Cardiology in the Young最新文献

{"title":"Usefulness of hepatic CT attenuation values in assessment of Fontan-associated liver disease progression: a comparative study with Model of End-stage Liver Disease Excluding International Normalized Ratio scores.","authors":"Yosuke Kugo, Takashi Kido, Takuji Watanabe, Toshiaki Nagashima, Masaki Taira, Daisuke Yoshioka, Kazuo Shimamura, Shigeru Miyagawa","doi":"10.1017/S1047951125000393","DOIUrl":"10.1017/S1047951125000393","url":null,"abstract":"<p><p>Fontan-associated liver disease leads to liver cirrhosis and hepatocellular carcinoma, worsening patient prognosis. Although the Model of End-Stage Liver Disease Excluding International Normalized Ratio score correlates with disease severity, precise prediction methods remain elusive. The hepatic computed tomography (CT) attenuation is used to assess steatohepatitis, which may offer insight into disease progression. This study aimed to determine the usefulness of hepatic CT attenuation values in assessing Fontan-associated liver disease progression. All post-Fontan patients with >20 years' follow-up data between 1980 and 2021 were reviewed. We set five regions of interest with a 20-mm-diameter circle in the peripheral region of the liver to obtain minimum, maximum, mean, and standard deviation of the CT attenuation values, which were adjusted to those of the aorta. The impact of hepatic CT attenuation values on cirrhosis development was evaluated. Cox regression revealed significant associations between adjusted minimum (hazard ratio: 0.01 [0.00-0.02, <i>p</i> < 0.01), adjusted maximum (hazard ratio: 159 [4.34-5831, <i>p</i> < 0.01]), and standard deviation (hazard ratio: 1.89 [1.29-2.76, <i>p</i> < 0.01]) and Model of End-Stage Liver Disease Excluding International Normalized Ratio score (hazard ratio: 1.2 [1.02-1.43, <i>p</i> = 0.03]) with cirrhosis. In cirrhosis cases, the adjusted minimum value exhibited significant longitudinal alteration prior to cirrhosis (<i>p</i> < 0.01), whereas Model of End-Stage Liver Disease Excluding International Normalized Ratio scores remained stable. The hepatic CT attenuation values were associated with cirrhosis development and the longitudinal changes are more sensitive than the Model of End-Stage Liver Disease Excluding International Normalized Ratio score.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"831-835"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405733","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":"Chylothorax: a rare postoperative complication in paediatric cardiac surgery patients - a 15-year retrospective study from a tertiary care centre in a developing country.","authors":"Bshara Sleem, Jad Abdul Khalek, Adham Makarem, Salah Yamout, Christophe El Rassi, Rana Zareef, Mounir Obeid, Issam El Rassi, Fadi Bitar, Mariam Arabi","doi":"10.1017/S104795112500126X","DOIUrl":"10.1017/S104795112500126X","url":null,"abstract":"<p><p>Chylothorax, a postoperative complication of CHD surgery, involves chyle accumulation in the pleural cavity, posing challenges in diagnosis and management. This retrospective study investigates the prevalence, aetiology, management, and outcomes of postoperative chylothorax in paediatric patients undergoing cardiac corrective surgery at a tertiary care centre over 15 years. Medical records of paediatric patients who underwent cardiothoracic surgery at the Children's Heart Center at the American University of Beirut Medical Center between 2007 and 2022 were retrospectively reviewed. Data collection included demographic characteristics, blood parameters, chylous fluid characteristics, diagnostic criteria, treatment modalities, and hospitalisation details. Ethical approval was obtained, and descriptive statistics were employed using SAS 9.4. Among 2,997 children who underwent cardiothoracic surgery, nineteen cases of postoperative chylothorax were identified. The majority were females (63.2%) with a median age of 9 months. Glenn, Fontan, and Blalock-Taussig shunt-related surgeries were the most common operations associated with chylothorax. Single ventricle physiology was the predominant CHD observed (58%). Diagnosis relied primarily on clinical presentation, imaging studies, and triglyceride levels in pleural fluid. Treatment options included conservative dietary modifications, medical therapy such as octreotide, and surgical intervention if necessary. No mortalities were reported, and patients were adequately followed up. This study sheds light on postoperative chylothorax in paediatric cardiac patients, offering insights into its epidemiology, aetiology, clinical features, and treatment outcomes. While conservative and medical approaches effectively managed chylothorax in this group, larger studies are needed to develop standardised diagnostic and treatment protocols, improving outcomes in paediatric patients with postoperative chylothorax.