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Pediatric Cardiology

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https://www.readbyqxmd.com/read/28321483/distribution-of-kawasaki-disease-coronary-artery-aneurysms-and-the-relationship-to-coronary-artery-diameter
#1
Etsuko Tsuda, Nobuyuki Tsujii, Kohji Kimura, Atsuko Suzuki
We investigated how the diameter of coronary artery aneurysm (CAA) relates to the distribution immediately after Kawasaki disease (KD). Two hundred and four pts (155 males and 49 females) who had undergone selective coronary angiography (CAGs) less than 100 days after the onset of KD were studied. We measured the maximum diameter of each artery segment in the initial CAGs. We analyzed the relationship between the maximum diameters and the distribution of CAA. We divided the patients into four groups based on the maximum CAA diameter in each patient (large(L) ≥8 mm, medium(M) ≥6 and <8 mm, small(S) ≥4 and <6 mm, very small(VS) <4 mm) and counted the affected segments...
March 20, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28315943/hyperoxia-reduces-oxygen-consumption-in-children-with-pulmonary-hypertension
#2
Long Guo, Prashant Bobhate, Shine Kumar, Karunakar Vadlamudi, Tarek Kaddoura, Mohamed Elgendi, Paula Holinski, James Y Coe, Jennifer Rutledge, Ian Adatia
High inspired oxygen concentration (FiO2 > 0.85) is administered to test pulmonary vascular reactivity in children with pulmonary hypertension (PH). It is difficult to measure oxygen consumption (VO2) if the subject is breathing a hyperoxic gas mixture so the assumption is made that baseline VO2 does not change. We hypothesized that hyperoxia changes VO2. We sought to compare the VO2 measured by a thermodilution catheter in room air and hyperoxia. A retrospective review of the hemodynamic data obtained in children with PH who underwent cardiac catheterization was conducted between 2009 and 2014...
March 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28315942/forgotten-right-ventricle-in-pediatric-dilated-cardiomyopathy
#3
Hala Mounir Agha, Hossam Ibrahim, Inas Abd El Satar, Naglae Abd El Rahman, Doaa Abd El Aziz, Zeinab Salah, Sonia El Saeidi, Fatma Mostafa, Wael Attia, Mohamed Abd El Rahman, Gaser Abd El Mohsen
To evaluate the right ventricular (RV) function in relation to that of the left ventricle (LV) in patients with dilated cardiomyopathy (DCM). Echocardiographic examination was done using tissue Doppler imaging (TDI) and two-dimensional speckle tracking echocardiography (2D-STE) for 32 pediatric patients with DCM comparing them to another 32 normal matched controls. The global longitudinal strain (GLS) derived from 2D-STE was used to reflect the LV systolic function. Tricuspid annular plan systolic excursion (TAPSE) and the following RV TDI derived indexes: peak systolic velocity (S'), peak early diastolic velocity E', peak late diastolic velocity A', isovolumic acceleration (IVA) and myocardial performance index (MPI) were measured...
March 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28289784/high-blood-pressure-states-in-children-adolescents-and-young-adults-associate-accelerated-vascular-aging-with-a-higher-impact-in-females-arterial-properties
#4
S Curcio, V García-Espinosa, J M Castro, G Peluso, M Marotta, M Arana, P Chiesa, G Giachetto, D Bia, Yanina Zócalo
The aims of the study were to determine (1) whether the presence of High blood pressure (HBP) states in the youth associate a steeper rate of age-related change in arterial geometrical and wall properties with respect to subjects with no previous cardiovascular risk factor (CRF) exposure, (2) in which parameters and in what magnitude, and (3) the existence of a gender-related difference in the impact of this condition on arterial properties. 300 individuals (mean/range: 15/4-29 years; 133 females) were included...
March 13, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28271153/low-iron-stores-in-otherwise-healthy-children-affect-electrocardiographic-markers-of-important-cardiac-events
#5
Cem Karadeniz, Rahmi Özdemir, Mustafa Demirol, Nagehan Katipoğlu, Yılmaz Yozgat, Timur Meşe, Nurettin Ünal
Both an excess of iron and iron deficiency (ID) may lead to significant cardiac problems. Parameters that represent ventricular repolarization heterogeneity, like QT dispersion (QTd), corrected QT dispersion (QTcd), the interval between the peak and the end of the T wave (Tp-e), and Tp-e dispersion, have not been evaluated in otherwise healthy children with low iron levels before. Here we assessed the effects of low iron storage on P wave dispersion (PWd), QTd, Tp-e intervals, and Tp-e dispersion in otherwise healthy children...
