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Pediatric Cardiology

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October 17, 2016: Pediatric Cardiology
Yong-Hee Park, Da-Hye Yoo, Eun-Hee Kim, In-Kyung Song, Ji-Hyun Lee, Hee-Soo Kim, Woong-Han Kim, Jin-Tae Kim
This study aimed to investigate the optimal transducer level for accurate measurement of atrial and pulmonary arterial pressures in the supine position for patients with functional single ventricle. Contrast-enhanced chest computed tomographic images of 108 patients who underwent either the bidirectional cavopulmonary shunt (BCPS) placement or the Fontan procedure were reviewed. Vertical distances from the skin of the back to the uppermost levels of fluid in the single atrium or the pulmonary artery confluence and their ratios to the greatest anteroposterior (AP) diameter of the thoracic cage were determined...
October 1, 2016: Pediatric Cardiology
A Dionne, M Bakloul, C Manlhiot, B W McCrindle, M Hosking, C Houde, D Pepelassis, N Dahdah
Coronary artery (CA) aneurysms are serious complications of Kawasaki disease (KD) responsible for ischemic events. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are reported with limited data on indications and comparative efficacy. Retrospective multicenter comparison of CA intervention following KD is performed in this study. Twenty two cases were available from 5 centers, of whom 11 underwent CABG, 10 PCI and 1 systemic thrombolysis. Age at intervention (8.3 ± 3.9 vs 11...
September 23, 2016: Pediatric Cardiology
Shahryar M Chowdhury, Suma P Goudar, G Hamilton Baker, Carolyn L Taylor, Girish S Shirali, Mark K Friedberg, Andreea Dragulescu, Karen S Chessa, Luc Mertens
The accuracy of echocardiographic measures of right ventricular (RV) diastolic function has been sparsely studied. Our objective was to evaluate the correlation between echocardiographic and reference standard measures of RV diastolic function derived from micromanometer pressure analysis before and after preload alteration in children. Echocardiograms and micromanometer pressure analyses were prospectively performed before and after fluid bolus in children undergoing right heart catheterization. The isovolumic relaxation time constant (τ) and end-diastolic pressure (EDP) were measured...
September 21, 2016: Pediatric Cardiology
Guido E Pieles, Victoria Husk, Teresa Blackwell, Deirdre Wilson, Simon M Collin, Craig A Williams, A Graham Stuart
Theme park operators and medical professionals advise children with heart conditions against using rollercoaster rides, but these recommendations are not evidence-based. The underlying assumption is that the combination of adrenergic stimulation through stress and acceleration might trigger arrhythmias in susceptible individuals. We conducted a cross-sectional observational study to assess heart rate and rhythm in healthy children during commercial rollercoaster rides. Twenty healthy children (9 male) aged 11-15 (mean 13...
September 21, 2016: Pediatric Cardiology
Hyo Soon An, Jae Suk Baek, Gi Beom Kim, Young Ah Lee, Mi Kyoung Song, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
To investigate intrinsic vascular abnormalities of the ascending aorta before adulthood in Turner syndrome patients (TS), we compared 25 adolescent TS patients (mean age 14.6 ± 3.4 years) and 16 healthy controls from a university hospital. Blood pressure and other vascular indices were evaluated using echocardiography such as aortic strain, stiffness index, distensibility, and pulse wave velocity. Aortic strain (0.1237 vs. 0.1865, respectively; P = 0.003) and aortic distensibility (0.0049 vs. 0.0081, P = 0...
September 15, 2016: Pediatric Cardiology
Javier Rodríguez-Fanjul, Ana Serrano Llop, Monica Balaguer, Carles Bautista-Rodriguez, Julio Moreno Hernando, Iolanda Jordan
This study aimed to explore the pattern of lung ultrasound (LUS) in newborns with congenital heart disease (CHD) and to investigate the accuracy of LUS assessing pulmonary overflow (PO) during the first days of life. Lung ultrasound was performed in 51 newborns during the first days of life, and newborns were classified in two groups depending on the predisposition to develop POas evaluated by the abundance of B-lines. The results were compared to the physical examination (PE), chest X-ray, and echocardiography...
