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Cardiology in the Young

Kavita Morparia, Courtney Peshkovsky, Meena Kalyanaraman
Purulent pericarditis occurs rarely in the current antibiotic era. We describe clinical and echocardiographic features of purulent pericarditis in a previously healthy child with influenza and community-acquired methicillin-resistant Staphylococcus aureus co-infection. The child was already on appropriate antibiotics and had a very subtle clinical presentation, with prominent abdominal symptoms. Timely surgical drainage led to complete recovery.
September 17, 2018: Cardiology in the Young
Sihong Huang, Paul Martin, M Jay Campbell
Coronary artery disease after bone marrow transplantation is rare in children and young adults. We report the case of a 21-year-old who developed coronary artery disease and acute myocardial infarction secondary to graft versus host disease following bone marrow transplantation. Physicians caring for young patients after bone marrow transplantation should be aware of the potential for coronary artery disease and evaluate appropriately.
September 17, 2018: Cardiology in the Young
Katsutoshi Nakano, Taiyu Hayashi, Hiroshi Ono
A male neonate with d-transposition of the great arteries was diagnosed with the concomitant anomaly of left circumflex aortic arch and right-sided ductus arteriosus, which formed a vascular ring. Initial postnatal echocardiography had demonstrated an obscured aortic isthmus mimicking coarctation of the aorta, which could be a diagnostic clue to circumflex aortic arch.
September 17, 2018: Cardiology in the Young
Zdenka Reinhardt, Georg Hansmann, John O'Sullivan, Bari Murtuza, Martin Köstenberger, Dietmar Schranz, Damien Bonnet, Michael Burch
Advanced medical and surgical treatment of heart failure and management of patients following heart transplantation is an emerging area. Treatment options at various levels are becoming available in an increasing number of countries. This rapidly evolving field involves a complex multi-disciplinary approach with a number of complementary medical and surgical strategies, including pharmacotherapy, structural cardiac interventions, electrophysiological optimisation, mechanical circulatory support, and heart transplantation...
September 12, 2018: Cardiology in the Young
Shuichi Shiraishi, Toshihide Nakano, Shinichiro Oda, Hideaki Kado
BackgroundsThe aim of this study was to assess the impact of age at bidirectional cavopulmonary anastomosis on haemodynamics after total cavopulmonary connection. METHODS: We conducted a retrospective analysis of 100 consecutive patients who underwent total cavopulmonary connection from 2010 to 2014. All patients had previously undergone bidirectional cavopulmonary anastomosis. These patients were classified into two groups according to age at bidirectional cavopulmonary anastomosis: younger group, 6 months (n=67)...
September 10, 2018: Cardiology in the Young
Daiji Takeuchi, Takashi Azuma, Hiroshi Niinami
We reported a successful case of thoracic endovascular aortic repair of a late aortic aneurysm after patch repair of an interrupted aortic arch and favourable outcome 4 years after the procedure.
September 10, 2018: Cardiology in the Young
Luis Altamirano-Diaz, Kambiz Norozi, Jaime A Seabrook, Eva Welisch
For one-third of the Peruvian population living in large cities outside the capital city Lima, there is no access to paediatric cardiology services provided by the public health care system. Children with suspected CHD living in these areas are referred to the adult cardiologist working at the regional hospitals for care and treatment. This is a consequence of the universal health care system and the heavily skewed distribution of the health care workforce towards the capital city of Lima. This imbalance has resulted in a severe shortage of paediatric cardiologists practicing outside of Lima and the adult cardiologists that remain are left to make up for this deficit...
September 10, 2018: Cardiology in the Young
Anne C Taylor, Katherine E Bates, Alaina K Kipps
Limited evidence exists to guide chest tube management following cardiac surgery in children. We assessed chest tube practice variation by surveying paediatric heart centres to prepare for a multi-site quality improvement project. We summarised management strategies highlighting variability in criteria for chest tube removal between and within centres. This lack of standardisation provides an opportunity for quality improvement.
September 10, 2018: Cardiology in the Young
Jeffrey R Boris, Thomas Bernadzikowski
IntroductionSevere fatigue and cognitive dysfunction are frequent symptoms in patients with postural orthostatic tachycardia syndrome. They can be debilitating, and often do not resolve despite improvement in haemodynamic symptoms. Our analysis was intended to assess clinical outcomes of medication treatment for these symptoms in a large, single-centre paediatric programme.Materials and MethodsWe performed a retrospective review of patients treated for fatigue and cognitive dysfunction. Patients aged 18 years or younger at the time of initial diagnosis were included...
September 10, 2018: Cardiology in the Young
Russell C Gongwer, Kimberlee Gauvreau, Susanna Y Huh, Kevin A Sztam, Kathy J Jenkins
BACKGROUND: Growth failure is prevalent among infants with CHD. A Standardized Clinical Assessment and Management Plan was introduced at Boston Children's Hospital's cardiac medical ward to identify patients with growth failure, evaluate relevant contributing conditions, and recommend a management plan including collaboration with nutrition physicians. OBJECTIVE: The objective of this study was to determine whether enrolled patients had improved growth compared with historical controls...
September 3, 2018: Cardiology in the Young
Takuro Kojima, Tomohiko Imamura, Yousuke Osada, Shouta Muraji, Marie Nakano, Takayuki Oyanagi, Shigeki Yoshiba, Toshiki Kobayashi, Naokata Sumitomo
BACKGROUND: Catheter interventions for residual lesions in the early postoperative period after CHD operations are still not established as a reliable treatment option. METHODS: We retrospectively reviewed our institutional experience of cardiac catheterisations and catheter interventions performed in the early postoperative period. We classified our patients into two groups. The "hyper" acute phase group - operation to cardiac catheterisation of ⩽7 days - and acute phase group - operation to cardiac catheterisation from 7 to 30 days...
