PROGRESS IN PEDIATRIC CARDIOLOGY最新文献

英文中文

Congenital tricuspid valve calcification: A diagnostic and surgical challenge. Case report 先天性三尖瓣钙化：诊断和手术的挑战。病例报告

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-10-14 DOI: 10.1016/j.ppedcard.2025.101876

Alex Ismael Catalán Cabrera , Edwin Martin Bedoya Rivera , Alfredo Ernesto Homes Linfa , Mónica Medina Durand , Karen del Rosario Condori Alvino , Geovanna Geraldine Gutiérrez Iparraguirre , Nelly Tamayo Huiza

Among congenital anomalies of the tricuspid valve, Ebstein’s anomaly is the most frequent, followed by tricuspid valve dysplasia[1], and, more rarely, congenital tricuspid valve calcification. All these conditions may present with tricuspid regurgitation, which can become severe and lead to early hemodynamic compromise.

We present the case of a one-month-old infant with persistent cyanosis and hemodynamic instability. Prostaglandin infusion was initiated to maintain ductal patency and ensure pulmonary blood flow, achieving hemodynamic stabilization. Echocardiography revealed severe tricuspid regurgitation with a markedly echogenic anterior leaflet, without apical displacement of the valve leaflets. Cardiac tomography further suggested calcification of the tricuspid valve.

This case represented a diagnostic and therapeutic challenge. Intraoperative findings confirmed congenital tricuspid valve calcification, which precluded repair. The patient underwent surgical intervention with a favorable postoperative course. Pathological examination corroborated the diagnosis. The patient was discharged and continues follow-up in outpatient pediatric cardiology.

This case underscores that surgical management should be guided by tricuspid valve morphology and clinical presentation [2], with some patients requiring early intervention.

在先天性三尖瓣畸形中，Ebstein畸形最为常见，其次为三尖瓣发育不良[1]，而先天性三尖瓣钙化更为罕见。所有这些情况都可能出现三尖瓣反流，这可能变得严重并导致早期血流动力学损害。我们提出的情况下，一个月大的婴儿持续紫绀和血流动力学不稳定。开始前列腺素输注以维持导管通畅，确保肺血流，实现血流动力学稳定。超声心动图显示严重的三尖瓣反流，前叶回声明显，瓣叶顶端未移位。心脏断层进一步提示三尖瓣钙化。这个病例代表了诊断和治疗的挑战。术中发现证实先天性三尖瓣钙化，无法修复。患者接受手术治疗，术后病程良好。病理检查证实了诊断。患者出院并继续在门诊儿科心脏病科随访。本病例强调手术治疗应根据三尖瓣形态和临床表现[2]进行指导，部分患者需要早期干预。

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引用次数: 0

Response to letter: Temperature management during neonatal ASO 回复：新生儿ASO期间的温度管理

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-10-14 DOI: 10.1016/j.ppedcard.2025.101881

Uri Pollak

引用次数: 0

Successful treatment of aortic root thrombus and neonatal myocardial infarction with systemic tissue plasminogen activator 全身组织型纤溶酶原激活剂成功治疗主动脉根部血栓及新生儿心肌梗死

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-10-10 DOI: 10.1016/j.ppedcard.2025.101878

Liza Hashim , Theodore Millette , Michael Shorofsky

Neonatal myocardial infarction portends a grim prognosis, especially when severe left ventricular (LV) dysfunction is also seen. This report describes a 1-day-old with an uncomplicated prenatal course and delivery who presented with bacteremia and an aortic root thrombus, which led to left main coronary artery (LMCA) ischemia on day of life 1. He was treated with systemic tissue plasminogen activator with complete thrombus resolution, effectively restoring LMCA flow. With the addition of guideline-directed medical therapy, his LV function improved.

新生儿心肌梗死预示着一个严峻的预后，特别是当严重的左心室（LV）功能障碍也可见。本报告描述了一名出生1天的婴儿，其没有复杂的产前过程和分娩过程，在出生第1天出现菌血症和主动脉根部血栓，导致左主干冠状动脉（LMCA）缺血。他接受了系统性组织纤溶酶原激活剂治疗，血栓完全溶解，有效地恢复了LMCA血流。加上指导的药物治疗，他的左室功能有所改善。

引用次数: 0

Postoperative treatment contributions to post-traumatic stress symptoms in preschool-aged children after cardiac surgery 术后治疗对学龄前儿童心脏手术后创伤后应激症状的影响

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-10-10 DOI: 10.1016/j.ppedcard.2025.101879

Kelly A. Hardy , Mary S. Dietrich , Mary Jo Gilmer , D. Catherine Fuchs , Terrah Foster Akard

Background

Advancements in pediatric cardiac surgery have led to improved survival for congenital heart disease. Children who survive cardiac surgery are at high risk for non-cardiac comorbidities, including post-traumatic stress symptoms (PTSS). However, few studies have examined PTSS in preschool children following cardiac surgery.

