Cardiology in the Young最新文献

{"title":"Mitral annular disjunction versus myocardial Ischemia in coronary artery anomalies.","authors":"Vincent Bui, Silvana Molossi, Lindsay F Eilers, Shagun Sachdeva, Tam T Doan","doi":"10.1017/S1047951125001465","DOIUrl":"10.1017/S1047951125001465","url":null,"abstract":"<p><p>Both mitral annular disjunction and coronary artery anomalies are associated with ventricular arrhythmia, though data on their co-occurrence are limited. We herein present two patients with anomalous aortic origin of a coronary artery and mitral annular disjunction who had ventricular arrhythmia. Mitral annular disjunction should be considered as a potential cause of ventricular arrhythmia when stress tests rule out ischaemia.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1054-1056"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762901","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":"Transthoracic intracardiac line use and complications in the paediatric single ventricle population.","authors":"Nina Zook, Justin Kochanski, Shilpa Vellore Govardhan, John Nigro, Meredith Ray, Pilar Anton-Martin","doi":"10.1017/S1047951125001623","DOIUrl":"10.1017/S1047951125001623","url":null,"abstract":"<p><p>Transthoracic intracardiac lines provide a unique access point for postoperative monitoring and management in paediatric cardiothoracic surgeries, particularly within the single ventricle population where preserving vasculature is crucial for future interventions. This retrospective review examined paediatric single ventricle patients undergoing cardiothoracic surgeries at a tertiary children's hospital between 2011 and 2018, focusing on the use of and factors associated with transthoracic line complications (infection, thrombosis, malfunction, and migration). A total of 338 lines were placed during the study period, with the majority occurring during palliative surgeries (86.5%). Lines remained in place for a median of 14 days postoperatively. Complications occurred in 21 lines (6.2%), comprising 8 migrations (2.4%), 7 thrombosis (2.1%), 4 malfunctions (1.2%), and 2 infections (0.6%). The presence of a surgical shunt was significantly associated with line complications (odds ratio 2.58, confidence interval 1.05 - 6.31; <i>P</i> 0.03). The use of transthoracic intracardiac lines seems to be safe and should be considered as a primary alternative to other central lines in the single ventricle population. A prospective assessment of transthoracic line complications, along with delineation of unit protocols, may further enhance outcomes in this complex population.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"958-963"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954642","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":"Delayed cerebral metastases after left-atrial myxoma resection in a child.","authors":"Siming Liu, Fangbao Ding, Jiaquan Zhu","doi":"10.1017/S1047951125001659","DOIUrl":"10.1017/S1047951125001659","url":null,"abstract":"<p><p>Atrial myxoma in children is rare, with vision loss and cerebral metastasis seldom reported. We present the case of a 12-year-old girl who experienced sudden vision loss and acute infarction, with a left atrial myxoma identified and surgically resected. One year later, she was readmitted with severe neurological symptoms. Imaging revealed multiple hypometabolic brain lesions, which were confirmed as metastatic myxoma through surgical resection and pathology. This case underscores the critical need for long-term follow-up in patients with cardiac myxoma to monitor potential delayed neurological complications.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1088-1091"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092882","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":"Recommendations for the training and practice of fetal cardiology from the Association of European Paediatric Cardiology (AEPC) - ERRATUM.","authors":"Joanna H Dangel, Sally-Ann Clur, Gurleen Sharland, Ulrike Herberg","doi":"10.1017/S1047951125001325","DOIUrl":"10.1017/S1047951125001325","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":"35 5","pages":"1092"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pulmonary valve in tetralogy of Fallot: insights from a necroscopy series.","authors":"Rohit S Loomba, Justin T Tretter, Robert H Anderson, Diane E Spicer","doi":"10.1017/S1047951125001398","DOIUrl":"10.1017/S1047951125001398","url":null,"abstract":"<p><strong>Background: </strong>Tetralogy of Fallot is the most common cyanotic congenital malformation of the heart. The right ventricular outflow tract is of great interest in this setting, but most of the focus on this feature has been on the size of the so-called pulmonary valvar \"annulus\". We aimed to characterise other aspects of the morphology of the pulmonary root in heart specimens with tetralogy of Fallot.</p><p><strong>Methods: </strong>We reviewed archived hearts with tetralogy of Fallot from four registries. The pulmonary root was examined with specific attention to the number of sinuses, the number of leaflets, presence of any fusion of leaflets, and the direction of the zone of apposition between the leaflets. Cluster analyses were then conducted to see if the features permitted segregation into groups.</p><p><strong>Results: </strong>We examined a total of 155 hearts. The pulmonary valve had two leaflets in 62%, three leaflets in 34%, and one leaflet in 3%. Irrespective of leaflet morphology, most hearts had two sinuses. Cluster analysis permitted segregation into three groups, with the direction of the zone of apposition being the most important feature for segregation.