Percutaneous Treatment of Ascending Aortic Obstruction in a Young Child After Orthotopic Heart Transplantation
We report a case of a 14-month-old child with ascending aortic obstruction (AAO) post cardiac transplantation, who underwent successful percutaneous ascending aortic stent angioplasty. Congenital or acquired AAO is typically treated with surgical augmentation. The experience with percutaneous techniques is limited and often avoided due to challenges with equipment stability and proximity to coronary arteries and aortic valve leaflets. This case highlights that a percutaneous approach to relief of AAO is a feasible alternative even in small children utilizing a newer pre-mounted stent. (Source: Mammalian Genome)
Source: Mammalian Genome - February 10, 2023 Category: Genetics & Stem Cells Source Type: research
Accuracy of Respiratory Variation in Inferior Vena Cava Diameter to Predict Fluid Responsiveness in Children Under Mechanical Ventilation
In conclusion, ∆IVC was found to have a moderate accuracy in predicting fluid responsiveness in mechanically ventilated children and is an inferior predictor when compared to ∆Vpeak. (Source: Mammalian Genome)
Source: Mammalian Genome - February 9, 2023 Category: Genetics & Stem Cells Source Type: research
Development of a Pediatric Cardiology Cardiopulmonary Exercise Testing Database
AbstractCardiopulmonary exercise testing (CPET) provides clinicians with information vital to the management of pediatric cardiology patients. CPET can also be used to measure cardiorespiratory fitness (CRF) in these patients. CRF is a robust marker of overall health in children. However, a complete understanding of CRF in pediatric cardiology patients is limited by lack of large, standardized CPET databases. Our purpose was to develop a standardized CPET database, describe available data at our institution, and discuss challenges and opportunities associated with this project. CPETs performed from 1993 to present in an ur...
Source: Mammalian Genome - February 9, 2023 Category: Genetics & Stem Cells Source Type: research
Prediction Model with External Validation for Early Detection of Postoperative Pediatric Chylothorax
AbstractEarlier diagnosis of chylothorax following pediatric cardiac surgery is associated with decreased duration of chylothorax. Pleural fluid testing is used to diagnosis chylothorax which may delay detection in patients who are not enterally fed at time of chylothorax onset. Our aim was to develop and externally validate a prediction model to detect chylothorax earlier than pleural fluid testing in pediatric patients following cardiac surgery. A multivariable logistic regression model was developed to detect chylothorax using a stepwise approach. The model was developed using data from patients < 18 years fol...
Source: Mammalian Genome - February 8, 2023 Category: Genetics & Stem Cells Source Type: research
Hemodynamic and Clinical Response to Liver Transplantation in Children and Young Adults POPH Patients
This study retrospectively evaluated echocardiography and catheterization data before and after liver transplantation in 12 patients who underwent liver transplantation from 2001 to 2019. The 12 patients included one male and 11 females, of median age at liver transplantation of 10 years, 2 months. Nine patients underwent liver transplantation for congenital biliary atresia and three for portal vein aplasia or hypoplasia. Mean pulmonary arterial pressure was 44.1 ± 8.1 mmHg at the first cardiac catheter examination, 35.3 ± 7.8 mmHg before liver transplantation, and 29.5 ± 9.3 mmHg 6 months after liver...
Source: Mammalian Genome - February 8, 2023 Category: Genetics & Stem Cells Source Type: research
Association Between Birth Weight Z-Scores and Early Outcomes Following Truncus Arteriosus Repair
AbstractIn infants undergoing truncus arteriosus (TA) repair, we sought to determine associations between fetal growth restrictions as measured by birth weight Z-score and early outcomes. We utilized the Pediatric Health Information System (PHIS) database to identify infants < 90 days old who underwent TA repair from 2004 to 2019. The primary exposure variable was birth weight Z-score, calculated based on gestational age at birth, gender, and birth weight. The primary outcome was postoperative hospital mortality. Secondary outcomes included major complications, prolon ged postoperative length of hospital stay (LO...
Source: Mammalian Genome - February 7, 2023 Category: Genetics & Stem Cells Source Type: research
Perioperative Nutritional Status and Organ Dysfunction Following Surgery for Congenital Heart Disease
AbstractChildren with congenital heart disease (CHD) are at risk of malnutrition; however, there is limited information regarding the impact of nutritional status on organ dysfunction and outcomes after surgery for CHD. The study aim was to assess the association between malnutrition, organ dysfunction, and outcomes after surgery for CHD. Retrospective cohort study of patients aged 30 days to 18 years admitted to the cardiac intensive care unit (CICU) following cardiac surgery. Nutritional status (malnutrition defined as weight for agez-score < − 2) and validated organ dysfunction scores (pSOFA and PELOD-2) ...