September 13, 2016: Pediatric Cardiology
Ahmed Kheiwa, Sanjeev Aggarwal, Thomas J Forbes, Daniel R Turner, Daisuke Kobayashi
Myocardial deformation measured by speckle tracking echocardiography can detect subtle abnormalities of left ventricular function before an obvious abnormality in traditional echocardiographic parameters such as ejection fraction is seen. We hypothesized that patients with coarctation of the aorta (CoA) may have impaired myocardial deformation that may persist even after successful transcatheter intervention. This is a retrospective study to assess the myocardial deformation in patients undergoing transcatheter intervention of CoA...
September 8, 2016: Pediatric Cardiology
Tyler H Harris, Jeffrey G Gossett
Care of adults with coronary artery disease focuses on troponins to rapidly move patients to catheterization. Troponins are increasingly drawn in children, but emergent catheterization may not be indicted. We sought to establish etiologies of troponin elevation and ascertain the yield of diagnostic tests, in this population. Retrospective review of patients from January 1, 2002, to December 31, 2011, who had any elevated troponin during the study period. Patients were excluded for recent cardiac surgery, "significant" congenital heart disease, if they were neonates in the NICU or were on ECMO...
August 29, 2016: Pediatric Cardiology
Giacomo Pongiglione, Alessandro Possidoni, Umberto di Luzio Paparatti, Anna Maria Costanzo, Giuliana Gualberti, Marco Bonvicini, Alessandro Rimini, Gabriella Agnoletti, Maria Pia Calabrò, Marco Pozzi, Roberto Tumbarello, Patrizia Salice, Patrizio Fiorini, Maria Giovanna Russo, Ornella Milanesi
Children affected by hemodynamically significant congenital heart disease (HSCHD) experience severe respiratory complications that can increase the frequency of hospitalizations. The aim of the SINERGY study was to describe the incidence of respiratory diseases and to collect information on active and passive immunoprophylaxis in the first 2 years of life. In this retrospective, multicenter, and epidemiologic study, children with HSCHD were enrolled across 11 Italian sites. Children born between December 31, 2007, and December 31, 2012, were observed during their first 2 years of life...
August 29, 2016: Pediatric Cardiology
Brian A Boe, Jeffrey D Zampi, Kurt R Schumacher, Sunkyung Yu, Aimee K Armstrong
We sought to describe the use and outcomes of small, medium and large premounted stents in patients with congenital heart disease, including incidence of and risk factors for re-intervention and development of in-stent stenosis. Premounted stents offer several advantages over traditional manually crimped bare-metal stents, especially in small patients. There are no data describing the medium-term effectiveness and outcomes of premounted stents in congenital heart disease. We performed a single-center retrospective review of all small, medium and large premounted stents implanted over an 8-year period...
August 27, 2016: Pediatric Cardiology
Erin A Paul, Kristina Orfali, Thomas J Starc
We hypothesized that enthusiasm for surgery increased for infants with hypoplastic left heart syndrome (HLHS) at Columbia University Medical Center (CUMC) between 1995 and 2012. We sought to identify factors that engendered this paradigm shift. Confidential surveys were distributed to providers at CUMC in 1995 and 2012 to measure enthusiasm for surgical intervention for HLHS. Surgical preference scores are presented as median [interquartile range]. Surveys were completed by 99/176 providers (56 % response rate) in 1995 and 153/267 (57 %) in 2012...
August 27, 2016: Pediatric Cardiology
Fengyu Wang, Haili Wang, Lina Wang, Shiyuan Zhou, Mingxiu Chang, Jiping Zhou, Yongheng Dou, Yanli Wang, Xiangdong Shi
The nuclear factor of activated T lymphocytes (NFATC1) signaling has been demonstrated to play important roles in cardiac valve and septal development. Genetic variants in genes involved in NFATC1 signaling may affect their expression and promote the formation of congenital heart disease (CHD). The goal of this study was to investigate the associations of single nucleotide polymorphism (SNP) in seven genes (NFATC1, VEGFR, VEGF, RANKL, FGFR1, BCL-6 and ZNRD1) with the risk of CHD. Twenty-nine polymorphisms were genotyped by using MassARRAY RS1000 platform in 277 CHD child patients and 293 controls from the Henan Province in China...
August 27, 2016: Pediatric Cardiology
Alberto García, Karen Moreno, Miguel Ronderos, Néstor Sandoval, Mónica Caicedo, Rodolfo J Dennis
More evidence is needed that links the diagnosis of different congenital heart diseases (CHD) identified after birth, with intermediate altitudes above sea level in geographically and ethnically diverse populations. Our aim was to estimate relative frequencies of CHD diagnosis by altitude and gender in the pediatric population of 12 cities in Colombia. This was a cross-sectional study based on the information collected between 2008 and 2013 in Colombia, during annual congenital heart disease (CHD) case detection campaigns in the post-natal period...