March 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28271152/arrhythmias-after-fontan-operation-with-intra-atrial-lateral-tunnel-versus-extra-cardiac-conduit-a-systematic-review-and-meta-analysis
#6
Dongxu Li, Qiang Fan, Yasutaka Hirata, Minoru Ono, Qi An
Current studies on the incidence of arrhythmias after the intra-atrial lateral tunnel (ILT) Fontan operation and the extra-cardiac conduit (ECC) Fontan operation are limited, with controversial results. This systematic review aimed to compare the prevalence of arrhythmias in patients who underwent ECC or ILT Fontan. Relevant studies comparing the incidence of arrhythmias and pacemaker implantation in ILT with ECC were identified through a literature search using MEDLINE, EMBASE, and the cochrane central register of controlled trials...
March 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28251252/perimembranous-ventricular-septal-defect%C3%A2-device%C3%A2-closure-choosing%C3%A2-between-amplatzer-duct-occluder-i-and-ii
#7
Amal El-Sisi, R Sobhy, V Jaccoub, H Hamza
Transcatheter closure of perimembranous ventricular septal defects (pmVSDs) is a well-established procedure. Recently, Amplatzer duct occluders (ADO) I and II have been reported to close large series of pmVSDs successfully (off-label use). ADOs are economical compared with the standard Amplatzer VSD occluders, a major consideration in developing countries with low-budget programs. We report closure of symptomatic, hemodynamically significant pmVSDs using the ADOI and ADOII devices. Although there are no set criteria for choosing between ADOI and ADOII, the former's price tag includes snare and long sheath...
March 1, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28239753/six-minute-walk-test-in-evaluation-of-children-with-pulmonary-arterial-hypertension
#8
Malgorzata Zuk, Anna Migdal, Dorota Jagiellowicz-Kowalska, Katarzyna Mazurkiewicz, Anna Sadel-Wieczorek, Grazyna Brzezinska-Rajszys
Six-minute walk test (6MWT) is a submaximal exercise test applied for evaluation of adults with pulmonary arterial hypertension (PAH). It was widely used as an endpoint in the clinical trials. The aim of the study was to assess the usefulness of 6MWT in management of children with PAH and to establish correlations with other clinical features. 164 6MWT were performed in 15 children between 5 and 18 years with PAH confirmed by right heart catheterization (102 in patients with shunt, 62 without shunt). Distance in 6MWT (6MWD)-% of predicted for age and gender, desaturation at the maximum effort, peak heart rate (HR)-% of maximal HR, were compared to the level of NTproBNP, WHO-FC, echocardiography parameters, and events of PAH treatment intensification...
February 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28239752/potential-and-limitations-of-cochrane-reviews-in-pediatric-cardiology-a-systematic-analysis
#9
Martin Poryo, Sara Khosrawikatoli, Hashim Abdul-Khaliq, Sascha Meyer
Evidence-based medicine has contributed substantially to the quality of medical care in pediatric and adult cardiology. However, our impression from the bedside is that a substantial number of Cochrane reviews generate inconclusive data that are of limited clinical benefit. We performed a systematic synopsis of Cochrane reviews published between 2001 and 2015 in the field of pediatric cardiology. Main outcome parameters were the number and percentage of conclusive, partly conclusive, and inconclusive reviews as well as their recommendations and their development over three a priori defined intervals...
February 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28238152/myocardial-infarction-in-neonates-a-review-of-an-entity-with-significant-morbidity-and-mortality
#10
REVIEW
Koyelle Papneja, Anthony K Chan, Tapas K Mondal, Bosco Paes
Coronary artery disease is a global problem with high mortality rates and significant residual sequelae that affect long-term quality of life. Myocardial infarction (MI) in neonates is a recognized, uncommon entity, but the incidence and broad spectrum of the disease is unknown and likely underestimated due to limited reporting which in the majority is confined to acute ischemic events. The challenges involve clinical diagnosis which masquerades in the early phase as non-specific symptoms and signs that are commonly found in a host of neonatal disorders...
