Cardiology in the Young最新文献

{"title":"Elevated pressure gradient in paediatric infective endocarditis: a possible new major Duke criteria.","authors":"Michal Gafner, Gal Sharvit, Einat Birk, Eran Shostak, Gabriel Chodick, Elchanan Bruckheimer, Haim Ben-Zvi, Gabriel Amir, Alexander Lowenthal, Oded Scheuerman","doi":"10.1017/S1047951125100875","DOIUrl":"https://doi.org/10.1017/S1047951125100875","url":null,"abstract":"<p><strong>Aim: </strong>To examine the added value of an elevated calculated peak right ventricular outflow tract pressure gradient as a surrogate for infective endocarditis diagnosis.</p><p><strong>Methods: </strong>A cohort study included patients admitted between 2003 and 2020 at a tertiary children's medical centre. Patients with surgically inserted exogenous right ventricular outflow tract conduits and infective endocarditis were included. Infective endocarditis was diagnosed using the revised Duke criteria (2023). Controls had right ventricular outflow tract conduits and febrile illness from other causes. Clinical, laboratory, and echocardiographic findings, including calculated peak right ventricular outflow tract pressure gradient, were collected.</p><p><strong>Results: </strong>Among 26 febrile episodes (11 with infective endocarditis, 15 controls), the infective endocarditis group had a higher peak right ventricular outflow tract pressure gradient during acute illness (70 vs. 23 mmHg, <i>p</i> < 0.05). On admission, 18% of infective endocarditis patients had a definite diagnosis by Duke's criteria, 45% had a probable diagnosis, and 36% lacked confirmation. Including peak right ventricular outflow tract gradient as a major criterion would yield a 90% diagnosis rate upon admission (45% definite, 45% possible).</p><p><strong>Conclusions: </strong>Increased right ventricular outflow tract pressure gradient in febrile patients with exogenous conduit in the right ventricular outflow tract is a potential marker for infective endocarditis. Including this gradient as a major Duke criterion enables earlier and more definitive diagnosis in debatable cases.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599464","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":"Infracardiac total anomalous pulmonary venous drainage with concomitant hypoplastic aortic arch in a preterm neonate: a rare and complex surgical challenge.","authors":"Munavvar Gasimova, Bahruz Aliyev, Aynur Abbasaliyeva, Cabir Gulmaliyev, Khayala Mammadova, Shiraslan Bakhshaliyev","doi":"10.1017/S104795112510053X","DOIUrl":"https://doi.org/10.1017/S104795112510053X","url":null,"abstract":"<p><p>Total anomalous pulmonary venous drainage associated with hypoplastic aortic arch represents an exceptionally rare and intricate congenital cardiac anomaly. We report the case of a 13-day-old late preterm neonate presenting with infracardiac total anomalous pulmonary venous drainage, severe pulmonary hypertension, and a hypoplastic aortic arch. The patient underwent single-stage surgical correction involving rerouting of the pulmonary venous confluence to the left atrium and aortic arch reconstruction using autologous pericardial patch under cardiopulmonary bypass with selective cerebral perfusion. Postoperative recovery was favourable, marked by successful extubation, resolution of pulmonary hypertension, and absence of residual anatomical obstruction. This case highlights the feasibility and effectiveness of early, comprehensive surgical repair and the necessity of coordinated multidisciplinary perioperative care. Long-term follow-up remains vital for monitoring functional outcomes and detecting late complications.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599524","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":"Ductus arteriosus obstruction induced by vertical vein stenting in single-ventricle physiology with supracardiac total anomalous pulmonary venous connection.","authors":"Tomoaki Taruya, Shin Ono, Hideaki Ueda","doi":"10.1017/S1047951125100929","DOIUrl":"https://doi.org/10.1017/S1047951125100929","url":null,"abstract":"<p><p>A newborn with right atrial isomerism, single-ventricle physiology, supracardiac total anomalous pulmonary venous connection, and pulmonary atresia underwent vertical vein stenting, resulting in ductus arteriosus compression. Subsequent ductal stenting restored patency, preventing haemodynamic compromise and ensuring survival. This case highlights the risk of secondary ductal obstruction in vertical vein stenting and the importance of early recognition and intervention.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599462","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":"Impact of pulmonary artery capacitance index on early outcomes following paediatric heart transplantation.","authors":"Angela M Monafo, William A Harris, Carolyn L Taylor, Minoo N Kavarana, Jason R Buckley, Andrew J Savage, Anthony M Hlavacek, Varsha M Bandisode, John F Rhodes, John M Costello, Shahryar M Chowdhury","doi":"10.1017/S1047951125100747","DOIUrl":"https://doi.org/10.1017/S1047951125100747","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary artery capacitance is a relatively novel measurement associated with adverse outcomes in pulmonary arterial hypertension. We sought to determine if preoperative indexed pulmonary artery capacitance was related to outcomes in paediatric heart transplant recipients, describe the changes in indexed pulmonary artery capacitance after transplantation, and compare its discriminatory ability to predict outcomes as compared to conventional predictors.