Annals of Pediatric Cardiology最新文献

{"title":"Dual left ventricular pseudoaneurysms following osteomyelitis of the femur in a child.","authors":"Samir Shakya, Anand Ujjwal Singh, Pradip Kumar Chapagain, Anil Bhattarai","doi":"10.4103/apc.apc_61_26","DOIUrl":"10.4103/apc.apc_61_26","url":null,"abstract":"<p><p>Left ventricular pseudoaneurysm is a rare complication following infective pericarditis in children. We report a very rare case of dual left ventricular pseudoaneurysms in a 4-year-old girl, who was diagnosed following osteomyelitis of the right femur with disseminated infection. In the absence of cardiac symptoms, cardiac imaging including echocardiography and computed tomography helped to diagnose the dual ventricular pseudoaneurysms. The patient was successfully managed with urgent surgical repair of the two pseudoaneurysms without any complication.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"349-351"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583301","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":"Unifying nomenclature describing the individuals with Fontan circulation.","authors":"Ashish H Shah, David Renaud, Sivasubramanian Ramakrishnan, Miriam Michel","doi":"10.4103/apc.apc_356_25","DOIUrl":"10.4103/apc.apc_356_25","url":null,"abstract":"<p><p>Language shapes clinical care, research interpretation, and patient identity, particularly in chronic and heterogeneous conditions. Individuals living with a Fontan circulation represent a growing and diverse population unified by a surgically created physiology rather than a single anatomical diagnosis. Despite this, terminology used in clinical practice and research remains inconsistent, variably defining individuals by surgical procedure, anatomy, or loosely applied disease labels. Such variability complicates communication, limits comparability across studies, and risks reducing person-centered care. In this review, we examine the historical evolution and current use of terminology describing individuals with a Fontan circulation, highlight the clinical and research implications of inconsistent language, and delineate distinctions between anatomical substrates and shared Fontan physiology. We propose adoption of standardized, person-first nomenclature, specifically \"individuals (or patients) with a Fontan circulation\" with precise anatomical descriptors used where relevant. Unified terminology may enhance clarity, data harmonization, and patient-centered outcomes across the Fontan community.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"303-306"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583406","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":"Looking beyond survival in congenital heart diseases: Are we there yet?","authors":"Debasis Das","doi":"10.4103/apc.apc_231_26","DOIUrl":"10.4103/apc.apc_231_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 3","pages":"265-266"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583337","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":"Takotsubo cardiomyopathy in an infant with acute mediastinitis following cardiovascular surgery: An unusual diagnosis and successful management.","authors":"Andrés Felipe Rubio-Duarte, María Antonella Diaz-Caraballo, Valeria Ramirez-Jaramillo, Javier Mauricio Castro-Monsalve","doi":"10.4103/apc.apc_311_25","DOIUrl":"10.4103/apc.apc_311_25","url":null,"abstract":"<p><p>Takotsubo syndrome (TTS) is a rare cause of ventricular dysfunction in children, commonly associated with neurological injury and emotional stress. After cardiac surgery, ventricular dysfunction may result from cardiopulmonary bypass-related myocardial stunning; however, other causes, including TTS, may develop days or weeks after surgical procedures. Stress factors can have multiple etiologies; rarely, sepsis is the triggering factor in infants following cardiac surgery. We present the case of a 5-month-old girl who, 2 weeks after ventricular septal defect repair, developed infectious mediastinitis secondary to a deep surgical site infection, with echocardiographic findings consistent with Takotsubo cardiomyopathy.