Objective

The purpose of this study was to examine relationships between postoperative variables (cardiac physiology, postoperative intensive care unit length of stay, duration of mechanical ventilation, and number of prior surgeries) and the development of PTSS in children between three and six years old following cardiac surgery.

Methods

Primary caregivers of children aged three to six years who underwent cardiac surgery between 2018 and 2020 were invited to participate in this cross-sectional, descriptive study. We obtained data related to the child's surgery through medical chart review. Caregivers completed the Young Child Posttraumatic Stress Disorder Checklist to explore child PTSS. We assessed the strength and direction of the relationships between postoperative variables and child PTSS using correlational methods.

Results

Caregivers of children with single ventricle physiology reported greater child PTSS than those with biventricular physiology. Length of stay, duration of mechanical ventilation, and number of prior surgeries were not significantly associated with child PTSS.

Conclusion

Results demonstrated that preschool-aged children may develop PTSS following cardiac surgery. Those with single ventricle physiology may be more susceptible to the development of PTSS than children with biventricular physiology. Additional work is needed to identify risk factors for the development of PTSS in preschool children following cardiac surgery.

背景：儿童心脏手术的进步提高了先天性心脏病的生存率。心脏手术后存活的儿童是非心脏合并症的高风险，包括创伤后应激症状（PTSS）。然而，很少有研究检查学龄前儿童心脏手术后的创伤后应激障碍。目的本研究的目的是研究心脏手术后3 - 6岁儿童的术后变量（心脏生理学、术后重症监护病房住院时间、机械通气持续时间和术前手术次数）与PTSS发展之间的关系。方法邀请2018年至2020年期间接受心脏手术的3至6岁儿童的主要照顾者参加这项横断面描述性研究。我们通过病历回顾获得了患儿手术的相关资料。照顾者完成幼儿创伤后应激障碍检查表以探讨儿童创伤后应激障碍。我们使用相关方法评估术后变量与儿童创伤后应激障碍之间关系的强度和方向。结果单心室生理患儿的护理人员报告的PTSS高于双心室生理患儿。住院时间、机械通气持续时间和既往手术次数与儿童PTSS无显著相关。结论学龄前儿童心脏手术后可能发生创伤后应激障碍。单心室生理的儿童可能比双心室生理的儿童更容易发生PTSS。需要进一步的工作来确定学龄前儿童心脏手术后PTSS发展的危险因素。

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引用次数: 0

Treatment of a ventricular thrombus with rivaroxaban in a patient with hypoplastic left heart syndrome 利伐沙班治疗左心发育不全综合征患者的心室血栓

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-09-13 DOI: 10.1016/j.ppedcard.2025.101875

Steven R. Scaglione , Connor T.A. Smith , Mark W. Russell , Kurt R. Schumacher , Ashley Huebschman , Bronwyn Crandall , Carlen G. Fifer

Hypoplastic left heart syndrome (HLHS) is a severe form of congenital heart disease characterized by poor development of left-sided cardiac structures. The current standard of care aims to create a stable circulation that relies on a single ventricle (SV) by utilizing a series of staged palliative surgical operations, typically leading to a Fontan procedure. These patients are at higher risk of both systemic and intraventricular thromboembolism secondary to abnormal circulation and its sequelae, such as protein-losing enteropathy (PLE). The direct oral anticoagulant (DOACs) drug class acts by direct inhibition of factor Xa, and these medications are gaining popularity for the prevention and treatment of thromboses in the SV population due to their convenient oral route and lack of need for frequent therapeutic level monitoring. While the use of DOACs has been well explored in adult patients, there remains a paucity of literature reporting on DOAC use in the treatment of intraventricular thrombus in the pediatric SV population. We present the first reported case of rivaroxaban use to treat an intracardiac thrombus and describe the clinical course and outcome in a pediatric patient with Fontan circulation.