</p><p><strong>Methods: </strong>This was a retrospective study of paediatric patients who underwent heart transplant at our centre from July 2014 to May 2022. Variables from preoperative and postoperative clinical, catheterisation, and echo evaluations were recorded. The primary composite outcome measure included postoperative mortality, postoperative length of stay in the top quartile, and/or evidence of end organ dysfunction.</p><p><strong>Results: </strong>Of the 23 patients included in the analysis, 11 met the composite outcome. There was no statistical difference between indexed pulmonary artery capacitance values in patients who met the composite outcome [1.8 ml/mmHg/m² (interquartile 0.8, 2.4)] and those who did not [1.4 (interquartile 0.9, 1.7)], <i>p</i> = 0.17. There were no significant signs of post-operative right heart failure in either group. There was no significant difference between pre-transplant and post-transplant indexed pulmonary artery capacitance or indexed pulmonary vascular resistance.</p><p><strong>Conclusions: </strong>Preoperative pulmonary artery capacitance was not associated with our composite outcome in paediatric heart transplant recipients. It did not appear to be additive to pulmonary vascular resistance in paediatric heart transplant patients. Pulmonary vascular disease did not appear to drive outcomes in this group.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599523","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":"First-in-man transcatheter Fontan completion in post Kawashima patient after successful recruiting of separately draining hepatic veins - A case report.","authors":"Muthukumaran Chinnasamy Sivaprakasam, Rajaguru Ganesan, Anuradha Sridhar, Zeeshan S Lakhani","doi":"10.1017/S1047951125100668","DOIUrl":"https://doi.org/10.1017/S1047951125100668","url":null,"abstract":"<p><strong>Background: </strong>Heterotaxy patients after Kawashima surgery, with separately draining hepatic veins pose a complexity for Fontan completion. We describe a novel percutaneous technique for hepatic vein diversion and complete transcatheter Fontan.</p><p><strong>Case report: </strong>A 6-year-old female with single ventricle physiology and bilateral hepatic vein drainage underwent Kawashima surgery. She later developed a complete heart block and elevated mean pulmonary pressures (17 mmHg). Permanent pacemaker implantation and left hepatic vein ligation were performed. Due to elevated pulmonary pressures, transcatheter Fontan completion was chosen over surgical options, and hepatic veins were included without prior surgical preparation as there were well-developed venous collaterals between the hepatic veins. The patient remained asymptomatic post-intervention with no complications and was discharged on anticoagulation therapy.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599465","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 novel associations between frailty and neurodevelopmental outcomes in CHD.","authors":"Casey Vogel, Bradley S Marino, Amy Cassedy, Michael Natarus, Pooja Parikh, Clayton Hinkle, Kiona Y Allen","doi":"10.1017/S1047951125100863","DOIUrl":"https://doi.org/10.1017/S1047951125100863","url":null,"abstract":"<p><strong>Objectives: </strong>\"Frailty\" is associated with worse outcomes in adult cardiology. There is limited data on the associations between frailty and outcomes in paediatric cardiology. We aimed to define the prevalence of frailty and identify associations between frailty and neurodevelopmental and quality-of-life outcomes in high-risk paediatric cardiac populations.</p><p><strong>Study design: </strong>This cross-sectional study included patients 4-18 years seen in a neurodevelopmental programme between 6/2017 and 11/2022. Demographic and clinical data were obtained from medical records. As part of the routine care, physical therapy assessment and neurocognitive, psychosocial, adaptive functioning, and quality-of-life surveys were administered. Social determinants of health were assessed by insurance status and Childhood Opportunity Index. Frailty was defined as the abnormality in 3 of 5 categories: body composition, weakness, slowness, physical activity, and exhaustion. Chi-Square, Student t, and Wilcoxon Rank Sum tests were used to assess differences between frail and non-frail groups.