Associated Factors of Liver Disease After Fontan Operation in Relation to Ultrasound Liver Elastography
AbstractAlthough the Fontan operation can improve outcomes, surviving patients still face Fontan-associated liver disease (FALD). The aim of this study was to determine the associated factors of FALD in relation to ultrasound liver elastography. A cross-sectional study was conducted for all patients on whom an ultrasound upper-abdomen and ultrasound liver elastography was performed at more than 1  year after the Fontan operation. The data consisted of the age at operation, type of Fontan operation, and laboratory data such as gamma-glutamyl transferase (GGT), aspartate aminotransferase-to-platelet ratio index (APRI), ...
Source: Pediatric Cardiology - August 1, 2020 Category: Cardiology Source Type: research

Prophylactic Peritoneal Drainage is Associated with Improved Fluid Output after Congenital Heart Surgery
AbstractInfants undergoing congenital heart surgery (CHS) with cardiopulmonary bypass (CPB) are at risk of acute kidney injury (AKI) and fluid overload. We hypothesized that placement of a passive peritoneal drain (PPD) can improve postoperative fluid output in such infants. We analyzed 115 consecutive patients, age birth to 60  days, admitted to the PICU after CHS with CPB between 2012 and 2018. Patients who needed postoperative ECMO were excluded. Linear and logistic regression models compared postoperative fluid balances, diuretics administration, AKI, vasoactive-inotropic scores (VIS), time intubated, and length o...
Source: Pediatric Cardiology - July 30, 2020 Category: Cardiology Source Type: research

Pulmonary Vasodilator Therapy in Children with Single Ventricle Physiology: Effects on Saturation and Pulmonary Arterial Pressure
AbstractIn children with single ventricle physiology, increased pulmonary vascular resistance may impede surgical progression or result in failing single ventricle physiology. The use of pulmonary vasodilators has been suggested as a potential therapy. However, knowledge on indication, dosage, and effect is limited. A retrospective case notes review of all (n = 36) children with single ventricle physiology, treated with pulmonary vasodilators by the UK Pulmonary Hypertension Service for Children 2004–2017. Therapy was initiated in Stage 1 (n = 12), Glenn (n = 8), or TCPC (n&t...
Source: Pediatric Cardiology - July 30, 2020 Category: Cardiology Source Type: research

Chiari Network Associated with Hypoxemia in a Neonate: Case Report and Review of the Literature
We present the case of a neonate with hypoxemia and a Chiari network protruding into the right ventricular inflow tract associated with right-to-left shunting across the patent foramen ovale throughout the cardiac cycle. We noted spontaneous improvement after 3  weeks of life. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - July 29, 2020 Category: Cardiology Source Type: research

Echocardiographic Identification of Pulmonary Artery Flow Reversal: An Indicator of Adverse Outcomes in Single Ventricle Physiology
AbstractIndividuals with single ventricle congenital heart disease (CHD) undergo multiple staged surgical palliations. Staged single ventricle palliation with a superior cavopulmonary connection (SCPC) in infancy followed by a Fontan in early childhood relies on passive, unobstructed pulmonary blood flow and normal pulmonary vasculature. We hypothesized that patients with echocardiographic identification of retrograde flow in a branch pulmonary artery (PA) after SCPC or Fontan are at increased risk for adverse outcomes. We conducted a retrospective chart review of patients seen at Children ’s Wisconsin from 1999 to 2...
Source: Pediatric Cardiology - July 24, 2020 Category: Cardiology Source Type: research

Implementation of a Pediatric Chest Pain Local Consensus Guideline Decreases the Total Tests Performed Without Negatively Affecting the Yield of Abnormal Cardiac Results
AbstractPediatric chest pain is common and though usually benign often leads to unnecessary diagnostic testing. There is limited evidence as to whether a local consensus guideline can decrease testing frequency without negatively affecting the overall yield. In addition, it is unknown whether the addition of pulmonary function testing to a cardiopulmonary exercise test increases the diagnostic yield in pediatric patients with chest pain. A retrospective chart review was performed on all new pediatric patients who presented with chest pain at our academic center ’s pediatric cardiology clinic 18 months before and afte...
Source: Pediatric Cardiology - July 24, 2020 Category: Cardiology Source Type: research

