Cardiology in the Young最新文献

{"title":"Standardising cardiac CT-based personalised surgical planning and execution in congenital aortic valvar disease.","authors":"Justin T Tretter, Lama Dakik, Munir Ahmad, John P Costello, Nelson Burbano-Vera, Margaret Fuchs, Joanna Ghobrial, Kenneth Zahka, Hani K Najm","doi":"10.1017/S1047951125109475","DOIUrl":"https://doi.org/10.1017/S1047951125109475","url":null,"abstract":"<p><strong>Background: </strong>Congenital aortic valvar disease represents a heterogeneous population with suboptimal surgical repair or replacement outcomes. We assess our approach and short-term outcomes in this population using cardiac CT evaluation for personalised surgical planning and execution.</p><p><strong>Methods: </strong>We assessed patients who underwent aortic valvar surgery from February 2022 to August 2024. Pre-surgical evaluation included cardiac CT with quantitative assessment of the leaflet geometry and measures of leaflet coaptation. A standardised approach towards surgical execution guided by this assessment was established and followed.</p><p><strong>Results: </strong>Seventy-three patients underwent surgery at a median age of 26.0 years (interquartile range 19-44), 65.8% males. Forty-eight patients (65.8%) underwent some form of aortic valvar repair, with 22 of these 48 patients undergoing a valve-sparing aortic root replacement. The remaining 25 patients (34.2%) underwent some form of aortic valvar replacement. Mean post-surgical follow-up was 4.2 ± 6.1 months. Moderate or greater aortic regurgitation was present in 45 patients (61.6%) pre-operatively versus 2 patients (2.7%) post-operatively (p-value < 0.001). The peak and mean gradient improved from 33.2 ± 31.3 mmHg and 16.9 ± 10.7 mmHg pre-operatively, to 16.9 mmHg±10.7 mmHg and 9.5 ± 6.4 mmHg post-operatively (<i>p</i>-value < 0.001).</p><p><strong>Conclusion: </strong>The heterogeneity and complexity of the dysfunctional and/or dilated (neo-)aortic root encountered in those presenting for surgery necessitates a methodical, detailed three- and four-dimensional assessment. By applying such an approach, we have aimed to standardise not only the assessment, but also description and surgical execution in this challenging patient population. Excellent short-term results have been achieved, necessitating long-term follow-up to understand the potential benefits towards this personalised approach.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032839","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":"Facility dog intervention and young children's anxiety during outpatient echocardiography.","authors":"Leslie Grissim, Spencer Shreeve, Briana P Keller, Michelle Robertson, Patti Runyan, Jessika Boles","doi":"10.1017/S1047951125109530","DOIUrl":"https://doi.org/10.1017/S1047951125109530","url":null,"abstract":"<p><strong>Background and objectives: </strong>With more than 1 million children in the United States living with a heart defect or condition, it is important to identify interventions that may minimise the long-term impacts of repeated medical surveillance and care. Thus, the purpose of this quasi-experimental study was to examine relationships between facility dog intervention and young children's anxiety during outpatient echocardiogram.</p><p><strong>Methods: </strong>Participants were seventy children aged 18 months to 8 years undergoing echocardiogram in a paediatric cardiology clinic. Child anxiety was scored by a trained nurse observer pre- and post-procedure using the modified Yale Preoperative Anxiety Scale. Facility dog intervention included individualised play, positioning, therapeutic conversation and touch, and emotional support throughout to promote coping and compliance. Parents and staff completed a post-procedural perceptions survey about their experiences.</p><p><strong>Results: </strong>Paired samples <i>t</i>-tests demonstrated child anxiety levels were significantly lower post-procedure compared to pre-procedure (<i>Z</i> = -3.974, <i>p</i> < .001). This direction held for nearly all participants; however, those with prior echocardiogram history demonstrated significantly higher anxiety levels at the pre-procedural timepoint (<i>z</i> = -2.442, <i>p</i> = .015). Caregivers (97.2%) and staff (87.9%) agreed or strongly agreed that facility dog intervention was helpful in this context.</p><p><strong>Conclusions: </strong>Facility dog intervention was associated with a significant reduction in young children's anxiety across procedural timepoints in outpatient echocardiography. The intervention was perceived as helpful by families and staff; no workflow changes or barriers were noted. Thus, facility dog intervention may be a well-received and promising care innovation for this vulnerable chronic population.