Cardiology in the Young最新文献

{"title":"The spaces in between: silence as a witness to accompaniment in congenital heart disease.","authors":"Colin J McMahon","doi":"10.1017/S1047951126123610","DOIUrl":"https://doi.org/10.1017/S1047951126123610","url":null,"abstract":"<p><p>Paediatric cardiology is often experienced as a noisy environment. Outpatient clinics, echocardiography laboratories, ICUs, catheterisation suites, and operating theatres are filled with alarms, conversations, machines, movement, and continual clinical activity. Beneath this activity, however, another dimension of CHD care exists: silence. These pauses are not simply absences within clinical work, but moments through which patients, families, nurses, physiologists, and clinicians encounter uncertainty, adaptation, fear, relief, and continuity across time. Across fetal diagnosis, infancy, childhood, adolescence, transition to adult services, and survivorship, silence emerges repeatedly within care. Some silences wound. Others sustain. At times, they create space for reflection and presence; at others, they may leave questions unspoken or emotions unsupported. Over years of care, individuals may be shaped by these experiences in ways rarely acknowledged within clinical medicine. This reflective perspective explores the role of silence, listening, and presence across the longitudinal experience of children and families living with CHD and those who care for them.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711173","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":"Pre-intervention mortality in ectopia cordis: an underrecognised phase of care.","authors":"Kajal Khatri, Zara Shirazi, Sohail Khan Bangash","doi":"10.1017/S1047951126123774","DOIUrl":"https://doi.org/10.1017/S1047951126123774","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711227","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":"Machine learning-based prediction of postoperative restenosis risk following direct repair of paediatric coarctation of the aorta.","authors":"Ruge Duan, Zixu Wang, Kexin Yang, Nan Ding, Hanlu Yi, Yao-Bin Zhu, Song Bai, Xiaofeng Li, Feng Tong, Zhi-Qiang Li","doi":"10.1017/S1047951126112931","DOIUrl":"https://doi.org/10.1017/S1047951126112931","url":null,"abstract":"<p><strong>Objectives: </strong>Coarctation of the aorta is a congenital cardiovascular disease with focal aortic luminal narrowing, and paediatric patients face a high postoperative restenosis risk. This study aimed to develop and validate an interpretable machine learning model for early predicting restenosis after paediatric coarctation of the aorta direct repair using preoperative and intraoperative data.</p><p><strong>Methods: </strong>A total of 117 patients (2016-2024) were retrospectively enrolled, divided into restenosis (21 cases, 17.9%) and non-restenosis (96 cases, 82.1%) groups (restenosis was defined as a peak systolic pressure gradient >20 mmHg measured by echocardiography). Recursive feature elimination with cross-validation screened key variables; six machine learning models were built with 5-fold randomised search cross-validation tuning, using the area under the curve as the primary metric. SHapley Additive exPlanation analysed feature contributions.</p><p><strong>Results: </strong>The multilayer perceptron model performed best (mean area under the curve = 0.8333, 95% CI: 0.7111-0.9555, accuracy = 0.8376) with balanced precision-recall. SHapley Additive exPlanation identified low body surface area as the top risk factor. Resection and extended end-to-end anastomosis/end-to-side anastomosis were preferred surgically, while resection with end-to-end anastomosis should be avoided; end-to-side anastomosis reduced restenosis risk in patients with aortic arch hypoplasia.</p><p><strong>Conclusion: </strong>Machine learning models enable personalised, high-accuracy restenosis prediction. SHapley Additive exPlanation-facilitated risk factor identification optimises treatment strategies. Future prospective studies are needed to validate the models and develop clinical tools.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705452","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 congenital heart early-career exchange programme: collaboration to advance faculty development - CORRIGENDUM.","authors":"Heang M Lim, Elizabeth D Blume, Anne M Dubin, Joseph W Rossano, Jeffrey J Kim, Daniel J Penny, Sharon Chen, Kyong-Jin Lee, Sowmya Balasubramanian, Sara K Pasquali","doi":"10.1017/S1047951126123890","DOIUrl":"10.1017/S1047951126123890","url":null,"abstract":"","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1"},"PeriodicalIF":0.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700800","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 atrial flow regulator implantation in children with pulmonary arterial hypertension in resource-limited settings: a single-centre experience.","authors":"Bibhuti Das, Shreesha Maiya, Basha Khan, Vimal Raj, Shashi Raj","doi":"10.1017/S1047951126123555","DOIUrl":"https://doi.org/10.1017/S1047951126123555","url":null,"abstract":"<p><p>Pulmonary arterial hypertension in children remains a progressive disease marked by right ventricular failure and early mortality despite advances in targeted therapy. In resource-limited settings, access to parenteral prostacyclin is often constrained by cost, infrastructure, and challenges related to chronic administration. The atrial flow regulator is a transcatheter device that creates a controlled interatrial shunt to provide right-heart decompression. We describe our single-center experience with atrial flow regulator implantation in children with severe pulmonary arterial hypertension. We retrospectively reviewed six children with World Health Organization Group 1 pulmonary arterial hypertension who underwent