Association of Preoperative Mixed Venous Oxygen Saturation with Postoperative Segmental Pulmonary Hypertension in Pulmonary Atresia with Ventricular Septal Defect and Major Aortopulmonary Collaterals
This study aimed to identify preoperative hemodynamic factors associated with segmental pulmonary hypertension after intracardiac repair in patients with PA/VSD/MAPCAs. This study included 12 patients with PA/VSD/MAPCAs who underwent unifocalization and intracardiac repair from 2009 at our institution. Hemodynamic measurements of preoperative and postoperative cardiac catheterization were collected. Patients were considered to have pulmonary hypertension if the mean pulmonary pressure measured postoperatively at any peripheral pulmonary artery was  ≥ 20 mmHg. The data were compared between patients wi...
Source: Pediatric Cardiology - July 24, 2020 Category: Cardiology Source Type: research

Speckle Tracking Echocardiography in Pediatric Patients with Premature Ventricular Contractions
AbstractPremature ventricular contractions (PVCs) in pediatric patients without structural heart disease and normal left ventricular systolic function rarely require therapy, though it is unknown whether these patients have subclinical cardiac dysfunction. Speckle tracking echocardiography is an additional means of evaluating cardiac function in asymptomatic pediatric PVC patients with normal standard measures of left ventricular (LV) function. Asymptomatic pediatric patients (
Source: Pediatric Cardiology - July 18, 2020 Category: Cardiology Source Type: research

Telehealth for Pediatric Cardiology Practitioners in the Time of COVID-19
AbstractDue to the COVID-19 pandemic, there has been an increased interest in telehealth as a means of providing care for children by a pediatric cardiologist. In this article, we provide an overview of telehealth utilization as an extension of current pediatric cardiology practices and provide some insight into the rapid shift made to quickly implement these telehealth services into our everyday practices due to COVID-19 personal distancing requirements. Our panel will review helpful tips into the selection of appropriate patient populations and specific cardiac diagnoses for telehealth that put patient and family safety ...
Source: Pediatric Cardiology - July 12, 2020 Category: Cardiology Source Type: research

Electrophysiological Characteristics and Outcomes of Radiofrequency Catheter Ablation of Atrial Flutter in Children with or Without Congenital Heart Disease
This study therefore aimed to investigate the clinical features and RFCA of AFL in children with or without congenital heart disease. Data from 72 consecutive children (44 males; mean age, 6.1  ± 3.8 [0.9–15.0] years; and mean weight, 23.6 ± 13.9 [8.1–72.0] kg) undergoing RFCA for AFL from 2009 to 2019 were retrospectively reviewed. Thirty-three patients had normal cardiac structure and 39 had congenital heart disease (CHD) of whom 29 had undergone surgical repair and develo ped AFL at a mean of 3.1 ± 2.5 years later. Fifty-nine patients (84%) ...
Source: Pediatric Cardiology - July 8, 2020 Category: Cardiology Source Type: research

Multicenter Analysis of Truncal Valve Management and Outcomes in Children with Truncus Arteriosus
In conclusion, in a multicenter cohort of children with truncus arteriosus, 17% had truncal valve intervention during initial surgical repair. For patients in whom variable truncal valve insufficiency is present and primary intervention was not performed, late interventions were uncommon. Conservative surgical approach to truncal valve management may be justifiable. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - July 3, 2020 Category: Cardiology Source Type: research

Mitral Valve Replacement in Pediatrics Using an Extracellular Matrix Cylinder Valve: A Case Series
AbstractMitral valve replacement (MVR) in children under 2 years is associated with significant morbidity and mortality. Decellularized porcine intestinal submucosa is a commercially available formulation of an extracellular matrix (ECM) with an indication for cardiac tissue repair. The present study reports our experience using ECM cylinder valves in patients for MVR. A retrospective review of patients under 2 years who underwent ECM custom-made cylinder mitral valve (ECM-MV) replacement was performed. Clinical, demographic, operative and post-operative follow-up data, including serial echocardiographic data are presented...
Source: Pediatric Cardiology - June 30, 2020 Category: Cardiology Source Type: research

