International journal of cardiology. Congenital heart disease最新文献_第3页

Clinical characteristics and outcomes of cardiovascular surgery and transcatheter procedures in adults with Down syndrome and congenital heart disease 成人唐氏综合征和先天性心脏病的心血管手术和经导管手术的临床特点和结果

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-11-05 DOI: 10.1016/j.ijcchd.2025.100638

Takumi Osawa , Tomoko Machino-Ohtsuka , Keitaro Kume , Takahiro Yano , Koshiro Kanaoka , Yoko Sumita , Yusuke Yano , Ruriko Numata , Naoto Kawamatsu , Hideyuki Kato , Yuji Hiramatsu , Tomoko Ishizu

Background

Advances in medical care have increased the number of adults with Down syndrome and congenital heart disease (CHD), including those with residual or unrepaired lesions. However, clinical outcomes following invasive cardiovascular procedures in this population remain poorly understood.

Methods

We extracted data on patients with Down syndrome aged ≥16 years and diagnosed with CHD from the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination (JROAD-DPC), covering the period from April 1, 2013, to March 31, 2023. Patients who underwent cardiovascular surgery or transcatheter procedures were included in the analysis.

Results

The study included 115 patients (median age: 21 [17–33] years; 47.8 % female), of whom 72 underwent surgery and 43 underwent transcatheter intervention. Procedures were most common among those aged 16–29 years. The main CHD subtypes were tetralogy of Fallot, atrial septal defects, and atrioventricular septal defects. Catheter-based interventions were associated with shorter hospital stay and no in-hospital mortality. In contrast, all three deaths (4.2 %) occurred in the surgical group, with pulmonary hypertension medications used in two of these patients. Among surgical patients receiving pulmonary hypertension medications, the in-hospital mortality rate reached 25 %. In multivariate analysis, emergency admission and the use of pulmonary hypertension medications were independently associated with longer hospital stays after surgery.

Conclusions

In adults with Down syndrome and CHD, invasive cardiovascular procedures had relatively acceptable in-hospital outcomes. Careful patient selection and perioperative management are crucial when planning cardiac surgery, especially in patients taking medication for pulmonary hypertension.

医疗保健的进步增加了患有唐氏综合征和先天性心脏病（CHD）的成年人的数量，包括那些有残留或未修复病变的人。然而，在这一人群中，有创心血管手术后的临床结果仍然知之甚少。方法我们从日本所有心血管疾病诊断程序组合登记处（JROAD-DPC）中提取年龄≥16岁且诊断为冠心病的唐氏综合征患者的数据，涵盖时间为2013年4月1日至2023年3月31日。接受心血管手术或经导管手术的患者被纳入分析。结果纳入115例患者，中位年龄21岁[17-33]，女性47.8%，其中手术72例，经导管介入43例。手术在16-29岁的人群中最为常见。冠心病主要亚型为法洛四联症、房间隔缺损和房室间隔缺损。基于导管的干预措施与更短的住院时间和无院内死亡率相关。相比之下，所有3例死亡（4.2%）发生在手术组，其中2例患者使用了肺动脉高压药物。在接受肺动脉高压药物治疗的外科患者中，住院死亡率达到25%。在多变量分析中，急诊入院和肺动脉高压药物的使用与术后住院时间的延长独立相关。结论：在患有唐氏综合征和冠心病的成年人中，有创心血管手术具有相对可接受的住院结果。仔细的病人选择和围手术期管理是至关重要的，当计划心脏手术，特别是在病人服用药物肺动脉高压。

{"title":"Clinical characteristics and outcomes of cardiovascular surgery and transcatheter procedures in adults with Down syndrome and congenital heart disease","authors":"Takumi Osawa , Tomoko Machino-Ohtsuka , Keitaro Kume , Takahiro Yano , Koshiro Kanaoka , Yoko Sumita , Yusuke Yano , Ruriko Numata , Naoto Kawamatsu , Hideyuki Kato , Yuji Hiramatsu , Tomoko Ishizu","doi":"10.1016/j.ijcchd.2025.100638","DOIUrl":"10.1016/j.ijcchd.2025.100638","url":null,"abstract":"<div><h3>Background</h3><div>Advances in medical care have increased the number of adults with Down syndrome and congenital heart disease (CHD), including those with residual or unrepaired lesions. However, clinical outcomes following invasive cardiovascular procedures in this population remain poorly understood.</div></div><div><h3>Methods</h3><div>We extracted data on patients with Down syndrome aged ≥16 years and diagnosed with CHD from the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination (JROAD-DPC), covering the period from April 1, 2013, to March 31, 2023. Patients who underwent cardiovascular surgery or transcatheter procedures were included in the analysis.</div></div><div><h3>Results</h3><div>The study included 115 patients (median age: 21 [17–33] years; 47.8 % female), of whom 72 underwent surgery and 43 underwent transcatheter intervention. Procedures were most common among those aged 16–29 years. The main CHD subtypes were tetralogy of Fallot, atrial septal defects, and atrioventricular septal defects. Catheter-based interventions were associated with shorter hospital stay and no in-hospital mortality. In contrast, all three deaths (4.2 %) occurred in the surgical group, with pulmonary hypertension medications used in two of these patients. Among surgical patients receiving pulmonary hypertension medications, the in-hospital mortality rate reached 25 %. In multivariate analysis, emergency admission and the use of pulmonary hypertension medications were independently associated with longer hospital stays after surgery.</div></div><div><h3>Conclusions</h3><div>In adults with Down syndrome and CHD, invasive cardiovascular procedures had relatively acceptable in-hospital outcomes. Careful patient selection and perioperative management are crucial when planning cardiac surgery, especially in patients taking medication for pulmonary hypertension.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100638"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thrombus formation in neonates and early infants undergoing congenital heart surgery 接受先天性心脏手术的新生儿和早期婴儿血栓形成

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-08-27 DOI: 10.1016/j.ijcchd.2025.100617

Muneaki Matsubara , Alessandra Poppe , Thibault Schaeffer , Jonas Palm , Teresa Lemmen , Paul Philipp Heinisch , Nicole Piber , Andrea Amici , Alfred Hager , Peter Ewert , Jürgen Hörer , Masamichi Ono

Objective

This study evaluated thrombus formation and its impact on outcomes in neonates and early infants undergoing congenital heart surgery.