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 2","pages":"238-240"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389879","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":"Accuracy of deep learning-based heart sound analysis as screening tool for congenital heart disease: A diagnostic meta-analysis.","authors":"Sebastian Emmanuel Willyanto, Imke Maria Del Rosario Puling, Nyoman Deva Pramana Giri, Jesphine Arbi Wijaya, Liliana Dewi, Derren David Christian Homenta Rampengan, Valerinna Yogibuana Swastika Putri","doi":"10.4103/apc.apc_198_25","DOIUrl":"10.4103/apc.apc_198_25","url":null,"abstract":"<p><strong>Background: </strong>With over 260,000 yearly mortality, 87% from low socio-economic countries, congenital heart disease (CHD) stands as a major global health crisis. Echocardiography, the current diagnostic standardized approach, often delays diagnosis due to interpretation variability and limited availability in low socioeconomic countries. Hence, exploring alternative screening approaches is crucial. The deep learning (DL) method coupled with heart sound analysis is a promising diagnostic approach for early CHD detection.</p><p><strong>Objectives: </strong>This study focuses on the innovation of DL-based heart sound analysis in enhancing the diagnosis of CHD patients.</p><p><strong>Methods: </strong>The outcomes of interest of the study were the sensitivity, specificity, and area under the curve (AUC) of various diagnostic tools and DL methods used in diagnosing CHD. Quality appraisal was done using Quality Assessment of Diagnostic Accuracy Studies 2, while the diagnostic meta-analysis used Stata MP 17.</p><p><strong>Results: </strong>A comprehensive search across seven databases yielded 19 articles for analysis. Among these, 13 were deemed low-risk and six unclear-risk of bias. The results were observed through meta-analysis with sensitivity at 91% (95% confidence interval [CI] = 0.85-0.94, P = 0.001), specificity at 92% (95% CI = 0.86-0.95, P = 0.001), and an AUC of 96% (95% CI = 0.94-0.98).</p><p><strong>Conclusions: </strong>The adoption of DL-based heart sound analysis for CHD diagnosis shows promise, demonstrating good diagnostic accuracy and potential as an adjunctive tool to support triage or pre-screening, although further validation is required before it can be considered alongside echocardiography.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 2","pages":"173-182"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389857","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 output measurement in Fontan circulation: Challenges and potential emerging solutions.","authors":"Ashish H Shah, Veena Bharathi Kota, Sivasubramanian Ramakrishnan","doi":"10.4103/apc.apc_376_25","DOIUrl":"10.4103/apc.apc_376_25","url":null,"abstract":"<p><p>Similar to other cardiovascular conditions, accurate cardiac output (CO) assessment in Fontan patients is critical for evaluation of hemodynamic state. However, traditional methodologies, including the Fick principle, thermodilution, Doppler echocardiography, and cardiac magnetic resonance imaging face substantial limitations due to Fontan-specific anatomy and physiology. Impedance cardiography-based technologies offer a noninvasive alternative, yet they remain undervalidated in this unique population. This review highlights the challenges of established methods and emphasizes the need to explore, refine, and validate impedance cardiography-based CO monitoring across pediatric and adult Fontan patients.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 2","pages":"188-192"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389875","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":"Ascending aortic replacement for aneurysm in a 30-month-old child with EFEMP2-related cutis laxa.","authors":"Toshikazu Shimizu, Shinya Ugaki, Hisayuki Hongu, Koji Nomura","doi":"10.4103/apc.apc_241_25","DOIUrl":"10.4103/apc.apc_241_25","url":null,"abstract":"<p><p>EFEMP2-related cutis laxa is a rare autosomal recessive connective tissue disorder, and its characteristic symptom is arterial aneurysms and tortuosity. Herein, we describe a case of an ascending aortic aneurysm that was successfully managed with surgical repair in a 30-month-old female child with EFEMP2-related cutis laxa. Genetic testing revealed a compound heterozygous mutation in the EFEMP2 gene encoding fibulin-4 at 19 months of age. The aneurysm gradually enlarged in size, and the patient required ascending aortic replacement using the J-Graft with a diameter of 24 mm. Pathologic examination of the resected specimen showed medial thickening and tearing of elastic fibers in the media.