</p><p><strong>Conclusion: </strong>In two-thirds of our hearts with tetralogy of Fallot, the pulmonary valve had two leaflets. Most frequently there were three sinuses. In the setting of a valve with two sinuses, the zone of apposition between the leaflets pointing towards the aorta. Cluster analysis permitted statistically sound segregation of the heart and highlights the importance of delineating these features, specifically the leaflet and sinus morphology, with clinical imaging.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"978-984"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662547","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":"Potential role of targeted echocardiography as a screening test for select diagnoses in the paediatric population: bicuspid aortic valve and left ventricular hypertrophy.","authors":"Christina Yang, Lindsay A Edwards, Margaret M Vernon, Jeffrey Conwell, Sujatha Buddhe","doi":"10.1017/S1047951125001490","DOIUrl":"10.1017/S1047951125001490","url":null,"abstract":"<p><strong>Objective: </strong>We explore the role of targeted echocardiography as a screening tool for bicuspid aortic valve and left ventricular hypertrophy, specifically assessing the risk of missing significant cardiac findings that would otherwise be identified by comprehensive echocardiograms.</p><p><strong>Method: </strong>Children < 18 years at initial echocardiogram for indications of \"family history of bicuspid aortic valve\" and \"left ventricular hypertrophy on electrocardiogram\" were queried. Cardiology clinic notes and complete echocardiogram reports were reviewed for additional background histories and incidental findings. Follow-up clinic visits, if any, and management for those with incidental findings were reviewed.</p><p><strong>Results: </strong>Bicuspid aortic valve group included 138 patients, 71 (51%) males and mean age at comprehensive echo was 8.4 ± 4.8 years. Bicuspid aortic valve was found in 3.6%, incidental findings were found in 15 (11%), and follow-up was recommended in 4 (2.8%). Left ventricular hypertrophy group included 70 patients, 58 (83%) males and mean age at echo 10.9 ± 4.7 years. Left ventricular hypertrophy was found in 2.8%, incidental findings were found in 9 (13%), and follow-up was recommended in 2 (2.8%).None of the follow-up group developed symptoms or required cardiac medications, exercise restrictions, or catheter or surgical-based interventions, except for one case of mild aortic root dilation who was restricted from heavy weightlifting.</p><p><strong>Conclusion: </strong>The risk of missing clinically important findings with targeted echocardiography that would have been identified with comprehensive echocardiography is extremely low for screening indications of isolated left ventricular hypertrophy on electrocardiogram or family history of bicuspid aortic valve, suggesting that targeted echocardiography could be an effective screening tool.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"921-925"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966420","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":"High specificity electrocardiogram patterns for parvovirus B19 myocarditis in children: bridging electrocardiogram findings to aetiological diagnosis.","authors":"Roger Esmel-Vilomara, Paola Dolader, Susana Melendo, Ferran Rosés-Noguer, Ferran Gran","doi":"10.1017/S1047951125001878","DOIUrl":"10.1017/S1047951125001878","url":null,"abstract":"<p><strong>Introduction: </strong>Parvovirus B19 (PVB19) myocarditis is a life-threatening condition with high morbidity and mortality in children. While electrocardiograms are commonly used in the early assessment of myocarditis, no specific electrocardiogram pattern has been consistently linked to PVB19. The objective of this study is to identify a distinctive electrocardiogram pattern associated with PVB19 myocarditis and evaluate its diagnostic accuracy.</p><p><strong>Methods: </strong>This retrospective case-control study included 77 paediatric patients diagnosed with acute myocarditis at a single centre in Barcelona over 16 years (August 2008-September 2024). Twenty patients had PVB19 myocarditis, confirmed by polymerase chain reaction in blood or endomyocardial biopsy, while 57 patients had myocarditis caused by other viruses. Electrocardiogram were assessed by three cardiologists blinded to the aetiological diagnosis.</p><p><strong>Results: </strong>A specific electrocardiogram pattern in the limb leads, characterised by peaked P waves, low QRS complex voltages, and altered repolarisation (manifesting as negative or flat T waves, with or without QTc prolongation), was observed in 14 of 20 patients (70%) with PVB19 myocarditis. Two additional patients exhibited low voltages and altered repolarisation without peaked P waves, and all demonstrated repolarisation abnormalities. In contrast, only 1 of 57 patients with myocarditis from other viruses exhibited the full electrocardiogram pattern. The pattern demonstrated a specificity of 98% and a sensitivity of 70% for PVB19 myocarditis.</p><p><strong>Conclusion: </strong>The identified electrocardiogram pattern shows strong diagnostic specificity for PVB19 myocarditis in paediatric patients and may serve as a useful early diagnostic tool. Further multicentre studies are needed to confirm these findings and explore their clinical implications.