QT Prolongation After Minor Head Trauma in a Pediatric Patient
We report a case of QTc prolongation associated with mild concussion in a pediatric patient. An 11-year-old male presented to the emergency department after sustaining a head injury during football practice. He complained of headache and blurry vision. Physical examination was within normal apart from an irregular heart rhythm. Electrocardiogram (ECG) showed normal sinus rhythm with QTc (Bazett formula) 460  ms. The patient was diagnosed with concussion and referred for cardiology follow-up of the QTc. ECG the next day showed QTc 462 ms (heart rate 105 bpm) supine and 494 ms after suddenly standing up (...
Source: Pediatric Cardiology - October 10, 2019 Category: Cardiology Source Type: research

Reabsorbable Pins can Reinforce an Early Sternal Stability After Median Sternotomy in Young Children with Congenital Heart Disease
AbstractWe evaluated the efficacy of bioresorbable sternal reinforcement device (poly-l-lactide sternal pins) on sternal healing after median sternotomy in young children (with body weight less than 10  kg) with congenital heart disease (CHD). Data from 85 patients, who underwent CHD surgery through median sternotomy from October 2016 to May 2018, were collected and analyzed. Sternal pins were utilized in 85 patients (10 mm × 1 mm × 1 mm for patients with body weights less than 5 kg and 15  mm × 2 mm × 2 mm for those weighing between 5 and 10 kg) in addit...
Source: Pediatric Cardiology - September 23, 2019 Category: Cardiology Source Type: research

Echocardiographic Screening of Cardiovascular Status in Pediatric Sickle Cell Disease
In conclusion, mild RV pressure elevation and LV dilation in children with SCD is associated with abnormal laboratory markers of disease severity, but not with ventricular dysfunction over the 3-year study period. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - September 21, 2019 Category: Cardiology Source Type: research

The Limited Benefit of Follow-Up Echocardiograms After Repair of Tetralogy of Fallot
In conclusion, the likelihood and timing of AC echoc ardiograms and reinterventions vary based on the type of initial surgery. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - September 18, 2019 Category: Cardiology Source Type: research

Development of a Ductal Aneurysm in a Patient with Williams Syndrome, and Subsequent Interventional Closure
AbstractWhilst stenosis of systemic and pulmonary arteries in Williams syndrome is frequently described, aneurysm formation is uncommon. We provide the first description of a Williams patient with development of an aneurysm of the arterial duct. This aneurysm developed concomitantly with supravalvar aortic, and peripheral pulmonary stenosis. The duct was closed interventionally to reduce the risk of rupture. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - September 18, 2019 Category: Cardiology Source Type: research

Diagnosis and Management of Anomalous Left Anterior Descending Coronary Artery from the Pulmonary Artery in an Asymptomatic Infant
We report on a seemingly asymptomatic patient with ALADCAPA and a small restrictive muscular ventricular septal defect diagnosed by echocardiogram in the neonatal period. Our patient underwent elective repair at 3.5  months of age after which feeding and growth improved dramatically. Multimodality imaging is helpful to confirm this rare anomaly; however, echocardiographic clues including lack of left coronary branching or an abnormal coronary course should raise suspicion for ALADCAPA. This case provides suppo rt for early repair in children with an incidental finding of this anomaly as subclinical ischemia may be und...
Source: Pediatric Cardiology - September 14, 2019 Category: Cardiology Source Type: research

Progression of Aortic Regurgitation After Subarterial Ventricular Septal Defect Repair: Optimal Timing of the Operation
AbstractIn patients with subarterial ventricular septal defect (VSD), the progression of aortic regurgitation (AR) still remains unclear. This review is to identify the incidence of AR progression after VSD repair and to determine the optimal operation timing for subarterial VSD repair with or without aortic valve prolapse or AR. From January 2002 to December 2015, 103 patients who underwent subarterial VSD repair alone at our hospital were reviewed. All patients routinely underwent echocardiography (echo) performed by our pediatric cardiologists. The operative approach was through the pulmonary artery in all patients. The...
Source: Pediatric Cardiology - September 13, 2019 Category: Cardiology Source Type: research