February 25, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28236162/regression-and-complications-of-z-score-based-giant-aneurysms-in-a-dutch-cohort-of-kawasaki-disease-patients
#11
S M Dietz, I M Kuipers, J C D Koole, J M P J Breur, Z Fejzic, S Frerich, M Dalinghaus, A A W Roest, B A Hutten, T W Kuijpers
Kawasaki disease (KD) is a pediatric vasculitis. Its main complication is the development of coronary artery aneurysms (CAA), with giant CAA at the end of the spectrum. We evaluated regression and event-free rates in a non-Asian cohort of patients with giant CAA using the current z-scores adjusted for body surface area instead of absolute diameters. KD patients with giant CAA (z-score ≥10) visiting our outpatient clinic between January 1999 and September 2015 were included. Patient characteristics and clinical details were extracted from medical records...
February 24, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28224170/multicenter-off-label-use-of-nit-occlud-coil-in-retrograde-closure-of-small-patent-ductus-arteriosus
#12
Keyhan Sayadpour Zanjani, Rodina Sobhy, Rania El-Kaffas, Amal El-Sisi
We studied the safety and efficacy of closing patent ductus arteriosus by Nit-Occlud coils via retrograde approach. This is a retrospective study of 46 attempts to close ducts by this method in two hospitals in Egypt and Iran. Ductus arteriosus was crossed by left or right Judkins or endhole catheters. The coil was delivered via the same catheter or the provided endhole catheter after exchange. The procedure was successful in 42 out of 46 attempts. Fluoroscopy and procedural times were significantly shorter when the catheter was not exchanged...
February 21, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214968/piloting-the-use-of-patient-specific-cardiac-models-as-a-novel-tool-to-facilitate-communication-during-cinical-consultations
#13
Giovanni Biglino, Despina Koniordou, Marisa Gasparini, Claudio Capelli, Lindsay-Kay Leaver, Sachin Khambadkone, Silvia Schievano, Andrew M Taylor, Jo Wray
This pilot study aimed to assess the impact of using patient-specific three-dimensional (3D) models of congenital heart disease (CHD) during consultations with adolescent patients. Adolescent CHD patients (n = 20, age 15-18 years, 15 male) were asked to complete two questionnaires during a cardiology transition clinic at a specialist centre. The first questionnaire was completed just before routine consultation with the cardiologist, the second just after the consultation. During the consultation, each patient was presented with a 3D full heart model realised from their medical imaging data...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214967/increased-atrial-%C3%AE-adrenergic-receptors-and-grk-2-gene-expression-can-play-a-fundamental-role-in-heart-failure-after-repair-of-congenital-heart-disease-with-cardiopulmonary-bypass
#14
Marcela Silva Oliveira, Fabio Carmona, Walter V A Vicente, Paulo H Manso, Karina M Mata, Mara Rúbia Celes, Erica C Campos, Simone G Ramos
Surgeries to correct congenital heart diseases are increasing in Brazil and worldwide. However, even with the advances in surgical techniques and perfusion, some cases, especially the more complex ones, can develop heart failure and death. A retrospective study of patients who underwent surgery for correction of congenital heart diseases with cardiopulmonary bypass (CPB) in a university tertiary-care hospital that died, showed infarction in different stages of evolution and scattered microcalcifications in the myocardium, even without coronary obstruction...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214966/anomalous-coronary-arteries-and-myocardial-bridges-risk-stratification-in-children-using-novel-cardiac-catheterization-techniques
#15
Hitesh Agrawal, Silvana Molossi, Mahboob Alam, S Kristen Sexson-Tejtel, Carlos M Mery, E Dean McKenzie, Charles D Fraser, Athar M Qureshi
The evaluation of the vast majority of children with anomalous aortic origin of a coronary artery (AAOCA) and/or myocardial bridges is performed with non-invasive testing. However, a subset of these patients may benefit from invasive testing for risk stratification. All patients included in the Coronary Anomalies Program (CAP) at Texas Children's Hospital who underwent cardiac catheterization were included. Techniques included selective coronary angiograms (SCA), intravascular ultrasound (IVUS), and fractional flow reserve (FFR) measurements with provocative testing using adenosine and/or dobutamine infusions...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214965/surgical-correction-of-aberrant-right-coronary-anomalies-stranding-an-aortic-commissure-with-and-without-unroofing
