Cardiology in the Young最新文献

{"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":"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":"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":"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":"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":"Kabuki patients with CHDs: outcomes after cardiac surgery.","authors":"Regina W Lam, Victoria Haro, Sarah Tabbutt, Hiroo Kinami, V Mohan Reddy, Minso Kim","doi":"10.1017/S1047951125000435","DOIUrl":"10.1017/S1047951125000435","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to examine the surgical outcome of Kabuki syndrome patients after neonatal congenital heart surgery.</p><p><strong>Methods: </strong>This was a single-centre retrospective study of Kabuki syndrome patients undergoing neonatal congenital heart surgery from 2018 to 2023. Primary outcome was survival to discharge after index surgery. Secondary outcomes were morbidities and complications. Survival and hospital length of stay were compared to neonates with non-Kabuki genetic anomalies undergoing congenital heart surgery in the same time period.</p><p><strong>Results: </strong>A total of seven patients were reviewed. All Kabuki syndrome patients had left-sided lesions including three with hypoplastic left heart syndrome, three with aortic stenosis and/or aortic arch hypoplasia, and one with an isolated coarctation of aorta. Hospital survival was 5/7 (71% compared to 88% for neonates with non-Kabuki genetic anomalies). To date, four remain alive, including one with hypoplastic left heart syndrome. A higher percentage of Kabuki syndrome patients had unplanned interventions (43% vs 15% in non-Kabuki), abnormal brain imaging (29% vs 5%), and bacteremia (29% vs 9%). Median total ventilator days for Kabuki patients were also longer (16 days vs 6 days in non-Kabuki) as was hospital length of stay (66 days vs 41 days).</p><p><strong>Conclusions: </strong>Despite survival to discharge after index operation, Kabuki syndrome patients with single ventricle physiology remain at high risk of mortality and morbidity after cardiac surgery. However, they may be discharged without ventilator dependency and survive to toddler years.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"722-725"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499307","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":"Sodium-glucose cotransporter-2 inhibitor use in patients with a Fontan circulation.","authors":"Stephanie S Gaydos, Kimberly E McHugh, Frances K Woodard, Rochelle N Judd, Thomas J Brenzel, Heather T Henderson, Andrew J Savage, Andrew M Atz, David Gregg","doi":"10.1017/S1047951125000514","DOIUrl":"10.1017/S1047951125000514","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 inhibitors reduce cardiovascular outcomes in patients with congestive heart failure and a biventricular circulation. Congestive heart failure in Fontan univentricular circulation is distinctly different. Experience with sodium-glucose cotransporter-2 inhibitors in this group has not yet been well described.</p><p><strong>Objectives: </strong>This work describes safety and tolerability of sodium-glucose cotransporter-2 inhibitors in patients with Fontan circulation.</p><p><strong>Methods: </strong>Single-centre review of patients with Fontan circulation prescribed a sodium-glucose cotransporter-2 inhibitors for congestive heart failure. Primary outcome was tolerability or need for discontinuation. Secondary outcomes were changes in New York Heart Association class, congestive heart failure hospitalisation, ventricular function, exercise performance, and laboratory values.</p><p><strong>Results: </strong>We identified 25 patients with Fontan circulation prescribed an sodium-glucose cotransporter-2 inhibitors, most with a systemic right ventricle. Over a third of subjects had at least moderately reduced baseline ventricular function. Baseline catheterisation showed a mean Fontan pressure of 17.1 ± 3.7 mmHg and pulmonary capillary wedge pressure 11.7 ± 3.2 mmHg at rest; 59% had occult diastolic dysfunction with abnormal pulmonary capillary wedge pressure elevation following volume expansion. Most were on congestive heart failure medications and/or a pulmonary vasodilator prior to sodium-glucose cotransporter-2 inhibitors addition, and three had a congestive heart failure hospitalisation within the previous year. All reported good medication tolerance except one patient was nonadherent to medications and two discontinued sodium-glucose cotransporter-2 inhibitors for perceived side effects. There were no significant differences in secondary outcomes. There was, however, a downward trend of serum brain natriuretic peptide (<i>n</i> = 13) and improved peak VO2 (<i>n</i> = 6), though neither statistically significant (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>This series, the largest published to date, suggests that sodium-glucose cotransporter-2 inhibitors are safe and tolerable congestive heart failure therapy in Fontan circulation. Further research is warranted to explore therapy in this unique population.