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Pediatric Cardiology

Richard G Trohman, Summer B Dewdney, Parikshit S Sharma
A 56-year-old female was hospitalized and her admission ECG differed from previous tracings. Knowledge of variant cardiac anatomy along with awareness of common pitfalls in ECG recording reveals the clinical diagnosis and explains the difference.
September 19, 2018: Pediatric Cardiology
Ji-Hoon Na, Sohyun Kim, Lucy Youngmin Eun
Timely diagnosis of coronary involvement is paramount in Kawasaki disease (KD) as it can be associated with long-term morbidity. However, echocardiographic measurements of coronary artery dilation in KD are inconsistent and not proficient for all abnormal arteries. The purpose of this study was to investigate more valuable indices and determine their sensitivity and specificity for early diagnosis of coronary involvement in KD. We performed this retrospective study in 218 children. All patients underwent laboratory and echocardiographic evaluations upon admission...
September 14, 2018: Pediatric Cardiology
Hubert Krysztofiak, Marcel Młyńczak, Andrzej Folga, Wojciech Braksator, Łukasz A Małek
It has been demonstrated that regular sport activity in children leads to physiological changes in the heart including increased left ventricular (LV) myocardial thickness and mass (LVM). The aim of the study was to establish the first specific normal values of LVM for child and adolescent athletes. Parasternal long-axis, 2D-guided echocardiographic measurements were obtained from a group of 791 Caucasian child athletes (age 5-18 years, 58.7% boys). For the preparation of normative data, LVM-for-lean body mass (LBM) reference curves were constructed using the LMS method...
September 12, 2018: Pediatric Cardiology
C Paech, F Wagner, V Strehlow, R A Gebauer
Ablation of accessory pathways (AP) is one of the most often performed procedures in pediatric electrophysiology. In pediatric patients these procedures are mostly performed in anaesthesia or sedation. In some of these patients who are referred for electrophysiologic (EP) study, we could observe disappearance of the preexcitation, i.e. antegrade conduction of an AP during introduction of sedation. As a suppression of AP conduction capacities has been reported as negative side effect of propofol and other anaesthetics, the aim of this study was to evaluate risk factors for drug-induced suppression of AP conduction properties...
September 10, 2018: Pediatric Cardiology
S W van Wijk, M M P Driessen, F J Meijboom, T Takken, P A Doevendans, J M Breur
Long-term after arterial switch operation for transposition of the great arteries, abnormal coronary anatomy and altered loading conditions could compromise ventricular function. The current study investigates whether left ventricular function, measured with echocardiographic bi-plane ejection fraction and deformation imaging, in patients long term after arterial switch operation for transposition of the great arteries differs from healthy peers. A cross-sectional cohort study of patients at least 12 years after arterial switch operation was analyzed with bi-plane Simpson's left ventricular ejection fraction (LVEF) and deformation (speckle tracking) echocardiography...
September 10, 2018: Pediatric Cardiology
S Holowachuk, W Zhang, S K Gandhi, A H Anis, J E Potts, K C Harris
The clinical benefit of early extubation following congenital heart surgery has been demonstrated; however, its effect on resource utilization has not been rigorously evaluated. We sought to determine the cost savings of implementing an early extubation pathway for children undergoing surgery for congenital heart disease. We performed a cost savings analysis after implementation of an early extubation strategy among children undergoing congenital heart surgery at British Columbia Children's Hospital (BCCH) over a 2...
September 10, 2018: Pediatric Cardiology
Emrah Şişli, Osman Nuri Tuncer, Suat Şenkaya, Eser Doğan, Hatice Şahin, Mehmet Fatih Ayık, Yüksel Atay
The original version of the article unfortunately contained an alignment error in Table 1. The correct version of Table 1 is given below.
September 10, 2018: Pediatric Cardiology
Yuhao Wu, Liangjing Xin, Yuehang Zhou, Hongyu Kuang, Xin Jin, Yonggang Li, Chun Wu
A meta-analysis was performed for a comparison of outcomes between sutureless technique and conventional surgery for primary repair for total anomalous pulmonary venous connection (TAPVC). Electronic databases including PubMed, EMbase, Scopus, and Cochrane Library were searched systematically for the single-arm studies regarding sutureless repair or conventional surgery, and two-arm studies compared the outcomes of sutureless repair and conventional surgery for TAPVC. Corresponding data were extracted and the methodological quality was assessed by two reviewers independently...