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 2","pages":"219-221"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389844","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":"Cardiopulmonary exercise testing-derived circulatory power predicts major adverse cardiac events in adults with repaired tetralogy of Fallot.","authors":"Evan Niu, Rachel Sareli, Bibhuti B Das, Candice Sareli, Jianli Niu","doi":"10.4103/apc.apc_1_26","DOIUrl":"10.4103/apc.apc_1_26","url":null,"abstract":"<p><strong>Background: </strong>Adults with repaired tetralogy of Fallot (rTOF) remain at increased risk for major adverse cardiac events (MACEs). Cardiopulmonary exercise testing (CPET) is increasingly used for risk stratification, though prognostic data beyond peak oxygen consumption (VO₂) are limited in this population. We evaluated the prognostic significance of CPET-derived variables for predicting MACE in adults with rTOF.</p><p><strong>Methods: </strong>Clinical and CPET data from 47 adults with rTOF who underwent symptom-limited CPET were retrospectively analyzed. MACE was defined as cardiac-related hospitalization, device implantation, surgical intervention, or death. Associations between CPET variables and MACE were assessed using multivariable Cox regression adjusted for age, sex, and body mass index. Discriminative performance was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Over a mean follow-up of 20.8 months, 9 patients (19.1%) experienced MACE. Peak VO₂, oxygen uptake efficiency slope (OUES), and circulatory power (CircP) were significantly lower in patients with New York Heart Association functional class III and in those who developed MACE. CircP was positively associated with peak VO₂ (<i>r</i> = 0.899), OUES (<i>r</i> = 0.503), ventilatory anaerobic threshold (<i>r</i> = 0.537), and rate-pressure product (<i>r</i> = 0.673). On multivariable analysis, peak VO₂ (adjusted hazard ratio [aHR]: 0.80; <i>P</i> = 0.002), CircP (aHR: 0.99; <i>P</i> = 0.012), and OUES (aHR: 0.99; <i>P</i> = 0.015) were independently associated with MACE. ROC analysis demonstrated comparable discriminative performance among these variables, with CircP showing the highest sensitivity, specificity, and predictive values. Kaplan-Meier analyses confirmed significantly higher event rates below identified thresholds.</p><p><strong>Conclusions: </strong>Peak VO₂, CircP, and OUES are significant predictors for adverse outcomes in adults with rTOF. CircP demonstrated relatively strong overall prognostic performance, supporting its potential role in clinical risk stratification. Larger studies are warranted to validate these findings.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 2","pages":"147-155"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389899","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":"Methodological considerations in assessing postintervention fitness and quality of life in congenital heart disease.","authors":"Ankur Sharma, Sushma Narsing Katkuri, Varshini Vadhithala, Arun Kumar, Sushma Verma, Dhanya Dedeepya","doi":"10.4103/apc.apc_348_25","DOIUrl":"10.4103/apc.apc_348_25","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 2","pages":"258-259"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389761","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":"Arterial switch operation after left ventricular retraining with ductal stent: Our experience.","authors":"Debasis Das, Tanulina Sarkar, Shubhadeep Das, Varsha Malladi, Manish Kumar Sharma, Shivani Gajpal, Amitabha Chattopadhyay","doi":"10.4103/apc.apc_312_25","DOIUrl":"10.4103/apc.apc_312_25","url":null,"abstract":"<p><p>Late-presenting transposition of the great arteries (TGAs) with an intact ventricular septum is characterized by left ventricular (LV) regression, making primary arterial switch operation (ASO) unsafe. Ductal stenting offers a less invasive alternative compared to conventional LV retraining using pulmonary artery banding and Blalock-Taussig-Thomas shunt. We analyzed outcomes of ASO following ductal stenting for LV retraining in six consecutive TGA children (median weight 3.3 kg). Median age at stenting and at surgery was 2 months and 2.5 months, respectively. The median interval from stenting to surgery was 33 days (8-238 days). LV mass increased significantly from 31.5 ± 3.8 to 60.6 ± 9.4 g/m² (<i>P</i> = 0.0021), and LV posterior wall thickness increased from 3.4 ± 0.4 to 4.4 ± 0.3 mm (<i>P</i> = 0.0048). All patients underwent successful ASO with ductal stent removal and no mortality. Ductal stenting appears to be a safe, effective strategy for LV retraining, and enabling late ASO.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 2","pages":"183-187"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389860","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}