Cardiology in the Young最新文献

{"title":"Manoeuvering an alterra pre stent around obstacles.","authors":"Frank Han, Priti Patel","doi":"10.1017/S1047951125100759","DOIUrl":"https://doi.org/10.1017/S1047951125100759","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1"},"PeriodicalIF":0.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of the child opportunity index on outcomes in paediatric patients with Wolff-Parkinson-White.","authors":"Brock A Karolcik, Kevin L Smith, Michael J Calcaterra, Mary D Schiff, Maya I Ragavan, Tarek Alsaied, Christopher W Follansbee, Lee B Beerman, Gaurav Arora","doi":"10.1017/S1047951125100802","DOIUrl":"https://doi.org/10.1017/S1047951125100802","url":null,"abstract":"<p><strong>Background: </strong>The Child Opportunity Index is an index of 29 indicators of social determinants of health linked to the United States of America Census. Disparities in the treatment of Wolff-Parkinson-White have not be reported. We hypothesise that lower Child Opportunity Index levels are associated with greater disease burden (antiarrhythmic use, ablation success, and Wolff-Parkinson-White recurrence) and ablation utilisation.</p><p><strong>Methods: </strong>A retrospective, single-centre study was performed with Wolff-Parkinson-White patients who received care from January 2021 to July 2023. Following exclusion for <5 years old and with haemodynamically significant CHD, 267 patients were included (45% high, 30% moderate, and 25% low Child Opportunity Index). Multi-level logistic and log-linear regression was performed to assess the relationship between Child Opportunity Index levels and outcomes.</p><p><strong>Results: </strong>Low patients were more likely to be Black (<i>p</i> < 0.0001) and to have public insurance (<i>p</i> = 0.0006), though, there were no significant differences in ablation utilisation (<i>p</i> = 0.44) or time from diagnosis to ablation (<i>p</i> = 0.37) between groups. There was an inverse relationship with emergency department use (<i>p</i> = 0.007). The low group had 2.8 times greater odds of having one or more emergency department visits compared to the high group (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>The Child Opportunity Index was not related with ablation utilisation, while there was an inverse relationship in emergency department use. These findings suggest that while social determinants of health, as measured by Child Opportunity Index, may influence emergency department utilisation, they do not appear to impact the overall management and procedural timing for Wolff-Parkinson-White treatment.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ivabradine treatment of atrial arrhythmia in an adolescent following heart transplantation.","authors":"Stefan Kurath-Koller, Lisa Sallmon, Hannes Sallmon","doi":"10.1017/S1047951125100735","DOIUrl":"https://doi.org/10.1017/S1047951125100735","url":null,"abstract":"<p><p>Premature atrial complexes are frequent among patients after heart transplantation. We herein report on the successful use of ivabradine in a 15-year old patient who exhibited marked palpitations caused by atrial premature complexes after orthotopic bicaval heart transplantation.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal left pulmonary artery-to-left atrial fistula with aplasia of the left lung: successful postnatal transcatheter closure.","authors":"Bilgehan Betül Biçer, Hayrettin Hakan Aykan, Tevfik Karagöz, Ercan Tutar","doi":"10.1017/S1047951125001714","DOIUrl":"https://doi.org/10.1017/S1047951125001714","url":null,"abstract":"<p><strong>Introduction: </strong>In the presence of fetal cardiomegaly, when there is no cardiac malformation or dysfunction, systemic or pulmonary arteriovenous malformations that may cause volume loading should be sought. We aimed to present a fetus who had cardiomegaly and left pulmonary artery-left atrial fistula and who underwent transcatheter closure in the early postnatal period.