Long-Term Evaluation of Post-transplant Lymphoproliferative Disorders in Paediatric Heart Transplantation in Sao Paulo, Brazil
AbstractWe sought to better define the demographics and characteristics of post-transplant lymphoproliferative disorders (PTLD) in a cohort of paediatric OHT patients from a developing country. Data were collected from the Heart Institute, Sao Paulo, for all paediatric OHT recipients from October 1992 to October 2018. Group differences between the PTLD and non-PTLD cohorts were assessed by Fisher exact and Mann –WhitneyU tests. Kaplan –Meier curves analysed the survival in each group. Data were reviewed for 202 paediatric OHT recipients. Overall 1-, 5- and 10-year survival for the entire cohort was 76.5%, 68.3%...
Source: Pediatric Cardiology - September 10, 2019 Category: Cardiology Source Type: research

Effect of Trisomy 21 on Postoperative Length of Stay and Non-cardiac Surgery After Complete Repair of Tetralogy of Fallot
AbstractTrisomy 21 (T21) is the most common chromosomal abnormality, and is frequently associated with congenital heart disease. Results of previous studies evaluating the effect of T21 on postoperative outcomes and complications following heart surgery have been mixed. Our goal was to determine if T21 is associated with higher frequency of adverse postoperative outcomes following repair of tetralogy of Fallot (TOF). A query of the Pediatric Health Information System was performed for patients who underwent complete repair of TOF from 2004 to 2015. Patients with a genetic syndrome other than T21 and tracheostomy and/or gas...
Source: Pediatric Cardiology - September 7, 2019 Category: Cardiology Source Type: research

What is the Significance of Elevated Troponin I in Children and Adolescents? A Diagnostic Approach
AbstractTroponin is a marker that displays cardiac injury quickly and accurately. In adults, troponin elevation is usually associated with coronary artery disease and requires urgent cardiac catheterization. In healthy children, myocardial injury is rare and may develop due to many different causes. Therefore, troponin elevation in children and adolescents does not usually require emergency cardiac catheterization. The aim of this study is to assess the most common causes of troponin elevation in children and adolescents and to show which diagnostic tests are helpful in assessing pediatric patients with elevated troponin. ...
Source: Pediatric Cardiology - September 4, 2019 Category: Cardiology Source Type: research

Acute Change in Ventricular Contractility-Load Coupling After Corrective Surgery for Congenital Heart Defect: A Retrospective Cohort Study
AbstractVentricular performance and its loading condition change drastically after surgical correction of congenital heart defect. Pressure –volume loops analysis can provide quantitative information about ventriculo-arterial coupling (VAC) indicating the interaction between ventricular contractility and loading condition. Therefore, we investigated changes in VAC after corrective surgery for ventricular septal defect (VSD)/tetralogy of Fallot (TOF), and implication of ventriculo-arterial decoupling as a prognostic factor of post-operative outcomes. In children with VSD/TOF, pre- and post-operative arterial elastance...
Source: Pediatric Cardiology - September 3, 2019 Category: Cardiology Source Type: research

Outcome for Conservative Surgery for the Correction of Severe Mitral Valve Regurgitation in Children: A Single-Center Experience
We present our experience in a cohort of patients undergoing surgical correction for severe mitral regurgitation. Fifty-five patients (age 1  month–18 years; median 5 years) were included in the present analysis. Different surgical techniques were used (posterior leaflet augmentation in 25, isolated cleft closure in 12, Alfieri-type procedure in 10, annuloplasty in 5, with artificial chordae in 2, and quadrangular resection with cho rdal transposition in 1). Follow-up time ranged from 1 to 192 months (median 38[IQR 12–54] months). Operative and follow-up mortality was 0%. Reintervention in t...
Source: Pediatric Cardiology - September 3, 2019 Category: Cardiology Source Type: research

Ascending Aortic Aneurysm After Repair of Aortico –Left Ventricular Tunnel
AbstractAscending aortic aneurysm following aortico –left ventricular tunnel (ALVT) repair is an uncommon but life-threatening complication. A 27-year-old man had received patch closure for ALVT at infancy. Eighteen years later, aortic valve replacement for severe aortic regurgitation and direct suture for recurrent slit tunnel were performed. Anot her 9 years later, ascending aortic replacement was performed because of ascending aortic aneurysm. Thus we report an uncommon case of ascending aortic aneurysm 27 years after the repair of an ALVT. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - September 3, 2019 Category: Cardiology Source Type: research