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032778","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":"Dosing of intravenous alprostadil in neonates with ductal-dependent CHD.","authors":"Alyssa Renee Miles, Trent Abel, Arabela Stock, Michelle Smith, Amy Kiskaddon","doi":"10.1017/S1047951125109542","DOIUrl":"https://doi.org/10.1017/S1047951125109542","url":null,"abstract":"<p><strong>Introduction: </strong>Neonates with ductal-dependent CHD rely on the patency of the ductus arteriosus to maintain circulation. Alprostadil is utilised to maintain ductal patency, although optimal dosing has not been determined. This study aims to describe alprostadil dosing in neonates with ductal-dependent CHD.</p><p><strong>Methods: </strong>This is a single-centre retrospective study including neonatal patients with ductal-dependent CHD who received alprostadil from January 2015 to December 2015 (cohort 1) and January 2021 to December 2021 (cohort 2). The primary objective was to describe alprostadil dosing in the two study periods. Secondary objectives included clinical outcomes and adverse events associated with different alprostadil dosing strategies.</p><p><strong>Results: </strong>Sixty-five patients met eligibility for inclusion in this study: thirty-eight patients in cohort 1 and twenty-seven patient s in cohort 2. Baseline demographics were similar between cohorts. Initial alprostadil dosing in cohort 1 and cohort 2 was 0.006 mcg/kg/min and 0.025 mcg/kg/min (<i>p</i> = < 0.001), respectively. Patients in cohort 2 were found to have a higher incidence of apneic events, apneic events requiring respiratory support, and the incidence of fever ≥38 °C.</p><p><strong>Conclusions: </strong>In this single-centre study, we report that higher doses of alprostadil were associated with an increased risk of adverse events, which should be validated by prospective multicentre studies.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032800","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 atrial flow regulator device in children and patients with CHD: a literature review.","authors":"Fausto Frazzetto, Enrico Piccinelli, Mara Pilati, Micol Rebonato, Gianfranco Butera","doi":"10.1017/S1047951125109463","DOIUrl":"https://doi.org/10.1017/S1047951125109463","url":null,"abstract":"<p><p>The Occlutech Atrial Flow Regulator is a self-expandable double-disc nitinol device with a central fenestration designed to create a calibrated communication across the interatrial septum. It has been used in adult patients with heart failure and pulmonary hypertension. Its use in the paediatric population or adults with CHD has been published in several case reports and case series. This study aims to review the potential, efficacy, and safety of this device in the paediatric and adult populations living with CHD, as well as in paediatric patients with pulmonary hypertension or advanced heart failure.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032847","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":"Empowering Patients with Congenital Heart Disease: Development of a Digital Question Prompt List for Shared Decision-Making: A Pilot Study.","authors":"Hajar Habibi, Emily Tulloh, Michael A Gatzoulis","doi":"10.1017/S1047951125109396","DOIUrl":"https://doi.org/10.1017/S1047951125109396","url":null,"abstract":"<p><strong>Background: </strong>Advancements in healthcare have significantly improved the prospect of patients with CHD, with over 97% now surviving adulthood. This growing population requires lifelong care and support to manage their condition. Digital health innovations, such as the \"Ask Me Anything\" (AMA) tool, aim to empower patients and improve collaboration with clinicians.</p><p><strong>Methods: </strong>In this pilot study, 70 patients were invited to participate, and 58 completed the questionnaire (response rate: 82.9%). Patients completed a digital question prompt list (QPL) prior to their consultations to select key topics from a predefined list of questions. Permission from the institution was obtained before conducting the pilot study.</p><p><strong>Results: </strong>Patients frequently selected questions related to prognosis, ageing, emotional well-being, lifestyle, and potential future interventions. The tool allowed for more personalised consultations and promoted active patient participation.