August 26, 2016: Pediatric Cardiology
Xiao-Mei Li, He Jiang, Yan-Hui Li, Yan Zhang, Hai-Ju Liu, Hai-Yan Ge, Yi Zhang, Mei-Ting Li
Outflow tract ventricular arrhythmias (OTVAs) are common in children; however, experience is limited on their radiofrequency catheter ablation (RFCA). The purpose of this study was to assess the outcomes of mapping and ablation of pediatric OTVAs and to evaluate the role of ECG algorithms in distinguishing the origin of OTVAs. We compared retrospectively collected single-center data on 92 consecutive pediatric patients (58 male; age, 8.2 ± 2.9 [range 3.6-18] years) who underwent RFCA for OTVAs from 2009 to 2015...
August 26, 2016: Pediatric Cardiology
Philip L Wackel, Andrew W McCrary, Salim F Idriss, Samuel J Asirvatham, Bryan C Cannon
The need to perform catheter ablation of ventricular arrhythmia from within the sinuses of Valsalva in a pediatric patient is uncommon. This has been reported in adults, but there are little data about the feasibility, safety or efficacy of catheter ablation in the sinuses of Valsalva in the pediatric patients. This is a retrospective review of all patients aged 18 years or less, at two separate institutions with no structural heart disease that underwent an ablation procedure for ventricular arrhythmia mapped to the sinus of Valsalva from 2010 to 2015...
August 25, 2016: Pediatric Cardiology
Mohammed Ebrahim, Sanjeet Hegde, Beth Printz, Mark Abcede, James A Proudfoot, Christopher Davis
Noninvasive measurement of cardiac output (CO) and particularly stroke volume (SV) remain difficult but potentially valuable. These variables can be particularly challenging to measure in children with congenital heart disease (CHD). Impedance cardiography (IC) is a technique shown to be accurate in measuring SV in adults and in children with structurally normal hearts. The ease of use and rapidity of SV measurement using IC makes it potentially attractive for young patients with CHD. Advances in IC technology have led to more sophisticated signal-morphology IC (SMIC) devices that may further improve accuracy...
August 25, 2016: Pediatric Cardiology
Jiao Chen, Liang Xie, Li Dai, Li Yu, Lijun Liu, Yongbi Zhou, Guiying Wu, Fengfei Qin, Hanmin Liu
The objective of this study was to detect the effect of a large ventricular septal defect (VSD) on right ventricular function before and after birth. All consecutive children with large VSD who were born in our hospital between January 2013-February 2016 and followed up throughout early infancy, and who lacked malformations or chromosomal abnormalities, were identified by a retrospective review of the medical records and included in this retrospective longitudinal case-control study (n = 30). Thirty normal control cases with an equivalent gestational age and gender served as controls...
August 25, 2016: Pediatric Cardiology
Garick D Hill, Nancy A Rudd, Nancy S Ghanayem, David A Hehir, Peter J Bartz
For infants with single-ventricle lesions with aortic arch hypoplasia, the interstage period from discharge following stage 1 palliation (S1P) until stage 2 palliation (S2P) remains high risk. Significant variability among institutions exists around the timing of S2P. We sought to describe institutional variation in timing of S2P, determine the association between timing of S2P and interstage mortality, and determine the impact of earlier S2P on hospital morbidity and mortality. The National Pediatric Cardiology Quality Improvement Collaborative registry was queried...
August 24, 2016: Pediatric Cardiology
Prema Ramaswamy, Daniela Rafii, Marina Osmolovsky, Arpit Agarwal, Cynthia Amirtharaj
Evidence suggests an association between left heart obstructive lesions and dilated coronary sinus (DCS), but this has not been studied in fetuses. A retrospective review of fetal echocardiograms (FE) over an 8-year period was conducted, and patients with DCS were identified and confirmed postnatally. There were 5840 FE performed on 4920 women during this period. Of 49 patients with DCS, 22 had normal intracardiac anatomy and 27 patients had congenital heart disease (CHD) yielding an incidence of 4.6 % in the presence of CHD (27/584)...
August 24, 2016: Pediatric Cardiology
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