首页 > 最新文献

Annals of Pediatric Cardiology最新文献

英文 中文
Deferred Norwood in the setting of airway compression in double-inlet left ventricle with dextro-transposition of the great arteries. 双入口左心室伴右大动脉外翻时气道受压的延迟诺伍德。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_30_24
Diego R Ruiz-Avila, Subhrajit Lahiri, Syed Javed Zaidi, Harma Khachig Turbendian

A 4.1 kg male neonate with a diagnosis of double-inlet left ventricle with dextro-transposition of the great arteries was intubated shortly after birth due to respiratory insufficiency. The initial management consisted of a successful Stage I hybrid procedure. Persistent respiratory insufficiency led to cross-sectional imaging and bronchoscopy that demonstrated severe airway compression from a dilated main pulmonary artery. A Norwood procedure with Blalock-Thomas-Taussig shunt was performed at 1 month of age to relieve the airway obstruction. The patient was discharged home on room air at 2 months of age. This case highlights a unique single-ventricle anatomic variant with airway compression, which was successfully managed with deferred Norwood palliation.

一名体重 4.1 千克的男性新生儿被诊断为左心室双入口、大动脉右侧横位,出生后不久就因呼吸功能不全而被插管。最初的治疗包括成功的 I 期混合手术。持续的呼吸功能不全导致横断面成像和支气管镜检查显示主肺动脉扩张导致气道严重受压。1 个月大时,为缓解气道阻塞,患者接受了带有布洛克-托马斯-陶西分流术的诺伍德手术。患者在 2 个月大时出院回家,呼吸室内空气。该病例突显了一种独特的单心室解剖变异并伴有气道受压,通过延期诺伍德姑息术成功地解决了这一问题。
{"title":"Deferred Norwood in the setting of airway compression in double-inlet left ventricle with dextro-transposition of the great arteries.","authors":"Diego R Ruiz-Avila, Subhrajit Lahiri, Syed Javed Zaidi, Harma Khachig Turbendian","doi":"10.4103/apc.apc_30_24","DOIUrl":"10.4103/apc.apc_30_24","url":null,"abstract":"<p><p>A 4.1 kg male neonate with a diagnosis of double-inlet left ventricle with dextro-transposition of the great arteries was intubated shortly after birth due to respiratory insufficiency. The initial management consisted of a successful Stage I hybrid procedure. Persistent respiratory insufficiency led to cross-sectional imaging and bronchoscopy that demonstrated severe airway compression from a dilated main pulmonary artery. A Norwood procedure with Blalock-Thomas-Taussig shunt was performed at 1 month of age to relieve the airway obstruction. The patient was discharged home on room air at 2 months of age. This case highlights a unique single-ventricle anatomic variant with airway compression, which was successfully managed with deferred Norwood palliation.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial intelligence in pediatric cardiology: Where do we stand in 2024? 儿科心脏病学中的人工智能:2024 年我们将何去何从?
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_72_24
Supratim Sen, Sivasubramanian Ramakrishnan
{"title":"Artificial intelligence in pediatric cardiology: Where do we stand in 2024?","authors":"Supratim Sen, Sivasubramanian Ramakrishnan","doi":"10.4103/apc.apc_72_24","DOIUrl":"10.4103/apc.apc_72_24","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term outcome of permanent epicardial pacemaker implantation in neonates: Experience from an Indian center. 新生儿永久性心外膜起搏器植入术的长期疗效:印度中心的经验。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_37_24
Deepanjan Bhattacharya, Narayanan Namboodiri, Krishna Kumar Mohanan Nair, Baiju S Dharan, Deepa Sasikumar, Arun Gopalakrishnan, K M Krishnamoorthy, Sabarinath Menon, Sowmya Ramanan, Sudip Dutta Baruah

Introduction: Permanent pacemaker implantation (PPI) in neonates is challenging with respect to indications, device selection, implantation technique, and long-term outcomes. Complex anatomy, the need for long-term pacing with high rates, and a problematic postoperative period are the major problems.

Methods: We prospectively followed up 22 newborns who underwent PPI below 28 days of life at our institute.

Results: The median age at implantation was 2 days (interquartile range 1-9 days), and 9% were born preterm. The average heart rate before implantation was 46.4 ± 7.2 bpm. Maternal lupus antibodies were positive in 8 (36.4%) neonates, whereas 11 (50.0%) had associated congenital heart disease. Nineteen neonates underwent single chamber (VVI) and three underwent dual chamber (DDD) pacemaker implantation. Over a median follow-up of 46 months (range 2-123 months), the average ventricular pacing percentage was 87.5 ± 24.9%, with a stable pacing threshold. Seven children underwent pulse generator replacement due to battery depletion at a median age of 47 months. Pacing-induced ventricular dysfunction was seen in five children at a median age of 23.6 months, and two underwent upgradation to cardiac resynchronization therapy. Overall mortality was 13.6%, all due to tissue hypoperfusion and lactic acidosis in the postimplantation period.