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"798-804"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613502","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":"Mini-invasive surgical approach for hybrid pulmonary valve implantation: an option for very high-risk patients.","authors":"Biagio Castaldi, Vincenzo Tarzia, Giuseppe Tarantini, Domenico Sirico, Daniela Mancuso, Nicola Pradegan, Giovanni Di Salvo, Gino Gerosa","doi":"10.1017/S1047951125000411","DOIUrl":"10.1017/S1047951125000411","url":null,"abstract":"<p><p>Transcatheter pulmonary valve replacement is the first choice to treat residual or recurrent right ventricular outflow tract dysfunction. Surgery is an effective option when anatomy is not permissive for transcatheter procedures. When surgical risk is too high, hybrid procedures might be considered.In this paper, we describe the first use of Harmony valve in Europe in a 59 years old patient with a huge right ventricular outflow tract. The procedure was performed by a hybrid approach: before valve deployment, through an anterior mini-thoracotomy, the pulmonary artery was plicated to create a landing zone. The valve was deployed by trans-femoral venous approach. It was secured by putting a suture on the distal stent raw under fluoroscopic guidance. The procedure was uneventful and patient's New York Heart Association class rapidly improved from III-IV to II.In conclusion, hybrid strategies might represent an acceptable option for huge right ventricular outflow tract, to be less invasive and to minimise device embolisation risks. When a good match between patient's anatomy and device can be achieved, a mini-invasive or micro-invasive surgical approach might be considered to minimise bleeding risks and shorten the hospital's length of stay.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"845-849"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514824","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":"Risk of late sudden death after surgery for congenital heart disease.","authors":"Joseph S Needleman, Robert D Whitehill, J'Neka S Claxton, Courtney McCracken, Rachel Zmora, Jeffrey M Vinocur, Matthew E Oster, Lazaros Kochilas","doi":"10.1017/S1047951125000277","DOIUrl":"10.1017/S1047951125000277","url":null,"abstract":"<p><strong>Background: </strong>Sudden cardiac death is a significant concern among patients with congenital heart disease (CHD). We assessed the risk of remote sudden cardiac death after congenital heart surgery.</p><p><strong>Methods: </strong>Patients undergoing congenital heart surgery before 21 years of age between 1982 and 2003 in the Pediatric Cardiac Care Consortium registry were linked to National Death Index data through 2019. Sudden cardiac death was defined as death associated with a cardiac arrest or ventricular fibrillation diagnosis code. Standardised mortality ratios relative to the general population were calculated using Centers for Disease Control and Prevention data.</p><p><strong>Results: </strong>Among 30,566 patients discharged after their initial surgery, 2,718 deaths occurred over a median period of 23 years (IQR 19-27). Of 463 (17%) sudden cardiac deaths, the median age was 1.7 years (IQR 0.5-16.5). The mean incidence was 7 per 10,000 person-years (95% CI: 0.64-0.77), ranging from 2.7 for left-to-right shunt lesions to 37 for single-ventricle physiology. Cardiac comorbidities including heart failure (13.6%) and arrhythmias (7.1%) were more frequent among sudden cardiac death patients. Standard mortality ratios for sudden cardiac death were elevated across all CHD types, ranging from 8.0 (95% CI: 6.3-9.6) for left-to-right shunts to 107.7 (95% CI: 88.9-126.5) for single-ventricle physiology.</p><p><strong>Conclusion: </strong>Sudden cardiac death risk is higher post-congenital heart surgery compared to the general population. Even patients with mild CHD are at risk, highlighting the need for long-term follow-up for all patients. Heart failure and arrhythmia prevalence suggest potential therapeutic targets to reduce sudden cardiac death risk.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"805-811"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514842","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":"Closure of perimembranous ventricular septal defects using the Amplatzer vascular plug II: experience of a Mexican centre.","authors":"Roberto Mijangos-Vázquez, Rogelio Hernández-Reyes","doi":"10.1017/S1047951125000381","DOIUrl":"10.1017/S1047951125000381","url":null,"abstract":"<p><strong>Objectives: </strong>To demonstrate safety and efficacy of using the Amplatzer^TM vascular plug II device for perimembranous ventricular septal defect closure with retrograde approach and show the follow-up in all patients.</p><p><strong>Background: </strong>At present, there is no FDA-approved device for transcatheter closure of perimembranous ventricular septal defects. Small studies and case reports have shown the use of various catheter-based devices in an off-label management; however, there are no large studies to show their efficacy. The second generation of Amplatzer^TM vascular plug seems to offer a safe and attractive alternative for this procedure. Besides, a retrograde approach might decrease procedure time and radiation exposure time.