Methods

Neonates and early infants (≤90 days) undergoing congenital heart surgery with cardiopulmonary bypass from 2001 to 2024 were analyzed. Thrombi were detected by transthoracic echocardiography and cardiac catheterization.

Results

Among 2331 patients, 170 (7.3 %) developed thrombi during hospitalization. Median age at surgery and time to thrombus detection in affected patients were 12 (interquartile range: 7–34) and 7 (interquartile range: 3–15) days, respectively. Among surgical procedures performed in at least 10 patients, thrombi were most frequently observed following tricuspid valve repair (28.6 %), followed by arterial switch operation, ventricular septal defect closure, and aortic arch repair (15.8 %). The most common thrombus location was the superior vena cava in 61 patients, followed by the inferior vena cava in 33, the aorta in 31, and the right atrium in 21 patients. Additional surgical interventions were required in 28 patients. The length of hospital stay was significantly longer in patients with thrombi (27 vs. 15 days, p < 0.001). Independent risk factors for thrombus formation included preoperative cardiopulmonary resuscitation (odds ratio: 2.037, p = 0.001), tricuspid valve repair (odds ratio: 6.206, p < 0.001), and Norwood procedure (odds ratio: 1.558, p = 0.027).

Conclusions

The incidence of thrombus formation was 7.3 % in neonates and early infants undergoing congenital heart surgery. Thrombus was most frequently observed in the superior vena cava and resulted in prolonged hospitalization. Preoperative cardiopulmonary resuscitation, tricuspid valve repair, and Norwood procedures carried the highest thrombotic risk.

目的探讨新生儿和早期婴儿接受先天性心脏手术后血栓形成及其对预后的影响。方法对2001 ~ 2024年接受先天性心脏手术合并体外循环的新生儿和早期婴儿（≤90天）进行分析。经胸超声心动图和心导管检查血栓。结果2331例患者中，住院期间发生血栓170例（7.3%）。患者手术年龄中位数为12天（四分位数范围7 - 34天），血栓检测时间中位数为7天（四分位数范围3-15天）。在至少10例患者的外科手术中，三尖瓣修复术后最常观察到血栓（28.6%），其次是动脉转换手术、室间隔缺损闭合和主动脉弓修复（15.8%）。61例患者血栓最常见的部位为上腔静脉，33例为下腔静脉，31例为主动脉，21例为右心房。28例患者需要额外的手术干预。血栓患者的住院时间明显更长（27天vs 15天，p < 0.001）。血栓形成的独立危险因素包括术前心肺复苏（优势比：2.037,p = 0.001）、三尖瓣修复（优势比：6.206,p < 0.001）和诺伍德手术（优势比：1.558,p = 0.027）。结论先天性心脏手术中新生儿及早期婴儿血栓形成的发生率为7.3%。血栓最常见于上腔静脉，导致住院时间延长。术前心肺复苏、三尖瓣修复和诺伍德手术的血栓形成风险最高。

{"title":"Thrombus formation in neonates and early infants undergoing congenital heart surgery","authors":"Muneaki Matsubara , Alessandra Poppe , Thibault Schaeffer , Jonas Palm , Teresa Lemmen , Paul Philipp Heinisch , Nicole Piber , Andrea Amici , Alfred Hager , Peter Ewert , Jürgen Hörer , Masamichi Ono","doi":"10.1016/j.ijcchd.2025.100617","DOIUrl":"10.1016/j.ijcchd.2025.100617","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated thrombus formation and its impact on outcomes in neonates and early infants undergoing congenital heart surgery.</div></div><div><h3>Methods</h3><div>Neonates and early infants (≤90 days) undergoing congenital heart surgery with cardiopulmonary bypass from 2001 to 2024 were analyzed. Thrombi were detected by transthoracic echocardiography and cardiac catheterization.</div></div><div><h3>Results</h3><div>Among 2331 patients, 170 (7.3 %) developed thrombi during hospitalization. Median age at surgery and time to thrombus detection in affected patients were 12 (interquartile range: 7–34) and 7 (interquartile range: 3–15) days, respectively. Among surgical procedures performed in at least 10 patients, thrombi were most frequently observed following tricuspid valve repair (28.6 %), followed by arterial switch operation, ventricular septal defect closure, and aortic arch repair (15.8 %). The most common thrombus location was the superior vena cava in 61 patients, followed by the inferior vena cava in 33, the aorta in 31, and the right atrium in 21 patients. Additional surgical interventions were required in 28 patients. The length of hospital stay was significantly longer in patients with thrombi (27 vs. 15 days, p < 0.001). Independent risk factors for thrombus formation included preoperative cardiopulmonary resuscitation (odds ratio: 2.037, p = 0.001), tricuspid valve repair (odds ratio: 6.206, p < 0.001), and Norwood procedure (odds ratio: 1.558, p = 0.027).</div></div><div><h3>Conclusions</h3><div>The incidence of thrombus formation was 7.3 % in neonates and early infants undergoing congenital heart surgery. Thrombus was most frequently observed in the superior vena cava and resulted in prolonged hospitalization. Preoperative cardiopulmonary resuscitation, tricuspid valve repair, and Norwood procedures carried the highest thrombotic risk.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100617"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac autonomic function in patients with single ventricle physiology after Fontan palliation: A literature review Fontan姑息治疗后单心室患者的心脏自主神经功能：文献综述

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-10-30 DOI: 10.1016/j.ijcchd.2025.100636

Elizaveta Polyakova , Marieke Nederend , Philippine Kies , Anastasia D. Egorova , Monique R.M. Jongbloed

Background

The Fontan operation has significantly improved survival in patients with single ventricle physiology. This comes at a price of highly prevalent long-term complications. Autonomic dysfunction has been documented in patients after Fontan palliation. Although autonomic dysfunction is associated with a range of adverse outcomes, the exact clinical implications in patients with a Fontan circulation remain unclear.