</p><p><strong>Results: </strong>Of the 270 patients, 101 (37%) met the frailty criteria. Frailty was not associated with social determinants of health, cardiac diagnosis, genetic syndrome, number of cardiac surgeries, or history of clinical complications. Frail patients were more likely to be older (<i>p</i> = 0.004) and have neurocognitive (<i>p</i> = 0.024), emotional (<i>p</i> = 0.003), social (<i>p</i> < 0.001), motor (<i>p</i> < 0.001), and adaptive dysfunction (<i>p</i> < 0.001) and lower quality of life (<i>p</i> = 0.029).</p><p><strong>Conclusion: </strong>Frailty is common in school-aged patients with cardiac disease and is associated with adverse neurocognitive, psychosocial, motor, and adaptive outcomes and worse quality of life. Risk stratification for frailty may be a critical evaluation and screening element of high-risk cardiac patients in neurodevelopmental programmes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-9"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599526","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 vascular complication in a preterm neonate: iliac artery injury following patent ductus arteriosus device closure.","authors":"Uğur Karagöz, Çağatay Bilen","doi":"10.1017/S1047951125100516","DOIUrl":"https://doi.org/10.1017/S1047951125100516","url":null,"abstract":"<p><p>Percutaneous closure of patent ductus arteriosus has become increasingly common with advancements in interventional cardiology, especially in preterm infants. However, complications related to vascular access remain a significant concern, particularly in neonates with low birth weight. We reported a case of a 12-day-old preterm infant born at 33 weeks of gestation, who developed a right external iliac artery injury during catheter-based patent ductus arteriosus closure, necessitating emergent surgical intervention. Postoperatively, the patient recovered without signs of ischaemia or neurologic deficit. This case underscores the importance of careful vascular access planning and highlights the potential for serious complications even in technically successful patent ductus arteriosus closures in neonates.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599461","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":"Electrocardiographic findings in newborns with bicuspid aortic valve.","authors":"Line C Stormly, Magdalena Hansson, Anna M Dehn, Maria M Pærregaard, Anna A Raja, R Ottilia B Vøgg, Niels Vejlstrup, Alex H Christensen, Kasper K Iversen, Henning Bundgaard, Anne-Sophie Sillesen","doi":"10.1017/S1047951125001684","DOIUrl":"https://doi.org/10.1017/S1047951125001684","url":null,"abstract":"<p><strong>Background: </strong>Bicuspid aortic valve is considered to have a multifactorial origin. Some research suggests a defect in neural crest cell signalling may increase the risk of developing bicuspid aortic valve, and also impact on the proximal conduction system.</p><p><strong>Purpose: </strong>To examine electrocardiographic parameters in unselected newborns from the general population diagnosed with bicuspid aortic valve within 30 days after birth.</p><p><strong>Methods: </strong>This is a substudy of the Copenhagen Baby Heart Study; a multicentre, prospective, population-based cohort study with prenatal inclusion. Cardiac examination, including transthoracic echocardiography and electrocardiography, were obtained within 30 days after birth. Newborns diagnosed with bicuspid aortic valve were matched 1:4 with newborns with structurally normal hearts based on age, sex, gestational age, weight, and length at examination.</p><p><strong>Results: </strong>A total of 127 newborns with bicuspid aortic valve (84 boys, median age 11 days) and 508 controls (336 boys, median age 11 days) were included. Newborns with bicuspid aortic valve had a significantly longer PR-interval (100 vs 96 ms, <i>p = 0.011</i>) and QRS duration (56 vs 54 ms, <i>p = 0.042</i>), and a significantly lower R-wave amplitude in V6 (759 vs 906 µV, <i>p = 0.047</i>) compared to controls. However, when correcting for multiple testing none of the results were significant.</p><p><strong>Conclusion: </strong>Newborns from the general population with bicuspid aortic valve demonstrated a slightly longer PR-interval, a longer QRS duration, and a lower maximum R-wave amplitude in V6 than matched controls, although non-significant after correcting for multiple testing. This may represent early signs of conduction abnormalities, but longitudinal follow-up will provide further clarification.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599463","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":"Ten years of percutaneous treatment of sinus venosus defects: evolution of an innovative procedure.","authors":"Alessia Callegari, Gareth J Morgan","doi":"10.1017/S1047951125100681","DOIUrl":"https://doi.org/10.1017/S1047951125100681","url":null,"abstract":"<p><strong>Introduction: </strong>The superior sinus venosus defect is an uncommon CHD, typically associated with partial anomalous pulmonary venous drainage. While surgical correction is the traditional treatment, transcatheter techniques have emerged as a promising alternative. This analysis assesses the evolution of transcatheter correction for superior sinus venosus defect over the past decade, analysing trends on technique, procedural outcomes, and safety.