Impact of Right Ventricular Surface Area-to-Volume Ratio on Ventricular Remodeling After Pulmonary Valve Replacement
AbstractOptimal reverse remodeling of the right ventricle (RV), a sentinel goal of pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot, is not fully predicted by volume-based pre-PVR parameters. Our objectives were to characterize novel geometric RV parameters in patients receiving PVR and in controls, and to identify associations between these parameters and chamber remodeling post-PVR. Secondary analysis was performed on cardiac magnetic resonance (CMR) data from 60 patients enrolled in a randomized trial of PVR with and without surgical RV remodeling. 20 healthy age-matched subjects served as...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Percutaneous VA-ECMO from Cannulation to Decannulation: Novel Use of a Vascular Closure Device in Pediatrics
We present a series of eight patients who underwent decannulation with a collagen plug-based vascular closure device (MANTA) for the common femoral artery. Seven of the patients were successfully decannulated without access site-related vascular complications. One required conversion to surgical cut-down with arterial repair due to device failure. This series demonstrates the successful use of the MANTA device in percutaneous VA-ECMO decannulation in the pediatric population, while highlighting potential technical challenges for success. (Source: Pediatric Cardiology)
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Tomographic Plane Visualization (ToPlaV): a Tool to Enhance Echocardiographic Training
AbstractVisual learning is an important part of echocardiographic training. Our aim is to describe and evaluate a visual teaching tool, tomographic plane visualization (ToPlaV) as an adjunct to skills training in pediatric echocardiography image acquisition. This tool incorporates learning theory by applying psychomotor skills that closely emulate the skills used in echocardiography. ToPlaV was used as part of a transthoracic bootcamp for first year cardiology fellows. A qualitative survey was given to trainees to evaluate their perceptions of its usefulness. There was universal agreement among fellow trainees that ToPlaV ...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Changes in Cerebral Regional Oxygen Saturation Variability in Neonates Undergoing Cardiac Surgery: A Prospective Cohort Study
AbstractNear-infrared spectroscopy is routinely used in the monitoring of cerebral regional oxygen saturation (crSO2) in neonates following congenital heart surgery. Decreased postoperative crSO2 variability in these patients is associated with worse clinical outcomes, including neurodevelopmental outcomes. We sought to explore changes in crSO2 variability between the preoperative and postoperative periods and associations with short-term clinical outcomes in neonates undergoing cardiac surgery. We performed a prospective cohort study of neonates undergoing cardiac surgery with cardiopulmonary bypass between November 2019 ...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Risk of Hypovitaminosis and Vitamin C Deficiency in Pediatric Patients Undergoing Cardiopulmonary Bypass
AbstractVitamin C levels are known rapidly decrease in adult critical illness. Vitamin C scavenges free radicals, provides critical protection of the endothelial barrier, and improves endothelial responsiveness to catecholamines. Children with congenital heart disease and undergoing cardiac surgery might be at increased risk for low circulating vitamin C levels. A prospective single-center observational study investigated perioperative changes in vitamin C levels in critically ill Children who underwent congenital heart surgery using CPB. Vitamin C serum levels were collected preoperatively and postoperatively (upon admiss...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Associations of Home Monitoring Data to Interventional Catheterization for Infants with Recurrent Coarctation of the Aorta and Hypoplastic Left Heart Syndrome
This study aimed to investigate if caregiver-entered data resulted in earlie r identification of patients requiring interventional catheterization for RCoA. Retrospective home monitoring data were extracted from five high-volume Children’s High Acuity Monitoring Program®-affiliated centers (defined as contributing > 20 patients to the registry) between 2014 and 2021 after IRB approval. Demographics and caregiver-recorded data evaluated include weight, heart rate (HR), oxygen saturation (SpO2), video recordings, and ‘red flag’ concerns prior to interstage readmissions. 27% (44/161) of infants required interve...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Multisystem Inflammatory Syndrome in Children (MIS-C): Reduced Exercise Duration and Capacity at Six Month Follow-Up
AbstractMyocarditis is common in Multisystem Inflammatory Syndrome in Children (MIS-C), and the mechanism may differ from idiopathic/viral myocarditis as MIS-C involves a hyper-inflammatory state weeks after COVID-19. We sought to evaluate exercise stress testing (EST) in these patients as EST may help guide return-to-play recommendations. Retrospective cohort study evaluating ESTs (standard Bruce treadmill protocol) from MIS-C patients from 2020 to 2022, compared to myocarditis patients and age, sex, and weight matched controls from 2005 to 2019. ESTs included 22 MIS-C patients (mean age 11.9 years) with 14 cardiopulmonar...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Risk Factors and Outcome of Pulmonary Artery Stenting After Bidirectional Cavopulmonary Connection (BDCPC) in Single Ventricle Circulation
