Cardiology in the Young最新文献

{"title":"Evaluation and treatment of pericardial effusion in paediatric patients post-haematopoietic cell transplantation.","authors":"Josaura V Fernandez Sanchez, Saleh Bhar, Kristen Shaver, Christian Lilje, Tami John, Brian Friend, Nino Rainusso, Anitha Parthiban, Athar Qureshi, Tao Wang, Mengfen Wu, Baheyeldin Salem","doi":"10.1017/S1047951125100553","DOIUrl":"https://doi.org/10.1017/S1047951125100553","url":null,"abstract":"<p><strong>Background: </strong>Cardiac complications after haematopoietic cell transplantation in paediatric patients are significant yet under-recognised. Pericardial effusion has been associated with worse outcomes and transplant-related mortality.</p><p><strong>Objectives: </strong>We aimed to evaluate the incidence, risk factors, and clinical course of pericardial effusion after paediatric allogeneic haematopoietic cell transplantation. We identified transplantation recipients \"at risk\" for clinically significant pericardial effusion based on our definition, described our clinical experience and provided recommendations for screening and management.</p><p><strong>Study design: </strong>Clinical data of children who underwent allogeneic haematopoietic cell transplantation at Texas Children's Hospital from January 2010 to April 2021 were analyzed retrospectively. Factors potentially contributing to time to pericardial effusion, time to pericardial effusion resolution, and overall survival were evaluated.</p><p><strong>Results: </strong>We included 629 haematopoietic cell transplantation recipients with a median age at transplantation of 8.5 years (0.1-24.3). Seventy-three patients (11.6%) developed pericardial effusion within a median time of 102 days (1-403) post-haematopoietic cell transplantation, and 50 (68.5%) had resolution of pericardial effusion at the time of last evaluation. Older age at the time of haematopoietic cell transplantation, transplant-associated thrombotic microangiopathy, and cytomegalovirus diagnoses independently increased the risk of pericardial effusion development, while cytomegalovirus diagnosis decreased the likelihood of pericardial effusion resolution. Both non-significant pericardial effusion development and clinically significant effusion development were significantly associated with post-haematopoietic cell transplantation mortality, compared to no pericardial effusion development.</p><p><strong>Conclusions: </strong>Paediatric haematopoietic cell transplantation recipients with malignant diseases, older age at the time of transplantation, cytomegalovirus infection, or transplant-associated thrombotic microangiopathy are at higher risk for pericardial effusion development, which in turn predicts worse outcomes with increased risk of death. We propose a model for improved detection, evaluation, and management of pericardial effusion post-haematopoietic cell transplantation.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-10"},"PeriodicalIF":0.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658431","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":"Successful transcatheter device occlusion of a silent patent ductus arteriosus after treatment for infective endarteritis.","authors":"Danielle D Strah, Stephen T Dalby, John Arnold, Brent M Gordon","doi":"10.1017/S1047951125001921","DOIUrl":"https://doi.org/10.1017/S1047951125001921","url":null,"abstract":"<p><p>The silent patent ductus arteriosus is currently considered a benign lesion with some practitioners dismissing these patients from cardiac follow-up. We present a 5-year-old male with no known cardiac history who presented with endarteritis in a silent patent ductus arteriosus and underwent successful antibiotic treatment and transcatheter device occlusion.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648636","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 complication of cyanotic CHD: brain abscess.","authors":"Ali Nazım Güzelbağ, Buruç Erkan, İsa Özyılmaz, Muhammet Hamza Halil Toprak, Erkut Öztürk","doi":"10.1017/S1047951125100711","DOIUrl":"https://doi.org/10.1017/S1047951125100711","url":null,"abstract":"<p><strong>Background: </strong>Brain abscess is a rare but life-threatening complication in patients with cyanotic congenital heart disease (CHD), especially in those without prior corrective surgery.</p><p><strong>Methods: </strong>We report the case of a 36-year-old woman with unoperated cyanotic CHD who presented with neurological deficits. Diagnostic evaluation included cranial magnetic resonance imaging (MRI).