</p><p><strong>Conclusions: </strong>The AMA tool demonstrates feasibility in engaging ACHD patients and supporting shared decision-making. Further research is needed to optimise system integration and evaluate long-term outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-5"},"PeriodicalIF":0.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032726","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":"Paediatric ischaemic stroke as the first manifestation of a giant left atrium: a case report.","authors":"María Cecilia Martínez Morales, Miguel Angel Martínez Cárdenas, Marco Antonio Ruiz Ontiveros, Iván Guillermo Jiménez Delgado","doi":"10.1017/S1047951125101364","DOIUrl":"10.1017/S1047951125101364","url":null,"abstract":"<p><p>Giant left atrium is extremely rare in the paediatric population, especially in asymptomatic cases. We report a 5-year-old child with a giant left atrium due to \"non-rheumatic\" mitral valve regurgitation that presented as a stroke secondary to atrial tachycardia. This case is noteworthy for the unusual \"silent\" manifestation of a giant left atrium.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1953-1955"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798231","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 a broken heart: takotsubo cardiomyopathy following anaesthetic induction.","authors":"Danielle D Strah, Peter Chau, Branden M Engorn, Dana Mueller","doi":"10.1017/S1047951125101625","DOIUrl":"10.1017/S1047951125101625","url":null,"abstract":"<p><p>Takotsubo cardiomyopathy, also known as stress cardiomyopathy or broken heart syndrome, is named for echocardiographic features that look like the \"tako-tsubo\" (octopus trap). While classically associated with older women after experiencing significant emotional distress, it can also occur in paediatrics. Our patient is an 11-year-old male with a complex medical history who developed Takotsubo cardiomyopathy after cardiac arrest during anaesthesia induction. He was successfully resuscitated, but this case highlights an example of an unusual drug interaction and the first of its description in paediatrics.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1929-1931"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early results of complete surgical correction of tetralogy of Fallot with pulmonary valve formation from the right atrium: a comparative analysis with traditional correction without valve construction.","authors":"Mustafa Kemal Avşar, Ramush Bejiqi, Yasin Güzel, Cenap Zeybek, Barıs Kirat, İbrahim Ozgur Onsel, Mehmet Salih Bilal","doi":"10.1017/S1047951125100565","DOIUrl":"10.1017/S1047951125100565","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pulmonary regurgitation following tetralogy of Fallot repair burdens the right ventricle. This study evaluated early outcomes of pulmonary valve reconstruction using right atrial tissue versus standard transannular patch repair.</p><p><strong>Methods: </strong>A retrospective analysis of 412 tetralogy of Fallot patients (2014-2024) was conducted: Atrial Valve Group (<i>n</i> = 205) underwent valve reconstruction; No-Valve Group (<i>n</i> = 207) received standard repair. Patients were followed for 1 year with echocardiographic assessments. Outcomes included right ventricular insufficiency, ventilation duration, and ICU stay.</p><p><strong>Results: </strong>Atrial Valve Group had lower right ventricular insufficiency at 12 months (9.3% vs. 19.8%, <i>p</i> = 0.004, OR = 2.39, 95% CI: 1.32-4.33), shorter ventilation times (6.1 vs. 18.0 hours, <i>p</i> < 0.001, Cohen's <i>d</i> = 3.54), and reduced ICU stays (3.0 vs. 5.7 days, <i>p</i> < 0.001, Cohen's <i>d</i> = 1.87), despite longer CPB durations (47.1 vs. 40.5 minutes, <i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>Right atrial tissue reconstruction reduces early and intermediate-term right ventricular dysfunction post-tetralogy of Fallot repair. Long-term studies are needed.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1824-1843"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999722","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":"Sternal opening width is associated with increased risk for capillary leak syndrome and death in neonates and infants after cardiac surgery with delayed sternal closure.","authors":"Christoffer Lindbom, Lars Lindberg, Phan-Kiet Tran, Ann-Katrin Krokström, Katarina Hanséus, Michal Odermarsky, Petru Liuba","doi":"10.1017/S1047951125101455","DOIUrl":"10.1017/S1047951125101455","url":null,"abstract":"<p><p>Capillary leak syndrome is a serious postoperative complication in neonates and infants after open-heart surgery for CHD. The aim of this study was to investigate the relationship between sternal opening width and the occurrence of capillary leak syndrome in