September 8, 2018: Pediatric Cardiology
Edon J Rabinowitz, Lorry G Rubin, Kinjal Desai, Denise A Hayes, Aykut Tugertimur, Elena N Kwon, Preeta Dhanantwari, Nilanjana Misra, Guillaume Stoffels, Andrew D Blaufox, Elizabeth Mitchell
BACKGROUND: In 2017, the AHA published revised guidelines for the diagnosis of Kawasaki disease (KD). In the absence of compelling data supporting or refuting the utility of lack of tapering (LT) and perivascular brightness (PB), expert panel consensus removed LT and PB from consideration. We hypothesize that LT and PB are unreliable, subjective findings, non-specific to KD, which can be seen in systemic febrile illnesses without KD and in normal controls. METHODS: We performed a single-center retrospective study from 1/2008 to 12/2016...
September 8, 2018: Pediatric Cardiology
Jigar C Chauhan, Rituparna Deb
CO2 removal by the lungs depends upon ventilation and pulmonary blood flow, with end tidal CO2 (EtCO2 ) as surrogate for it. We studied indices based on EtCO2 measured routinely during anesthesia for cardiac catheterization, along with simultaneously calculated Qp:Qs (pulmonary-to-systemic-blood-flow ratio) in children with complex congenital heart disease to assess the relationship between these measures. A retrospective, single-center, correlational cohort study was conducted at a tertiary-care, free-standing children's hospital...
September 8, 2018: Pediatric Cardiology
Gabriel Altit, Shazia Bhombal, Valerie Y Chock, Theresa A Tacy
Right ventricular (RV) function as assessed by deformation has been evaluated prenatally and after palliation in hypoplastic left heart syndrome (HLHS). However, limited data exist about the immediate postnatal cardiac adaptation and RV function in HLHS. We compared echocardiographic measures of cardiac performance in HLHS versus controls in their first week of life. As a secondary objective, we evaluated if markers at the first echocardiogram were associated with mid- and long-term outcomes. Clinical and echocardiographic data of patients with HLHS between 2013 and 2016 were reviewed...
September 3, 2018: Pediatric Cardiology
Sowmya Kasturi, Seshadri Balaji, Abish Sudhakar, Gopalraj S Sunil, Brijesh P Kottayil, Praveen Reddy Bayya, Raman Krishna Kumar
The long-term outcome after repair of tetralogy of Fallot (TOF) is critically dependent pulmonary valve competence that is compromised by trans-annular patch (TAP). We compared a new echocardiographic index [pulmonary annulus index (PAI)] to conventional methods of predicting need for TAP in infants undergoing TOF repair. Consecutive infants undergoing TOF repair were prospectively studied. Pre-operative aortic and pulmonary annuli and main pulmonary artery (MPA) diameters were measured and z scores determined...
September 3, 2018: Pediatric Cardiology
Asha Jois, Diana Zannino, Nigel Curtis, Michael Cheung, David P Burgner, Katherine Y H Chen
Acute viral myocarditis is an uncommon inflammatory disease of the myocardium. Little is known about the long-term cardiovascular risk for individuals who have recovered from the acute illness. We compared intermediate vascular phenotypes relating to arterial structure (aortic and carotid intima-media thickness) and function (pulse wave velocity, carotid arterial distensibility and compliance) in 15 participants, a median of 9.1 years after an episode of acute viral myocarditis, and 45 control participants...
September 3, 2018: Pediatric Cardiology
Christopher M Janson, Scott R Ceresnak, Jaeun M Choi, Anne M Dubin, Kara S Motonaga, Glenn E Mann, Madelyn Kahana, Ingrid Fitz-James, Lisa Wise-Faberowski, Komal Kamra, Lynn Nappo, Anthony Trela, Robert H Pass
Catheter stability, an important factor in ablation success, is affected by ventilation. Optimal ventilation strategies for pediatric catheter ablation are not known. We hypothesized that small tidal volume and positive end-expiratory pressure are associated with reduced ablation catheter movement at annular positions. Subjects aged 5-25 years undergoing ablation for supraventricular tachycardia (SVT) or WPW at two centers from March 2015 to September 2016 were prospectively enrolled and randomized to receive mechanical ventilation with either positive end-expiratory pressure of 5 cm H2 O (PEEP) or 0 cm H2 O (ZEEP)...