Relation Between Exercise Capacity and Extracardiac Conduit Size in Patients with Fontan Circulation
AbstractBecause Fontan circulation does not have a subpulmonary ventricle, the preload is limited. In Fontan circulation with extracardiac conduit, the size of conduit could be an important factor in determining the preload. We compared exercise capacity with each conduit size and tried to search for optimal conduit size in Fontan circulation. We reviewed the medical record of 677 patients with Fontan circulation. Patients who had other type Fontan circulation (Kawashima, atriopulmonary, lateral tunnel), SpO2 
Source: Pediatric Cardiology - August 31, 2019 Category: Cardiology Source Type: research

Umbilical Cord Blood Gas in Newborns with Prenatal Diagnosis of Congenital Heart Disease: Insight into In-Utero and Delivery Hemodynamics
AbstractThe primary objective was to determine if newborns with congenital heart disease (CHD) are at a higher risk for acidosis at delivery as determined by cord blood gas analysis. The secondary objective was to determine whether specific fetal cardiac diagnosis, delivery method, or duration of labor is associated with an increased risk for acidosis. This was a retrospective study of newborns with CHD diagnosed prenatally and comparable patients without a CHD diagnosis. Study participants included 134 CHD-affected newborns and 134 controls. Median UA pH in CHD newborns was 7.22 (CI 7.2 –7.4) and in controls it was ...
Source: Pediatric Cardiology - August 30, 2019 Category: Cardiology Source Type: research

Prophylactic Opening of the Pleural Cavity for Postoperative Drainage is a Risk Factor for Prolonged Pleural Effusion After a Fontan Operation
AbstractPostoperative prolonged pleural effusion (PPE) remains a confounding problem after a Fontan operation. We aimed to describe the risk factors for PPE after a Fontan operation and to clarify the impact of prophylactic opening of the pleural cavity (POPC) for drainage tube insertion on PPE. We retrospectively reviewed the medical charts of 50 consecutive patients who underwent a Fontan operation at our institution. POPC for postoperative drainage was performed based on each surgeon ’s preference. Patients were divided into three groups for analysis: group A (n = 12), no opening; group B (n =...
Source: Pediatric Cardiology - August 29, 2019 Category: Cardiology Source Type: research

Minimum Travel Distance Among Publicly Insured Infants with Severe Congenital Heart Disease: Potential Impact of In-state Restrictions
AbstractTravel distance to surgical centers may be increased when coverage restrictions prevent children with congenital heart disease (CHD) from receiving care at out-of-state congenital heart surgery centers. We estimated the minimum travel distance to congenital heart surgery centers among publicly insured infants with time-sensitive CHD surgical needs, under two different scenarios: if they were and were not restricted to in-state centers. Using 2012 Medicaid Analytic eXtract data from 40 states, we identified 4598 infants with CHD that require surgery in the first year of life. We calculated the minimum travel distanc...
Source: Pediatric Cardiology - August 28, 2019 Category: Cardiology Source Type: research

Impact of Ethnicity on the Prevalence of Early Repolarization Pattern in Children: Comparison Between Caucasian and African Populations
AbstractThe patterns and prevalence of early repolarization pattern (ER) in pediatric populations from ethnic backgrounds other than Caucasian have not been determined. Black African children (ages 4 –12) from north-west Madagascar were prospectively recruited and their ECGs compared with those of age- and sex-matched Caucasian ethnicity individuals. ER was defined by ≥ 0.1 mV J-point elevation in at least two contiguous inferior and/or lateral ECG leads. A total of 616 children were incl uded. There was a trend toward a higher frequency of ER in the Africans compared to the Caucasians (23.3% vs. 17.1%...
Source: Pediatric Cardiology - August 24, 2019 Category: Cardiology Source Type: research

