{"title":"Hybrid approach to transcatheter pulmonary valve replacement in patients with excessively large anatomy.","authors":"Qiao Li, Yunfei Ling, Changping Gan, Yuan Feng, Zhengang Zhao","doi":"10.1017/S1047951125001842","DOIUrl":"https://doi.org/10.1017/S1047951125001842","url":null,"abstract":"<p><p>After right ventricular outflow tract obstruction reconstruction for CHD, surgical pulmonary valve replacement, or transcatheter pulmonary valve replacement may be performed if complicated by moderately severe or severe right ventricular outflow tract dysfunction. However, for patients whose anatomy is not suitable for transcatheter pulmonary valve replacement, surgical pulmonary valve replacement is the only option, but it has a higher rate of perioperative complications and longer hospitalisation for patients. In two cases of severe transcatheter pulmonary valve replacement in which percutaneous pulmonary valve implantation could not be performed directly due to the presence of a large right ventricle, a significant decrease in right ventricular function, and significant widening of the pulmonary arteries, we used a new hybridisation procedure to partially fold and reduce the diameter of the significantly widened pulmonary artery trunk without cardiopulmonary bypass by surgically opening the thorax in a median way, and then successfully implanted a percutaneous self-expanding pulmonary valve valve, with good immediate results in the postoperative period. The postoperative recovery was rapid and the recent results were excellent.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180811","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":"Reverse Potts shunt as rescue from venoarterial extracorporeal membrane oxygenation in pulmonary veno-occlusive disease.","authors":"Emily Davies, Can Yerebakan, John T Berger","doi":"10.1017/S1047951125001957","DOIUrl":"https://doi.org/10.1017/S1047951125001957","url":null,"abstract":"<p><p>Pulmonary veno-occlusive disease has no definitive cure apart from lung transplant. The reverse Potts shunt can be a palliative bridge to transplant. A post-arrest 14-year-old with severe pulmonary veno-occlusive disease on extracorporeal membrane oxygenation support was decannulated after reverse Potts shunt and survived to lung transplant. Reverse Potts shunt should be considered as a rescue in select patients with end-stage pulmonary veno-occlusive disease.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118924","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}
Megan M McKittrick, Stephanie-Grace A Raymundo, Laura A Maitoza
{"title":"A fatal triad: a case of obstructed total anomalous pulmonary venous return, single ventricle physiology, and single lung with tracheal rings.","authors":"Megan M McKittrick, Stephanie-Grace A Raymundo, Laura A Maitoza","doi":"10.1017/S1047951125001477","DOIUrl":"https://doi.org/10.1017/S1047951125001477","url":null,"abstract":"<p><p>A neonate with unbalanced right-dominant atrioventricular canal defect with intact atrial septum and abnormal pulmonary venous return developed bradycardic arrest and a subsequent diagnosis of tracheal rings and left lung aplasia. This report details the fatal nature of the triad of hypoplastic left heart, pulmonary venous obstruction, and airway anomalies, along with the role of advanced imaging in prognostication.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118843","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":"Isolated foetal left ventricular apical hypoplasia: would you know how to spot it?","authors":"Beatriz Picazo-Angelin, Gonzalo Cortazar-Rocandio, Almudena Ortiz-Garrido","doi":"10.1017/S1047951125001908","DOIUrl":"https://doi.org/10.1017/S1047951125001908","url":null,"abstract":"<p><p>Isolated left ventricular apical hypoplasia is a rare cardiac malformation. This entity is easily diagnosed if its key features are recognised, but will puzzle the clinician who is not aware of its existence. It is characterised by echocardiographic findings of a spherical left ventricle, an elongated right ventricle wrapping around the deficient left ventricular apex, and abnormal papillary muscles' origin.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118844","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}
Lyndsey Hunter-Adamson, Alexandra Birely, Ashley E Neal, Sonali S Patel, Alaina K Kipps
{"title":"Current status and improvement opportunities for onboarding paediatric acute care cardiology advanced practice providers.","authors":"Lyndsey Hunter-Adamson, Alexandra Birely, Ashley E Neal, Sonali S Patel, Alaina K Kipps","doi":"10.1017/S1047951125001866","DOIUrl":"https://doi.org/10.1017/S1047951125001866","url":null,"abstract":"<p><strong>Background: </strong>Specialised training opportunities in paediatric cardiology are rare for advanced practice providers, creating an educational gap for novice practitioners. Standardised curricula have been cited as a beneficial intervention to optimally prepare these providers for highly specialised fields. We sought to understand the current onboarding practices of advanced practice providers in paediatric acute care cardiology to identify opportunities for curricular improvement.</p><p><strong>Materials and methods: </strong>A survey developed by a task force by the Pediatric Acute Care Cardiology Collaborative (PAC<sup>3</sup>) was distributed across PAC<sup>3</sup> programmes in May 2023 to evaluate the onboarding practices of advanced practice providers at paediatric heart centres nationwide.