</p><p><strong>Results: </strong>Imaging revealed a brain abscess. Contributing factors included chronic hypoxia, polycythaemia, and right-to-left shunting facilitating systemic circulation of infectious agents. The patient was treated with intravenous antibiotics and surgical drainage.</p><p><strong>Conclusions: </strong>This case highlights the elevated risk of brain abscess in uncorrected cyanotic CHD and underlines the importance of early recognition and timely management to avoid fatal outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-5"},"PeriodicalIF":0.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648635","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":"Early outcomes of Myval™ Octacor transcatheter pulmonary valve implantation in dysfunctional right ventricular outflow tract conduits and pulmonary valve bioprostheses: a single-centre UK experience.","authors":"Mohammed Kamal Badawy, Atul Kalantre, Marinos Kantzis","doi":"10.1017/S1047951125100590","DOIUrl":"https://doi.org/10.1017/S1047951125100590","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter pulmonary valve implantation has emerged as a minimally invasive and preferred therapeutic option for patients with dysfunction of previously repaired right ventricular outflow tracts. The Myval™ Octacor valve is a new device designed for this purpose, though limited reports exist regarding its use in the pulmonary position.</p><p><strong>Aims: </strong>To report the immediate and short-term outcomes of percutaneous pulmonary valve implantation using the Myval™ Octacor valve in patients with severe right ventricular-pulmonary artery conduit or pulmonary valve bioprosthesis dysfunction.</p><p><strong>Methods: </strong>This was a single-centre retrospective review of data obtained from case files.</p><p><strong>Results: </strong>The Myval™ Octacor valve was used in ten patients with a mean age of 34.5 ± 7.4 years. The median procedure duration and fluoroscopy time were 146 minutes and 30.5 minutes, respectively. The median Z-score for valves used was -0.5. The median right ventricular systolic pressure decreased from 68.5 mmHg pre-procedure to 33 mmHg post-procedure. The median peak instantaneous gradient across the right ventricular outflow tract or conduit decreased from 30 mmHg to 6.5 mmHg. There were no reported incidences of frame fracture, conduit rupture, device embolisation, or endocarditis.</p><p><strong>Conclusion: </strong>This is the first UK experience of using the new-generation Myval™ Octacor valve in percutaneous pulmonary valve implantation. The results demonstrate the valve's safety and clinical efficacy, with favourable outcomes in terms of procedural success, haemodynamic improvement, and echocardiographic findings.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641882","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":"Cardiology across continents: key lessons from a case-based discussion.","authors":"Paul W Warren, Eleanor Greiner, Taniya Rachel Issacs, Ashley E Neal, Daniel Peck, Navaneetha Sasikumar","doi":"10.1017/S1047951125100899","DOIUrl":"https://doi.org/10.1017/S1047951125100899","url":null,"abstract":"<p><p>The content learned in paediatric cardiology fellowship is variable depending on the socio-economic and geographic setting in which training takes place and may result in knowledge gaps. We highlight the key lessons learned from a recent case-based learning session, hosted by Heart University, between two programmes from different geographic and resource settings.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641881","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":"Takeuchi repair for anomalous origin of the left coronary artery from the pulmonary artery: functional recovery and late complications in an 18-patient cohort.","authors":"Osman Nuri Tuncer, Mahsati Akhundova, Ertürk Levent, Yüksel Atay","doi":"10.1017/S1047951125100528","DOIUrl":"https://doi.org/10.1017/S1047951125100528","url":null,"abstract":"<p><strong>Background: </strong>The Takeuchi procedure remains an important surgical option for treating anomalous origin of the left coronary artery from the pulmonary artery, particularly in cases where direct coronary reimplantation is not feasible. However, long-term outcome data in paediatric patients are limited.