</p><p><strong>Methods and results: </strong>Patients with congenital perimembranous ventricular septal defects who underwent transcatheter closure using Amplatzer vascular plug II devices were included. Primary end point was to determine efficacy and safety of this generation of devices and the incidence of complications at follow-up (complete heart block and aortic/tricuspid/mitral regurgitation). Forty-five patients underwent perimembranous ventricular septal defect closure at a median age of 6 years (9 months-17 years). During the catheterization, there were only minor complications and at follow-up of 48 ± 25.7 months (up to 96 months). Closure rate was high of 93.3% and freedom from atrioventricular block was 100%.</p><p><strong>Conclusions: </strong>The second generation of the Amplatzer^TM vascular plug II seems to offer a safe and attractive alternative for percutaneous closure of the perimembranous ventricular septal defects.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"683-687"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482256","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":"Perceived barriers to neurodevelopmental follow-up among cardiac neurodevelopmental outcome collaborative institutional and affiliated members.","authors":"Faridis Serrano, Elizabeth J Willen, Estrella Mazarico de Thomas, Danielle Guffey, Sarah Plummer, Caren S Goldberg, Sonia Monteiro","doi":"10.1017/S1047951125001295","DOIUrl":"10.1017/S1047951125001295","url":null,"abstract":"<p><strong>Objective: </strong>Neurodevelopmental follow-up programmes for children with CHD help identify neurodevelopmental impairments and support the delivery of recommended interventions. The Cardiac Neurodevelopmental Outcome Collaborative, Diversity, Equity, and Inclusion Special Interest Group surveyed members to assess perceived patient barriers to neurodevelopmental follow-up, previous diversity and inclusion education, and confidence in caring for historically marginalised populations.</p><p><strong>Methods: </strong>A link to a Redcap online survey was emailed to Cardiac Neurodevelopmental Outcome Collaborative members on 23 April 2022, with 4 weeks given to complete.</p><p><strong>Results: </strong>Eighty-four participants from 37 institutions in North America completed the survey. Respondents acknowledged that education on the importance of neurodevelopmental follow-up and frequent accommodations for cancellations or rescheduling clinic visits is essential. Language interpretation and written materials were available in languages other than English, but a limited number provided fully translated evaluation reports. Driving distance and the caregiver's lack of understanding of the rationale for neurodevelopmental follow-up were the top perceived barriers to programme attendance. At the institutional level, training for cultural competency was typically provided, and most respondents felt comfortable caring for patients from diverse backgrounds. However, many agreed their programmes could do more to make evaluations accessible to historically marginalised/underserved populations.</p><p><strong>Conclusions: </strong>Multiple barriers exist to cardiac neurodevelopmental follow-up, particularly for patients from under-represented minorities and for those whose primary language is not English. Surveying families will be valuable to understand how we may overcome these barriers. Further education about the importance of neurodevelopmental follow-up programmes continues to be essential.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"756-762"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584760","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":"Surgical resection is an effective adjunct to the management of an advanced metastatic osteosarcoma.","authors":"Hani K Najm, Samuel M Hoenig, John P Costello","doi":"10.1017/S1047951125001192","DOIUrl":"10.1017/S1047951125001192","url":null,"abstract":"<p><p>Cardiac involvement of metastatic osteosarcoma is exceedingly rare and carries a dismal prognosis. Documentation of the surgical management of cardiac metastatic osteosarcoma is limited. We describe the successful resection of a ∼ 3.9 x 2.2 cm mass involving the right atrioventricular groove and right ventricular inferolateral wall, granting our patient 12 months of excellent cardiac function in the face of advanced metastatic disease.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"853-855"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623625","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 case of isolated right subclavian artery and right patent ductus arteriosus successfully treated with catheter intervention in early infancy.","authors":"Makoto Yoshida, Tao Fujioka, Akio Inage","doi":"10.1017/S104795112500040X","DOIUrl":"10.1017/S104795112500040X","url":null,"abstract":"<p><p>In isolated subclavian artery, abnormal aortic arch development causes a loss of continuity with the aorta. Patent ductus arteriosus is a known cause of congestive heart failure. Herein, we present a rare case of congestive heart failure caused by isolated right subclavian artery and right patent ductus arteriosus associated with left-sided aortic arch treated by early closure.