Postoperative Inhaled Nitric Oxide Does Not Decrease Length of Stay in Pediatric Cardiac Surgery Admissions
AbstractPulmonary hypertension is one of the most challenging complications in congenital heart surgery. The purpose of this study was to characterize inhaled nitric oxide administration in children with and without pulmonary hypertension who underwent congenital heart surgery and to describe the effect of nitric oxide administration on admission outcomes. This is a cross-sectional study utilizing data from the Pediatric Health Information System (PHIS) and PHIS  + databases from 2004 to 2015. Pediatric patients with a congenital heart disease diagnosis were included and divided into groups with pulmonary hyp...
Source: Pediatric Cardiology - August 24, 2019 Category: Cardiology Source Type: research

Herniated Liver Mimicking Right Atrial Mass
AbstractIn a newborn that underwent surgery due to omphalocele, postoperative echocardiography revealed an accidental finding of a right atrial (RA) mass. Echocardiography prior to surgery was inconspicuous. Applying color Doppler, a pulsatile flow exiting the mass could be depicted and a tubular structure lancing through the mass. Thrombus formation was suspected. However, sonographic tissue texture of this formation equaled liver tissue. Abdominal ultrasound revealed protrusion of hepatic tissue through a diaphragmatic hernia indenting the RA mimicking a thrombus. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - August 22, 2019 Category: Cardiology Source Type: research

Long QT Syndrome: Genetics and Future Perspective
AbstractLong QT syndrome (LQTS) is an inherited primary arrhythmia syndrome that may present with malignant arrhythmia and, rarely, risk of sudden death. The clinical symptoms include palpitations, syncope, and anoxic seizures secondary to ventricular arrhythmia, classicallytorsade de pointes. This predisposition to malignant arrhythmia is from a cardiac ion channelopathy that results in delayed repolarization of the cardiomyocyte action potential. The QT interval on the surface electrocardiogram is a summation of the individual cellular ventricular action potential durations, and hence is a surrogate marker of the abnorma...
Source: Pediatric Cardiology - August 22, 2019 Category: Cardiology Source Type: research

Risk Factors for Prolonged Pleural Effusion After Extracardiac Fontan Operation
In conclusion, patients with HLHS and higher central venous press ure at BCPS were more likely to have a prolonged pleural effusion after Fontan operation, but fenestration was more likely to decrease prolonged effusion. We should consider closer management of fluid status before, during, and after surgery in patients with these risk factors after Fontan operation . (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - August 21, 2019 Category: Cardiology Source Type: research

Propofol Formulation Affects Myocardial Function in Newborn Infants
This study aimed to evaluate the effects of propofol in diluted and undiluted formulations on cardiac function in infants. Infants>  30 days received propofol sedation for central line insertion. Cases were divided into two groups: those who received undiluted 1% propofol (P1%); and those who received a diluted formulation (Pd) of equal volumes propofol 1% and 0.9% NaCl. Echocardiograms were performed pre (t0)-, immediately post (t1)-, and 1-h post (t2) propofol administration. Myocardial deformation was assessed with tissue Doppler imaging (TDI) analysis and peak longitudinal strain (LS). 18 cases were incl...
Source: Pediatric Cardiology - August 14, 2019 Category: Cardiology Source Type: research

Correlation of Echocardiogram and Exercise Test Data in Children with Aortic Stenosis
We report 65 studies, 51 patients (mean age of 13  ± 4 years; 75% males), with aortic stenosis (AS) who had a maximal exercise test between 2005 and 2016. We defined three groups based on resting mean Doppler gradient across their aortic valve: severe AS (n = 10; gradient of ≥ 40 mmHg), moderate AS (n = 20; gradient 25–39 mmHg), and mild AS (n = 35; gradient ≤ 24 mmHg). We studied symptoms (chest pain) during exercise, resting electrocardiogram changes (left ventricular hypertrophy [LVH]), complex arrh...
Source: Pediatric Cardiology - August 7, 2019 Category: Cardiology Source Type: research

Use of Near-Infrared Spectroscopy to Monitor Lower Extremity Perfusion in Pediatric Patients Undergoing Cardiac Catheterization
AbstractAcute femoral artery occlusion is common in pediatric patients following cardiac catheterization. A variety of means are utilized to assess lower extremity (LE) perfusion and arterial patency following cardiac catheterization including palpation of pulses, pulse oximetry, subjective assessment of lower extremity color and temperature, and ultrasound. We sought to evaluate the utility of Near-Infrared Spectroscopy (NIRS) to monitor LE perfusion in pediatric patients undergoing cardiac catheterization. INVOS pediatric sensors were placed on bilateral LE in all pediatric patients  ≤ 40 kg undergo...
Source: Pediatric Cardiology - August 2, 2019 Category: Cardiology Source Type: research