</p><p><strong>Methods: </strong>We retrospectively reviewed 18 paediatric patients who underwent Takeuchi repair between 2007 and 2023. Clinical characteristics, echocardiographic data, and outcomes-including survival, ventricular function, mitral regurgitation, and reintervention-were analysed. Kaplan-Meier analysis was used to assess survival and freedom from reintervention, and paired comparisons were evaluated using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The median age at surgery was 6 months (range: 25 days to 12 years). Preoperative left ventricular ejection fraction was significantly depressed (median 23.5%), and mitral regurgitation was present in all patients. There were two early deaths (11.1%), both in patients with severe heart failure. No late mortality was observed during a maximum follow-up of 10.9 years. All survivors achieved New York Heart Association class I status. Left ventricular ejection fraction improved significantly postoperatively (<i>p</i> < 0.0001), and mitral regurgitation grade also decreased significantly (<i>p</i> < 0.001), with 94.4% showing only mild residual mitral regurgitation. Reintervention occurred in three patients (16.7%) for pulmonary artery stenosis or baffle leak. Freedom from reintervention at 10.9 years was 66.7%.</p><p><strong>Conclusion: </strong>The Takeuchi procedure offers excellent survival and functional recovery in paediatric anomalous origin of the left coronary artery from the pulmonary artery patients when coronary translocation is not feasible. Although late complications such as pulmonary artery stenosis or baffle leak can occur, outcomes remain favourable with appropriate follow-up.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625402","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":"\"Like everybody else\": Adolescent perceptions of safe, independent driving with a CHD.","authors":"Leigh Ann DiFusco, Rachel A Solomon, Lindsey H Lee, C Ward McIntosh, Catherine C McDonald","doi":"10.1017/S1047951125100784","DOIUrl":"https://doi.org/10.1017/S1047951125100784","url":null,"abstract":"<p><strong>Objective: </strong>The impact of CHD on safe driving for adolescents is currently unknown. A prospective, qualitative descriptive study was conducted among adolescents with CHD to describe perceived barriers, facilitators, and impacts of CHD on safe, independent driving among adolescents.</p><p><strong>Study design: </strong>Twenty-eight adolescents aged 15-19 years with CHD participated in virtual, semi-structured interviews in 2023. Adolescent interview data were analysed with conventional content analysis refined by Theoretical Domains Framework in NVivo software.</p><p><strong>Results: </strong>Mean participant age was 16.4 ± 0.23 years (57% male). Single ventricle physiology (25%) and septal defects (32%) were prevalent diagnoses among the study population. Most participants (92%) did not have driving restrictions.</p><p><strong>Two themes emerged from the data: </strong>Driving as a normal rite of passage for adolescents with CHD; and confident-but curious-about the impacts of CHD on driving. Adolescents felt confident that driving is not impacted by CHD. They were curious about the likelihood of cardiovascular emergencies and related symptoms while driving. Perceived barriers and facilitators to safe, independent driving were like what has been described in published literature among adolescents without CHD.</p><p><strong>Conclusion: </strong>These findings celebrate the normalcy of driving during adolescence and reveal curiosities about the impacts of stress, anxiety, fatigue, and risks of heart attack and stroke on driving. Adolescents may look to CHD healthcare providers to help them learn about driving. These findings may inform the development of tools to facilitate meaningful conversations with adolescents regarding driving safety as part of the transition to adult CHD care.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625399","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":"Identifying kidney injury via urinary biomarkers after the comprehensive stage II palliation and bidirectional Glenn procedure: a pilot study.","authors":"Rachel Harris, Tyler Cunningham, Andrew R Yates, Christina Phelps, Diana Zepeda-Orozco, Brian Beckman, Isaac Kistler, Robin Alexander, Catherine D Krawczeski, Jianli Bi","doi":"10.1017/S1047951125100838","DOIUrl":"https://doi.org/10.1017/S1047951125100838","url":null,"abstract":"<p><p>Single ventricle patients undergoing comprehensive stage II palliation have higher incidence of severe acute kidney injury compared to the bidirectional Glenn palliation; however, the optimal method for early detection remains unknown. Several urinary biomarkers are increased