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"842-844"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555774","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":"Comparison of different approaches applied for surgical correction of partial anomalous pulmonary venous connection.","authors":"Fan Fan, Song Bai, Xiaofeng Li, Zhiqiang Li, Feng Tong, Jian Guo, Nan Ding, Zhangke Guo","doi":"10.1017/S1047951125000617","DOIUrl":"10.1017/S1047951125000617","url":null,"abstract":"<p><strong>Background: </strong>Right anterolateral thoracotomy or left anterolateral thoracotomy applied to partial anomalous pulmonary venous connection correction have been reported to obtain cosmetic and less invasive outcomes as alternative approaches to median sternotomy. However, the application of different approaches is still confusing. We compared the perioperative and mid-term outcomes to seek indications of different approaches and guide surgical treatment of partial anomalous pulmonary venous connection.</p><p><strong>Methods: </strong>From July 2019 to August 2023, 44 patients who underwent surgical correction of partial anomalous pulmonary venous connection were recruited. Of these, 13 (29.6%) patients who underwent median sternotomy were separated into M group, 28 (63.6%) patients who underwent right anterolateral thoracotomy were separated into R group, and three (6.8%) patients who underwent left anterolateral thoracotomy were separated into L group. Clinical data were reviewed and compared between each group.</p><p><strong>Results: </strong>In M group, direct anastomosis accounted for the most (7, 53.8%), in R group, intra-atrial rerouting accounted for the most (22, 78.6%), and in L group, direct anastomosis accounted for the most (3, 100%). R group had shorter cardiopulmonary bypass time (70.0 ± 32.4 vs113.1 ± 83.3, <i>p</i> = 0.029), shorter ICU stay (1.0 ± 0.2 vs 1.9 ± 1.7, <i>p</i> = 0.01), shorter postoperative stay (6.0 ± 1.2 vs 8.3 ± 5.0, <i>p</i> = 0.021), and fewer chest tube drainage (8.4 ± 4.3 vs 13.9 ± 10.2, <i>p</i> = 0.026) compared with M group. Three left-sided partial anomalous pulmonary venous connection in L group adopted off-pump approach.</p><p><strong>Conclusions: </strong>Median sternotomy S.V.C. can be applicable to all anatomic types of partial anomalous pulmonary venous connection especially for complex types. Considering the minimally invasive advantages, we prefer applying right anterolateral thoracotomy for pulmonary vein connected to right atrium or proximal end of off-pump. Applying left anterolateral thoracotomy for left-sided partial anomalous pulmonary venous connection without atrial septal defect by off-pump.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"776-783"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514822","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":"Percutaneous closure of anomalous left coronary artery from pulmonary artery rare procedure in desperate situation: case report.","authors":"Mirza Mohd Kamran, Arun Gopi, Saurabhi Das, Zeeshan Lakhani, Amira Sheikh, Janeel Musthafa, G Raghuram, Musthafa P P Mohammad","doi":"10.1017/S1047951125000472","DOIUrl":"10.1017/S1047951125000472","url":null,"abstract":"<p><strong>Background: </strong>When anomalous left coronary artery from the pulmonary artery is diagnosed in infancy, it is associated with high mortality, but collaterals permit rare adult survival despite coronary steal. We report normalisation of perfusion abnormality after transcatheter proximal left coronary occlusion in a symptomatic adult with inducible ischaemia.</p><p><strong>Methods: </strong>A forty-eight-year-old female presented with exertional chest pain; EKG showed sinus rhythm with left axis deviation with intraventricular conduction defect. Echocardiogram diagnosed an anomalous left coronary artery arising from the pulmonary artery with normal ventricular function which was further confirmed by CT. The case was discussed with the surgical team, and it was decided to surgically ligate. The patient did not give consent for the surgical procedure; the patient was taken up for the procedure.</p><p><strong>Results: </strong>Device was released safely after confirming the position on echocardiogram after the procedure showed improvement in intraventricular conduction defect and QTc duration, and also no significant ischaemic changes were noted. Myocardial perfusion scintigraphy was done after 6 months of procedure which showed improvement in contractile function and perfusion of left ventricle.</p><p><strong>Conclusions: </strong>Device closure in long-standing anomalous left coronary artery from pulmonary artery case is safe, and long-term follow-up is needed.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"866-871"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522592","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}