QT Variability Index is Correlated with Autonomic Nerve Activity in Healthy Children
AbstractThe QT variability index (QTVI), which measures the instability of myocardial repolarization, is usually calculated from a single electrocardiogram (ECG) recording and can be easily applied in children. It is well known that frequency analysis of heart rate variability (HRV) can detect autonomic balance, but it is not clear whether QTVI is correlated with autonomic tone. Therefore, we evaluated the association between QTVI and HRV to elucidate whether QTVI is correlated with autonomic nerve activity. Apparently, healthy 320 children aged 0 –7 years who visited Fujita Health University Hospital for heart ...
Source: Pediatric Cardiology - June 22, 2020 Category: Cardiology Source Type: research

Impact of Anesthetic and Ventilation Strategies on Invasive Hemodynamic Measurements in Pediatric Heart Transplant Recipients
This study aimed to evaluate the hemodynamic impacts of different anesthetic and ventilatory strategies.MethodsWe compared retrospectively the cardiac index, right- and left-sided filling pressures, and pulmonary and systemic vascular resistances of all clinically well and rejection-free heart transplant recipients catheterized from 2005 through 2017. Effects of spontaneous versus positive pressure ventilation and of sedation versus general anesthesia were tested with generalized linear mixed models for repeated measures using robust sandwich estimators of the covariance matrices. Least squared means showed adjusted mean o...
Source: Pediatric Cardiology - June 18, 2020 Category: Cardiology Source Type: research

A Quality Improvement Initiative to Reduce Surgical Site Infections in Patients Undergoing Delayed Sternal Closure After Pediatric Cardiac Surgery
AbstractSternal wound infections (SWI) in delayed sternal closure (DSC) patients are a healthcare burden after congenital heart surgery. There are no guidelines specific for pediatric DSC patients to prevent this costly complication. The hypothesis was that the modifications to a bundled approach for DSC patients would decrease the SWI rate. For this prospective cohort study, DSC patients were postoperatively admitted to a pediatric cardiac care unit from February 2017 to January 2018. Using a modified protocol for prevention of SWI, the infection rates pre- and post-modified protocol were compared. The primary outcome mea...
Source: Pediatric Cardiology - June 18, 2020 Category: Cardiology Source Type: research

Decreased Pulmonary Arterial Compliance is a Predictor for Poor Outcomes in Infants with Isolated Atrial Septal Defect and Pulmonary Hypertension
This study aimed to investigate risk factors for poor outcomes in infants with isolated atrial septal defect (ASD) and pulmonary hypertension who had unexpectedly fatal course. We retrospectively reviewed 22 infants with isolated ASD and pulmonary hypertension, and analyzed the relationship between clinical outcomes and pulmonary hemodynamic parameters including pulmonary arterial resistance (Rp) and compliance (Cp) based on cardiac catheterization among them. Age and weight at cardiac catheterization were 5 (1 –11) months and 4.9 (3.1–9.2) kg, respectively. There were 17 individuals with Down syndrome. Pulmona...
Source: Pediatric Cardiology - June 18, 2020 Category: Cardiology Source Type: research

The Spectrum of Cardiac Anomalies Associated with Heterotaxy: A Single-Center Study of a Large Series Based on Computed Tomography
AbstractThe aim of the study was to identify and correlate the anatomical variants of cardiac structures among patients with heterotaxy. In this retrospective cross-sectional analysis of 13  years duration, 302 patients of congenital heart diseases associated with heterotaxy were studied. All these patients had undergone a meticulous clinical evaluation, echocardiography, and cardiac computed tomography. The mean age of the cohort was 38.4 months, with 180 males and 122 females. The cohort had 184 patients of right isomerism and 118 of left isomerism. More than half of the cohort had abnormal pulmonary veins. Ove...
Source: Pediatric Cardiology - June 18, 2020 Category: Cardiology Source Type: research

Kawasaki Disease Features and Myocarditis in a Patient with COVID-19
AbstractA 10-year-old male with prolonged fever, rash, and conjunctivitis presented to the emergency department with concern for Kawasaki disease, found to have myocarditis and PCR positive for SARS-CoV-2. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 15, 2020 Category: Cardiology Source Type: research