Tbx3-Mediated Regulation of Cardiac Conduction System Development and Function: Potential Contributions of Alternative RNA Processing
AbstractIn this article, we provide a brief summary of work by us and others to discover the molecular underpinnings of early conduction system development and function. We focus on how the multifunctional protein Tbx3 contributes to acquisition and homeostasis of the tissue-specific properties of the sinoatrial and atrioventricular nodes. We also provide unpublished, preliminary findings supporting the role of Tbx3-regulated alternative RNA processing in the developing conduction system. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - August 1, 2019 Category: Cardiology Source Type: research

Decrease in Cerebral Oxygen Saturation During the 6-Minute Walk Test in Pediatric Pulmonary Arterial Hypertension
AbstractThis observational study aimed to investigate the relationship between regional cerebral oxygen saturation (rSO2) during the 6-minute walk test (6-MWT) and the demographic/clinical features of patients with pulmonary arterial hypertension (PAH). Cerebral oxygenation was evaluated during the 6-MWT in 20 pediatric patients with PAH aged  ≥ 7 years [13 male, 7 female; median age 12.25 (range 7–18) years]. In all patients, regional cerebral oxygen saturation    (rSO2), arterial oxygen saturation (SpO2), and heart rate (HR) were measured using near-infrared spectroscopy (NIRS) for 2...
Source: Pediatric Cardiology - July 31, 2019 Category: Cardiology Source Type: research

Chemotherapy-Induced Cardiotoxicity in Adolescent After Heart Transplant: Do Not Forget the Right Ventricle
We present the case of a 19-year-old heart transplant recipient who developed severe right ventricular dysfunction secondary to treatment of an abdominal lymphoma. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - July 31, 2019 Category: Cardiology Source Type: research

Upcoming Events in Pediatric Cardiology
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - July 29, 2019 Category: Cardiology Source Type: research

Covered Stent as a Bridge to Surgery for Obstructive Melody Pulmonary Valve Endocarditis
We report a patient with acute heart failure caused by obstructive pulmonary vegetation in a Melody valve. Because of severe right ventricular dysfunction, immediate cardiac surgery was contraindicated. The patient underwent trans-catheter implantation of a covered stent to relieve obstruction. Following an initially good outcome, surgery was performed 2  weeks later. This was complicated by left main coronary artery tear and fatal bleeding. Despite covered stent was an effective bridge, surgery remains extremely challenging in such cases with important surrounding inflammation and fibrosis as well as potential proxim...
Source: Pediatric Cardiology - July 27, 2019 Category: Cardiology Source Type: research

Postnatal Cardiac Development and Regenerative Potential in Large Mammals
AbstractThe neonatal capacity for cardiac regeneration in mice is well studied and has been used to develop many potential strategies for adult cardiac regenerative repair following injury. However, translating these findings from rodents to designing regenerative therapeutics for adult human heart disease remains elusive. Large mammals including pigs, dogs, and sheep are widely used as animal models of humans in preclinical trials of new cardiac drugs and devices. However, very little is known about the fundamental cardiac cell biology and the timing of postnatal cardiac events that influence cardiomyocyte proliferation i...
Source: Pediatric Cardiology - July 25, 2019 Category: Cardiology Source Type: research

Transcriptional and Epigenetic Regulation of Cardiac Electrophysiology
AbstractSpatiotemporal gene expression during cardiac development is a highly regulated process. Activation of key signaling pathways involved in electrophysiological programming, such as Notch and Wnt signaling, occurs in early cardiovascular development and these pathways are reactivated during pathologic remodeling. Direct targets of these signaling pathways have also been associated with inherited arrhythmias such as Brugada syndrome and arrhythmogenic cardiomyopathy. In addition, evidence is emerging from animal models that reactivation of Notch and Wnt signaling during cardiac pathology may predispose to acquired arr...
Source: Pediatric Cardiology - July 25, 2019 Category: Cardiology Source Type: research