左心发育不良综合征（HLHS）是一种严重的先天性心脏病，其特征是左侧心脏结构发育不良。目前的护理标准旨在通过一系列分阶段的姑息性外科手术（通常是Fontan手术）来建立一个依赖于单心室（SV）的稳定循环。这些患者继发于循环异常及其后遗症（如蛋白质丢失性肠病（PLE））的系统性和脑室内血栓栓塞的风险更高。直接口服抗凝药物（DOACs）类药物通过直接抑制Xa因子起作用，这些药物由于其方便的口服途径和不需要频繁的治疗水平监测，在SV人群中预防和治疗血栓形成越来越受欢迎。虽然DOAC在成人患者中的应用已经得到了很好的探索，但在儿童SV人群中使用DOAC治疗脑室内血栓的文献报道仍然很少。我们报道了首例利伐沙班用于治疗心内血栓的病例，并描述了一名Fontan循环患儿的临床过程和结果。

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引用次数: 0

Systolic function of a single left ventricle and exercise capacity in adults after Fontan palliation: A preliminary study using exercise echocardiography Fontan姑息治疗后成人单左心室收缩功能和运动能力的初步研究

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-09-12 DOI: 10.1016/j.ppedcard.2025.101872

Małgorzata Kowalczyk , Maria Kordybach-Prokopiuk , Piotr Hoffman , Mirosław Kowalski

Background

Patients with functionally single ventricle after Fontan palliation are an increasingly large group in adult congenital heart disease departments. This cohort is also among the most complex to manage. However, many patients face a range of complications. Due to several reasons, patients following Fontan palliation experience significant reductions in exercise capacity. Cardiopulmonary exercise testing (CPET) provides means to assess exercise tolerance with objective parameters.

Objectives

The aim of the study is comparison of Stress Echocardiography (SE) parameters and CPET data in order to discover the potential relationship between them.

Methods

We enrolled 30 patients with a functionally single ventricle of left ventricle morphology who had undergone Fontan palliation and were hospitalized at the Department of Congenital Heart Defects between 2019 and 2021. The study was conducted using a bicycle ergometer in a semi-recumbent position. The parameters measured at rest and at peak exercise included the ejection fraction (EF) of the single ventricle and global longitudinal strain (GLS). The results of the current CPET were also incorporated. Demographic data, previous interventions, pharmacological treatment, and comorbidities were extracted from the patients' medical records.

Results

GLS measured at rest and EF measured at peak exercise correlated with Predicted Peak Oxygen Consumption (pVO2%pred).

Conclusion

GLS of the single left ventricle shows a meaningful association with pVO₂%pred and EF measured at peak exercise during stress echocardiography also correlates with pVO₂%pred, suggesting that both parameters provide complementary insights into the functional capacity and contractile reserve of the single ventricle in Fontan patients.

背景：在成人先天性心脏病科，Fontan姑息治疗后的功能性单心室患者越来越多。这个群体也是最难管理的群体之一。然而，许多患者面临一系列并发症。由于几个原因，接受丰坦姑息治疗的患者运动能力显著下降。心肺运动试验（CPET）提供了客观参数评价运动耐量的方法。目的比较应激超声心动图（SE）参数与CPET数据，探讨两者之间的潜在关系。方法入选30例2019 - 2021年在先天性心脏缺陷科接受Fontan姑息治疗的左心室形态学功能单心室患者。这项研究是用半卧位的自行车测力仪进行的。静息和运动高峰时测量的参数包括单心室射血分数（EF）和总纵向应变（GLS）。目前CPET的结果也被纳入。从患者的医疗记录中提取了人口统计数据、既往干预措施、药物治疗和合并症。结果静息时gls和运动时EF与预测耗氧量（pVO2%pred）呈正相关。结论单左心室ls与应激超声心动图峰值运动时测量的pVO 2 %pred有显著相关性，EF也与pVO 2 %pred相关，提示这两个参数为Fontan患者单心室功能容量和收缩储备提供了补充信息。

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引用次数: 0

A newborn case absent pulmonary valve with intact ventricular septum and UHL anomaly 新生儿肺动脉瓣缺失伴室间隔完整及UHL异常1例

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-09-12 DOI: 10.1016/j.ppedcard.2025.101873

Pelin Altınbezer , Ömer Nuri Aksoy , Utku Arman Örün

Absent pulmonary valve is a very rare anomaly and is often seen together with tetralogy of Fallot. Absent pulmonary valve with intact ventricular septum without tetralogy of Fallot is a very rare condition, and right ventricular myocardial pathologies may accompany these patients. We present a newborn case with Uhl anomaly, intact ventricular septum, and absent pulmonary valve leaflets.

