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Pediatric Cardiology

Min-Jung Cho, Ji-Won Lee, JeSang Lee, Yong Beom Shin
Although progressive cardiac dysfunction is the leading cause of death in patients with Duchenne muscular dystrophy (DMD), their cardiac function measured by conventional echocardiography has been generally interpreted as normal at a young age. We aimed to determine whether two-dimensional speckle tracking echocardiography (STE) or tissue Doppler imaging (TDI) could be used for early identification and detection of cardiac dysfunction in young patients with DMD. Thirteen pediatric patients (mean age, 9.69 ± 2...
July 12, 2018: Pediatric Cardiology
Love Ahlström, Michal Odermarsky, Torsten Malm, Jens Johansson Ramgren, Petru Liuba
In transposition of the great arteries (TGA), certain coronary patterns have been associated with major adverse events early after the arterial switch operation (ASO). We sought to determine the impact of preoperative echocardiographic (ECHO) diagnosis on the intra- and postoperative morbidity. All patients with TGA born between June 2001 and June 2017 and who underwent ASO were reviewed. Data on presumed coronary anatomy (CA) preoperatively were obtained from the preoperative ECHO report. Intraoperative CA was categorized according to Yacoub classification...
July 12, 2018: Pediatric Cardiology
Yajuan Zhang, Yabing Duan, Jun Yan, Qiang Wang, Shoujun Li, Haitao Xu
OBJECTIVE: The purpose of the study is to compare the effects of nesiritide on the discharge time and pleural effusion in children with total cavopulmonary connection (TCPC), and to provide a more reasonable clinical method for these children. METHODS: Forty-four who children underwent cavopulmonary connection between January 2016 and 2017 were retrospectively collected, and 5 children were excluded from analysis due to postoperative thrombosis or second Fontan surgery due to high pulmonary hypertension...
July 12, 2018: Pediatric Cardiology
Ayşe Güler Eroğlu, Sezen Ugan Atik, Betül Çinar, Murat Tuğberk Bakar, İrfan Levent Saltik
We evaluated the natural course of congenital aortic valvular stenosis (AVS) and factors affecting AVS progression during long-term follow-up with echocardiography. Medical records of 388 patients with AVS were reviewed; patients with concomitant lesions other than aortic regurgitation (AR) were excluded. Trivial AVS was defined as a transvalvular Doppler peak systolic instantaneous gradient of < 25 mmHg; mild stenosis, 25-49 mmHg; moderate stenosis, 50-75 mmHg; and severe stenosis, > 75 mmHg...
July 6, 2018: Pediatric Cardiology
Tomoaki Murakami, Masahiro Shiraishi, Taro Murakami, Atsuhito Takeda
Although the arterial switch operation has become the standard procedure for infants with complete transposition of the great arteries, possible late adverse events after surgery have not been fully elucidated. One such problem may be the postoperative function of the aorta that is radically manipulated. The current study enrolled 12 patients aged 4-9 years who had undergone an arterial switch operation. The ascending and descending aortic pressure waveforms were recorded by a catheter-mounted pressure sensor...
June 19, 2018: Pediatric Cardiology
Sezen Ugan Atik, Ayşe Güler Eroğlu, Betül Çinar, Murat Tuğberk Bakar, İrfan Levent Saltik
The two main modalities used for congenital aortic valvular stenosis (AVS) treatment are balloon aortic valve dilatation (BAD) and surgical aortic valvuloplasty (SAV). This study evaluates residual and recurrent stenosis, aortic regurgitation (AR) development/progression, reintervention rates, and the risk factors associated with this end point in patients with non-critical congenital AVS who underwent BAD or SAV after up to 18 years of follow-up. From 1990 to 2017, 70 consecutive interventions were performed in patients with AVS, and 61 were included in this study (33 BADs and 28 SAVs)...
June 19, 2018: Pediatric Cardiology
Debbra Chong, Yan Ting Chua, Shu-Ling Chong, Gene Yong-Kwang Ong
Troponin I is a cardiac enzyme that is released during myocardial injury. However, cardiac enzymes are non-specific and can occur in many cardiac and non-cardiac pathologies. We aim to (1) describe the range of acute conditions that were associated with raised troponins in the paediatric population in our institution and (2) quantify the extent of troponin elevation and correlate it with the underlying aetiology. We performed a retrospective observational study in a tertiary institution which included patients from 1 January 2009 to 31 December 2013...