Paediatric Inflammatory Multisystem Syndrome: Temporally Associated with SARS-CoV-2 (PIMS-TS): Cardiac Features, Management and Short-Term Outcomes at a UK Tertiary Paediatric Hospital
We describe cardiac findings and short-term outcomes in children with PIMS-TS at a tertiary children’s hospital. Single-center observational study of children with PIMS-TS from 10th April to 9th May 2020. Data on ECG and echocardiogram were retrospectively analyzed along with demographics, clinical features and blood parameters. Fifteen children with median age of 8.8 (IQR 6.4–11.2) years were included, all were from African/Afro-Caribbean, South Asian, Mixed or other m inority ethnic groups. All showed raised inflammatory/cardiac markers (CRP, ferritin, Troponin I, CK and pro-BNP). Transient valve regurgitatio...
Source: Pediatric Cardiology - June 12, 2020 Category: Cardiology Source Type: research

Assessing Patent Ductus Arteriosus (PDA) Significance on Cardiac Output by Whole-Body Bio-impedance
AbstractWe evaluated the effectiveness of a whole-body bioimpedance device (NICaS ®, NI Medical, Petach Tikva, Israel) to predict the presence of a hemodynamically significant patent ductus arteriosus (PDA) in premature infants. A total of 36 infants less than 35 week’s gestation age and birth weights of less than 1750 g were included in the study. Using the NICaS® device, w e obtained whole-body bioimpedance measurements of stroke volume index (SI), cardiac output index (CI) and total peripheral resistance index. A total of 61 measurements were taken together with echocardiograph imaging. The study popu...
Source: Pediatric Cardiology - June 10, 2020 Category: Cardiology Source Type: research

Upcoming Events in Pediatric Cardiology Pediatric Cardiology 41-5
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - June 8, 2020 Category: Cardiology Source Type: research

Health Care Transition Perceptions Among Parents of Adolescents with Congenital Heart Defects in Georgia and New York
AbstractWith increasing survival trends for children and adolescents with congenital heart defects (CHD), there is a growing need to focus on transition from pediatric to adult specialty cardiac care. To better understand parental perspectives on the transition process, a survey was distributed to 451 parents of adolescents with CHD who had recent contact with the healthcare system in Georgia (GA) and New York (NY). Among respondents, 90.7% reported excellent, very good or good health-related quality of life (HRQoL) for their adolescent. While the majority of parents (77.8%) had been told by a provider about their adolesce...
Source: Pediatric Cardiology - June 4, 2020 Category: Cardiology Source Type: research

Levels of Physical Activity and Physical Fitness in Pediatric Pacemaker Patients: A Cross-Sectional Study
AbstractChildren with heart diseases have reduced physical activity (PA) levels relative to their peers, which in turn increases cardiovascular risk. To the best of our knowledge, physical fitness and objectively measured PA levels have not been previously studied in children with pacemakers. We evaluated PA levels and physical fitness in pediatric pacemaker patients compared to their healthy peers. Twenty-eight pediatric patients with pacemakers (15 female, 13 male; mean age 13.43  ± 3.68 years) and 24 healthy subjects (14 female, 10 male; mean age 13.08 ± 3.67 years) we...
Source: Pediatric Cardiology - May 30, 2020 Category: Cardiology Source Type: research

Long-Term Follow-Up of Pediatric Patients After Congenital Coronary Artery Fistula Closure
In this study, we performed clinical examinations and computed tomography angiography (CTA) to characterize outcomes after CAF closure in pediatric patients. The medical records of 79 pediatric patients who underwent surgical closure of CAF were retrospectively reviewed. The median age of the patients included in the study at the time of surgery was 3.4  years (range 0.2 to 15.3 years). The patients had been followed up for 11 years (range 1 to 17 years) with electrocardiography, echocardiography, and coronary CTA. There were 67 medium-to-large CAF and 12 small CAF. Twenty-six (32.9%) CAF arose from the...
Source: Pediatric Cardiology - May 30, 2020 Category: Cardiology Source Type: research