Aims

The aims of this review are to address (1) the extent and characteristics of autonomic dysfunction in Fontan patients; (2) its association with clinical short- and long-term outcomes, and (3) identify key gaps in the literature.

Methods

A literature search was performed in PubMed using a dedicated query for single ventricle disease and cardiac autonomic (dys)function.

Results

Data from the literature consistently indicated overt autonomic dysfunction in patients after Fontan operation versus controls, marked by reduced heart rate variability and impaired parasympathetic tone. However, autonomic dysfunction showed different associations with clinical outcomes in Fontan patients. Several studies reported an association with diminished exercise capacity, arrhythmias, organ function markers, while other studies found no clear predictive value. Gaps in literature include data on adult patients, the influence of anatomical substrate, sex and lifestyle, as well as specific “driving” factors for the development of cardiac autonomic dysfunction.

Conclusion

Autonomic dysfunction in Fontan patients is a persistent and potentially progressive condition, characterized by reduced heart rate variability and reduced parasympathetic tone. Long-term studies are needed to clarify its clinical significance and address gaps in literature relating to contributing factors like sex, anatomy, and underlying mechanisms.

背景Fontan手术可显著提高单心室生理患者的生存率。这是以非常普遍的长期并发症为代价的。在Fontan姑息治疗后的患者中有植物神经功能障碍的记录。尽管自主神经功能障碍与一系列不良后果相关，但Fontan循环患者的确切临床意义尚不清楚。本综述的目的是解决(1)Fontan患者自主神经功能障碍的程度和特征；(2)其与临床短期和长期预后的关系；(3)确定文献中的关键空白。方法在PubMed上使用单心室疾病和心脏自主神经（dys）功能的专用查询进行文献检索。结果来自文献的数据一致表明Fontan手术后患者与对照组相比存在明显的自主神经功能障碍，其特征是心率变异性降低和副交感神经张力受损。然而，自主神经功能障碍与Fontan患者的临床结果有不同的相关性。一些研究报告了与运动能力下降、心律失常、器官功能指标的关联，而其他研究没有发现明确的预测价值。文献中的空白包括成年患者的数据，解剖基质、性别和生活方式的影响，以及心脏自主神经功能障碍发展的具体“驱动”因素。结论Fontan患者的自主神经功能障碍是一种持续的、潜在的进行性疾病，其特征是心率变异性降低和副交感神经张力降低。需要长期的研究来阐明其临床意义，并解决与性别、解剖学和潜在机制等因素相关的文献空白。

{"title":"Cardiac autonomic function in patients with single ventricle physiology after Fontan palliation: A literature review","authors":"Elizaveta Polyakova , Marieke Nederend , Philippine Kies , Anastasia D. Egorova , Monique R.M. Jongbloed","doi":"10.1016/j.ijcchd.2025.100636","DOIUrl":"10.1016/j.ijcchd.2025.100636","url":null,"abstract":"<div><h3>Background</h3><div>The Fontan operation has significantly improved survival in patients with single ventricle physiology. This comes at a price of highly prevalent long-term complications. Autonomic dysfunction has been documented in patients after Fontan palliation. Although autonomic dysfunction is associated with a range of adverse outcomes, the exact clinical implications in patients with a Fontan circulation remain unclear.</div></div><div><h3>Aims</h3><div>The aims of this review are to address (1) the extent and characteristics of autonomic dysfunction in Fontan patients; (2) its association with clinical short- and long-term outcomes, and (3) identify key gaps in the literature.</div></div><div><h3>Methods</h3><div>A literature search was performed in PubMed using a dedicated query for single ventricle disease and cardiac autonomic (dys)function.</div></div><div><h3>Results</h3><div>Data from the literature consistently indicated overt autonomic dysfunction in patients after Fontan operation versus controls, marked by reduced heart rate variability and impaired parasympathetic tone. However, autonomic dysfunction showed different associations with clinical outcomes in Fontan patients. Several studies reported an association with diminished exercise capacity, arrhythmias, organ function markers, while other studies found no clear predictive value. Gaps in literature include data on adult patients, the influence of anatomical substrate, sex and lifestyle, as well as specific “driving” factors for the development of cardiac autonomic dysfunction.</div></div><div><h3>Conclusion</h3><div>Autonomic dysfunction in Fontan patients is a persistent and potentially progressive condition, characterized by reduced heart rate variability and reduced parasympathetic tone. Long-term studies are needed to clarify its clinical significance and address gaps in literature relating to contributing factors like sex, anatomy, and underlying mechanisms.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100636"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in the imaging of pulmonary hypertension 肺动脉高压的影像学研究进展

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-09-10 DOI: 10.1016/j.ijcchd.2025.100619

Polona Kačar , Katja Prokšelj , Sarah Ghonim , Thomas Semple , Sonya V. Babu-Narayan , Heba Nashat , Stephen J. Wort , Michael A. Gatzoulis , Margarita Brida