June 19, 2018: Pediatric Cardiology
Edon J Rabinowitz, David B Meyer, Priya Kholwadwala, Nina Kohn, Adnan Bakar
Post-pericardiotomy syndrome (PPS) is an inflammatory process involving the pleura, pericardium, or both and occurs after cardiothoracic surgery. Surgical atrial septal defect (ASD) closure is associated with higher incidence of PPS post-operatively as compared to other operations. Reported incidence of PPS varies from 1 to 40%. NSAIDs are often used to treat PPS and in our center, some practitioners have prescribed ibuprofen prophylactically. This study sought to investigate the impact of prophylactic treatment with ibuprofen on the development and severity of PPS following surgical ASD closure, with particular attention to secundum-type ASDs...
June 14, 2018: Pediatric Cardiology
Susanna Tran, Patrick M Sullivan, John Cleveland, S Ram Kumar, Cheryl Takao
Single ventricle palliation relies on the pulmonary vasculature accommodating non-pulsatile systemic venous return. Mean pulmonary artery pressure (MPAP) and indexed pulmonary vascular resistance (PVRi) are two measures that impact pulmonary blood flow following bidirectional cavopulmonary connection (BCPC). The purpose of the study was to determine which hemodynamic features are associated with adverse outcomes after BCPC. Pre-operative hemodynamic data and post-operative morbidity and mortality in 250 patients undergoing BCPC at a single center from 2008 to 2014 were reviewed...
June 14, 2018: Pediatric Cardiology
Geoffrey D Huntley, Abhishek J Deshmukh, Carole A Warnes, Suraj Kapa, Alexander C Egbe
Placement of an epicardial pacemaker system is often preferred over an endocardial system in patients who have undergone a Fontan operation, but data are limited on how these two systems perform over time in patients with Fontan palliation. We performed a retrospective review of adults with Fontan palliation who had pacemaker implantation and interrogation data at Mayo Clinic from 1994 to 2014. Lead parameters, pacing mode, and polarity were collected at the earliest device interrogation report. Clinic notes and device interrogation reports were reviewed at implantation, 6 months, and yearly after implantation to determine impedance, capture threshold (CT), and energy threshold (ET)...
June 14, 2018: Pediatric Cardiology
Corrado Di Mambro, Camilla Calvieri, Massimo Stefano Silvetti, Ilaria Tamburri, Salvatore Giannico, Anwar Baban, Sonia Albanese, Gianluca Brancaccio, Adriano Carotti, Fiore Salvatore Iorio, Fabrizio Drago
Atrioventricular Septal Defect (AVSD) is a rare congenital heart defect (CHD) often associated with genetic syndromes, most commonly Down syndrome (DS). Over the last four decades, surgical repair has increased survival and improved quality of life in these patients. The prevalence of bradyarrhythmias namely, atrioventricular block (AVB) and sinus node dysfunction (SND) in AVSD is partially known. 522 cases with both partial and complete AVSD (38.7% with DS), undergoing intracardiac repair from 1982 to 2016 at our institution, were reviewed from our system database...
June 13, 2018: Pediatric Cardiology
Omar Qayum, Noor Alshami, Chizitam F Ibezim, Kimberly J Reid, Janelle R Noel-MacDonnell, Geetha Raghuveer
Atherosclerotic cardiovascular disease (CVD), a leading cause of death globally, has origins in childhood. Major risk factors include family history of premature CVD, dyslipidemia, diabetes mellitus, and hypertension. Lipoprotein (a) [Lp(a)], an inherited lipoprotein, is associated with premature CVD, but its impact on cardiovascular health during childhood is less understood. The objective of the study was to examine the relationship between Lp(a), family history of premature CVD, dyslipidemia, and vascular function and structure in a high-risk pediatric population...
June 13, 2018: Pediatric Cardiology
Thomas J Kulik, Lynn A Sleeper, Christina VanderPluym, Stephen P Sanders
Infants with a single ventricle can develop systemic ventricular dysfunction (SVD) after stage 1 operation, but available information is sparse. We reviewed our patients having Norwood, Sano, or hybrid procedures to better understand this problem. We conducted a retrospective, case-controlled cohort study of 267 patients having stage1 operation, examining outcomes between stages 1 and 2 (survival and subsequent cardiac surgeries), predictor variables, and histology of hearts explanted at transplantation. SVD developed in 32 (12%) patients and resolved in 13 (41%); mean age of onset was 3...
June 13, 2018: Pediatric Cardiology
Keren Zloto, Tal Tirosh-Wagner, Yoav Bolkier, Omer Bar-Yosef, Amir Vardi, David Mishali, Yael Nevo-Caspi, Gidi Paret
Current clinical risk assessment strategies have poor accuracy for identifying patients who will suffer adverse perioperative events. There is an ongoing need to integrate clinical variables with novel technology and biomarkers to accurately predict outcome after pediatric heart surgery. We tested the hypothesis that miRNAs-208a, -208b, and -499 can serve as noninvasive biomarkers for the extent of myocardial damage and the postoperative clinical course of pediatric patients with congenital heart defects (CHDs) at an early time point following surgery...