device implantation between 2021 and 2024. Baseline assessment included echocardiography, cardiac magnetic resonance imaging, right-heart catheterization, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and 6-minute walk distance. All patients had advanced pulmonary vascular disease despite combination oral therapy. Median indexed pulmonary vascular resistance was 17.0 Wood units·m² (10.8-28.5), median right ventricular ejection fraction was 31% (22-39), and median 6-minute walk distance was 250 m (190-280). Device implantation was successful in all patients, with no periprocedural mortality. During follow-up, NT-proBNP levels decreased and 6-minute walk distance improved. Friedman testing demonstrated significant changes over time for NT-proBNP (<i>p</i> = 0.002) and 6-minute walk distance (<i>p</i> = 0.003). In this small cohort, atrial flow regulator implantation was technically feasible and associated with favorable longitudinal trends in biomarker and functional measures. In resource-constrained settings, it may serve as an adjunctive strategy for carefully selected high-risk patients. Larger multicenter studies are needed to refine patient selection and long-term outcomes.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700793","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":"Parental perspectives on delirium in paediatric cardiac patients: a North American survey.","authors":"Brittany Shutes, Kayla Ann Harvey, Chance Alvarado, Kate Kanwar, Sandra L Staveski","doi":"10.1017/S1047951126123701","DOIUrl":"https://doi.org/10.1017/S1047951126123701","url":null,"abstract":"<p><strong>Background: </strong>Delirium is an inherently prevalent and particularly challenging aspect of pediatric heart disease that benefits from engagement of a vulnerable parent population. However, parental experience of witnessing their child's episode(s) of delirium is seldom reported on in the cardiac population. Our aim was to identify and describe the specific impact of bearing witness to delirium symptoms as a parent or caregiver.</p><p><strong>Methods: </strong>A cross-sectional online survey was distributed via parent social media groups and e-mail lists, displayed at conferences, and posted in clinical spaces from August 2023 through March 2024.</p><p><strong>Results: </strong>Fifty-one parents/caregivers provided meaningful responses. Most parents/caregivers were white (47, 92%), married (43/50, 86%), female (43, 84%), had a bachelor's degree or greater (39, 77%), and nearly half (24, 47%) had a household income greater than $150,000. Half (26, 51%) of the children with delirum symptoms were less than 3 years old at first episode. Most (40, 78%) parents/caregivers described witnessing their child's delirium symptoms as \"very\" or \"extremely distressing\" and 17 (33%) were \"very\" or \"extremely fearful\" of further episodes. Only 39% (19/51) of parents/caregivers received support despite 90% indicating they would have wanted more support. Of the 13 parents/caregivers who indicated their experience with delirium still impacts their daily life, seven screened positive by Impact of Event Scale 6 criteria for probable post-traumatic stress disorder.</p><p><strong>Conclusion: </strong>This survey provides new evidence on the distressing nature of witnessing a child's delirium episodes(s). Recognition of the impact on parents/caregivers and efforts to improve support and parental education should be undertaken.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683621","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":"Epidemiology of Kawasaki disease in Chandigarh, India (2020-2024): COVID-19 pandemic-related decline and post-pandemic resurgence.","authors":"Rakesh Kumar Pilania, Suprit Basu, Yamini Sharma, Aarti Goyal, Ripudaman Singh, Jyoti Dixit, Abarna Thangaraj, Akhila Dass, Akanksha Dhiman, Saniya Sharma, Manpreet Dhaliwal, Jayakanthan Kabeerdoss, Pandiarajan Vignesh, Deepti Suri, Sanjeev Naganur, Manphool Singhal, Amit Rawat, Shankar Prinja, Surjit Singh","doi":"10.1017/S1047951126123683","DOIUrl":"https://doi.org/10.1017/S1047951126123683","url":null,"abstract":"<p><strong>Background: </strong>Kawasaki disease is the leading cause of acquired heart disease in children worldwide. Previous studies from Chandigarh, India, documented a rising incidence until 2019. The COVID-19 pandemic, with its infection-control measures and emergence of multisystem inflammatory syndrome in children, disrupted established epidemiological trends. We aimed to evaluate the impact of the pandemic on incidence, clinical features, and coronary outcomes in children with Kawasaki disease in the Union Territory of Chandigarh.</p><p><strong>Methods: </strong>This study was conducted at the tertiary care teaching institute in North-West India, from January 2020 to December 2024. Demographic, clinical, laboratory, and echocardiographic data were collected. Population estimates were derived from national census projections, and annual incidence rates were calculated for children <5 years and <15 years. Temporal and seasonal trends were analysed using regression models and Chow tests.</p><p><strong>Findings: </strong>A total of 442 children with Kawasaki disease were diagnosed during the study period-of these, 60 (median age 40.5 months, 62% male, 63% complete, and 37% incomplete Kawasaki disease) were residents of Chandigarh. Incidence declined markedly during the pandemic (1.7 and 3.4 per 100,000 children <5 years in 2020 and 2021, respectively), followed by a rebound in 2022 (8.4) and 2023 (5.8), and a sharp rise in 2024 (13.9), the highest incidence recorded to date in Chandigarh. Coronary artery abnormalities were detected in 13% of patients, with 3.3% showing persistent lesions at 6 weeks. No deaths occurred, and seasonal patterns remained unchanged compared with 2015-2019.