Pulmonary hypertension (PH) is a complex and progressive disorder characterized by elevated pulmonary arterial pressures leading to right ventricular dysfunction and increased morbidity and mortality. Non-invasive imaging, including echocardiography, computed tomography (CT) and cardiovascular magnetic resonance (CMR), plays a crucial role in the diagnosis, risk stratification, and management of PH. The integration of these imaging modalities facilitates a multimodal approach to PH evaluation, enabling more precise diagnosis, improved phenotyping, and better-guided therapeutic decision-making. Echocardiography remains the first-line modality, offering valuable insights into pulmonary artery pressures, right ventricular size and function, and associated cardiac anomalies. Recent developments in speckle-tracking echocardiography and 3D imaging have enhanced its diagnostic and prognostic utility. CT imaging provides detailed evaluation of the pulmonary vasculature, parenchyma, and perfusion, which is essential in distinguishing PH subtypes. CMR is non-invasive, radiation free, and highly sensitive to changes in anatomy and function making it ideal for the long-term follow up of patients with PH. It offers in-depth evaluation of all cardiac chambers as well as pulmonary blood flow assessment and tissue characterisation. In this work we discuss current strengths, limitations, and future directions in these key imaging modalities used for the comprehensive assessment of PH.

肺动脉高压（PH）是一种复杂的进行性疾病，其特征是肺动脉压升高导致右心室功能障碍，发病率和死亡率增加。非侵入性成像，包括超声心动图、计算机断层扫描（CT）和心血管磁共振（CMR），在PH的诊断、风险分层和管理中起着至关重要的作用。这些成像模式的整合促进了PH评估的多模式方法，实现了更精确的诊断，改善了表型，并更好地指导了治疗决策。超声心动图仍然是一线方式，提供有价值的见解肺动脉压，右心室大小和功能，以及相关的心脏异常。斑点跟踪超声心动图和3D成像的最新发展增强了其诊断和预后的效用。CT成像提供了肺血管、实质和灌注的详细评估，这是区分PH亚型所必需的。CMR是非侵入性的，无辐射的，对解剖和功能的变化高度敏感，使其成为ph患者长期随访的理想选择。它提供对所有心腔的深入评估，以及肺血流评估和组织特征。在这项工作中，我们讨论了用于PH综合评估的这些关键成像模式的当前优势、局限性和未来方向。

{"title":"Advances in the imaging of pulmonary hypertension","authors":"Polona Kačar , Katja Prokšelj , Sarah Ghonim , Thomas Semple , Sonya V. Babu-Narayan , Heba Nashat , Stephen J. Wort , Michael A. Gatzoulis , Margarita Brida","doi":"10.1016/j.ijcchd.2025.100619","DOIUrl":"10.1016/j.ijcchd.2025.100619","url":null,"abstract":"<div><div>Pulmonary hypertension (PH) is a complex and progressive disorder characterized by elevated pulmonary arterial pressures leading to right ventricular dysfunction and increased morbidity and mortality. Non-invasive imaging, including echocardiography, computed tomography (CT) and cardiovascular magnetic resonance (CMR), plays a crucial role in the diagnosis, risk stratification, and management of PH. The integration of these imaging modalities facilitates a multimodal approach to PH evaluation, enabling more precise diagnosis, improved phenotyping, and better-guided therapeutic decision-making. Echocardiography remains the first-line modality, offering valuable insights into pulmonary artery pressures, right ventricular size and function, and associated cardiac anomalies. Recent developments in speckle-tracking echocardiography and 3D imaging have enhanced its diagnostic and prognostic utility. CT imaging provides detailed evaluation of the pulmonary vasculature, parenchyma, and perfusion, which is essential in distinguishing PH subtypes. CMR is non-invasive, radiation free, and highly sensitive to changes in anatomy and function making it ideal for the long-term follow up of patients with PH. It offers in-depth evaluation of all cardiac chambers as well as pulmonary blood flow assessment and tissue characterisation. In this work we discuss current strengths, limitations, and future directions in these key imaging modalities used for the comprehensive assessment of PH.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100619"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Congenital Cardiac Diagnosis Translator (CCDT): Enhancing interoperability in congenital cardiac diagnosis terminology 先天性心脏诊断翻译（CCDT）：增强先天性心脏诊断术语的互操作性

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-10-09 DOI: 10.1016/j.ijcchd.2025.100628

Sarah Kübler, Ely Erez, Justin Cohen, Peter J. Gruber

Objectives

Congenital heart diseases (CHDs) are classified using diverse terminologies worldwide, creating barriers to effective communication and collaboration in both clinical practice and research. This project aimed to develop a tool to improve interoperability between commonly used CHD classification systems.

Methods and results

The Congenital Cardiac Diagnosis Translator (CCDT) was developed by manually cross-matching diagnostic terms across six coding systems: Fyler, HPO, IPCCC, STS, ICD-10, and ICD-11. Terms were reviewed one system at a time. When an exact match was unavailable, the most specific encompassing diagnosis was selected; in cases where no suitable match existed, no translation was provided. Mappings were consolidated into a curated master lookup table. The CCDT was implemented as a web-based tool with a graphical user interface, enabling term-specific searches. Translations were qualitatively validated by clinical experts in congenital cardiology to ensure accuracy and relevance. The CCDT includes 505 unique congenital heart diagnoses cross-mapped across six coding systems. Qualitative feedback indicated that the translator is intuitive, accurate, and easy to use.

Conclusions

The CCDT provides a scalable, expert-informed solution for improving interoperability across CHD classification systems. By standardizing diagnostic terminology, it supports global collaboration and data sharing in congenital cardiology. The translator is freely accessible and will continue to evolve alongside diagnostic systems.