June 12, 2018: Pediatric Cardiology
Amin M Arfi, M O Galal, A Kouatli, H Baho, Heba Abozeid, J Al Ata
Management of neonatal native coarctation is debated till now. Surgical therapy remains an option but may be unwarranted in critically sick infants with complex lesions. Balloon dilatation has been employed but with early re-stenosis. Stent angioplasty has also been used but as a bridge towards definitive surgical therapy. Four critically sick infants with complex coarctation and additional co-morbidity factors underwent primary stent therapy as surgical intervention was denied. One patient had died earlier due to reasons unrelated to the procedure...
June 12, 2018: Pediatric Cardiology
Massimiliano Marini, Daniele Ravanelli, Fabrizio Guarracini, Maurizio Del Greco, Silvia Quintarelli, Anna Cima, Alessio Coser, Marta Martin, Aldo Valentini, Roberto Bonmassari
The aim of this study is to evaluate the cost-effectiveness of an extended use of 3D non-fluoroscopic mapping systems (NMSs) during paediatric catheter ablation (CA) in an adult EP Lab. This study includes 58 consecutive patients (aged between 8 and 18) who underwent CA from March 2005 to February 2015. We compare the fluoroscopy data of two groups: group I, patients who underwent CA from 2005 to 2008 using only fluoroscopy, and group II, patients who underwent CA from 2008 to 2015 performed also using NMSs...
June 12, 2018: Pediatric Cardiology
Arvind Hoskoppal, Shaji Menon, Felicia Trachtenberg, Kristin M Burns, Julie De Backer, Bruce D Gelb, Marie Gleason, Jeanne James, Wyman W Lai, Aimee Liou, Lynn Mahony, Aaron K Olson, Reed E Pyeritz, Angela M Sharkey, Mario Stylianou, Stephanie Burns Wechsler, Luciana Young, Jami C Levine, Elif Seda Selamet Tierney, Ronald V Lacro, Timothy J Bradley
Few data exist regarding predictors of rapid aortic root dilation and referral for aortic surgery in Marfan syndrome (MFS). To identify independent predictors of the rate of aortic root (AoR) dilation and referral for aortic surgery, we investigated the data from the Pediatric Heart Network randomized trial of atenolol versus losartan in young patients with MFS. Data were analyzed from the echocardiograms at 0, 12, 24, and 36 months read in the core laboratory of 608 trial subjects, aged 6 months to 25 years, who met original Ghent criteria and had an AoR z-score (AoRz) > 3...
June 11, 2018: Pediatric Cardiology
D E Segar, J R Maldonado, C G Brown, I H Law
Up to 10% of Fontan patients require pacemakers; an epicardial approach has historically been used. A transvenous approach can be used but carries risk of Fontan obstruction, thromboembolism, and can be technically challenging. The safety and efficacy of these approaches is not well described. The aim of this study was to compare epicardial and transvenous pacemaker outcomes in Fontan patients, specifically, device performance and adverse event rate. A retrospective review was performed on Fontan pacemaker patients followed at a single institution...
June 11, 2018: Pediatric Cardiology
Sean M Lang, R Lee Crawford, Pushpa Shivaram, Joshua A Daily, Elijah H Bolin, Xinyu Tang, R Thomas Collins
Pulmonary artery (PA) stenosis is the most common late sequela following arterial switch for d-transposition of the great arteries. The purpose of this study was to assess the effectiveness of transthoracic echocardiography in evaluating the pulmonary arteries following repair. This was a retrospective, cross-sectional analysis of all echocardiograms performed on patients following arterial switch operation. A numerical scoring system was devised and used to quantify PA visualization based on 2D images, color mapping, and spectral Doppler...
June 7, 2018: Pediatric Cardiology
Yakup Ergul, Serhat Koca, Celal Akdeniz, Volkan Tuzcu
In Ebstein's anomaly (EA), tachycardia substrates are complex, and accessory pathway (AP) ablations are often challenging. This study demonstrates the utility of the EnSite Velocity system (St. Jude Medical, St Paul, MN) in the catheter ablation of supraventricular tachycardia in children with EA. Twenty patients [Female/Male = 8/12, median age 11.5 years (2.6-18)] with EA who underwent catheter ablation guided by the EnSite Velocity system between December 2011 and December 2016 were retrospectively evaluated...
June 7, 2018: Pediatric Cardiology
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