Source: Mammalian Genome - February 6, 2023 Category: Genetics & Stem Cells Source Type: research
The Utility of CT Angiography in Neonates with Pulmonary Atresia with Intact Ventricular Septum and Concern for Right Ventricular Dependent Coronary Circulation: Case Series
We describe six neonates with PA-IVS who underwent both CCT and cardiac catheterization at our institution prior to any surgical or transcatheter intervention between 2009 and 2019. Imaging was concerning for RVDCC in all six patients. The average tricuspidZ-score was − 4.19 (2.1 to − 5.34). Two patients underwent cardiac transplantation and two patients underwent ductal stenting. The overall mortality rate was 50%. CCT findings closely mirrored the findings of invasive cardiac catheterization and identified important morphological variations. The av erage radiation exposure (DLP) per CCT was (10.5 mGy cm, r...
Source: Mammalian Genome - February 2, 2023 Category: Genetics & Stem Cells Source Type: research
Safety of Continuing Anticoagulation Prior to Cardiac Catheterization in Pediatric Patients: A Los Angeles Center Experience
AbstractThis is the first report specifically describing outcomes of pediatric patients who underwent cardiac catheterization while on uninterrupted anticoagulation. One hundred forty-four cardiac catheterizations were identified that met inclusion criteria at our institution from 11/2014 to 10/2019. The median age and weight of the patients were 6.3 [0.01 –20.9] years and 19.3 [2.1–172.5] kg, respectively. Seventy-eight (54%) catheterizations involved inpatients. The most common cardiac diagnoses among the cohort were single ventricle (n = 41), conotruncal defects (n = 37), and structurally normal heart (n =...
Source: Mammalian Genome - February 2, 2023 Category: Genetics & Stem Cells Source Type: research
Gabapentin Can Improve Irritability and Feeding Tolerance in Single Ventricle Interstage Patients: A Case Series
We present a case series of five patients in which four of the five patients showed improvement within 48 h of starting gabapentin. The use of gabapentin in single ventricle interstage patients to treat visceral hyperalgesia shows promise based on our case series, but future multi-center prospective studies would be beneficial. (Source: Mammalian Genome)
Source: Mammalian Genome - February 1, 2023 Category: Genetics & Stem Cells Source Type: research
Exercise Stress Echocardiography in Kawasaki Disease Patients with Coronary Aneurysms
AbstractThe most significant sequelae of Kawasaki disease (KD) are coronary artery aneurysms, which can lead to risk of future myocardial ischemia. Exercise stress echocardiography allows for non-invasive assessment of myocardial dysfunction. We reviewed our single center experience with exercise stress echocardiography in patients with previous history of KD with coronary aneurysms. We reviewed the records of 53 KD patients who underwent exercise stress echocardiography from 2000 to 2020. Abnormal stress echocardiograms were defined as those showing no increase in biventricular systolic function post-exercise or regional ...
Source: Mammalian Genome - February 1, 2023 Category: Genetics & Stem Cells Source Type: research
Author Response to Letter to the Editor: “Referring Provider Opinions of Pediatric Cardiology Evaluations Performed by Nurse Practitioners”
(Source: Mammalian Genome)
Source: Mammalian Genome - February 1, 2023 Category: Genetics & Stem Cells Source Type: research
Incidence, Predictors, and Outcomes of Cardiac Perforation During Pediatric Cardiac Catheterization: a Retrospective Observational Study from the Congenital Cardiac Interventional Study Consortium (CCISC)
ConclusionsCardiac perforation during cardiac catheterization is a life-threatening complication with a range of associated secondary complications. Higher CRISP score, lower age, and radiofrequency perforation of pulmonary valve are independent predictors. (Source: Mammalian Genome)
Source: Mammalian Genome - January 27, 2023 Category: Genetics & Stem Cells Source Type: research
Biomarker sST2 in Adults with Transposition of the Great Arteries Palliated by Mustard Procedure: A Five-Year Follow-up
AbstractThe Mustard procedure was an early cardiac surgery for transposition of the great arteries (TGA). Despite being successful, it has been associated with long-term arrhythmias and heart failure. A key factor complicating management in adults with congenital heart disease (CHD) is the deficiency of biomarkers predicting outcome. Soluble suppression of tumorogenicity-2 (sST2) is secreted by cardiomyocytes in response to mechanical strain and fibrosis. We hypothesized that adults with a Mustard procedure would have higher levels of sST2 than healthy individuals, and this would correlate with clinical outcome. We perform...
Source: Mammalian Genome - January 27, 2023 Category: Genetics & Stem Cells Source Type: research
Transfemoral Perimembranous Ventricular Septal Defect Device Closure in Infants Weighing ≤ 10 kg
AbstractTranscatheter closure of Perimembranous VSDs (PMVSD) remains challenging particularly in infants. The aim of this study is to evaluate the efficacy and safety of transfemoral PMVSD device closure in infants weighing ≤ 10 kg in a single centre. Retrospective review of departmental databases and medical charts to define patient cohort and collect demographic, procedural and follow-up data. Between July 2014 and March 2021, 16 patients underwent attempted transfemoral PMVSD device closure (12 retrograde) a t a median age of 11 months (interquartile range [IQR] 9–15.5) and a median weight of 8.3 kg (IQR 7.2...
Source: Mammalian Genome - January 25, 2023 Category: Genetics & Stem Cells Source Type: research