目的先天性心脏病（CHDs）在世界范围内使用不同的术语进行分类，这给临床实践和研究中的有效沟通和合作造成了障碍。该项目旨在开发一种工具来提高常用CHD分类系统之间的互操作性。方法与结果先天性心脏诊断翻译器（CCDT）通过人工交叉匹配6个编码系统的诊断术语：Fyler、HPO、IPCCC、STS、ICD-10和ICD-11。术语是一次一个系统地审查。当无法获得完全匹配时，选择最具体的综合诊断；在没有适当匹配的情况下，不提供翻译。映射被合并到一个策划的主查找表中。CCDT是作为基于web的工具实现的，具有图形用户界面，支持特定术语的搜索。翻译由先天性心脏病学临床专家进行定性验证，以确保准确性和相关性。CCDT包括505个独特的先天性心脏病诊断，跨六个编码系统交叉映射。定性反馈表明，翻译直观，准确，易于使用。CCDT为提高冠心病分类系统的互操作性提供了一个可扩展的、专家知情的解决方案。通过标准化诊断术语，它支持先天性心脏病学的全球合作和数据共享。翻译器可以免费使用，并将与诊断系统一起继续发展。

{"title":"The Congenital Cardiac Diagnosis Translator (CCDT): Enhancing interoperability in congenital cardiac diagnosis terminology","authors":"Sarah Kübler, Ely Erez, Justin Cohen, Peter J. Gruber","doi":"10.1016/j.ijcchd.2025.100628","DOIUrl":"10.1016/j.ijcchd.2025.100628","url":null,"abstract":"<div><h3>Objectives</h3><div>Congenital heart diseases (CHDs) are classified using diverse terminologies worldwide, creating barriers to effective communication and collaboration in both clinical practice and research. This project aimed to develop a tool to improve interoperability between commonly used CHD classification systems.</div></div><div><h3>Methods and results</h3><div>The Congenital Cardiac Diagnosis Translator (CCDT) was developed by manually cross-matching diagnostic terms across six coding systems: Fyler, HPO, IPCCC, STS, ICD-10, and ICD-11. Terms were reviewed one system at a time. When an exact match was unavailable, the most specific encompassing diagnosis was selected; in cases where no suitable match existed, no translation was provided. Mappings were consolidated into a curated master lookup table. The CCDT was implemented as a web-based tool with a graphical user interface, enabling term-specific searches. Translations were qualitatively validated by clinical experts in congenital cardiology to ensure accuracy and relevance. The CCDT includes 505 unique congenital heart diagnoses cross-mapped across six coding systems. Qualitative feedback indicated that the translator is intuitive, accurate, and easy to use.</div></div><div><h3>Conclusions</h3><div>The CCDT provides a scalable, expert-informed solution for improving interoperability across CHD classification systems. By standardizing diagnostic terminology, it supports global collaboration and data sharing in congenital cardiology. The translator is freely accessible and will continue to evolve alongside diagnostic systems.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100628"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Right ventricular pressure-volume loop analysis in congenital heart disease 先天性心脏病右心室压力-容积环分析

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-10-02 DOI: 10.1016/j.ijcchd.2025.100625

Renée S. Joosen , Michael G. Dickinson , Marielle C. van de Veerdonk , Rahi S. Alipour Symakani , Daphne Merkus , Michiel Voskuil , Gregor J. Krings , Johannes M.P.J. Breur

Background

Right ventricular (RV) function is an independent predictor of prognosis in patients with congenital heart disease (CHD). Early detection is therefore crucial but current methods to assess RV function are highly load-dependent. RV pressure-volume (PV) loop analysis is an invasive technique which is load-independent and considered the gold standard for evaluating RV adaptation in relation to its load. However, RV PV loop analysis can be time consuming and prone to inter-operator variability.

Methods

This article provides a comprehensive guide on performing RV PV loop analysis using the multi-beat method in pediatric and adult patients with complex CHD.

Results

RV PV loop analysis using the multi-beat method can be safely and reliably applied in children and adults with complex CHD.

Conclusion

RV PV loop analysis offers a valuable tool for advanced insight into RV adaptation and a deeper understanding of cardiac physiology in complex CHD patients with RV pressure and/or volume overload. By enhancing our understanding of RV adaptation, this approach holds great potential for improving patient management and optimizing treatment strategies.

背景：右心室（RV）功能是先天性心脏病（CHD）患者预后的独立预测因子。因此，早期检测至关重要，但目前评估右心室功能的方法高度依赖于负荷。RV压力-体积（PV）环分析是一种与负荷无关的侵入性技术，被认为是评估RV与负荷相关的适应性的金标准。然而，RV PV回路分析可能是耗时的，并且容易受到操作者之间的变化。方法采用多拍法对儿童和成人复杂冠心病患者进行RV - PV环路分析。结果采用多拍法进行rv PV环路分析可安全可靠地应用于儿童和成人复杂冠心病患者。结论右心室PV环分析为深入了解右心室适应和更深入地了解右心室压力和/或容量过载的复杂冠心病患者的心脏生理提供了有价值的工具。通过增强我们对RV适应的理解，这种方法在改善患者管理和优化治疗策略方面具有巨大的潜力。

{"title":"Right ventricular pressure-volume loop analysis in congenital heart disease","authors":"Renée S. Joosen , Michael G. Dickinson , Marielle C. van de Veerdonk , Rahi S. Alipour Symakani , Daphne Merkus , Michiel Voskuil , Gregor J. Krings , Johannes M.P.J. Breur","doi":"10.1016/j.ijcchd.2025.100625","DOIUrl":"10.1016/j.ijcchd.2025.100625","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular (RV) function is an independent predictor of prognosis in patients with congenital heart disease (CHD). Early detection is therefore crucial but current methods to assess RV function are highly load-dependent. RV pressure-volume (PV) loop analysis is an invasive technique which is load-independent and considered the gold standard for evaluating RV adaptation in relation to its load. However, RV PV loop analysis can be time consuming and prone to inter-operator variability.</div></div><div><h3>Methods</h3><div>This article provides a comprehensive guide on performing RV PV loop analysis using the multi-beat method in pediatric and adult patients with complex CHD.</div></div><div><h3>Results</h3><div>RV PV loop analysis using the multi-beat method can be safely and reliably applied in children and adults with complex CHD.</div></div><div><h3>Conclusion</h3><div>RV PV loop analysis offers a valuable tool for advanced insight into RV adaptation and a deeper understanding of cardiac physiology in complex CHD patients with RV pressure and/or volume overload. By enhancing our understanding of RV adaptation, this approach holds great potential for improving patient management and optimizing treatment strategies.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100625"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identification of priority practice areas for evidence-based care in congenital heart Disease: An exploratory Survey of non-medical healthcare professionals affiliated with the Italian Society of Pediatric Cardiology 确定先天性心脏病循证护理的优先实践领域：意大利儿科心脏病学会附属的非医疗保健专业人员的探索性调查