Border Medicine: The Pediatric Cardiology Perspective
AbstractPediatric cardiology and cardiovascular surgery have witnessed significant advancements over the last two decades. In spite of this progress, congenital heart disease (CHD) still remains as one of the major causes of death in infants and young children in the United States. Many patient-related and patient-independent factors influence the outcomes in patients with CHD, one of which is the geographical location. In the US –Mexico border, management and outcomes of patients with CHD are further complicated by additional problems stemming from complex interplay between two different health systems, and socioeco...
Source: Pediatric Cardiology - July 25, 2019 Category: Cardiology Source Type: research

Postnatal Outcome Following Prenatal Diagnosis of Discordant Atrioventricular and Ventriculoarterial Connections
In conclusion, the short- and medium-term outlook for fetuses with isolated DAVVAC, and those with DAVVAC and pulmonary stenosis are good. Antenatal risk factors for postnatal mortality include Ebstein’s anomaly of the tricuspid valve, especially if associated with t ricuspid regurgitation, and the presence of complex associated lesions. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - July 25, 2019 Category: Cardiology Source Type: research

Differential Myocardial Mechanics in Volume and Pressure Loaded Right Ventricles Demonstrated by Cardiac Magnetic Resonance
AbstractIn patients with D-looped transposition of the great arteries (D-TGA) status post atrial switch operation, the systemic right ventricle (RV) shifts to predominantly circumferential (CS) rather than longitudinal strain (LS), which may represent adaptation or dysfunction. We aimed to evaluate myocardial mechanics in pressure loaded, volume-loaded, and normal RVs by cardiac magnetic resonance (CMR). Patients with D-TGA post atrial switch operation with CMR from 2008 to 2015 were matched 1:1 for age and RV ejection fraction (EF) with repaired tetralogy of Fallot (TOF) patients (volume-loaded RVs), and 1:1 for age with ...
Source: Pediatric Cardiology - July 25, 2019 Category: Cardiology Source Type: research

Aspiration After Congenital Heart Surgery
AbstractDysphagia and vocal cord dysfunction are frequent complications after congenital heart surgery. Both are risk factors for aspiration, which can lead to pneumonia, progressive lung disease, and respiratory arrest. A protocol was implemented to promote early detection of aspiration in a high-risk cohort of patients. Retrospective data were collected on all patients under 120 days old who underwent the Norwood procedure, aortic arch repair, Blalock –Taussig shunt placement, or cervical cannulation for extracorporeal membrane oxygenation from 10/2012 to 05/2016 at a single institution. Patients underwent an asses...
Source: Pediatric Cardiology - July 24, 2019 Category: Cardiology Source Type: research

Phases and Mechanisms of Embryonic Cardiomyocyte Proliferation and Ventricular Wall Morphogenesis
AbstractIf viewed as a movie, heart morphogenesis appears to unfold in a continuous and seamless manner. At the mechanistic level, however, a series of discreet and separable processes sequentially underlie heart development. This is evident in examining the expansion of the ventricular wall, which accounts for most of the contractile force of each heartbeat. Ventricular wall expansion is driven by cardiomyocyte proliferation coupled with a morphogenetic program that causes wall thickening rather than lengthening. Although most studies of these processes have focused on heart-intrinsic processes, it is increasingly clear t...
Source: Pediatric Cardiology - July 24, 2019 Category: Cardiology Source Type: research

Comprehensive MR Analysis of Cardiac Function, Aortic Hemodynamics and Left Ventricular Strain in Pediatric Cohort with Isolated Bicuspid Aortic Valve
AbstractBicuspid aortic valve (BAV) disease demonstrates a range of clinical presentations and complications. We aim to use cardiac MRI (CMR) to evaluate left ventricular (LV) parameters, myocardial strain and aortic hemodynamics in pediatric BAV patients with and without aortic stenosis (AS) or regurgitation (AR) compared to tricuspid aortic valve (TAV) controls. We identified 58 pediatric BAV patients without additional cardiovascular pathology and 25 healthy TAV controls (15.3  ± 2.2 years) who underwent CMR with 4D flow. BAV cohort included subgroups with no valvulopathy (n = 13,...
Source: Pediatric Cardiology - July 24, 2019 Category: Cardiology Source Type: research