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"745-747"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499310","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}

{"title":"Markers of growth and nutrition in children with acquired chylothorax post CHD surgery.","authors":"Kevin N Marzotto, Karin R Videlefsky, Meghan P Howell, Thomas R Kimball, Frank A Pigula, Kurt D Piggott","doi":"10.1017/S1047951125001222","DOIUrl":"10.1017/S1047951125001222","url":null,"abstract":"<p><strong>Background: </strong>Acquired chylothorax is an established complication of CHD surgery, affecting 2-9% of patients. CHD places a child at risk for failure to thrive, with subsequent chylothorax imposing additional risk.</p><p><strong>Objective: </strong>We conducted a retrospective chart review to ascertain quantitative markers of nutrition and growth in children affected by chylothorax following CHD surgery between 2018 and 2022 compared to controls.</p><p><strong>Methods: </strong>We utilised electronic medical record system, EPIC, at Children's Hospital, New Orleans, targeting subjects < 18 years old who underwent CHD surgery between 2018 and 2022 and developed a subsequent chylothorax. Study subjects were identified using the 10th revision of the International Classification of Diseases codes (ICD-10 codes: J94.0, I89.8, and J90.0). Each chylothorax case (<i>n</i> = 20) was matched by procedure type and age to a control with no chylothorax (<i>n</i> = 20). Data were recorded in REDCap and analysed using SPSS.</p><p><strong>Results: </strong>After removal of outliers, we analysed 19 total matched pairs. There was no statistical difference in growth velocity (<i>p</i> = 0.12), weight change (operation to discharge) (<i>p</i> = 0.95), weight change (admission to discharge) (<i>p</i> = 0.35), Z-score change (operation to discharge) (<i>p</i> = 0.90), Z-score change (admission to discharge) (<i>p</i> = 0.21), serum protein (<i>p</i> = 0.88), or serum albumin (<i>p</i> = 0.82). Among cases, linear regression demonstrated no significant association between maximum chylous output and growth velocity (<i>p</i> = 0.91), weight change (operation to discharge) (<i>p</i> = 0.15), or weight change (admission to discharge) (<i>p</i> = 0.98).</p><p><strong>Conclusions: </strong>We did not observe statistically significant markers of growth or nutrition in children with chylothorax post-CHD surgery compared to those without chylothorax. Multisite data collection and analysis is required to better ascertain clinical impact and guide clinical practice.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"791-797"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536689","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":"Use of Bivalirudin for a Pediatric Patient with Two Mechanical Heart Valves: a case report.","authors":"Joshua W Branstetter, John Wagner, Hania Zaki, Gary Woods, Heather Viamonte","doi":"10.1017/S1047951125001283","DOIUrl":"10.1017/S1047951125001283","url":null,"abstract":"<p><p>Despite advances in the development of systemic anticoagulants, there remain few agents approved for utilisation in patients with mechanical heart valves. Currently, recommendations for periprocedural and long-term anticoagulation in mechanical heart valves include unfractionated heparin or vitamin K antagonists, and there are some reports for off-label use of low-molecular-weight heparins. Emerging data on parenteral direct thrombin inhibitors, such as bivalirudin, have led to increased utilisation in both extracorporeal membrane oxygenation and ventricular assist devices. We present the case of a paediatric patient with rheumatic heart disease who had significant bleeding on unfractionated heparin who successfully received prolonged bivalirudin therapy in the setting of mechanical aortic and mitral heart valves.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"872-875"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647375","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}