Conclusions: PPI in neonates has a favorable outcome with excellent lead survival. Overall mortality is 13.6%, which is predominantly in the postimplantation period and related to myocardial dysfunction.

简介:新生儿永久起搏器植入术(PPI)在适应症、设备选择、植入技术和长期疗效方面具有挑战性。复杂的解剖结构、高频率的长期起搏需求以及棘手的术后问题是主要问题:方法:我们对我院出生 28 天以下接受 PPI 的 22 名新生儿进行了前瞻性随访:结果:植入时的中位年龄为 2 天(四分位距为 1-9 天),9% 为早产儿。植入前的平均心率为 46.4 ± 7.2 bpm。8名新生儿(36.4%)的母体狼疮抗体呈阳性,11名新生儿(50.0%)伴有先天性心脏病。19名新生儿接受了单腔(VVI)起搏器植入手术,3名新生儿接受了双腔(DDD)起搏器植入手术。中位随访时间为 46 个月(2-123 个月),平均心室起搏率为 87.5 ± 24.9%,起搏阈值稳定。七名患儿在中位年龄 47 个月时因电池耗尽而更换了脉冲发生器。中位年龄为 23.6 个月的五名患儿出现了起搏诱发的心室功能障碍,其中两名患儿接受了心脏再同步化治疗。总死亡率为13.6%,均为植入后组织灌注不足和乳酸酸中毒所致:结论:新生儿 PPI 术后效果良好,导联存活率极高。总死亡率为 13.6%,主要发生在植入后,与心肌功能障碍有关。
{"title":"Long-term outcome of permanent epicardial pacemaker implantation in neonates: Experience from an Indian center.","authors":"Deepanjan Bhattacharya, Narayanan Namboodiri, Krishna Kumar Mohanan Nair, Baiju S Dharan, Deepa Sasikumar, Arun Gopalakrishnan, K M Krishnamoorthy, Sabarinath Menon, Sowmya Ramanan, Sudip Dutta Baruah","doi":"10.4103/apc.apc_37_24","DOIUrl":"10.4103/apc.apc_37_24","url":null,"abstract":"<p><strong>Introduction: </strong>Permanent pacemaker implantation (PPI) in neonates is challenging with respect to indications, device selection, implantation technique, and long-term outcomes. Complex anatomy, the need for long-term pacing with high rates, and a problematic postoperative period are the major problems.</p><p><strong>Methods: </strong>We prospectively followed up 22 newborns who underwent PPI below 28 days of life at our institute.</p><p><strong>Results: </strong>The median age at implantation was 2 days (interquartile range 1-9 days), and 9% were born preterm. The average heart rate before implantation was 46.4 ± 7.2 bpm. Maternal lupus antibodies were positive in 8 (36.4%) neonates, whereas 11 (50.0%) had associated congenital heart disease. Nineteen neonates underwent single chamber (VVI) and three underwent dual chamber (DDD) pacemaker implantation. Over a median follow-up of 46 months (range 2-123 months), the average ventricular pacing percentage was 87.5 ± 24.9%, with a stable pacing threshold. Seven children underwent pulse generator replacement due to battery depletion at a median age of 47 months. Pacing-induced ventricular dysfunction was seen in five children at a median age of 23.6 months, and two underwent upgradation to cardiac resynchronization therapy. Overall mortality was 13.6%, all due to tissue hypoperfusion and lactic acidosis in the postimplantation period.</p><p><strong>Conclusions: </strong>PPI in neonates has a favorable outcome with excellent lead survival. Overall mortality is 13.6%, which is predominantly in the postimplantation period and related to myocardial dysfunction.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Procedural outcomes of percutaneous closure of perimembranous and other ventricular septal defects using Konar-MF occluder and short-term follow-up. 使用 Konar-MF 封堵器经皮封堵室间隔缺损和其他室间隔缺损的手术效果及短期随访。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_201_23
Somrita Laha, Debasree Gangopadhyay, Mahua Roy, Anoop Singh, Debabrata Nandi, Joyeeta Dutta

Introduction: The study aims to assess the procedural outcomes and follow-up after transcatheter closure of ventricular septal defects (VSDs) in children utilizing the Konar-MF™ occluder (Lifetech Scientific, Shenzhen, PRC) device.

