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Heart valve sizing in children

Peter Murin, Nicodème Sinzobahamvya, Antonia Schulz, Victoria Lorenzen, Stanislav Ovroutski, Felix Berger, Joachim Photiadis, Mi-Young Cho
OBJECTIVES: The technique of subcoronary autograft implantation for the Ross procedure has shown excellent durability of aortic valve function in adults. However, its use in children with hypoplastic aortic annulus or multilevel left ventricular outflow tract obstruction (LVOTO) was traditionally precluded. We combined this technique with a Konno incision and evaluated LVOTO relief and durability of the autograft function in growing patients. METHODS: Between January 2012 and January 2017, 13 patients with severe LVOTO and hypoplastic aortic annulus underwent Ross-Konno procedure with subcoronary autograft implantation...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Allison K Cabalka, Jeremy D Asnes, David T Balzer, John P Cheatham, Matthew J Gillespie, Thomas K Jones, Henri Justino, Dennis W Kim, Te-Hsin Lung, Daniel R Turner, Doff B McElhinney
BACKGROUND: Stented bioprosthetic valves (BPVs) are commonly used for surgical pulmonary valve (PV) replacement in postoperative congenital heart disease, but develop structural failure in a time-related fashion. The Melody transcatheter PV (TPV) (Medtronic, Minneapolis, Minn) has been used to treat BPV dysfunction, but there have been few studies in this population. METHODS: We performed a retrospective, multicenter study to evaluate Melody valve function in patients who underwent TPV replacement (TPVR) into a dysfunctional pulmonary BPV...
April 2018: Journal of Thoracic and Cardiovascular Surgery
Lilly-Ann Mohlkert, Jenny Hallberg, Olof Broberg, Annika Rydberg, Cecilia Pegelow Halvorsen, Petru Liuba, Vineta Fellman, Magnus Domellöf, Gunnar Sjöberg, Mikael Norman
BACKGROUND: Preterm birth has been associated with increased risk of cardiovascular morbidity in adult life. We evaluated whether preterm birth is associated with deviating cardiac structure and function before school start. METHODS AND RESULTS: In total, 176 children aged 6 years and born extremely preterm (EXPT; gestational age of 22-26 weeks) and 134 children born at term (control [CTRL]) were studied. We used echocardiography to assess left heart dimensions, geometry, and functions...
January 20, 2018: Journal of the American Heart Association
Sunjay Kaushal, Brody Wehman, Nicholas Pietris, Casey Naughton, Soren M Bentzen, Grace Bigham, Rachana Mishra, Sudhish Sharma, Luca Vricella, Allen D Everett, Kristopher B Deatrick, Sihong Huang, Helina Mehta, William A Ravekes, Naru Hibino, Darcy L Difede, Aisha Khan, Joshua M Hare
Despite advances in surgical technique and postoperative care, long-term survival of children born with hypoplastic left heart syndrome (HLHS) remains limited, with cardiac transplantation as the only alternative for patients with failing single ventricle circulations. Maintenance of systemic right ventricular function is crucial for long-term survival, and interventions that improve ventricular function and avoid or defer transplantation in patients with HLHS are urgently needed. We hypothesize that the young myocardium of the HLHS patient is responsive to the biological cues delivered by bone marrow-derived mesenchymal stem cells (MSCs) to improve and preserve right ventricle function...
October 2017: American Heart Journal
Matthew A Jolley, Sunil J Ghelani, Adi Adar, David M Harrild
BACKGROUND: The mitral valve has a complex three-dimensional (3D) morphology that is incompletely described by two-dimensional echocardiography (echo). Three-dimensional echo provides a more robust tool to analyze the mitral valve. The shape of the mitral annulus and leaflets, and differences with age, have not been described by 3D echo in normal children. Our objective was to characterize and quantify the 3D mitral valve morphology in children with normal transthoracic echocardiograms over a broad spectrum of age and to identify differences in valve shape with age...
June 2017: Journal of the American Society of Echocardiography
Clement Karsenty, Khaled Hadeed, Philippe Acar
The recent technical advances allow the use in practice of three-dimensional echocardiography in children especially through the new high frequency matrix probe. It is difficult or even impossible to hold breathing during children' acquisition so to avoid motion full volume artifact, one beat and live 3D modes are suitable. 3D echocardiography is more accurate than 2D to assess the size, location, and relationship with surrounding structures of atrial and ventricular septal defects and thus helps in the therapeutic decision...
May 2017: La Presse Médicale
Sharan Ramaswamy, Makensley Lordeus, Omkar V Mankame, Lilliam Valdes-Cruz, Steven Bibevski, Sarah M Bell, Ivan Baez, Frank Scholl
Infants and children born with severe cardiac valve lesions have no effective long term treatment options since currently available tissue or mechanical prosthetic valves have sizing limitations and no avenue to accommodate the growth of the pediatric patient. Tissue engineered heart valves (TEHVs) which could provide for growth, self-repair, infection resistance, and long-term replacement could be an ideal solution. Porcine small intestinal submucosa (PSIS) has recently emerged as a potentially attractive bioscaffold for TEHVs...