September 3, 2018: Cardiology in the Young
Marie Maagaard, Johan Heiberg, Filip Eckerström, Benjamin Asschenfeldt, Christian E Rex, Steffen Ringgaard, Vibeke E Hjortdal
Ventricular septal defects - large, surgically closed or small, untreated - have demonstrated lower peak exercise capacity compared with healthy controls. The mechanisms behind these findings are not yet fully understood. Therefore, we evaluated biventricular morphology in adults with a ventricular septal defect using MRI. Adults with either childhood surgically closed or small, untreated ventricular septal defects and healthy controls underwent cine MRI for the evaluation of biventricular volumes and quantitative flow scans for measurement of stroke index...
August 30, 2018: Cardiology in the Young
Mehmet G Ramoğlu, Serdar Epçaçan, Osman Yeşilbaş
Acute rheumatic fever is the most commonly acquired heart disease in developing countries. The most common cardiac presentation is valvular disease. Although some rhythm disturbances may occur during the acute stages of the disease, ventricular tachycardia is extremely rare. Here, a case of acute rheumatic fever with severe endocarditis involving four valves and ventricular tachycardia is presented.
August 30, 2018: Cardiology in the Young
Andrew Koth, Doug Sidell, Holly Bauser-Heaton, Lisa Wise-Faberowski, Frank L Hanley, Doff B McElhinney, Ritu Asija
BACKGROUND: A 22q11 chromosome deletion is common in patients with tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collaterals. We sought to determine whether 22q11 chromosome deletion is associated with increased postoperative morbidity after unifocalisation surgery. METHODS: We included all patients with this diagnosis undergoing primary or revision unifocalisation ± ventricular septal defect closure at our institution from 2008 to 2016, and we excluded patients with unknown 22q11 status...
August 30, 2018: Cardiology in the Young
Kentaro Akagi, Toshikatsu Tanaka, Shiro Baba
Severe pulmonary hypertension is a contraindication for liver transplantation owing to high mortality. However, decision-making regarding the treatment approach for patients with bilateral peripheral pulmonary artery stenosis, typically complicated by elevated main pulmonary artery and right ventricle pressures, can be challenging. Here, we report successful living donor liver transplantation after bilateral pulmonary artery stent implantation in a patient with Alagille syndrome, severe bilateral peripheral pulmonary artery stenosis, and extremely high main pulmonary artery and right ventricle pressures...
August 30, 2018: Cardiology in the Young
Ramzi Hamzeh, Ziad Bulbul, Jana Assy
In diffuse forms of arteriovenous malformation following Fontan procedure, "classical" medical therapy, inhaled nitric oxide and sildenafil, may play a role, until re-direction of hepatic flow to pulmonary circulation cures it. However, in refractory cases, as reported in our 2-year-old patient, unusual medications such as calcium channel blockers can be tried and continued if patients respond adequately.
August 29, 2018: Cardiology in the Young
Fabio Savorgnan, Nicholas B Zaban, Justin J Elhoff, Michael M Ross, John P Breinholt
BACKGROUND: Balloon atrial septostomy is performed in infants with dextro-transposition of the great arteries to improve oxygenation before surgery. It is performed in the catheterisation laboratory with fluoroscopy or at the bedside using echocardiography. It is unclear whether procedural safety and efficacy is superior in one location versus the other, although the bedside procedure may improve resource utilisation and present an opportunity for reducing cost. This study compares safety and efficacy of atrial septostomy performed at the patient's bedside versus the catheterisation laboratory...
August 28, 2018: Cardiology in the Young
Shamsur Chowdhury, Tanya Chadha, Mark Fafard, Michael Shillingford
TandemHeart, an adult ventricular assist device, is also being used in children for mechanical circulatory support. In this case series, we describe our experience using TandemHeart ventricular assist device with a modified circuit to provide mechanical circulatory support in three neonates for multiple indications. TandemHeart ventricular assist device with a modified circuit can be used successfully to provide extracorporeal support to neonates with complex CHD.
August 28, 2018: Cardiology in the Young
Kimberly I Mills, Sarah J van den Bosch, Kimberlee Gauvreau, Catherine K Allan, Ravi R Thiagarajan, David M Hoganson, Christopher W Baird, Meena Nathan, James A DiNardo, John N Kheir
BACKGROUND: Following stage 1 palliation, delayed sternal closure may be used as a technique to enhance thoracic compliance but may also prolong the length of stay and increase the risk of infection. METHODS: We reviewed all neonates undergoing stage 1 palliation at our institution between 2010 and 2017 to describe the effects of delayed sternal closure. RESULTS: During the study period, 193 patients underwent stage 1 palliation, of whom 12 died before an attempt at sternal closure...
August 28, 2018: Cardiology in the Young
Hasan Demetgul, Dilek Giray, Ali Delibas, Olgu Hallioglu
IntroductionThe aim of this study is to determine early changes in cardiac function of children with chronic kidney disease by using 2D-speckle tracking echocardiography. METHOD: The study included 38 children - 16 girls and 22 boys - diagnosed as having chronic kidney disease in the nephrology department with a glomerular filtration rate of <90 ml/minute/1.73 m2 for at least 3 months. A total of 37 - 15 girls and 22 boys - age- and sex-matched healthy children were included as the control group...
August 28, 2018: Cardiology in the Young
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