Lifestyles and Cardiovascular Prevention in Childhood and Adolescence
AbstractPathology studies demonstrated that coronary fatty streaks develop early in life and that even more advanced fibrous plaques are present in a proportion of adolescents. The presence and extent of atherosclerosis in children and adolescents can be correlated with the same risk factors present in adults; as well as, childhood levels of these risk factors predict adult cardiovascular diseases. Children are born with ideal cardiovascular health but, unfortunately, most of them develop over time modifiable behavioral risk factors. Achieving sustained lifestyle changes initiated too late in adults is difficult, and pharm...
Source: Pediatric Cardiology - July 24, 2019 Category: Cardiology Source Type: research

Through Tricuspid Closure for Doubly Committed Subarterial Ventricular Septal Defect with Right Vertical Subaxillary Mini-incision: A Matched-Pair Analysis
AbstractTo evaluate the feasibility and efficacy of the right subaxillary vertical mini-incision (RAVI) used for the closure of doubly committed subarterial ventricular septal defect (SAVSD) through tricuspid approach only. From June 2015 to September 2016, 32 SAVSD patients (mean age 2.4  ± 1.9 years, range 0.7–8 years) underwent surgical repair with either RAVI (incision length 3-4 cm) through tricuspid (group A, n = 16) or conventional median sternotomy incision through the main pulmonary artery approach (group B, n = 16). A retrospective 1:1 matched-...
Source: Pediatric Cardiology - July 23, 2019 Category: Cardiology Source Type: research

Partially Penetrant Cardiac Neural Crest Defects in Hand1 Phosphomutant Mice: Dimer Choice That Is Not So Critical
AbstractHand1 is a basic Helix –loop–Helix transcription factor that exhibits post-translationally regulated dimer partner choice that allows for a diverse set of Hand1 transcriptional complexes. Indeed, when Hand1 phosphoregulation is altered, conditionally activated hypophorylation (Hand1PO4−) and phosphorylation mimic (Hand1PO4+)Hand1 alleles disrupt both craniofacial and limb morphogenesis with 100% penetrance. Interestingly, activation of conditional Hand1 Phosphomutant alleles within post-migratory neural crest cells produce heart defects that include ventricular septal defects, double-outlet right ...
Source: Pediatric Cardiology - July 23, 2019 Category: Cardiology Source Type: research

Fetal Echocardiographic Parameters and Surgical Outcomes in Congenital Left-Sided Cardiac Lesions
This study aimed to evaluate fetal echocardiographic parameters associated with neonatal intervention and single-ventricle palliation (SVP) in fetuses with suspected left-sided cardiac lesions. Initial fetal echocardiograms (1/2002 –1/2017) were interpreted by the contemporary fetal cardiologist as coarctation of the aorta (COA), left heart hypoplasia (LHH), hypoplastic left heart syndrome (HLHS), mitral valve hypoplasia (MVH) ± stenosis, and aortic valve hypoplasia ± stenosis (AS). The cohort comprised 68 fetuses with suspected left-sided cardiac lesions (COAn =&thins...
Source: Pediatric Cardiology - July 23, 2019 Category: Cardiology Source Type: research

Insights into Arch Vessel Development in the Bovine Aortic Arch
This study aims to explain the higher coarctation rates, assess the branching of the arch vessels, understand their embryologic origins, and delineate the patterns of displacement of the arch vessels in bovine versus normal anatomy. This retrospective study reviewed the medical records of 178 infants (  
Source: Pediatric Cardiology - July 22, 2019 Category: Cardiology Source Type: research

Assessment of the Fetal Myocardial Performance Index in Well-Controlled Gestational Diabetics and to Determine Whether It Is Predictive of Adverse Perinatal Outcome
This study was aimed at determining if the myocardial performance index (MPI) is altered in well-controlled gestational diabetics and if so whether it is predictive of adverse perinatal outcome. In a prospective cross-sectional study, 54 consecutive women with well-controlled gestational diabetes controlled on insulin or metformin in the third trimester were recruited and matched with 54 women with normal pregnancies (control group). Using Doppler echocardiography, the MPI was calculated. Sonographic biophysical and placental resistance Doppler markers in both groups were also determined. An abnormal outcome was defined as...
Source: Pediatric Cardiology - July 19, 2019 Category: Cardiology Source Type: research