patients undergoing cardiac surgery with delayed sternal closure.We retrospectively analysed the clinical data of neonates and infants (aged < 12 months) who underwent open-heart surgery with delayed sternal closure at our institution between January 2016 and December 2021. Patients were categorised into groups based on postoperative diagnosis of capillary leak syndrome, defined as delayed sternal closure exceeding 3 days in combination with established clinical criteria. Stent length per kilogram (SL/kg) was calculated as the ratio of the sternal stent length to the patient\"s body weight (mm/kg).Of the 164 patients, 12 (7.3%) met capillary leak syndrome criteria. Capillary leak syndrome patients had higher median SL/kg (19.7%, <i>p</i> = 0.02), higher prenatal diagnosis rate (31.3%, <i>p</i> = 0.03), longer cardiopulmonary bypass time (24 min, <i>p</i> = 0.01), inotrope use (155 hours, <i>p</i> < 0.001), drainage time (99 hours, <i>p</i> < 0.001), duration of invasive ventilation (168 hours, <i>p</i> < 0.001), delayed sternal closure (3.8 days, <i>p</i> < 0.001), postoperative paediatric ICU length of stay (8.0 days, <i>p</i> < 0.001), and total hospital length of stay (8.5 days, <i>p</i> = 0.002). Nine deaths occurred, three of which were in the capillary leak syndrome group.Univariate analysis identified higher SL/kg (OR:1.17, 95% CI:1.00-1.38) as a risk factor for postoperative mortality. Multivariate analysis identified SL/kg (OR:1.28, 95% CI:1.05-1.58) and prolonged paediatric ICU length of stay (OR:1.11, 95% CI:1.03-1.21) as significant risk factors for mortality.In conclusion, capillary leak syndrome after open-heart surgery in neonates and infants with delayed sternal closure is associated with postoperative morbidity. Increased SL/kg and prolonged paediatric ICU length of stay are associated with mortality. Importantly, patients requiring wider sternal separation often present with greater haemodynamic instability and require more extensive postoperative support and prolonged intensive care. Thus, SL/kg may function as a surrogate marker of overall illness severity, rather than as an independent risk factor for capillary leak syndrome or mortality.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1792-1798"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999783","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":"An exploratory study of landiolol plus amiodarone versus amiodarone monotherapy in paediatric junctional ectopic tachycardia after surgery.","authors":"Luz Sandoval, Claudia Arenz, Michael Hamann, Sven Chlench","doi":"10.1017/S1047951125109268","DOIUrl":"10.1017/S1047951125109268","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether landiolol combined with amiodarone improves heart rate and rhythm control compared to amiodarone alone in paediatric patients with postoperative junctional ectopic tachycardia after surgery for congenital heart defect.</p><p><strong>Methods: </strong>We retrospectively identified 24 cases of junctional ectopic tachycardia among 962 children who underwent surgery for congenital heart defects at the German Paediatric Heart Centre between January 2022 and June 2024. Patients received either amiodarone monotherapy or a combination of landiolol and amiodarone. Time to heart rate control and rhythm normalisation, haemodynamic stability, and adverse events were assessed.</p><p><strong>Results: </strong>Patients who received amiodarone and landiolol achieved faster heart rate control than patients who received amiodarone alone (median 6.7 vs. 14.7 h, <i>p</i> = 0.02, Cohen's <i>d</i> = 1.05; large effect). Among patients who received landiolol first, control was reached even earlier (2.4 vs. 8 h, <i>p</i> = 0.05, Cohen's <i>d</i> = 1.49; very large effect). A significant heart rate reduction occurred within 40-120 min after landiolol initiation (mean difference: -23.7 bpm, 95% CI: -45.4 to -1.9, <i>p</i> = 0.04, <i>r</i> = 0.45; medium effect), while no significant effect was observed in patients who received amiodarone alone. Haemodynamic parameters remained stable, although hypotension requiring discontinuation occurred in 11.1% of Landiolol-treated patients.</p><p><strong>Conclusions: </strong>In this retrospective analysis, combined landiolol and amiodarone therapy demonstrated a shorter time to heart rate control compared to amiodarone alone, especially when landiolol was initiated first. These findings require confirmation in prospective studies.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1906-1912"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022853","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}