#16
Khaled Abdelhady, Samarth Durgam, Chawki Elzein, Michel N Ilbawi, David Rhoiney, Malek G Massad
The technique for successful surgical correction of an anomalous origin of the right coronary artery from the opposite aortic cusp with an aberrant course between the aorta and pulmonary artery is illustrated in a symptomatic 62-year-old woman. The intramural course of the right coronary artery traversed the tip of the commissure between the anterior and posterior leaflets, and its repair entailed unroofing of the intramural segment from inside the aortic intima. This technique required resuspension of the overlying commissure to maintain optimal aortic valve leaflet coaptation and prevent aortic insufficiency...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214964/speckle-tracking-in-alcapa-patients-after-surgical-repair-as-predictor-of-residual-coronary-disease
#17
Biagio Castaldi, Vladimiro Vida, Elena Reffo, Massimo Padalino, Queenette Daniels, Giovanni Stellin, Ornella Milanesi
Surgical re-implantation of the left coronary artery (LCA) is the treatment of choice in anomalous origin of left coronary artery from pulmonary artery (ALCAPA). Despite normalization of left ventricular function after surgery, residual coronary lesions or myocardial fibrosis may be found. The aim of this study was to detect regional left ventricular dysfunction predictive of coronary lesions or residual myocardial fibrosis using speckle tracking. We enrolled ten patients treated with surgical re-implantation of LCA for ALCAPA...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28210769/preprocedural-risk-assessment-prior-to-ppvi-with-cmr-and-cardiac-ct
#18
Ladonna Malone, Brian Fonseca, Thomas Fagan, Jane Gralla, Neil Wilson, Micheal DiMaria, Uyen Truong, Lorna P Browne
Percutaneous pulmonary valve intervention (PPVI) is a less invasive and less costly approach to pulmonary valve replacement compared with the surgical alternative. Potential complications of PPVI include coronary compression and pulmonary arterial injury/rupture. The purpose of this study was to characterize the morphological risk factors for PPVI complication with cardiac MRI and cardiac CTA. A retrospective review of 88 PPVI procedures was performed. 44 patients had preprocedural cardiac MRIs or CTAs available for review...
February 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28210768/the-lymphatic-circulation-in-adaptations-to-the-fontan-circulation
#19
REVIEW
Sabarinath Menon, Murthy Chennapragada, Shinya Ugaki, Gary F Sholler, Julian Ayer, David S Winlaw
Failing Fontan continues to be major problem for patients on the univentricular pathway. Failing Fontan is often complicated by chylothorax, plastic bronchitis and protein loosing enteropathy. The role of lymphatic circulation in Fontan circulation is still being researched. Newer imaging modalities give insight into the role of abnormal dilatation and retrograde flow in lymphatic channels post Fontan. Interventional strategies targeting abnormal lymphatic channels, provides an alternative management strategy for patients with failing Fontan...
February 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28197645/subclinical-decrease-in-myocardial-function-in-asymptomatic-infants-of-diabetic-mothers-a-tissue-doppler-study
#20
Jenny E Zablah, Dorota Gruber, Guillaume Stoffels, Estefania G Cabezas, Denise A Hayes
Infants of diabetic mothers (IDMs) with hypertrophic cardiomyopathy are recognized to have impaired myocardial performance, but less is known about ventricular function in IDMs without hypertrophy. We hypothesized that in asymptomatic newborns with normal two-dimensional echocardiographic evaluations, pulsed wave tissue Doppler imaging (TDI) would suggest a subclinical decrease in the cardiac function of IDMs compared to infants of non-diabetics (nIDMs). This is a retrospective cohort study of asymptomatic neonates ≥36 weeks gestation, at 0-7 days of life, with normal standard echocardiograms...
February 14, 2017: Pediatric Cardiology
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