The Compensatory Reserve Index Responds to Acute Hemodynamic Changes in Patients with Congenital Heart Disease: A Proof of Concept Study
In this study, the CRI accurately reflected acute hemodynamic changes associated with TcPVR. Further re search is justified to determine if the CRI can be useful as an early warning tool in patients with CHD at risk for decompensation during and after cardiac procedures. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - May 30, 2020 Category: Cardiology Source Type: research

The Impact of Syndromic Genetic Disorders on Medical Management and Mortality in Pediatric Hypertrophic Cardiomyopathy Patients
AbstractHypertrophic cardiomyopathy (HCM) is a prevalent cardiomyopathy in children, with variable etiologies, phenotypes, and associated syndromic genetic disorders (GD). The spectrum of evaluation in this heterogeneous population has not been well described. We aimed to describe mortality and medical management in the pediatric HCM population, and compare HCM pediatric patients with GD to those without GD. Children (
Source: Pediatric Cardiology - May 30, 2020 Category: Cardiology Source Type: research

A Comparison of Bidirectional Glenn vs. Hemi-Fontan Procedure: An Analysis of the Single Ventricle Reconstruction Trial Public Use Dataset
AbstractPatients with single ventricle (SV) heart defects have two primary surgical options for superior cavopulmonary connection (SCPC): bidirectional Glenn (BDG) and hemi-Fontan (HF). Outcomes based on type of SCPC have not been assessed in a multi-center cohort. This retrospective cohort study uses the Single Ventricle Reconstruction (SVR) Trial public use dataset. Infants who survived to SCPC were evaluated through 1  year of age, based on type of SCPC. The primary outcome was transplant-free survival at 1 year. The cohort included 343 patients undergoing SCPC across 15 centers in North America; 250 (73%) und...
Source: Pediatric Cardiology - May 29, 2020 Category: Cardiology Source Type: research

Central Vascular Thrombosis in Neonates with Congenital Heart Disease Awaiting Cardiac Intervention
AbstractCentral vascular thrombosis (CVT) in critically ill neonates carries significant clinical implications. Neonates with congenital heart disease (CHD) awaiting cardiac intervention might be associated with increased risk of thrombosis. Outcome analysis was undertaken. An analysis of 77 neonates with CHD who were admitted to the NICU prior to cardiac intervention between January 2015 and December 2016 was undertaken. Patients requiring extracorporeal life support prior to any cardiac intervention, or receiving prophylactic anticoagulation not related to central vascular catheter (CVC) were excluded. Diagnosis of CVT w...
Source: Pediatric Cardiology - May 29, 2020 Category: Cardiology Source Type: research

The Effect of Perioperative Administration of Treprostinil in Infants with Non-restrictive Ventricular Septal Defect and Severe Pulmonary Arterial Hypertension
This study investigated the efficacy and safety of intravenous treprostinil during the perioperative period in infants with non-restrictive ventricular septal defect (VSD) and severe pulmonary arterial hypertension (PAH) undergoing surgical VSD repair. This was a retrospective study. There were 79 infants with non-restrictive VSD and severe PAH receiving surgical treatment from January to December 2019 in our cardiac center. The patients were divided into the treprostinil group and control group according to whether intravenous treprostinil was used during the perioperative period. There were no significant differences in ...
Source: Pediatric Cardiology - May 28, 2020 Category: Cardiology Source Type: research

Covid-19 and Kawasaki Disease: A Glimpse at the Past for a Predictable Future
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - May 27, 2020 Category: Cardiology Source Type: research

Pediatric Cardiology Specialist ’s Opinions Toward the Acceptability of Comfort Care for Congenital Heart Disease
AbstractIn order to  evaluate physicians’ willingness to seek legal action to mandate surgery when parents refuse surgery for various congenital heart lesions, we surveyed pediatric cardiologists and cardiovascular surgeons at 4 children’s hospitals. We asked whether physicians would support parental refusal of s urgery for specific heart defects and, if not, whether they would seek legal action to mandate surgery. We then analyzed associations between physicians’ willingness to mandate surgery and national operative mortality rates for each lesion. We surveyed 126 cardiologists and 9 cardiac su...
Source: Pediatric Cardiology - May 18, 2020 Category: Cardiology Source Type: research