in other patient populations with postoperative kidney injury. We explored the kinetics of these biomarkers in this high-risk population.We conducted prospective, observational study of 20 patients with single ventricle physiology who underwent second stage palliation (July 2019-December 2021). Acute kidney injury was defined by Kidney Diseases Improving Global Guidelines, based on peak serum creatinine value and urine output. Urine samples were collected pre-operatively and at 1-, 6-, and 24-hours post-surgery. Urinary biomarkers neutrophil gelatinase-associated lipocalin, interleukin-18, liver fatty acid-binding protein, kidney injury molecule-1, and cystatin C were quantified by enzyme linked immunosorbent assay, normalised to urinary creatinine, and shown as median [interquartile range].Four patients (50%) undergoing comprehensive stage II and 1 patient (8%) undergoing bidirectional Glenn palliation developed stage ≥ 2 acute kidney injury. Comprehensive stage II compared to bidirectional Glenn group had higher median neutrophil gelatinase-associated lipocalin (1769 [1309-1961] versus 91[18-1120] ng/mg) and liver fatty acid-binding protein (12,836 [5016-19798] versus 1272 [220-5172] ng/mg) that peaked 1-hour post-surgery. Kidney injury molecule-1 was significantly greater at 1-, 6-, and 24-hours (greatest) post-surgery in comprehensive stage II than bidirectional Glenn (24h: 11[9-23]) versus 2 [1-6] ng/mg).Elevated urinary neutrophil gelatinase-associated lipocalin, liver fatty acid-binding protein, and kidney injury molecule-1 may be useful biomarkers for early detection of acute kidney injury in children following comprehensive stage II palliation.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-9"},"PeriodicalIF":0.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625401","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":"Complex stenting of an obstructed outflow graft of a heartmate 3 in an adult after a mustard procedure.","authors":"Daiji Takajo, Amr Matoq, Angela Lorts, Russel Hirsch","doi":"10.1017/S1047951125100693","DOIUrl":"https://doi.org/10.1017/S1047951125100693","url":null,"abstract":"<p><p>Ventricular assist devices, such as the HeartMate 3, are routinely used to support patents with failing ventricular function. However, extrinsic obstruction of the outflow graft has been identified as a complication associated with the HeartMate 3. We report a case of a patient with transposition of the great arteries (d-TGA), status post-Mustard procedure with severe systemic (right) ventricular dysfunction who developed extrinsic obstruction of theoutflow graft, 6 years after implant, leading to a significant reduction in HeartMate 3 flow. This patient required the placement of multiple stents to fully address the diffuse stenosis of the outflow graft. This case underscores the technical challenges involved in managing extrinsic obstruction of theoutflow graft in patients with this anatomy and highlights the importance of a tailored, multidisciplinary approach. It emphasises the need for careful planning around stent overlap, outflow graft angulation, and catheter and wire positioning in the context of complex anatomical and device-related interactions.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625400","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 young patient with atrial fibrillation, renal infarction, and acute cerebellar infarction: aortic coarctation associated with secondary hypertension.","authors":"Suchen Tang, Yi Zhou, Ronghua Huang, Zhengjiang Liu","doi":"10.1017/S1047951125100930","DOIUrl":"https://doi.org/10.1017/S1047951125100930","url":null,"abstract":"<p><p>Coarctation of the aorta is characterised by narrowing of the descending aorta and is a rare cause of secondary hypertension in children and young adults. The aortic stenosis lesion is in a special location with severe consequences, and long-term survival is very low, with high rates of disability and mortality, and can be challenging to detect due to its few clinical manifestations. We report a case of a young patient with atrial fibrillation, renal infarction, and acute cerebral infarction, which are consequences of untreated hypertension due to coarctation of the aorta. The purpose of this report is to emphasize the importance of early diagnosis and management of coarctation of the aorta as a cause of secondary hypertension in children and young adults.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607443","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}