</p><p><strong>Case presentation: </strong>23-week fetus referred because of severe cardiomegaly on screening obstetric ultrasonography. Fetal echocardiography revealed fistulous connection between dilated left pulmonary artery and left atrium with high velocity continuous flow at the left atrial orifice of fistula and retrograde flow from the ductus arteriosus to the pulmonary artery. Initially, the fetus followed by one-to-two weeks intervals for fetal heart failure and hydrops fetalis. Pregnancy was uneventful and the baby was born by caesarean section at 37 weeks, and oxygen saturation level was 95 %. Transthoracic echocardiography confirmed the prenatal diagnosis of a fistula between the left pulmonary artery and the left atrium (CTA showed left lung aplasia. Transcatheter closure was performed from antegrade route with Amplatzer Piccolo® Duct Occluder due to hypoxaemia. The baby showed normal growth and development at 15 months of ageThere is no pulmonary hypertension during the 15-month follow-up.</p><p><strong>Discussion: </strong>Pulmonary artery-to-left atrial fistula is a rare anomaly and is frequently described between the right pulmonary artery and the left atrium. Presentation of age depends on the size of the fistulous connection. Patients with large connections are presented in fetal age with cardiomegaly and heart failure or presented in early infancy with profound cyanosis. Although lung hypoplasia has been reported in patients with pulmonary artery-to-left atrial fistula/connection lung aplasia has never been reported in these patients. Surgical or transcatheter closure can be achieved successfully in these patients at neonatal period or early infancy like in our case.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience with etilefrine in refractory non-traumatic chylothorax: a case report.","authors":"Ryo Sakai, Kazuhiro Shiraga, Ryo Inuzuka","doi":"10.1017/S104795112510067X","DOIUrl":"https://doi.org/10.1017/S104795112510067X","url":null,"abstract":"<p><p>Noonan syndrome is associated with lymphatic system structural abnormalities and may present with potentially fatal refractory chylothorax. We report a 2-year-old boy with Noonan syndrome with non-traumatic chylothorax who was refractory to dietary therapy with medium-chain triglyceride milk, octreotide, prednisolone, lymphatic embolisation, and lymphatico-venous anastomosis but improved with etilefrine administration. Etilefrine may be a treatment option for paediatric chylothorax, regardless of the aetiology.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustaining and spreading success: expanding a multicentre quality improvement project to reduce postoperative chest tube duration after paediatric CHD.","authors":"Shreya S Sheth, Ashlin Tignor, Chloe Connelly, Nicolas L Madsen, Margaret Graupe, Katherine E Bates, Mayte Figueroa, Lawrence E Greiten, Stephen A Hart, Megan Jensen, Taylor Morse, Madalsa Patel, Amelia St John, David Saudek, Alaina K Kipps","doi":"10.1017/S1047951125001969","DOIUrl":"https://doi.org/10.1017/S1047951125001969","url":null,"abstract":"<p><strong>Objective: </strong>The Pediatric Acute Care Cardiology Collaborative (PAC³) previously showed decreased postoperative chest tube duration and length of stay in children undergoing 9 Society of Thoracic Surgeons benchmark operations. Here we report how these gains were sustained over time and spread to 8 additional centers within the PAC³ network.</p><p><strong>Methods: </strong>Patient data were prospectively collected across baseline and intervention phases at the original 9 centres (Pioneer) and 8 new centres (Spread). The Pioneer baseline phase was 6/2017-6/2018 and Spread was 5/2019-9/2019. The Pioneer intervention phase was 7/2018-7/2021 and Spread 10/2019-7/2021. The primary outcome measure was postoperative chest tube duration in hours, with the aim of 20% overall reduction. Balancing measures included chest tube reinsertion and readmission for pleural effusion. Statistical process control methods and traditional statistics were used to analyse outcomes over time.</p><p><strong>Results: </strong>Among 5,042 patients at 17 centres, demographics were comparable. The Pioneer cohort (<i>n</i> = 3,383) sustained a 22.6% reduction in mean chest tube duration (from 91.9 hours to 70.5 hours), while the Spread cohort (<i>n</i> = 1,659) showed a 9.7% reduction (from 73.1 hours to 66.0 hours) in the first 13 months following intervention. Across both cohorts, rates of reinsertion (2.0% versus 2.1%, <i>p</i> = 0.869) and readmission for effusion did not change (0.3% versus 0.5%, <i>p</i> = 0.285).</p><p><strong>Conclusions: </strong>This multicenter prospective quality improvement study demonstrated sustained reduction in chest tube duration at 9 centres while successfully spreading improvement to 8 additional centres. This project serves as a model for post-operative multicentre quality improvement across a large cohort of congenital cardiac surgery patients.