Ivabradine in Post-operative Junctional Ectopic Tachycardia (JET): Breaking New Ground
We report our initial experience with the use of Ivabradine in post-operative JET. A retrospective case records review of children with post-operative JET during the period from June 2018 to May 2019 was performed. Eight patients with post-operative JET were treated with Ivabradine during this period. The first patient was initially treated with Amiodarone. All eight patients responded to Ivabradine. The initial response was rate control permitting overdrive pacing. One patient had recurrence of JET 10  h after Ivabradine and after return to sinus rhythm. Amiodarone was administered along with the second dose of Ivabr...
Source: Pediatric Cardiology - July 18, 2019 Category: Cardiology Source Type: research

Superior Vena Cava Inflow Following Repair for Anomalous Right Pulmonary Venous Drainage in Children
AbstractRisk of superior vena cava (SVC) obstruction following repair of anomalous right upper pulmonary veins in children is unclear. The incidence and outcome of subclinical obstruction remained unknown. Retrospective single institutional study (07/1993 –02/2017) in a pediatric population (N = 42, median age 3.9-year, range 0.1–15.3 years). 33 (79%) children had repair without SVC translocation (“non-Warden”) and 9 (21%) had Warden-type surgery. Echocardiographic SVC obstruction was defined as (I) turbulent flow across SVC and (II) continuous flow pattern without return to b ase...
Source: Pediatric Cardiology - July 12, 2019 Category: Cardiology Source Type: research

Impact of Obesity on Left Ventricular Thickness in Children with Hypertrophic Cardiomyopathy
AbstractObesity is associated with additional left ventricular hypertrophy (LVH) in adults with hypertrophic cardiomyopathy (HCM). It is not known whether obesity can lead to further LVH in children with HCM. Echocardiographic LV dimensions were determined in 504 children with HCM. Measurements of interventricular septal thickness (IVST) and posterior wall thickness (PWT), and patients ’ weight and height were recorded. Obesity was defined as a body mass index (BMI) ≥ 99th percentile for age and sex. IVST data was available for 498 and PWT data for 484 patients. Patient age ranged from 2 to 20 y...
Source: Pediatric Cardiology - July 1, 2019 Category: Cardiology Source Type: research

Impact of Left Atrial Decompression on Patient Outcomes During Pediatric Venoarterial Extracorporeal Membrane Oxygenation: A Case –Control Study
The objectives of this study were to compare clinical outcomes between patients who did and did not undergo left atrial (LA) decompression, quantify decompression efficacy, and identify risk factors for development of left heart distension. This was a single-center retrospective case –control study. Pediatric VA ECMO patients who underwent LA decompression from June 2004 to March 2016 were identified, and a control cohort of VA ECMO patients who did not undergo LA decompression were matched based on diagnosis, extracorporeal cardiopulmonary resuscitation, and age. Among 194 VA ECMO cases, 21 (11%) underwent LA decomp...
Source: Pediatric Cardiology - June 27, 2019 Category: Cardiology Source Type: research

Electrocardiogram in Newborns: Beneficial or Not?
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 27, 2019 Category: Cardiology Source Type: research

Utility of 3D Printed Cardiac Models for Medical Student Education in Congenital Heart Disease: Across a Spectrum of Disease Severity
AbstractThe most common modes of medical education for congenital heart disease (CHD) rely heavily on 2-dimensional imaging. Three-dimensional (3D) printing technology allows for the creation of physical cardiac models that can be used for teaching trainees. 3D printed cardiac models were created for the following lesions: pulmonic stenosis, atrial septal defect, tetralogy of Fallot, d-transposition of the great arteries, coarctation of the aorta, and hypoplastic left heart syndrome. Medical students participated in a workshop consisting of different teaching stations. At the 3D printed station, students completed a pre- a...
Source: Pediatric Cardiology - June 25, 2019 Category: Cardiology Source Type: research