</p><p><strong>Methods: </strong>Systematic research identified 23 studies involving approximately 676 patients from 2014 to 2024. Data on demographics, procedural details, and outcomes were extracted, and study quality was assessed using established checklists. Descriptive analyses and trend evaluations were conducted.</p><p><strong>Results: </strong>Initially, transcatheter procedures were reserved for high surgical-risk cases, but recent studies emphasise selecting patients with favourable anatomy for interventional closure. Improved screening and patient referral have reduced exclusion rates. While earlier studies utilised 3D printing for planning, later studies increasingly employed periinterventional imaging, particularly CT-fluoroscopy fusion. Balloon-expandable long covered stents, especially custom-made designs, became predominant, with median stent length increasing from 55 mm to 75 mm. Complication rates, including stent embolisation and pulmonary vein obstruction, declined over time.</p><p><strong>Conclusions: </strong>Advancements in patient selection, imaging modalities, and procedural techniques have improved the safety and efficacy of transcatheter superior sinus venosus defect correction, reducing reliance on surgical interventions. Custom stents and advanced imaging have played key roles in achieving better outcomes. However, larger studies are required to confirm these findings and evaluate long-term outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-9"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599525","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":"Clinical implications of major haemolysis in children supported by a pulsatile ventricular assist device.","authors":"Emma R Powers, Michael A Brock, Jeffrey P Jacobs, Sukumar Suguna Narasimhulu, Shivaani R Mahabir, Giles J Peek, Dalia Lopez-Colon, Mark S Bleiweis, Joseph Philip","doi":"10.1017/S1047951124025137","DOIUrl":"https://doi.org/10.1017/S1047951124025137","url":null,"abstract":"<p><strong>Objective: </strong>Haemolysis is developing prominence in the setting of supporting increasingly complex children with heart failure with a ventricular assist device. The goal of this study is to better characterise haemolysis and its implications in children supported with pulsatile ventricular assist devices.</p><p><strong>Methods: </strong>This is a single-centre retrospective review of 44 children who were supported by Berlin Heart EXCOR between January 2006 and June 2020. Patients were divided into major haemolysers and non-major haemolysers. Major haemolysers were defined as patients with lactate dehydrogenase > 500U/L (2.5x the upper limits of normal) with either total bilirubin > 2mg/dL (with predominantly indirect hyperbilirubinemia) or anaemia out of proportion to the clinical scenario more than three days following implantation of the ventricular assist device(s). Patient demographics, ventricular assist device factors, and outcomes, including end-organ function and mortality, were compared between major haemolysers and non-major haemolysers.</p><p><strong>Main results: </strong>Forty-four patients supported by the Berlin EXCOR were included in the analytic cohort of the study: 27 major haemolysers and 17 non-major haemolysers. Major haemolysis was more common in those supported with single-ventricle ventricular assist device (i.e., VAD in the context of functionally univentricular anatomy) compared to those with biventricular hearts, p = 0.01. There were no patients with an isolated left ventricular assist device or isolated right ventricular assist device in our analytic cohort of 44 patients. Of the 19 patients with single-ventricle ventricular assist device, 84% (16/19) were major haemolysers. Of the 25 patients with a biventricular assist device, 44% (11/25) were major haemolysers. Major haemolysers and non-major haemolysers had a body surface area of 0.28 and 0.40, respectively (p = 0.01). Overall, survival to discharge from the hospital was 66% (n = 29/44). Survival to discharge from the hospital was 52% (14/27) in major haemolysers versus 88% (15/17) in non-major haemolysers, p = 0.02. Only 3 of the 27 with major haemolysis had severe haemolysis, that is, lactate dehydrogenase > 2000 and bilirubin above 10. Non-major haemolysers had a better improvement in creatinine clearance during ventricular assist device support, p < 0.0001. (During the same era of this study, 22 patients who were supported with Berlin Heart were excluded from the analytic cohort because they did not have any recorded measurement of lactate dehydrogenase. Seventeen of these 22 patients had no clinical evidence of haemolysis. Survival to discharge from the hospital in this excluded cohort was 86% [19/22].).</p><p><strong>Conclusions: </strong>Major haemolysis in patients with pulsatile ventricular assist device is more likely with single-ventricle ventricular assist device support and smaller body surface area.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583082","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}