developed AKI. Only in the infant subgroup were the cumulative hypotension and duration of hypotension higher in patients who developed AKI.</p><p><strong>Conclusions: </strong>AKI is common postpediatric cardiac surgery, with the majority being of low severity and transient nature. Intraoperative hypotension is associated with AKI in infants undergoing cardiac surgery.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"270-277"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583285","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":"Fetal atrial flutter in the setting of immune-mediated complete atrioventricular block: A unique combination of fetal arrhythmias.","authors":"Shaimaa Rakha, Fadwa Alahmadi","doi":"10.4103/apc.apc_43_26","DOIUrl":"10.4103/apc.apc_43_26","url":null,"abstract":"<p><p>Fetal exposure to maternal anti-Ro/SSA antibodies can result in several cardiac disorders, most commonly atrioventricular block (AVB). Immune-mediated complete AVB is typically an irreversible complication of maternal anti-Ro antibodies and could result in intrauterine fetal demise. Atrial arrhythmias are rarely reported in patients with maternal anti-Ro/SSA autoantibodies. This report presents a rare combination of fetal arrhythmias, with transient episodes of fetal atrial flutter superimposed on a complete AVB rhythm. No antiarrhythmic medication was required. However, the adverse outcome associated with advanced AVB was unavoidable.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"346-348"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583343","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":"Right atrial appendage for neopulmonary valve reconstruction in a child with tetralogy of Fallot with absent pulmonary valve.","authors":"Amitabh Satsangi, Srinivas Thimmasarthi, Arindam Choudhury, B Kanmaniyan, Pratik K Jha","doi":"10.4103/apc.apc_220_25","DOIUrl":"10.4103/apc.apc_220_25","url":null,"abstract":"<p><p>Absent pulmonary valve is a rare congenital heart anomaly frequently associated with tetralogy of Fallot. We present the case of a 12-year-old child who came with symptoms of cyanosis and a heart murmur. Echocardiographic evaluation revealed severe infundibular pulmonary stenosis and a large subaortic ventricular septal defect. Intraoperative findings confirmed the presence of a rudimentary pulmonary valve, with thin, chordae-like structures connected to the pulmonary leaflet remnants. The child underwent successful intracardiac repair, which involved the reconstruction of a neopulmonary valve utilizing the right atrial appendage tissue.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"352-354"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583258","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":"Single-stage repair of Scimitar variant with Swiss cheese ventricular septal defects without deep hypothermic circulatory arrest.","authors":"Mahmood Hosseinzadeh Maleki, Ali Heidari Bakavoli, Ghodsieh Hajzadeh, Hassan Birjandi, Navid Abbasiyan Fallahi","doi":"10.4103/apc.apc_339_25","DOIUrl":"10.4103/apc.apc_339_25","url":null,"abstract":"<p><p>Scimitar variant is a rare partial anomalous pulmonary venous connection that lacks right lung hypoplasia and cardiac dextroposition. Its coexistence with Swiss cheese-type ventricular septal defects (VSDs) is extremely rare and can result in complex hemodynamic changes. A 23-month-old boy with Scimitar variant and multiple Swiss cheese-type VSDs underwent single-stage repair. Preoperative imaging revealed anomalous drainage of the entire right pulmonary venous return into the inferior vena cava and a persistent left superior vena cava. The dominant perimembranous defect was patched, while smaller muscular defects were managed conservatively. The repair was performed without deep hypothermic circulatory arrest.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"342-345"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583426","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":"Lung ultrasound-driven improvements in pneumonia detection, antibiotic stewardship, and ventilation outcomes: A three-era study in a pediatric cardiac surgical intensive care unit.","authors":"Rajesh Madavathazathil Gopalakrishnan, A R Meghalakshmi, Rohini Dhar, Sandra Chaithanyam Bijukumar, Georg Gutjahr","doi":"10.4103/apc.apc_11_26","DOIUrl":"10.4103/apc.apc_11_26","url":null,"abstract":"<p><strong>Backgrounds: </strong>Postoperative pneumonia significantly prolongs mechanical ventilation (MV) and intensive care unit (ICU) stay after pediatric cardiac surgery. Lung ultrasound (LUS) offers superior diagnostic accuracy compared with chest radiography, but its longitudinal impact on clinical outcomes remains unclear. We evaluated the effect of structured LUS implementation on pneumonia detection, antibiotic stewardship, and ventilatory outcomes in a pediatric cardiac surgical ICU (PCSICU).</p><p><strong>Methods: </strong>This retrospective three-era study included all bronchoalveolar lavage (BAL) episodes performed for suspected postoperative pneumonia between 2019 and 2025. Patients were grouped as pre-LUS (2019-2020), LUS introduction (2021-2022), and established LUS (2023-2025). Outcomes included BAL positivity, antibiotic escalation, reintubation, and MV duration. In the established LUS era, pneumonia severity was classified using a structured 12-zone protocol into low-, moderate-, and high-yield categories. Categorical variables were compared using Chi-square tests and MV duration using Kruskal-Wallis with Bonferroni correction.</p><p><strong>Results: </strong>A total of 313 BAL episodes were analyzed (48, 125, and 140 across the three eras). BAL positivity declined significantly from 70.8% in the pre-LUS era to 42.4% and 43.6% in the later eras (<i>P</i> = 0.0018). Among BAL-positive cases, antibiotic escalation increased progressively (52.9%, 62.3%, and 88.5%; <i>P</i> = 0.00027), while blind escalation among BAL-negative patients decreased markedly (50.0%, 20.8%, and 8.9%; <i>P</i> = 0.00060). Median MV duration decreased significantly from 95.5 h to 46.5 h across three eras (<i>P</i> = 0.00030). Higher LUS yield categories were strongly associated with BAL positivity (<i>P</i> < 0.001), reintubation (P = 0.0336), and Tier-3 antibiotic escalation.</p><p><strong>Conclusion: </strong>Structured LUS adoption improved early pneumonia detection, antibiotic stewardship, and postoperative ventilatory outcomes. Routine LUS integration may significantly improve multidomain outcomes in PCSICUs.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"282-287"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583277","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":"Expanding echocardiography training beyond pediatric cardiology: Practice context, referral thresholds, and unanswered questions.","authors":"Ravindra Shamrao Pawar","doi":"10.4103/apc.apc_19_26","DOIUrl":"10.4103/apc.apc_19_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"317-319"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583327","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":"Aortic root abscess complicating a unicuspid aortic valve in a 15-year-old boy: A case report on surgical management.","authors":"Kanupriya Chaturvedi, Prerna Bhat, Sanjay Khatri, Gaurav Goyal, Sunil Kumar Kaushal","doi":"10.4103/apc.apc_67_26","DOIUrl":"10.4103/apc.apc_67_26","url":null,"abstract":"<p><p>Aortic root abscess, a dreaded and life-threatening complication of infective endocarditis (IE), is often challenging to deal with, both medically and surgically. If not treated in time, it can lead to cardiac fistula formation, rupture into a cardiac chamber, aneurysm formation or heart block, and arrhythmias. It is also a lesion that requires prompt recognition and early/urgent surgical intervention to minimize complications, morbidity, and mortality and improve outcomes. We present the challenging case of a 15-year-old boy, diagnosed with a unicuspid aortic valve during infancy, with progressively severe aortic stenosis, complicated by IE and aortic root abscess and the surgical decision-making and challenges encountered in his case.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"328-332"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583373","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}