</p><p><strong>Results: </strong>Survey responses reflected orienting practices at 19 paediatric heart centres representing varying programme and team sizes. Of the respondents, 32% felt their current model does not meet all the needs of the new team member. Key successful onboarding elements included a structured curriculum with goals and objectives, dedicated education time and materials, standardised assessments, and individualised learning in the presence of a supportive team. All respondents agreed that an online curriculum would be beneficial.</p><p><strong>Conclusions: </strong>There is no national standardised educational pathway for advanced practice providers entering paediatric acute care cardiology practice. There are opportunities to develop a formalised curriculum with structured learner assessment at a national level, which could be modified at the institution or learner level to enhance current onboarding practices.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109759","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}
Linda M Lambert, Felicia Trachtenberg, Russell Gongwer, Thomas Giorgio, Olukayode Garuba, Sandra Mihelic, Kathleen Rathge, Martha Rolland, Cynthia Smith, Mary Stumpf, Stacy Woyciechowski, Frances Woodard, Jennifer S Yauck, Victoria L Pemberton
{"title":"Parental and adolescent perceptions of clinical trial participation: the FUEL randomised controlled trial and open-label extension study.","authors":"Linda M Lambert, Felicia Trachtenberg, Russell Gongwer, Thomas Giorgio, Olukayode Garuba, Sandra Mihelic, Kathleen Rathge, Martha Rolland, Cynthia Smith, Mary Stumpf, Stacy Woyciechowski, Frances Woodard, Jennifer S Yauck, Victoria L Pemberton","doi":"10.1017/S1047951125001702","DOIUrl":"https://doi.org/10.1017/S1047951125001702","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent and parental perceptions of the Fontan Udenafil Exercise Longitudinal Assessment Randomised Controlled Trial (FUEL) and its open-label extension were examined, to identify factors affecting future research participation.</p><p><strong>Methods: </strong>A validated survey was administered at two time points to adolescents (12-19 years) and their parents to assess likes/dislikes of study participation, research team, study burden and benefits. A 5-point Likert scale (strongly disagree [-2] to strongly agree [ + 2]) was used, and scores were averaged. Regression models explored potential predictors. Open-ended questions queried the most/least appealing aspects of participation and considerations for future research.</p><p><strong>Results: </strong>Among 250 FUEL participants at 14 centres, 179 adolescent and 183 parent surveys were completed at T1 (6 months after randomisation). Perceptions of research participation were generally positive: 1.35 ± 0.45 for adolescents; 1.56 ± 0.38 (<i>p</i> < 0.001) for parents. There were no significant differences between females vs. males. Themes from open-ended responses included liking to help others and themselves, liking the study team, and disliking study burden. Adolescents liked the compensation and disliked study-related testing. At T2 (end of open-label extension study), 121 adolescents and 114 parents responded. Perception scores remained high at 1.39 ± 0.51 for adolescents and 1.58 ± 0.37 for parents (<i>p</i> = 0.001). There were no significant gender differences in perceptions between adolescents, but mothers had slightly better perceptions than fathers (<i>p</i> = 0.004).</p><p><strong>Conclusions: </strong>Perceptions of research were positive and slightly better for parents. Study teams and compensation were key contributors to positive perceptions. Study burden and testing were viewed less favourably. Future studies should consider families' preferences and potential barriers to participation.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109762","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}
Michael J Martinez, Hannah St Francis, Gloria Contreras Yametti, Rana Biary, Rakesh K Singh
{"title":"Severe hyperlactatemia from Warburg effect due to post-transplant lymphoproliferative disorder after paediatric heart transplantation with resolution following thiamine administration.","authors":"Michael J Martinez, Hannah St Francis, Gloria Contreras Yametti, Rana Biary, Rakesh K Singh","doi":"10.1017/S1047951125001830","DOIUrl":"https://doi.org/10.1017/S1047951125001830","url":null,"abstract":"<p><p>Hyperlactatemia is a common and concerning finding in the paediatric cardiac ICU as it may signify tissue hypoperfusion and/or hypoxia. However, it is important to include other aetiologies for an elevated lactate in the differential, especially when the lactate is significantly elevated (> 8 mmol/L). We present the case of metabolic acidosis with severe hyperlactatemia secondary to Warburg effect and presumed thiamine deficiency in a paediatric heart transplant patient with post-transplant lymphoproliferative disorder.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109768","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}
Hunter C Wilson, Kevin Maher, Ritu Sachdeva, Marcos Mills
