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Pediatric Cardiology

David A White, Gautam M Anand, Omar Qayum, Chizitam F Ibezim, Ashley K Sherman, Geetha Raghuveer
Atherosclerosis promoting cardiovascular disease risk factors (CVDrf) are highly prevalent among youth in the U.S. Determining which standard modifiable clinical measures (SMCMs) has the greatest impact on vascular structure and function is valuable for the health care provider to help identify children at highest risk. The aim of this study was to determine modifiable outpatient clinical predictors of vascular health in youth with CVDrf. Children and adolescents with CVDrf (n = 120, 13.1 ± 1.9 years, 49% female) were recruited from a pediatric preventive cardiology clinic...
February 13, 2019: Pediatric Cardiology
Dennis VanLoozen, Zachary Burch, Pushpa Shivaram, Zahid Amin
Extracorporeal membrane oxygenation complications involving vascular injury or intracardiac thrombosis in neonates are rare. We present a series of unique complications and describe their variable treatments.
February 13, 2019: Pediatric Cardiology
Joseph J Knadler, Mark Zobeck, Prakash Masand, Sarah Sartain, William B Kyle
Aortic arch thrombosis is an extremely rare but life-threatening diagnosis that is often misdiagnosed in the neonatal period. Strategies including surgical intervention, systemic anticoagulation, and thrombolysis have been previously described in the treatment of these neonates. We describe the case of a neonate who presented with concern for interrupted aortic arch and was diagnosed with an in utero aortic arch thrombosis. To our knowledge, this is the first reported case with evidence of aortic arch thrombosis in fetal life...
February 8, 2019: Pediatric Cardiology
Yusuke Ando, Yoshie Ochiai, Shigehiko Tokunaga, Manabu Hisahara, Hironori Baba, Chihiro Miyagi, Tomoya Takigawa
Progressive dilatation of the pulmonary autograft is one of the greatest concerns after the Ross procedure. Increased stress in the arterial wall may cause changes in the elastic properties of the pulmonary autograft, and thus lead to pathological dilatation. The present study aimed to investigate the changes in the autograft diameter and stiffness during follow-up after the Ross procedure. A total of ten patients underwent the Ross procedure at our institution between 2003 and 2011. Echocardiography was used to measure the diameters of the pulmonary autograft at the level of the annulus, sinus of Valsalva, and sinotubular junction...
February 7, 2019: Pediatric Cardiology
Serhat Koca, Celal Akdeniz, Volkan Tuzcu
Transseptal puncture (TP) is used in pediatric patients to access the left atrium in left-sided arrhythmia catheter ablation. Performing this procedure can be difficult and risky, especially in small children. In this study, we aimed to evaluate the safety and feasibility of TPs in children ≤ 30 kg. Between April 2012 and April 2018, a retrospective evaluation was conducted of the clinical features, procedural outcomes, and follow-ups of ≤ 30 kg pediatric patients who required TPs for left-sided ablations at a pediatric electrophysiology center in which a three-dimensional mapping system was routinely used...
February 7, 2019: Pediatric Cardiology
Peter Woolman, David W Bearl, Jonathan H Soslow, Debra A Dodd, Cary Thurm, Matt Hall, Brian Feingold, Justin Godown
DiGeorge syndrome (DGS) is commonly associated with both congenital heart disease (CHD) and immunologic abnormalities. While CHD may prompt consideration for heart transplantation (HTx), little is known about HTx management or outcomes in this group. The aim of this study was to describe the spectrum of patients with DGS who undergo HTx and report post-HTx outcomes. All pediatric HTx recipients (2002-2016) with DGS were identified using ICD codes from a linked billing and clinical registry database. Patient characteristics and outcomes were described and compared to non-DGS HTx recipients with CHD...
February 7, 2019: Pediatric Cardiology
Christian Meierhofer, Andreas Kühn, Jan Müller, Nerejda Shehu, Alfred Hager, Stefan Martinoff, Heiko Stern, Peter Ewert, Manfred Vogt
BACKGROUND: Exercise capacity is a well-defined marker of outcome in congenital heart disease. We analyzed seventeen cardiovascular magnetic resonance (CMR) derived parameters and their correlation to exercise capacity in patients with Ebstein's anomaly (EA). METHODS: Fifty-four surgery free patients, age 5 to 69 years (median 30 years) prospectively underwent CMR examination and cardiopulmonary exercise testing (CPET). The following volume/flow parameters were compared with peak oxygen uptake as the percentage of normal (peakVO2 %) using univariate and multivariate analysis: right and left ventricular ejection fraction (RVEF and LVEF), the indexed end-diastolic and end-systolic volumes (RVEDVi, RVESVi, LVEDVi, and LVESVi), the indexed stroke volumes (RVSVi and LVSVi), the total normalized right and left heart volumes; the total right to left heart volume ratio (R/L-ratio)...