AbstractAfter bidirectional cavopulmonary connection (BDCPC) central pulmonary arteries (PAs) of single ventricle (SV) patients can be affected by stenosis or even closure. Aim of this study is to compare SV patients with and without PA-stent implantation post-BDCPC regarding risk factors for stent implantation and outcome. Single center, retrospective (2006 –2021) study of 136 SV consecutive patients with and without PA-stent implantation post-BDCPC. Patient characteristics, risk factors for PA-stent implantation and PA growth were assessed comparing angiographic data pre-BDCPC and pre-TCPC. A total of 40/136 (29%) pati...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Effect of Balloon Pulmonary Valvuloplasty on Growth of Pulmonary Annulus in Infants with Tetralogy of Fallot
In this study, we evaluated the effect of PBPV on PA growth in infants with TOF. To eliminate the effect of the systemic to pulmonary shunt (SPS) that may promote PA growth, we divided TOF infants into 2 groups: group A, patients who underwent PBPV with or without other SPS, and group B, patients who attempted SPS but without PBPV. Sixty patients were included, 28 patients in group A and 32 patients in group B. Age at the time of intervention in group A (range, 0.4 –5.4; median 1.4 months) was lower than that in group B (range, 2.3–7.7; median 4.8 months),p-value 0.02. The body weight in group A (range, 3 –5.5; med...
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Correction: Tomographic Plane Visualization (ToPlaV): a Tool to Enhance Echocardiographic Training
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
Left Ventricular Function in Patients with Myopericarditis After mRNA COVID-19 Vaccination: Comment
(Source: Pediatric Cardiology)
Source: Pediatric Cardiology - August 20, 2023 Category: Cardiology Source Type: research
N-Terminal Pro-B-Type Natriuretic Peptide as a Marker of Severity of Heart Failure in Children with Congenital Heart Diseases
AbstractN-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used as a tool for diagnosis, severity assessment and prognostication of congestive heart failure (CHF) in adults, with specific cut off values for diagnosis and denoting points of intervention. However, there is scarcity of paediatric literature regarding role of NT-proBNP as a marker of heart failure severity and prognostication. So, this study was done to assess the utility of NT-proBNP as a marker of severity of heart failure in children with congenital heart diseases. Single centre, prospective observational study. Children (1 month to 5 years),...
Source: Pediatric Cardiology - August 11, 2023 Category: Cardiology Source Type: research
Unusual Vascular Ring in the Fetus
We present the clinical course and echocardiographic and genetic findings of two fetuses with an unusual vascular ring, created by a left aortic arch with a right arterial duct and an aberrant right subclavian artery. One fetus was diagnosed with 22q11.2 microdeletion and the other became symptomatic in infancy. It is important to consider the position of the arterial ductal ligament in patients who present with tracheoesophageal compressive symptoms in the presence of a left aortic arch. These cases also highlight that a vascular ring formed from a left arch may have similar associations to a vascular ring formed by a rig...
Source: Pediatric Cardiology - August 11, 2023 Category: Cardiology Source Type: research
Outcomes of Infant Supraventricular Tachycardia Management Without Medication
AbstractMost infants presenting with supraventricular tachycardia (SVT) are treated with an antiarrhythmic, primarily to prevent unrecognized future episodes that could lead to tachycardia-induced cardiomyopathy. A common practice at our institution is to not treat after the first presentation of infant SVT and instead educate parents on heart rate monitoring and reasons to present to care. The goal of this study was to evaluate the outcomes of non-pharmacologic treatment of infant SVT at first presentation and compare to outcomes of infants treated with an antiarrhythmic. This was a retrospective single center study of al...
Source: Pediatric Cardiology - August 10, 2023 Category: Cardiology Source Type: research
Perioperative Brain Injury in Children with Aortic Arch Anomalies: A Retrospective Study of Risk Factors and Outcomes
This study examines the incidence, risk factors, and outcomes of perioperative brain injury in children undergoing aortic arch repair who had aortic arch anomalies. A total of 145 children with aortic arch anomalies in our center undergoing aortic arch repair between January 2014 and December 2022 were enrolled. There were 129 (89.0%) with coarctation of the aorta (COA) and 16 (9.7%) with interrupted aortic arch (IAA). Risk factor analysis of brain injuries was done using perioperative imaging and included symptoms of hemorrhagic stroke, arterial ischemic stroke, white matter injury, cerebral sinus venous thrombosis, and o...
Source: Pediatric Cardiology - August 10, 2023 Category: Cardiology Source Type: research