{"title":"Cardiac point-of-care ultrasound in the paediatric cardiac ICU: assessment of imaging quality and interpretation.","authors":"Hunter C Wilson, Kevin Maher, Ritu Sachdeva, Marcos Mills","doi":"10.1017/S104795112500157X","DOIUrl":"https://doi.org/10.1017/S104795112500157X","url":null,"abstract":"<p><p>We evaluated quality characteristics of cardiac point-of-care ultrasound performed in our paediatric cardiac ICU. Of 47 included patients, diagnostic imaging was feasible in a high percentage of patients with good image quality. Intensivist interpretations of images were highly specific for dichotomised abnormal findings when compared to interpretation from a cardiologist with expertise in imaging but challenges in accurately assessing depressed ventricular function and the risk of discrepant interpretations exist even amongst frequent users with extensive training and experience. These findings may serve as a template for continued development of cardiac point-of-care ultrasound in a high-impact clinical environment.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092787","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}
Maria Sandstedt, Mikael Sandstedt, Janus Gudnason, Mats Börjesson, Frida Dangardt, Jan Sunnegårdh
{"title":"Subvalvular membranous aortic stenosis in Swedish children, a retrospective cohort study between 1994 and 2019.","authors":"Maria Sandstedt, Mikael Sandstedt, Janus Gudnason, Mats Börjesson, Frida Dangardt, Jan Sunnegårdh","doi":"10.1017/S1047951125001854","DOIUrl":"https://doi.org/10.1017/S1047951125001854","url":null,"abstract":"<p><strong>Background and aim: </strong>Membranous subaortic stenosis is a CHD with high recurrence-rate despite surgical treatment. This study investigated the outcome of operated patients and possible predictors for recurrence.</p><p><strong>Methods: </strong>Retrospective review of all patients (<i>n</i> = 38) ≤ 18 years of age operated for membranous subaortic stenosis between 1994-2019 at Sahlgrenska University Hospital. The primary outcomes were recurrence, reintervention, and mortality. Predictors of recurrence and reintervention were secondary outcomes.</p><p><strong>Results: </strong>Median age (range) at diagnosis, initial intervention, and last follow-up were 2.3 (0.003-17.2), 5.3 (0.03-17.5) and 17.5 (3.6-20.4) years, respectively. Median follow-up time was 9.9 (0.01-19.5) years. 61% were males, and 53% had other associated CHD. 19 patients (56%) developed recurrence and 7 (21%) underwent reintervention. One patient died peri-operatively. Age <u><</u>5 years at first intervention increased the likelihood of reintervention. Postoperative peak/mean gradients were higher in patients with disease recurrence.The median echocardiographic peak-/mean gradients at initial diagnosis, pre-, postoperative, and at last follow-up were 61/36, 83/50, 16/8, and 19/17 mmHg respectively (<i>p</i> < 0.0001 pre/post). Pre-/postoperative peak gradients were linearly correlated, decreasing by 80% pre-/postoperatively (<i>p</i> < 0.01). Presence of symptoms and the preoperative peak gradient were positively associated (<i>p</i> < 0.001) with a peak gradient threshold value of > 90 mmHg. The distance between the subaortic stenosis membrane and the aortic valve was inversely correlated to the preoperative peak-gradient (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Reintervention following surgical intervention of membranous subaortic stenosis is common. A positive correlation exists between high pre- and postoperative peak-gradient. A low postoperative peak gradient may be important in avoiding recurrence.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-11"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092897","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":"Ductal stenting in a limited-resource set up: a single naive centre experience in Eastern India of 88 patients.","authors":"Nurul Islam, Siddhartha Saha, Soumyadeep Biswas, Chandrasekhar Dey, Krishnendu Khan","doi":"10.1017/S104795112500174X","DOIUrl":"https://doi.org/10.1017/S104795112500174X","url":null,"abstract":"<p><strong>Objectives: </strong>To enumerate the experience in different parameters, including demographic, anatomic, procedural, ICU care, and outcome of ductal stenting procedures in duct-dependent pulmonary circulation in a resource-limited setup.</p><p><strong>Background: </strong>Stenting the arterial duct emerged as an alternative to a variety of surgical interventions in the early 1990s. Ductal stenting in neonates with duct-dependent pulmonary circulation may maintain duct patency reliably for several months as an alternative to systemic-to-pulmonary shunts.</p><p><strong>Methods: </strong>This is a retrospective review from a single centre with a developing paediatric cardiology unit and limited paediatric cardiac surgical scope. Eighty-nine symptomatic patients who needed stable ductal flow for adequate pulmonary circulation underwent the procedure from October 2018 to December 2022.</p><p><strong>Results: </strong>We had a procedural success rate of 98.8% (one case failed out of 89) and a successful discharge rate of 96.6% (85 discharged out of 88; 3 immediate mortalities). At the six-month follow-up, the success rate was 93% (6 mortalities in 88 patients). No patient underwent a rescue surgical shunt, but an elective Blalock-Taussig shunt was needed in 1 patient (1.1%). In the remaining 82 cases, 65 are now in follow-up, among them 22 already underwent single-ventricle palliation, and 8 underwent biventricular repair successfully.</p><p><strong>Conclusions: </strong>Ductal stenting is less invasive well-accepted alternative for first-stage palliation. Our focus in this study is to practice this even in resource-limited settings as an alternative to surgical shunts with good short- and mid-term outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092884","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}