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-08-28 DOI: 10.1016/j.ijcchd.2025.100616

Arianna Magon , Serena Francesca Flocco , Samantha Scolari , Gianluca Conte , Cristina Arrigoni , Greta Ghizzardi , Giovanna Campioni , Raluca-Bianca Nedesca , Enrico Gambirasi , Floriana Di Iorio , Rossella Orlando , Mariassunta Castaldi , Chiara Gatti , Paola Claudia Fazio , Mariella Rubin , Cinzia Pirti , Stefania Baratta , Assunta Carandente , Salvatore Angileri , Rosario Caruso

Introduction

s Identifying priority areas of nursing practice for individuals with congenital heart disease (CHD) is essential to address evolving care needs and support professional development. However, standardized criteria to guide such prioritization remain limited.

Methods

A cross-sectional observational study was conducted between April and September 2024 using an online survey distributed to all nurse members of the Italian Society of Pediatric Cardiology and Congenital Heart Diseases (SICPED). Sixteen CHD-related practice areas and five prioritization criteria were defined through literature review and expert consultation. Participants rated each area on a 5-point Likert scale according to the five criteria.

Results

A total of 78 nurses completed the survey. Among the criteria, the absence of clinical guidelines (mean = 4.04 ± 0.98) and the required level of professional competence (mean = 3.95 ± 1.24) received the highest scores. Mixed ANOVA revealed significant variability in scores across practice areas and criteria (F(48) = 2.385, p < .001). Four areas emerged as priority domains across multiple criteria: psychosocial and emotional support for individuals with CHD and their families, management of neonatal opioid withdrawal, palliative and end-of-life care, and the transition of adolescents with CHD to adult services.

Conclusions

This study provides a structured foundation for identifying nursing practice priorities in the care of individuals with CHD. These findings may guide the development of interdisciplinary strategies, clinical guidelines, and professional training initiatives within communities of practice.

确定先天性心脏病（CHD）患者护理实践的优先领域对于解决不断变化的护理需求和支持专业发展至关重要。然而，指导这种优先次序的标准化标准仍然有限。方法于2024年4月至9月对意大利儿科心脏病和先天性心脏病学会（SICPED）的所有护士成员进行在线调查，进行横断面观察性研究。通过文献回顾和专家咨询，确定了16个冠心病相关实践领域和5个优先标准。参与者根据五个标准对每个区域进行5分李克特评分。结果共78名护士完成调查。其中，缺乏临床指南（平均= 4.04±0.98）和专业能力要求水平（平均= 3.95±1.24）得分最高。混合方差分析显示，不同实践领域和标准的得分存在显著差异（F(48) = 2.385, p < .001）。在多个标准中，四个领域被列为优先领域：对冠心病患者及其家人的社会心理和情感支持，新生儿阿片类药物戒断的管理，姑息治疗和临终关怀，以及冠心病青少年向成人服务的过渡。结论：本研究为确定冠心病患者护理实践的优先事项提供了结构化的基础。这些发现可以指导跨学科策略、临床指南和实践社区内的专业培训计划的发展。

{"title":"Identification of priority practice areas for evidence-based care in congenital heart Disease: An exploratory Survey of non-medical healthcare professionals affiliated with the Italian Society of Pediatric Cardiology","authors":"Arianna Magon , Serena Francesca Flocco , Samantha Scolari , Gianluca Conte , Cristina Arrigoni , Greta Ghizzardi , Giovanna Campioni , Raluca-Bianca Nedesca , Enrico Gambirasi , Floriana Di Iorio , Rossella Orlando , Mariassunta Castaldi , Chiara Gatti , Paola Claudia Fazio , Mariella Rubin , Cinzia Pirti , Stefania Baratta , Assunta Carandente , Salvatore Angileri , Rosario Caruso","doi":"10.1016/j.ijcchd.2025.100616","DOIUrl":"10.1016/j.ijcchd.2025.100616","url":null,"abstract":"<div><h3>Introduction</h3><div>s Identifying priority areas of nursing practice for individuals with congenital heart disease (CHD) is essential to address evolving care needs and support professional development. However, standardized criteria to guide such prioritization remain limited.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study was conducted between April and September 2024 using an online survey distributed to all nurse members of the Italian Society of Pediatric Cardiology and Congenital Heart Diseases (SICPED). Sixteen CHD-related practice areas and five prioritization criteria were defined through literature review and expert consultation. Participants rated each area on a 5-point Likert scale according to the five criteria.</div></div><div><h3>Results</h3><div>A total of 78 nurses completed the survey. Among the criteria, the absence of clinical guidelines (mean = 4.04 ± 0.98) and the required level of professional competence (mean = 3.95 ± 1.24) received the highest scores. Mixed ANOVA revealed significant variability in scores across practice areas and criteria (F(48) = 2.385, p < .001). Four areas emerged as priority domains across multiple criteria: psychosocial and emotional support for individuals with CHD and their families, management of neonatal opioid withdrawal, palliative and end-of-life care, and the transition of adolescents with CHD to adult services.</div></div><div><h3>Conclusions</h3><div>This study provides a structured foundation for identifying nursing practice priorities in the care of individuals with CHD. These findings may guide the development of interdisciplinary strategies, clinical guidelines, and professional training initiatives within communities of practice.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100616"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical implications of progressive systemic ventricular dysfunction in adults with Fontan palliation 渐进性全身性脑室功能障碍在成人Fontan姑息治疗中的临床意义

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-09-13 DOI: 10.1016/j.ijcchd.2025.100620

Meena Bai, Ahmed Bahnasy, Sara Aboelmaaty, Mohamed Ellabbad, Ahmed Ali, Alexander C. Egbe

Background

The purpose of this study was to determine the clinical implications of progressive systemic ventricular (SV) systolic dysfunction in adults with Fontan palliation.