</p><p><strong>Interpretation: </strong>Kawasaki disease incidence in Chandigarh declined transiently during the COVID-19 pandemic but rebounded sharply post-pandemic, exceeding the highest previously reported estimates. Despite fluctuations, clinical features and coronary outcomes remained stable. These findings reinforce Kawasaki disease as an endemic childhood vasculitis in Chandigarh, India, and highlight the need for ongoing surveillance and early recognition as an important contributor to acquired heart disease burden in children.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683592","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":"Late-onset infective endocarditis after transcatheter atrial septal defect device closure involving mechanical factors: a case report.","authors":"Soo Jung Park, Dongsub Kim, Youngok Lee","doi":"10.1017/S1047951126113444","DOIUrl":"https://doi.org/10.1017/S1047951126113444","url":null,"abstract":"<p><p>Late-onset infective endocarditis after transcatheter atrial septal defect device closure is uncommon, and in selected patients, mechanical factors related to adverse device-tissue interaction may contribute to the development of late device-related infection. A 15-year-old boy presented with fever and systemic embolic manifestations eight years after transcatheter atrial septal defect closure. Echocardiography demonstrated a mobile mass on the left atrial surface of the occluder device, and computed tomography revealed splenic infarction and a mass-like lesion adjacent to the right lower pulmonary vein orifice. Emergent surgical intervention revealed extensive vegetation and fibrotic thickening predominantly along the right lower pulmonary vein orifice-adjacent left atrial wall, rather than on the device surface. The device was removed, the defect was closed using an autologous pericardial patch, and the patient completed six weeks of antibiotic therapy with an uneventful recovery. This case suggests that incomplete endothelialisation and chronic device-related mechanical interaction may create a vulnerable endocardial environment that facilitates bacterial adherence and subsequent infective endocarditis. Careful patient selection, prudent device sizing, and long-term echocardiographic surveillance may help identify patients in whom consideration of antibiotic prophylaxis during exposure to transient bacteremia could reduce the risk of subsequent infective endocarditis.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683567","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":"Beyond the pacemaker paradigm: cardioneuroablation for high-degree atrioventricular block in a young athlete.","authors":"Maria Ana Estevens, Ana R Sousa, Diogo Cavaco, Pedro Adragão","doi":"10.1017/S1047951126112037","DOIUrl":"https://doi.org/10.1017/S1047951126112037","url":null,"abstract":"<p><p>High-degree atrioventricular block in young patients often requires pacing, posing long-term risks. We present a 15-year-old athlete with sickle cell trait and high-degree atrioventricular block managed with cardioneuroablation. Post-cardioneuroablation, atrioventricular conduction normalised, and a nine-month follow-up showed no arrhythmias. This case underscores cardioneuroablation as a promising, less invasive alternative to pacing for young patients, requiring further research.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683564","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":"Parental mental health screening in paediatric cardiology clinics: a feasibility and acceptability study.","authors":"Andrea DeTemple Smith, Leandra Bitterfeld, Alexa Black, Kristi Lewis Glotzbach, Nelangi M Pinto, Laura K Wood, Zhining Ou, Sean Cunningham, Whitnee Hogan","doi":"10.1017/S1047951126123592","DOIUrl":"https://doi.org/10.1017/S1047951126123592","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the need, feasibility, and acceptability of parental mental health screening in cardiology clinics and explore the relationship between social risk factors and parental mental health.</p><p><strong>Study design: </strong>Single-centre pilot study in two outpatient cardiology clinics. Participants were parents or caregivers of a fetus or child with CHD. Parental mental health was assessed using the Depression, Anxiety, and Stress Scale - 21 Items and the Edinburgh Postnatal Depression Scale. A validated social risk factor screener was also completed. Parents with positive screening results were referred for follow-up with the clinic social worker.</p><p><strong>Results: </strong>A total of 131 participants enrolled, with an 83% consent rate. A total of 30% of participants screened positive for depression, anxiety, and/or stress. Among participants with a positive mental health screen, 36% did not have a previous mental health diagnosis; most were not currently receiving mental health services, and more than half were interested in receiving mental health services. Rates were similar between the prenatal and postnatal/early childhood years. Participants with a positive mental health screen had higher rates of several social risk factors. Acceptability was high, and the clinic social worker spent an average of 34 min per participant providing follow-up care.</p><p><strong>Conclusion: </strong>Stress, anxiety, and depression are common in parents/caregivers of a fetus or child with CHD. Longitudinal mental health screening in paediatric cardiology clinics identifies parents at risk for psychosocial challenges and structures related supports. Intervention sustainability using this approach is dependent on post-screening follow-up from social work support or staff with similar expertise.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677439","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}