September 3, 2018: Pediatric Cardiology
Shashank Behere, Jeanne Marie Baffa, Scott Penfil, Nicholas Slamon
Heart murmur evaluation is the most common cause of referral to cardiology, and auscultation of heart sounds with a stethoscope remains a key component of the initial cardiovascular exam. Adoption of telecardiology has been limited by challenges in teleauscultation. We set out to compare in-person auscultatory findings with heart sounds recorded by the Core stethoscope (Eko, Berkeley, CA) in patients with normal heart sounds, innocent heart murmurs, and a variety of pathologic findings. Our study demonstrates that Eko recordings had a high percent of agreement with in-person auscultation findings and echocardiogram findings, with moderate inter-rater reliability...
August 31, 2018: Pediatric Cardiology
Ahmad Saeed Azhar, Hasan Mohamed Aljefri
The purpose of this study is to evaluate post-operative length of stay (LOS) following surgical repair of congenital heart defects (CHD) and to investigate baseline pre-operative factors and predictors of post-operative LOS (pLOS). Retrospective chart review of all cases of corrective surgery for CHD performed at the Pediatric Cardiology Unit, King Abdulaziz University Hospital, Jeddah during January 2013-December 2016. Baseline demographics, clinical factors, pre-operative, intra-operative, post-operative cardiac and extra-cardiac complications were analyzed as independent factors of pLOS using stepwise linear regression...
August 31, 2018: Pediatric Cardiology
Michael V Di Maria, David W Brown, Frank Cetta, Salil Ginde, David Goldberg, Shaji C Menon, Heather M Phelps, Jack Rychik, Kurt R Schumacher, Philip Thrush, Gruschen Veldtman, Gail Wright, Adel K Younoszai
More children with single ventricle heart disease are surviving after Fontan surgery. This circulation has pervasive effects on multiple organ systems and has unique modes of failure. Many centers have created multidisciplinary programs to care for these patients. Our aim was to survey such programs to better understand current approaches to care. We hypothesized that significant variability in surveillance testing strategy would be present. Eleven academic institutions with established Fontan care programs performing a combined estimated 300 Fontan surgeries per year, with a total population of 1500-2000 Fontan patients, were surveyed using a REDCap survey regarding surveillance testing and basic practice philosophies...
August 29, 2018: Pediatric Cardiology
Harish Bangalore, Paul A Checchia, Elena C Ocampo, Jeffrey S Heinle, Charles G Minard, Lara S Shekerdemian
A surge in cortisol levels is seen after surgery with cardiopulmonary bypass (CPB). Based on evidence of attenuation of the cortisol response to repeated stress in other settings, we hypothesized that the magnitude of cortisol increase in children after a second exposure to CPB would be reduced. Serial cortisol levels were measured at three time points after each CPB: immediately (day 0), on the first morning (day 1), and second morning (day 2). Forty-six children underwent two surgeries with CPB during the study period...
August 27, 2018: Pediatric Cardiology
Yuntao Li, Xiaohong Zhang, Yani Yan, Qiuyan Pei
The purpose of the study was to explore the prognosis, as well as antenatal ultrasonic features of isolated left subclavian artery (ILSCA) and isolated left brachiocephalic trunk (ILBCT) malformations, in order to improve prognosis and provide guidance for prenatal diagnosis. The origin and routing of cephalic and cervical vessels were observed in patients diagnosed with right aortic arch or right arterial duct arch in our hospital from March 2015 to March 2017, and the spectrum features related to ILSCA and ILBCT were analyzed...
August 27, 2018: Pediatric Cardiology
Felix Neunhoeffer, Michael Hofbeck, Christian Schlensak, Martin Ulrich Schuhmann, Jörg Michel
Optimizing oxygen delivery to the brain is one of the main goals in children with congenital heart defects after surgery. It has been shown that cerebral oxygen saturation (cSO2) is depressed within the first day after neonatal cardiopulmonary bypass surgery. However, peri-operative cerebral oxygen metabolism has not yet been assessed in previous studies. The aim of this study was to describe the peri-operative changes in cerebral oxygen metabolism in neonates with congenital heart defects following cardiopulmonary bypass surgery...
August 25, 2018: Pediatric Cardiology
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