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1023-1027"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978981","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":"Exploring the influence of extra-corporeal membrane oxygenation (ECMO) support on neurodevelopmental outcomes in paediatric cardiac patients: a systematic review.","authors":"Jeevan Francis, Ashwini Chandiramani, Alan George, Joseph George, Tim Jones","doi":"10.1017/S1047951125001635","DOIUrl":"10.1017/S1047951125001635","url":null,"abstract":"<p><strong>Background: </strong>Mechanical circulatory support, and specifically extra-corporeal membrane oxygenation, plays a critical role in managing paediatric cardiac patients with severe heart failure. Whilst these technologies are vital for bridging patients to recovery or heart transplantation, it is imperative to study the influence of extra-corporeal membrane oxygenation on neurodevelopmental outcomes.</p><p><strong>Objectives: </strong>This systematic review aimed to evaluate the influence of extra-corporeal membrane oxygenation on neurodevelopmental outcomes in paediatric cardiac patients, both post-cardiotomy and non-cardiotomy patients were included.</p><p><strong>Methodology: </strong>A comprehensive search was conducted using PubMed, EMBASE, and PsychInfo to identify primary research articles exploring the effects of extra-corporeal membrane oxygenation on neurodevelopmental outcomes in paediatric heart patients from inception to June 2024.</p><p><strong>Results: </strong>Our search yielded 5488 papers of which eight papers were included featuring 302 patients.</p><p><strong>Conclusion: </strong>The discussion highlights the considerable variability in neurodevelopmental outcomes and how they are measured among extra-corporeal membrane oxygenation survivors. Outcomes vary by patient factors, with recovery potential influenced by the duration and timing of follow-up. We emphasised the importance of standardised assessment tools and extended follow-ups to gain a clearer understanding of these outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"888-899"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983174","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":"Gabapentin's safety and impact on benzodiazepine exposure post-superior cavopulmonary anastomosis.","authors":"Joshua W Branstetter, Hania Zaki, Samuel Van Horn, Andrew Peter, Maria Cabrera, Susan Hupp, Heather Viamonte","doi":"10.1017/S1047951125001647","DOIUrl":"10.1017/S1047951125001647","url":null,"abstract":"<p><strong>Introduction: </strong>In paediatric cardiac patients requiring staged palliation, superior cavopulmonary anastomosis is common. Pain control is a crucial aspect of postoperative care as agitation, untreated pain, and hypoventilation can cause increased pulmonary vascular resistance reduction and pulmonary blood flow.</p><p><strong>Methods: </strong>This was a large volume single-centre, retrospective cohort study evaluating the impact of gabapentin on opioid and benzodiazepine exposure in infants undergoing superior cavopulmonary anastomosis between January 2018 and December 2022. The primary endpoint was opioid exposure in morphine milligram equivalents per kilogram in infants receiving gabapentin compared to no gabapentin.</p><p><strong>Results: </strong>The study analysed 85 infants, 40 of which received perioperative gabapentin. Other than there being more males in the gabapentin group (70% versus 47%; <i>p</i> = 0.03), there was no difference in baseline characteristics. Opioid use, measured in morphine milligram equivalents per kilogram, was similar in the no gabapentin group compared to the gabapentin group during the first 5 POD's (2.66 (interquartile range1.76, 3.30) versus 2.27 (interquartile range R 1.75, 3.40); <i>p</i> = 0.93. However, there was a lower benzodiazepine exposure, measured in midazolam equivalents per kilogram, in the gabapentin group both on POD 2 (0.05 (interquartile range 0.00, 0.11) versus 0 (interquartile range 0.00, 0.08); <i>p</i> = 0.031) and cumulative (0.15 (interquartile range 0.00, 0.35) versus 0.05 (interquartile range 0.00, 0.15); <i>p</i> = 0.031).</p><p><strong>Conclusions: </strong>Gabapentin did not significantly reduce opioid exposure; however, its use was associated with modest reduction in benzodiazepine exposure. There were no differences in adverse events. Our findings suggest gabapentin is safe in infants undergoing superior cavopulmonary anastomosis; however, additional studies should be conducted to evaluate optimal gabapentin dosing.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"996-1001"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092889","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":"Transcatheter reduction of a large, stented fenestration in a paediatric patient post-Fontan palliation.","authors":"Judyta Szeliga, Maksym Lazu, Sebastian Góreczny","doi":"10.1017/S1047951125001751","DOIUrl":"10.1017/S1047951125001751","url":null,"abstract":"<p><p>Staged Fontan pathway treatment is a recognised surgical approach for managing congenital heart lesions with single ventricle physiology. Some patients necessitate communication between the tunnel and the atrium to maintain circulatory balance. During follow-up, adjustments to fenestration size may be required. While methods for enlarging or completely closing fenestrations are common, partially reducing flow through a fenestration remains challenging. We present an effective technique for partially reducing the size of a large, stented fenestration using a coronary stent and a vascular occluder.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":"35 5","pages":"1082-1084"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332489","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}