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global burden of CHD and inequities in cardiac care.","authors":"Swetha Manoj","doi":"10.1017/S1047951125100486","DOIUrl":"https://doi.org/10.1017/S1047951125100486","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardising discharge post-surgical pain control: a quality improvement project.","authors":"Kathyrn M Wheller, Robert D Stewart, Kristen L Breedlove, Frances Feesler, Gregory C Padrutt, Michael T Bigham","doi":"10.1017/S1047951125100474","DOIUrl":"https://doi.org/10.1017/S1047951125100474","url":null,"abstract":"<p><p>Healthcare-prescribed opioids are a known contributor to the opioid epidemic. Locally, there was an identified opportunity to improve opioid prescribing practices in cardiac surgical patients. The cardiac surgical team sought to standardise prescribing practices in postoperative patients and reduce opioid prescriptions at discharge. The improvement was undertaken at a large midwestern freestanding children's hospital with over 400 beds and 120 cardiac surgeries annually. A multidisciplinary team was formed, using the model for Improvement to guide the improvement work. The key improvement interventions included standardised evidence-based prescribing guidelines based patient age and surgical approach, enhanced pain management with non-opioid medications, and integration of prescribing guidelines into the electronic health record. The primary outcome measure was rate of compliance with the prescribing guidelines and secondary measures included morphine equivalent dosing at discharge, opioid-free discharge, and length of stay. A balancing measure of opioid re-prescriptions was tracked. There were 289 patients included in the primary study period (January 2019 through December 2021). Sustainability of key outcomes was tracked though December 2022. The guideline compliance increased from 24% to 100%. The morphine equivalent dosing decreased to 22.5 in 2021 then 0 in 2022, from baseline of 36.25 in 2019. Opioid-free discharges decreased from 8% (2019) to 1.5% (2021) and 0% in 2022. Establishment and compliance with standardised guidelines for post-operative cardiac surgical pain management yielded a reduction in morphine equivalent dosing, an increase opioid-free discharges, and no increase in length of stay or opioid re-prescriptions.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of aberrant origin of left and right vertebral artery from double aortic arch.","authors":"Bo Chen, Feng Huang, Qi An","doi":"10.1017/S1047951125001933","DOIUrl":"https://doi.org/10.1017/S1047951125001933","url":null,"abstract":"<p><p>Double aortic arch is an exceedingly rare congenital vascular anomaly, and its association with anomalous origins of the vertebral arteries is even more uncommon. Enhanced computed tomography revealed a double aortic arch with the left common carotid artery, left vertebral artery, and left subclavian artery originating from the left arch, and the right common carotid artery, right vertebral artery, and right subclavian artery arising from the right arch. To our knowledge, this is the first report of a double aortic arch with six distinct vessels originating from both arches. Enhanced CT should be considered in double aortic arch patients to identify such anomalous origins of branch arteries.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ivabradine treatment for an infant with potential accessory pathway-related refractory supraventricular tachycardia.","authors":"Ayse Sulu, Pelin Kosger, Eylem Kiral, Birsen Ucar","doi":"10.1017/S1047951125001945","DOIUrl":"https://doi.org/10.1017/S1047951125001945","url":null,"abstract":"<p><p>Ivabradine has been shown to be safe and effective in treating congenital and postoperative junctional ectopic tachycardia in children; however, in recent years, case reports have suggested that it may also be used to treat automaticity-related ectopic atrial tachycardia and focal atrial tachycardia. Here, we discussed a case in which we used ivabradine to induce sinus rhythm in a 38-day-old baby who had resistant supraventricular tachycardia and investigated potential accessory pathway-related tachycardia.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}