February 6, 2019: Pediatric Cardiology
Stephanie A Goldstein, Asaad G Beshish, Lauren B Bush, Ray E Lowery, Joshua H Wong, Kurt R Schumacher, Nadine L N Halligan, Timothy T Cornell, Albert P Rocchini
Prolonged pleural drainage is a common complication in patients after Fontan palliation and is associated with short- and long- term morbidities. Among many potential etiologies, prolonged drainage has an inflammatory component, but there are no descriptions of cytokines in Fontan pleural drainage to date. This study aimed to examine the inflammatory make-up of Fontan pleural drainage. This prospective age-range-matched cohort study recruited 25 patients undergoing Fontan procedure and 15 bi-ventricular patients undergoing cardiopulmonary bypass (CPB)...
February 1, 2019: Pediatric Cardiology
Qin Liu, Yaping Hou, Liu Yang, Min Zhao, Shengxu Li, Bo Xi
In contrast to the percentile-based definitions of elevated blood pressure (BP) and hypertension for children and adolescents of all ages in the 2004 fourth report, the 2017 American Academy of Pediatrics (AAP) BP guideline recommends a change to single BP cut-offs for clinical diagnosis (120/< 80-129/< 80 mmHg for elevated BP and ≥ 130/80 mmHg for hypertension) in adolescents aged 13 years and older, and it also recommends researchers using the percentile-based definitions for more precise BP classification...
February 1, 2019: Pediatric Cardiology
Brandon D Morrical, Joseph A Dearani, Crystal R Bonnichsen, Nathaniel W Taggart
Repair of Ebstein anomaly has evolved over the last decade, and timing of repair remains variable. There have been no studies of exercise or functional capacity in patients who have had tricuspid valve surgery for Ebstein anomaly in adulthood. We aimed to compare exercise capacity before and after tricuspid valve repair or replacement for Ebstein anomaly in adults at Mayo Clinic. We performed a retrospective chart review of all patients with Ebstein anomaly who underwent tricuspid valve surgery at Mayo Clinic between June 2007 and January 2015...
January 30, 2019: Pediatric Cardiology
Mary Lyn Stein, Luis G Quinonez, James A DiNardo, Morgan L Brown
Neonates undergoing congenital heart surgery require central venous access for diagnostic information and medication administration. There are multiple options for central access including peripherally inserted central catheters, umbilical, central venous, and transthoracic intracardiac lines. We retrospectively identified all patients younger than 30 days who underwent cardiac surgery in a 1-year period. Data were collected on demographic and medical characteristics, adverse events, pre-emptive transfusion of blood products prior to line removal, and transfusion of blood products following removal of transthoracic intracardiac lines and central venous lines...
January 30, 2019: Pediatric Cardiology
Femke van der Stelt, Sebastiaan N Siegerink, Gregor J Krings, Mirella M C Molenschot, Johannes M P J Breur
Cardiac catheterization is a commonly used form of imaging and treatment in pediatric patients with congenital heart disease. Traditionally, two-dimensional conventional angiography was the method used, but since 2000 three-dimensional rotational angiography (3DRA) is increasingly used in the field of cardiology in both adult and pediatric patients. To investigate the use and applications of 3DRA in pediatric congenital cardiology, literature was systematically reviewed and 29 eligible articles were found. Those showed that 3DRA is already a greatly valued diagnostic and therapeutic technique in pediatric cardiology...
January 24, 2019: Pediatric Cardiology
R Berrueco, G Sarquella-Brugada
No abstract text is available yet for this article.
January 23, 2019: Pediatric Cardiology
Thomas J Kulik, Julia E McSweeney, Joseph Tella, Mary P Mullen
Reports of "treat and repair" of cardiac shunting lesions with inoperably high pulmonary vascular resistance (PVR) mostly concern pre-tricuspid defects; post-tricuspid lesions are different. We report our experience with pulmonary artery (PA) banding ± targeted pulmonary hypertension medications in five patients with a large VSD and inoperably high PVR, and review previous reports of PA banding with post-tricuspid defects. Three of our 5 patients had mean PAP > 50 mmHg after banding and no or only a transient fall in PVR...