Methods

Retrospective study of Fontan patients with ≥2 echocardiograms at Mayo Clinic. SV systolic function was assessed using echo-derived ejection fraction (Echo_EF) at baseline, and annually for 3 years. Temporal decline in SV systolic function was estimated as relative change (relative Δ_Echo_EF)/year. Exploratory analysis was performed to assess the effect of guideline-directed medical therapy (GDMT) on Echo_EF.

Results

Of 414 patients (age 27 ± 9 years; males 228 [55 %]), 287 (69 %) and 127 (31 %) had dominant morphologic left ventricle (LV) and right ventricle (RV), respectively. Assessment of Echo_EF was feasible in 1464 of 1603 echocardiograms (91 %). The baseline Echo_EF was 54 % (48–58), and the relative Δ_Echo_EF was −3.9 % (95 %CI -6.3 to −2.5 %)/year. The predictors of progressive SV systolic dysfunction were older age, morphologic RV, ≥moderate atrioventricular valve regurgitation, cardiac implantable electronic devices, and atrial fibrillation. Progressive SV systolic dysfunction was associated with an approximately 2-fold increase in death/transplant (hazard ratio 1.92, p = 0.009), independent of baseline Echo_EF and comorbidities. GDMT was associated with improvement in Echo_EF in patients with morphologic LV.

Conclusions

The current study underscores the importance of longitudinal echocardiographic monitoring of SV systolic function, and the potential clinical benefits of GDMT in patients with morphologic LV. Further studies are required to determine whether interventions such as valve surgery, rhythm control strategy, and physiologic pacing would prevent or reverse SV systolic dysfunction.

本研究的目的是确定成人Fontan姑息治疗中进行性系统性心室（SV）收缩功能障碍的临床意义。方法对梅奥诊所超声心动图≥2张的Fontan患者进行回顾性研究。在基线时使用回声衍生射血分数（Echo_EF）评估SV收缩功能，并在3年内每年评估一次。SV收缩功能的时间下降估计为相对变化（相对Δ_Echo_EF）/年。采用探索性分析方法评价指南导向药物治疗（GDMT）对Echo_EF的影响。结果414例患者（年龄27±9岁，男性228例[55%]），287例（69%）和127例（31%）分别表现为左心室（LV）和右心室（RV）优势形态。1603张超声心动图中有1464张（91%）可评价Echo_EF。基线Echo_EF为54%(48-58)，相对Δ_Echo_EF为- 3.9% (95% CI -6.3 - 2.5%)/年。进行性SV收缩功能障碍的预测因子为年龄较大、形态RV、≥中度房室瓣膜返流、心脏植入式电子装置和心房颤动。进行性SV收缩功能障碍与死亡/移植增加约2倍相关（危险比1.92,p = 0.009），与基线Echo_EF和合并症无关。GDMT与形态学左室患者Echo_EF的改善相关。结论当前的研究强调了纵向超声心动图监测SV收缩功能的重要性，以及GDMT在形态学左室患者中的潜在临床益处。需要进一步的研究来确定诸如瓣膜手术、节律控制策略和生理性起搏等干预措施是否能预防或逆转SV收缩功能障碍。

{"title":"Clinical implications of progressive systemic ventricular dysfunction in adults with Fontan palliation","authors":"Meena Bai, Ahmed Bahnasy, Sara Aboelmaaty, Mohamed Ellabbad, Ahmed Ali, Alexander C. Egbe","doi":"10.1016/j.ijcchd.2025.100620","DOIUrl":"10.1016/j.ijcchd.2025.100620","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to determine the clinical implications of progressive systemic ventricular (SV) systolic dysfunction in adults with Fontan palliation.</div></div><div><h3>Methods</h3><div>Retrospective study of Fontan patients with ≥2 echocardiograms at Mayo Clinic. SV systolic function was assessed using echo-derived ejection fraction (Echo_EF) at baseline, and annually for 3 years. Temporal decline in SV systolic function was estimated as relative change (relative Δ_Echo_EF)/year. Exploratory analysis was performed to assess the effect of guideline-directed medical therapy (GDMT) on Echo_EF.</div></div><div><h3>Results</h3><div>Of 414 patients (age 27 ± 9 years; males 228 [55 %]), 287 (69 %) and 127 (31 %) had dominant morphologic left ventricle (LV) and right ventricle (RV), respectively. Assessment of Echo_EF was feasible in 1464 of 1603 echocardiograms (91 %). The baseline Echo_EF was 54 % (48–58), and the relative Δ_Echo_EF was −3.9 % (95 %CI -6.3 to −2.5 %)/year. The predictors of progressive SV systolic dysfunction were older age, morphologic RV, ≥moderate atrioventricular valve regurgitation, cardiac implantable electronic devices, and atrial fibrillation. Progressive SV systolic dysfunction was associated with an approximately 2-fold increase in death/transplant (hazard ratio 1.92, p = 0.009), independent of baseline Echo_EF and comorbidities. GDMT was associated with improvement in Echo_EF in patients with morphologic LV.</div></div><div><h3>Conclusions</h3><div>The current study underscores the importance of longitudinal echocardiographic monitoring of SV systolic function, and the potential clinical benefits of GDMT in patients with morphologic LV. Further studies are required to determine whether interventions such as valve surgery, rhythm control strategy, and physiologic pacing would prevent or reverse SV systolic dysfunction.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100620"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to set up a pregnancy heart team 如何成立孕心小组