March 2017: Cardiovascular Engineering and Technology
George M Alfieris, Michael F Swartz, Juan Lehoux, Edward L Bove
BACKGROUND: The optimal choice for pulmonary valve replacement (PVR) remains controversial. This study hypothesized that xenografts used for PVR would result in prolonged long-term survival and freedom from reoperation. METHODS: Children and adults with congenital heart disease requiring PVR using a xenograft from 1980 to 1985 were reviewed. In all cases, the xenograft valve was either sewn or manufactured into a Dacron conduit, and the conduit was sewn to the pulmonary artery bifurcation...
August 2016: Annals of Thoracic Surgery
H M Gardiner, A Kovacevic, G Tulzer, T Sarkola, U Herberg, J Dangel, A Öhman, J Bartrons, J S Carvalho, H Jicinska, V Fesslova, I Averiss, M Mellander
OBJECTIVES: Fetal aortic valvuloplasty (FV) aims to prevent fetal aortic valve stenosis progressing into hypoplastic left heart syndrome (HLHS), which results in postnatal univentricular (UV) circulation. Despite increasing numbers of FVs performed worldwide, the natural history of the disease in fetal life remains poorly defined. The primary aim of this study was to describe the natural history of fetal aortic stenosis, and a secondary aim was to test previously published criteria designed to identify cases of emerging HLHS with the potential for a biventricular (BV) outcome after FV...
September 2016: Ultrasound in Obstetrics & Gynecology
Julie Cleuziou, Keti Vitanova, Jelena Kasnar-Samprec, Jürgen Hörer, Rüdiger Lange, Christian Schreiber
OBJECTIVES: Small-sized homografts are rare but may be required for the reconstruction of the right ventricular outflow tract (RVOT). Down-sizing adult-sized homografts can be an option to overcome the shortage of availability. METHODS: Since 1994, we have been down-sizing adult-sized homografts by excising one cusp. The aim of the study was to analyse the durability of down-sized homografts and compare it with small-sized homografts in a paediatric population. All patients below a body weight of 14 kg were included in the study...
May 2016: European Journal of Cardio-thoracic Surgery
Massimiliano Cantinotti, Raffaele Giordano, Marco Scalese, Bruno Murzi, Nadia Assanta, Isabella Spadoni, Maura Crocetti, Marco Marotta, Sabrina Molinaro, Shelby Kutty, Giorgio Iervasi
BACKGROUND: Pediatric echocardiographic nomograms for systolic/diastolic functional indices are limited by small sample size and inconsistent methodologies. Our aim was to establish pediatric nomograms for mitral valve (MV) pulsed wave Doppler (PWD) and tissue Doppler imaging (TDI) velocities. METHODS: We performed PWD/TDI measurements of MV velocities and generated models testing for linear/logarithmic/exponential/square root relationships. Heteroscedasticity was accounted for by White test or Breusch-Pagan test...
October 2016: Journal of Cardiology
Simon J Sonntag, Maximilan Kütting, Pejman Farhadi Ghalati, Tim Kaufmann, Jaime Vázquez-Jiménez, Ulrich Steinseifer, Janez Vodiskar
PURPOSE: Implanting the largest valved conduit possible - oversizing - to reconstruct an absent connection from the right ventricle to the pulmonary artery in certain types of congenital heart defects has been suggested as a compensating measure for somatic outgrowth of the patient. However, one effect that has not been investigated yet is the hemodynamic consequence. For this purpose, virtual implantation and flow simulations were conducted in this study. METHODS: To isolate the effects of conduit oversizing on the hemodynamics observed after conduit implantation and outgrowth, calculated wall shear stresses (WSS) of image-based computational fluid dynamic (CFD) simulations were used as indicators...
October 2015: International Journal of Artificial Organs
Luigi P Badano, Marcelo H Miglioranza, Thor Edvardsen, Alexandre Siciliano Colafranceschi, Denisa Muraru, Fernando Bacal, Koen Nieman, Giacomo Zoppellaro, Fabiana G Marcondes Braga, Thomas Binder, Gilbert Habib, Patrizio Lancellotti
The cohort of long-term survivors of heart transplant is expanding, and the assessment of these patients requires specific knowledge of the surgical techniques employed to implant the donor heart, the physiology of the transplanted heart, complications of invasive tests routinely performed to detect graft rejection (GR), and the specific pathologies that may affect the transplanted heart. A joint EACVI/Brazilian cardiovascular imaging writing group committee has prepared these recommendations to provide a practical guide to echocardiographers involved in the follow-up of heart transplant patients and a framework for standardized and efficient use of cardiovascular imaging after heart transplant...