January 23, 2019: Pediatric Cardiology
Simone Jhaveri, Albree Tower-Rader, Kenneth Zahka
Certain coronary anomalies have been associated with sudden cardiac death. Anomalous origin of the right coronary artery (RCA) from the posterior non-coronary aortic cusp is exceedingly rare. Through multimodality imaging, we present a young female with an anomalous RCA arising from the non-coronary cusp. Given the unobstructed origin and benign course, no intervention was recommended.
January 23, 2019: Pediatric Cardiology
Rohit S Loomba, Peter C Frommelt, Robert H Anderson, Saul Flores, James S Tweddell
Isomerism, or heterotaxy, impacts morbidity and mortality after various stages of univentricular palliation. Timing of Fontan completing in these patients based on preoperative factors has not been investigated previously. The aim of this study was to determine the impact of preoperative factors on various outcomes including length of hospital stay and duration of chest tubes. A cross-sectional study was conducted. Patients with isomerism having undergone Fontan at the Children's Hospital of Wisconsin between 1998 and 2014 were identified...
January 22, 2019: Pediatric Cardiology
Simone Gulletta, Pasquale Vergara, Lorenzo Gigli, Giuseppe D'Angelo, Andrea Radinovic, Carmela Melania Barbaro, Nicola Trevisi, Paolo Della Bella
The current approach for catheter ablation (CA) of accessory pathways (AP) includes the use of standard catheters under fluoroscopic visualization. We hypothesize that use of contact force (CF) irrigated tip catheters might increase procedural safety in pediatric patients compared to standard irrigated tip catheters, by decreasing the number of radiofrequency (RF) pulses required to obtain AP elimination. Seventy-one pediatric patients (13.7 ± 2.5 years, 45 male) with ventricular pre-excitation were enrolled in the study...
January 21, 2019: Pediatric Cardiology
Tong Yi, Guohui Fan, Yunchao Xing, Wei Zhao, Liang Zhang, Fan Fan, Xianchao Jiang, Zhiling Ma, Jun Yan, Shoujun Li, Qiang Wang
OBJECTIVE: The bidirectional cavopulmonary shunt (BCPS) is an effective palliative procedure which has been widely used to boost outcome of the Fontan procedure. However, there is no standard duration time between these two procedures. Therefore, we investigated whether different time intervals between BCPS and Fontan procedure affects morbidity and mortality of Fontan patients. METHODS: Between 2004 and 2016, 210 post-BCPS patients underwent Fontan operation at Fuwai Hospital...
January 16, 2019: Pediatric Cardiology
Ahmad Almanla, Fatme Charafeddine, Mohamad Abutaqa, Hala Mustafa, Anas Tabbakh, Haytham Bou Hussein, Fadi Sawaya, Issam El-Rassi, Mariam Arabi, Ziad Bulbul, Fadi Bitar
Atrial septal defect (ASD) is one of the most common congenital heart defects. Transcatheter device closure of ASDs is safe and effective with most of the reported data being described from developed countries. To evaluate the short and mid-term results and experience of device closure of ASDs at a tertiary center in a developing country and compare it to that from developed countries. Retrospective study based on data collection from all patients who have undergone transcatheter percutaneous device closure for ASD from January 2005 until December 2017 at the Children's Heart Center at the American University of Beirut, Medical Center, Lebanon...
January 3, 2019: Pediatric Cardiology
Gabriel Amir, Georgy Frenkel, Amichay Rotstein, Elchanan Nachum, Elchanan Bruckheimer, Alexander Lowenthal, Tom Einbinder, Einat Birk
Infective endocarditis (IE) in the pediatric population can present as a life-threatening condition. Optimal timing for surgical intervention should consider surgical risks versus the risk of neurologic complications. We herein report our experience with this group of critically ill children. Retrospective analysis of patient charts of all patients who underwent urgent surgical treatment of aortic IE from 1994 to 2014 was performed. Nine patients with acute storming IE of the aortic valve or the ascending aorta were urgently operated (eight normal heart, one congenital aortic stenosis), age ranged from 8 weeks to 4...
January 2, 2019: Pediatric Cardiology
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