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI: 10.1016/j.ijcchd.2025.100635

K. Rijs , C.D. van der Marel , A.L.M.J. van der Knijff-van Dortmont , I.J.J. Dons-Sinke , V.F.R. Adriaens , J.M.J. Cornette , A.G.M.G.J. Mulders , J.J. Duvekot , M.M.P. Driessen , A.E. van den Bosch , J.A.A.E. Cuypers , R.M. Kauling , J.W. Roos-Hesselink

Cardiovascular disease (CVD) is the leading cause of maternal morbidity and mortality in developed countries, complicating 4–11 % of pregnancies. Women with CVD are at increased risk of maternal complications, including heart failure and arrhythmias, as well as adverse fetal outcomes such as preterm birth and perinatal mortality. Traditionally, care for pregnant women with CVD has been fragmented across specialties, leading to discontinuity and missed opportunities for optimization. To address this, recent European Society of Cardiology (ESC) guidelines strongly recommend the implementation of a pregnancy heart team: a dedicated multidisciplinary team providing integrated care for this high-risk population.

We describe the implementation and organization of a pregnancy heart team in our academic tertiary hospital. The core team consists of a cardiologist specialized in cardio-obstetrics, a maternal-fetal medicine specialist, and an obstetric anesthesiologist, with additional experts consulted as required. Patients are discussed at predefined time points: preconception, during pregnancy, and postpartum. Standardized risk assessment using the modified World Health Organization (mWHO) classification guides counseling, management, and delivery planning. Shared decision-making is central, balancing maternal and fetal risks with patient preferences. The team establishes individualized peripartum care plans covering timing, mode, and location of delivery, anesthesia strategies, anticoagulation management, and postpartum monitoring.

This structured, multidisciplinary model ensures continuity of care and offers a practical framework to improve outcomes in women with CVD during pregnancy.

心血管疾病（CVD）是发达国家孕产妇发病和死亡的主要原因，使4 - 11%的妊娠并发症。患有心血管疾病的妇女发生产妇并发症的风险增加，包括心力衰竭和心律失常，以及不良胎儿结局，如早产和围产期死亡。传统上，对患有心血管疾病的孕妇的护理分散在各个专科，导致不连续性和错失优化机会。为了解决这个问题，最近的欧洲心脏病学会（ESC）指南强烈建议实施妊娠心脏小组：一个专门的多学科小组，为这一高危人群提供综合护理。介绍了我院三级专科医院妊娠心脏科的实施与组织。核心小组由一名专门从事心脏产科的心脏病专家、一名母胎医学专家和一名产科麻醉师组成，并根据需要咨询其他专家。患者在预定的时间点进行讨论：孕前，怀孕期间和产后。使用经修订的世界卫生组织（mWHO）分类指南进行标准化风险评估，包括咨询、管理和交付计划。共同决策是核心，平衡产妇和胎儿的风险与患者的偏好。团队建立个性化的围产期护理计划，包括分娩的时间、方式和地点、麻醉策略、抗凝管理和产后监测。这种结构化的多学科模式确保了护理的连续性，并为改善妊娠期心血管疾病妇女的预后提供了实用的框架。

{"title":"How to set up a pregnancy heart team","authors":"K. Rijs , C.D. van der Marel , A.L.M.J. van der Knijff-van Dortmont , I.J.J. Dons-Sinke , V.F.R. Adriaens , J.M.J. Cornette , A.G.M.G.J. Mulders , J.J. Duvekot , M.M.P. Driessen , A.E. van den Bosch , J.A.A.E. Cuypers , R.M. Kauling , J.W. Roos-Hesselink","doi":"10.1016/j.ijcchd.2025.100635","DOIUrl":"10.1016/j.ijcchd.2025.100635","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) is the leading cause of maternal morbidity and mortality in developed countries, complicating 4–11 % of pregnancies. Women with CVD are at increased risk of maternal complications, including heart failure and arrhythmias, as well as adverse fetal outcomes such as preterm birth and perinatal mortality. Traditionally, care for pregnant women with CVD has been fragmented across specialties, leading to discontinuity and missed opportunities for optimization. To address this, recent European Society of Cardiology (ESC) guidelines strongly recommend the implementation of a pregnancy heart team: a dedicated multidisciplinary team providing integrated care for this high-risk population.</div><div>We describe the implementation and organization of a pregnancy heart team in our academic tertiary hospital. The core team consists of a cardiologist specialized in cardio-obstetrics, a maternal-fetal medicine specialist, and an obstetric anesthesiologist, with additional experts consulted as required. Patients are discussed at predefined time points: preconception, during pregnancy, and postpartum. Standardized risk assessment using the modified World Health Organization (mWHO) classification guides counseling, management, and delivery planning. Shared decision-making is central, balancing maternal and fetal risks with patient preferences. The team establishes individualized peripartum care plans covering timing, mode, and location of delivery, anesthesia strategies, anticoagulation management, and postpartum monitoring.</div><div>This structured, multidisciplinary model ensures continuity of care and offers a practical framework to improve outcomes in women with CVD during pregnancy.</div></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":"22 ","pages":"Article 100635"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous closure of perimembranous and infundibular ventricular septal defects: single-center experience in 203 patients with medium- and long-term follow-up 经皮膜周和小室间隔缺损闭合：203例中长期随访患者的单中心经验

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology. Congenital heart disease

Pub Date : 2025-12-01 Epub Date: 2025-11-11 DOI: 10.1016/j.ijcchd.2025.100641

Nataliia Yashchuk , Igor Ditkivskyy , Denys Voloshyn , Bogdan Cherpak , Yuliia Yermolovych

引用次数: 0