Human Deoxyribonuclease (rhDNase) Nebulization as an Alternative Treatment for Refractory Plastic Bronchitis After Fontan Surgery
We report the case of a 5-year-old boy who developed chronic plastic bronchitis after Fontan surgery for a complex congenital heart disease. During a new admission for acute exacerbation of plastic bronchitis, he started on a mucolytic treatment with inhaled rhDNAse instead of inhaled fibrinolytics because of the potential bleeding risk in a patient on combined coumarin and aspirin treatment. Respiratory symptoms resolved promptly, and the patient was discharged home on rhDNAse treatment. He remained clinically stable on rhDNAse treatment without further hospitalization until definitive treatment with dynamic lymphangiogra...
Source: Pediatric Cardiology - May 14, 2020 Category: Cardiology Source Type: research

Exercise Field Testing in Children: A New Approach for Age-Appropriate Evaluation of Cardiopulmonary Function
AbstractBased on the wide range of problems to effectively perform cardiopulmonary testing in young children, this study strives to develop a new cardiopulmonary exercise test for children using a mobile testing device worn in a backpack in order to test children during their natural movement habits, namely, running outdoors. A standard cardiopulmonary exercise ramp test on a cycle ergometer was performed by a group of twenty 7 –10-year-old children. The results were compared with a self-paced incremental running test performed using a mobile cardiopulmonary exercise measuring device in an outdoor park. The children ...
Source: Pediatric Cardiology - May 9, 2020 Category: Cardiology Source Type: research

Early Surgical  Closure of Atrial Septal Defect Improves Clinical Status of Symptomatic Young Children with Underlying Pulmonary Abnormalities
AbstractElective closure of atrial septal defect (ASD) is usually recommended during preschool ages. However, ASD may contribute to deteriorating health in the presence of significant comorbidity and, thus, may need earlier closure. There is a lack of clarity regarding the indications for and outcomes after ASD closure in infancy and early childhood. We investigated the benefits and safety of surgical ASD closure in symptomatic patients under 2  years of age. Retrospective chart review was conducted in patients who underwent surgical ASD closure within the first 2 years of life. Of 31 symptomatic ASD patients, 22...
Source: Pediatric Cardiology - May 9, 2020 Category: Cardiology Source Type: research

Outcome of Heart Disease in Syrian Refugee Children: Insights into Crisis
ConclusionDespite local and international efforts to manage Syrian refugee children with heart disease, there is significant shortage in providing treatment resulting in delays and mortality. More organized efforts are needed to help with this ongoing crisis. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - May 6, 2020 Category: Cardiology Source Type: research

Comparison of Fontan Surgical Options for Patients with Apicocaval Juxtaposition
This study investigates the hemodynamics and clinical outcomes of ACJ patients and potential surgical improvements. Ten consecutive ACJ patients were included, along with a reference cohort of ten non-ACJ patients. Magnetic resonance images were acquired at 6  ± 0.6 year follow-up for anatomical analysis and hemodynamic assessments using computational fluid dynamics. Metrics of interest are deformation index (DI), indexed power loss (iPL), and hepatic flow distribution (HFDoff). A “virtual” surgery was performed to explore potential hemodynamic improvements using a straightened conduit...
Source: Pediatric Cardiology - May 6, 2020 Category: Cardiology Source Type: research

Translation of the Frailty Paradigm from Older Adults to Children with Cardiac Disease
AbstractChildren and adolescents with cardiac disease (CCD) have significant morbidity and lower quality of life. However, there are no broadly applicable tools similar to the frailty score as described in the elderly, to define functional phenotype in terms of physical capability and psychosocial wellbeing in CCD. The purpose of this study is to investigate the domains of the frailty in CCD. We prospectively recruited CCD (8 –17.5 years old, 70% single ventricle, 27% heart failure, 12% pulmonary hypertension; NYHA classes I, II and III) and age and gender matched healthy controls (totaln = 56; CCD...
Source: Pediatric Cardiology - May 6, 2020 Category: Cardiology Source Type: research