September 2015: European Heart Journal Cardiovascular Imaging
Constance G Weismann, Kristin C Lombardi, Bernhard S Grell, Veronika Northrup, Lissa Sugeng
AIMS: Aortic stiffness and diastolic function are abnormal in adults with bicuspid aortic valves (BAVs). The goal of this study was to determine the relationship between aortic stiffness and left ventricular (LV) diastolic impairment in children with well-functioning BAV and no associated congenital heart disease. METHODS AND RESULTS: This is a retrospective review of echocardiograms in children with isolated BAV (group BAV; N = 50) and healthy frequency-matched controls (group Control; N = 50)...
February 2016: European Heart Journal Cardiovascular Imaging
Anita Saxena
Stenosis of the mitral valve most often occurs as a result of chronic rheumatic heart disease, causing thickening and fibrosis of the mitral valve apparatus. Rheumatic heart disease continues to be a major public health problem in several developing countries and mitral stenosis is also common in these regions. According to the reports from India and Africa, the disease tends to follow a rapidly progressive course in children. The treatment of choice is balloon dilatation of the mitral valve. Echocardiography is indispensable for this procedure...
April 2015: World Journal for Pediatric & Congenital Heart Surgery
Christopher K Davis, Dan A Dyar, Lisa A Vargas, Paul D Grossfeld
OBJECTIVE: The aim of this study was to characterize the cardiovascular and musculoskeletal systems of elite volleyball players, including aortic dimensions. Previous studies have shown that the upper limit of normal aortic sinus diameter for male and female athletes is 4 and 3.4 cm, respectively. DESIGN: Cross-sectional analysis. SETTING: United States Olympic Volleyball Training Facility and Rady Children's Hospital San Diego. PARTICIPANTS: Seventy (37 male) members of the US national volleyball team...
November 2015: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Jenna M Murray, Amy Hellinger, Roger Dionne, Loren Brown, Rosemary Galvin, Suzanne Griggs, Karen Mittler, Kathy Harney, Shannon Manzi, Christina VanderPluym, Annette Baker, Patricia O'Brien, Cheryl O'Connell, Christopher S Almond
Congenital heart disease is the leading cause of stroke in children. Warfarin therapy can be difficult to manage safely in this population because of its narrow therapeutic index, multiple drug and dietary interactions, small patient size, high-risk cardiac indications, and lack of data to support anticoagulation recommendations. We sought to describe our institution's effort to develop a dedicated cardiac anticoagulation service to address the special needs of this population and to review the literature. In 2009, in response to Joint Commission National Patient Safety Goals for Anticoagulation, Boston Children's Hospital created a dedicated pediatric Cardiac Anticoagulation Monitoring Program (CAMP)...
April 2015: Pediatric Cardiology
Willem A Helbing, Mohamed Ouhlous
MRI is an important additional tool in the diagnostic work-up of children with congenital heart disease. This review aims to summarise the role MRI has in this patient population. Echocardiography remains the main diagnostic tool in congenital heart disease. In specific situations, MRI is used for anatomical imaging of congenital heart disease. This includes detailed assessment of intracardiac anatomy with 2-D and 3-D sequences. MRI is particularly useful for assessment of retrosternal structures in the heart and for imaging large vessel anatomy...
January 2015: Pediatric Radiology
Peter C Frommelt, Eric Gerstenberger, James F Cnota, Meryl S Cohen, Jessica Gorentz, Kevin D Hill, J Blaine John, Jami C Levine, Jimmy Lu, William T Mahle, Rachel T McCandless, Luc Mertens, Gail D Pearson, Carolyn Spencer, Deepika Thacker, Ismee A Williams, Pierre C Wong, Jane W Newburger
BACKGROUND: In children with single right ventricular (RV) anomalies, changes in RV size and function may be influenced by shunt type chosen at the time of the Norwood procedure. OBJECTIVES: The study sought to identify shunt-related differences in echocardiographic findings at 14 months and ≤6 months pre-Fontan in survivors of the Norwood procedure. METHODS: We compared 2-dimensional and Doppler echocardiographic indices of RV size and function, neo-aortic and tricuspid valve annulus dimensions and function, and aortic size and patency at 14...
November 11, 2014: Journal of the American College of Cardiology
Luke Eckersley, John Stirling, Christopher Occleshaw, Nigel Wilson
This study identified tracheobronchial cartilage calcification in children with congenital heart disease. Calcification of the tracheobronchial airways has been found previously in adults receiving warfarin and in children receiving warfarin after mitral valve replacement. A 9-year-old girl who had received a Fontan repair 6 years previously underwent a cardiac computed tomography (CT) scan to evaluate pulmonary artery size. The result was an incidental finding of extensive tracheobronchial cartilage calcification...
August 2014: Pediatric Cardiology
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