肺动脉瓣缺失是一种非常罕见的异常，常与法洛四联症一起出现。肺动脉瓣缺失，室间隔完整，无法洛四联症是一种非常罕见的情况，右心室心肌病变可能伴随这些患者。我们报告了一例新生儿Uhl异常，室间隔完整，肺动脉瓣小叶缺失。

引用次数: 0

Percutaneous ventricular septal defect device closure in a child with Ebstein's anomaly – Hemodynamics and rationale in a rare combination of lesions 经皮室间隔缺损关闭装置在儿童Ebstein的异常-血流动力学和理论在一个罕见的组合病变

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-09-04 DOI: 10.1016/j.ppedcard.2025.101871

Sadik K.C. , Chetan Kumar Nanjegowda , Anand P. Subramanian

Ebstein's anomaly is only rarely associated with a ventricular septal defect. We report device closure of a moderate-sized perimembranous ventricular septal defect in a child with Ebstein's anomaly and discuss the potential hemodynamic advantages of shunt elimination in this scenario.

Ebstein异常很少与室间隔缺损相关。我们报道了一名患有Ebstein异常的儿童的中等大小的膜周围室间隔缺损的装置关闭，并讨论了在这种情况下分流消除的潜在血流动力学优势。

引用次数: 0

Energy drinks and our children: A time for action 能量饮料和我们的孩子：是行动的时候了

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-08-29 DOI: 10.1016/j.ppedcard.2025.101870

James J. Shepherd

引用次数: 0

Predictors of nonelective removal of peripherally inserted central catheters in children with heart disease 儿童心脏病患者非选择性切除外周中心导管的预测因素

IF 0.8 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2025-08-14 DOI: 10.1016/j.ppedcard.2025.101868

Nayana Maria Gomes de Souza, Patrícia Linard Avelar, Karla Maria Carneiro Rolim, René Rodrigues Pereira, Candice Torres de Melo Bezerra Cavalcante

Background

In the pediatric population with heart disease, evidence has assessed the risk factors for all types of access devices. However, there is little evidence to elucidate the predictive factors that cause major complications for nonelective removal of peripherally inserted central catheters (PICC) in this population.

Objective

The purpose of this study was to identify predictors of nonelective removal of PICC in a pediatric population hospitalized for heart disease.

Methods

This was a retrospective cohort study with a sample of 559 PICC lines inserted in 412 neonates, infants, toddlers, children, and adolescents admitted to the tertiary Pediatric Cardiology Unit of a public hospital in northeastern Brazil. We followed the children from insertion until the removal of the PICC. Bivariate analysis and logistic regression were conducted to identify predictors of nonelective removal.

Results

Among the variables investigated that maintained statistical significance for nonelective PICC catheter removal were selection of the external jugular vein, number of venipunctures, noncentral location of the catheter tip, and use of prostaglandin E1(PGE1). The previous central venous catheter insertion was determined as a protective factor for nonelective PICC removal.

Conclusion

External jugular vein selection for insertion, multiple venipuncture attempts, use of PGE1, and noncentral catheter tip position were associated with nonelective removal of the PICC catheter due to complications.

在患有心脏病的儿科人群中，已有证据评估了所有类型的通路装置的危险因素。然而，在这一人群中，几乎没有证据表明导致非选择性外周中心导管（PICC）切除的主要并发症的预测因素。目的本研究的目的是确定因心脏病住院的儿童非选择性PICC切除的预测因素。方法：这是一项回顾性队列研究，在巴西东北部一家公立医院三级儿科心脏病科住院的412名新生儿、婴儿、幼儿、儿童和青少年中插入559个PICC系样本。我们跟踪患儿从插入到取出PICC。进行双变量分析和逻辑回归来确定非选择性切除的预测因素。结果在非选择性PICC导管拔除的变量中，颈外静脉的选择、静脉穿刺次数、导管尖端的非中心位置和前列腺素E1（PGE1）的使用具有统计学意义。先前的中心静脉导管插入被确定为非选择性PICC切除的保护因素。结论选择颈外静脉插入、多次静脉穿刺、PGE1使用和导管尖端位置非中心与PICC导管因并发症而非选择性拔除有关。

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