Surgical Options for Pulmonary Atresia with Ventricular Septal Defect in Neonates and Young Infants
ConclusionsA staged repair strategy, compared with primary repair, was associated with comparable overall survival with less frequent re-interventions after repair in young infants with PA/VSD. Lowering the inter-stage mortality after initial palliation by vigilant outpatient care and aggressive home monitoring may be the key to better surgical outcomes in this subset.Graphic AbstractSurgical outcomes of PA with VSD according to the surgical strategies. Patient 1 (birth weight: 2.7  kg) underwent primary Rastelli-type repair at post-natal day # 50 (body weight: 3.8 kg) using Contegra® 12 mm. The postoper...
Source: Pediatric Cardiology - May 6, 2020 Category: Cardiology Source Type: research

CHA 2 DS 2 -VASc Score Predicts Adverse Outcome in Patients with Simple Congenital Heart Disease Regardless of Cardiac Rhythm
AbstractAdult patients with simple congenital heart disease (sACHD) represent an expanding population vulnerable to atrial arrhythmias (AA). CHA2DS2-VASc score estimates thromboembolic risk in non-valvular atrial fibrillation patients. We investigated the prognostic role of CHA2DS2-VASc score in a non-selected sACHD population regardless of cardiac rhythm. Between November 2009 and June 2018, 427 sACHD patients (377 in sinus rhythm, 50 in AA) were consecutively referred to our ACHD service. Cardiovascular hospitalization and/or all-cause death were considered as composite primary end-point. Patients were divided into group...
Source: Pediatric Cardiology - May 5, 2020 Category: Cardiology Source Type: research

Hybrid Approach to Right Ventricle Decompression in Muscular Pulmonary Atresia with Intact Ventricular Septum
We describe hybrid approach to decompress the right ventricle (RV) and establish RV to pulmonary artery connection in a neonate avoiding cardiopulmonary bypass. A 21-gauge access needle was used to perforate the atretic pulmonary valve via periventricular approach followed by stent placement. This case is an example of how patients with congenital heart disease can be palliated in creative ways through thoughtful collaboration between surgical and interventional cardiology teams. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - May 4, 2020 Category: Cardiology Source Type: research

Left and Right Ventricular Impairment Shortly After Correction of Tetralogy of Fallot
The objective of the current study was to assess the cardiac performance before and shortly after corrective surgery in ToF patients using conventional, TDI and ST echocardiographic techniques. Thirty-six ToF patients after surgery were included. Transthoracic echocardiography including TDI and ST techniques was performed preoperatively and at hospital discharge after surgery (10  days to 4 weeks after surgery). Median age at surgery was 7.5 months [5.5–10.9]. Regarding the LV systolic function there was a significant decrease in interventricular septum (IVS)S′ at discharge as compared to preoper...
Source: Pediatric Cardiology - May 4, 2020 Category: Cardiology Source Type: research

Construction of Femoral Vessel Nomograms for Planning Cardiac Interventional Procedures in Children 0 –4 Years Old
The objectives of this study were to construct femoral artery (FA) and femoral vein (FV) nomograms in children aged 0 –4 years and to construct probability curves for the occurrence of arterial access complications based on the size of the FA. The FV and FA are commonly accessed during cardiac catheterizations in children with congenital heart diseases (CHD). However, nomograms for vessel dimensions based on chi ld’s age or size are not available. This knowledge may be helpful for interventional planning. A prospective study was performed on 400 children (age 0–4 years) with CHD undergoing cardi...
Source: Pediatric Cardiology - May 3, 2020 Category: Cardiology Source Type: research

A Rare Report of Hypoplastic Coronary Arteries and Pulmonary Veins: A Case Report and Review of the Literature
AbstractCongenital coronary artery anomalies are estimated to affect about 1% of the general population. Hypoplastic coronary artery disease is an uncommon subset associated with significant mortality regardless whether another major cardiac anomaly is present. In this case report, we present an extremely rare case of an infant with hypoplastic coronary artery disease and hypoplastic pulmonary veins. A literature review pertinent to the clinical findings is also contained herein. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - May 2, 2020 Category: Cardiology Source Type: research

Preterm Birth of Infants Prenatally Diagnosed with Congenital Heart Disease, Characteristics, Associations, and Outcomes
AbstractThere are limited data on the relation between congenital heart disease (CHD) and preterm birth (PTB). We aimed to estimate the risk of PTB in newborns with CHD, to study associations and risk factors (modifiable and non-modifiable) as well as investigate postnatal outcomes. This was a retrospective cohort study of 336 pregnancies diagnosed with CHD between 2011 and 2016. Groups consisted of those delivered at or after 37  weeks, and those who delivered prior to 37 weeks. Collected data included maternal and fetal characteristics as well postnatal outcomes. Complete data were obtained from 237 singleton p...
Source: Pediatric Cardiology - April 30, 2020 Category: Cardiology Source Type: research

Impact of Confounding on Cost, Survival, and Length-of-Stay Outcomes for Neonates with Hypoplastic Left Heart Syndrome Undergoing Stage 1 Palliation Surgery
The objective of this analysis was to update trends in LOS and costs by survivorship and ECMO use among neonates with hypoplastic left heart syndrome (HLHS) undergoing stage 1 palliation surgery using 2016 data from the Healthcare Cost and Utilization Project Kids ’ Inpatient Database. We identified neonates ≤ 28 days old with HLHS undergoing Stage 1 surgery, defined as a Norwood procedure with modified Blalock–Taussig (BT) shunt, Sano modification, or both. Multivariable regression with year random effects was used to compare LOS and costs by hosp ital region, case volume, survivorship, a...
Source: Pediatric Cardiology - April 26, 2020 Category: Cardiology Source Type: research

Right Ventricular Systolic Function After the Cone Procedure for Ebstein's Anomaly: Comparison Between Echocardiography and Cardiac Magnetic Resonance
AbstractAlthough the Cone procedure has improved outcomes for patients with Ebstein ´s anomaly (EA), neither RV systolic function recovery in long-term follow-up nor the best echocardiographic parameters to assess RV function are well established. Thus, we evaluated RV performance after the Cone procedure comparing two-dimensional (2DEcho) and three-dimensional (3DEcho) echocardio graphy to cardiac magnetic resonance (CMR). We assessed 27 EA patients after the Cone procedure (53% female, median age of 20 years at the procedure, median post-operative follow-up duration of 8 years). Echocardiography was perfo...
Source: Pediatric Cardiology - April 25, 2020 Category: Cardiology Source Type: research

Determining Novel Urinary Biomarkers for Acute Kidney Injury and Prediction of Clinical Outcomes After Pediatric Cardiac Surgery
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - April 24, 2020 Category: Cardiology Source Type: research

The Potential Impact and Timeline of Engineering on Congenital Interventions
AbstractCongenital interventional cardiology has seen rapid growth in recent decades due to the expansion of available medical devices. Percutaneous interventions have become standard of care for many common congenital conditions. Unfortunately, patients with congenital heart disease often require multiple interventions throughout their lifespan. The availability of transcatheter devices that are biodegradable, biocompatible, durable, scalable, and can be delivered in the smallest sized patients will rely on continued advances in engineering. The development pipeline for these devices will require contributions of many ind...
Source: Pediatric Cardiology - March 20, 2020 Category: Cardiology Source Type: research

Decision-Making in the Catheter Laboratory: The Most Important Variable in Successful Outcomes
AbstractIncreasingly the importance of how and why we make decisions in the medical arena has been questioned. Traditionally the aeronautical and business worlds have shed a light on this complex area of human decision-making. In this review we reflect on what we already know about the complexity of decision-making in addition to directing particular focus on the challenges to decision-making in the high-intensity environment of the pediatric cardiac catheterization laboratory. We propose that the most critical factor in outcomes for children in the catheterization lab may not be technical failures but rather human factors...
Source: Pediatric Cardiology - March 20, 2020 Category: Cardiology Source Type: research

Tetralogy of Fallot Will be Treated Interventionally Within Two Decades
AbstractTetralogy of Fallot is considered a prototype congenital heart disease because of its embryological, anatomical, pathophysiological, and management aspects. Current management usually relies on a complete surgical repair that is electively performed between 3 and 6 months of age. With the advances of interventional cardiology especially in the fields of ventricular septal defect closure, stent, and pulmonary valve replacement, the question of complete repair of tetralogy of Fallot by interventional means can be discussed. Tetralogy of Fallot is a complex disease with multiple lesions, all individually amenable to t...
Source: Pediatric Cardiology - March 20, 2020 Category: Cardiology Source Type: research