Materials and methods: Clinical features, demographic characteristics, and follow-up findings of children undergoing percutaneous VSD device closure were retrospectively analyzed from the medical records.

Results: Fifty-seven patients underwent VSD closure using the Konar-MF occluder between January 2019 and April 2023. Median age and body weight of patients were 36 (5-216) months and 12.5 (3.8-42) kg, respectively. The mean size of the defect on the left ventricular side was 6.5 ± 2.4 mm on echocardiography; the mean pulmonary artery pressure was 19.1 ± 9.7 mmHg. Three patients with severe pulmonary hypertension had successful device closure. The most used device size was 8 mm × 6 mm. The initially chosen device was upsized in 4 (7.01%) patients and downsized in 1 (1.7%) patient. Forty-five patients (78.9%) had device closure through the retrograde route. The procedure was successful in 53 (93.0%) patients. Immediate shunt occlusion was achieved in 86.8% of patients. Major complications, namely, embolization (1) and moderate aortic regurgitation (1) in two patients were successfully managed by surgery. One patient with severe tricuspid regurgitation has been on close follow-up. There was no mortality. Late complications such as valve regurgitation or rhythm disturbance were not identified on a median follow-up of 6 (1.5-47) months.

Conclusion: Transcatheter VSD closure using a Konar-MF occluder device is safe and effective, even in smaller children. The ability to deliver both anterogradely and retrogradely is a unique advantage.

简介:该研究旨在评估使用Konar-MF™封堵器(Lifetech Scientific,中国深圳)经导管封堵儿童室间隔缺损(VSD)的手术效果和随访情况:回顾性分析病历中接受经皮VSD装置封堵术的儿童的临床特征、人口统计学特征和随访结果:在2019年1月至2023年4月期间,有57名患者使用Konar-MF封堵器进行了VSD封堵手术。患者的中位年龄和体重分别为 36(5-216)个月和 12.5(3.8-42)公斤。超声心动图显示,左心室一侧缺损的平均大小为 6.5 ± 2.4 毫米;平均肺动脉压为 19.1 ± 9.7 毫米汞柱。三名重度肺动脉高压患者成功关闭了装置。使用最多的装置尺寸为 8 毫米 × 6 毫米。有 4 例(7.01%)患者最初选择的装置尺寸有所增大,1 例(1.7%)患者的装置尺寸有所减小。45 名患者(78.9%)通过逆行途径关闭了装置。53 名患者(93.0%)手术成功。86.8%的患者立即实现了分流闭塞。主要并发症,即栓塞(1 例)和两名患者的中度主动脉瓣反流(1 例)均通过手术成功控制。一名三尖瓣严重反流患者一直在接受密切随访。没有出现死亡病例。中位随访时间为6(1.5-47)个月,未发现瓣膜返流或心律紊乱等晚期并发症:结论:使用Konar-MF闭塞器进行经导管VSD闭合是安全有效的,即使对较小的儿童也是如此。其独特的优点是既能逆行又能顺行。
{"title":"Procedural outcomes of percutaneous closure of perimembranous and other ventricular septal defects using Konar-MF occluder and short-term follow-up.","authors":"Somrita Laha, Debasree Gangopadhyay, Mahua Roy, Anoop Singh, Debabrata Nandi, Joyeeta Dutta","doi":"10.4103/apc.apc_201_23","DOIUrl":"10.4103/apc.apc_201_23","url":null,"abstract":"<p><strong>Introduction: </strong>The study aims to assess the procedural outcomes and follow-up after transcatheter closure of ventricular septal defects (VSDs) in children utilizing the Konar-MF™ occluder (Lifetech Scientific, Shenzhen, PRC) device.</p><p><strong>Materials and methods: </strong>Clinical features, demographic characteristics, and follow-up findings of children undergoing percutaneous VSD device closure were retrospectively analyzed from the medical records.</p><p><strong>Results: </strong>Fifty-seven patients underwent VSD closure using the Konar-MF occluder between January 2019 and April 2023. Median age and body weight of patients were 36 (5-216) months and 12.5 (3.8-42) kg, respectively. The mean size of the defect on the left ventricular side was 6.5 ± 2.4 mm on echocardiography; the mean pulmonary artery pressure was 19.1 ± 9.7 mmHg. Three patients with severe pulmonary hypertension had successful device closure. The most used device size was 8 mm × 6 mm. The initially chosen device was upsized in 4 (7.01%) patients and downsized in 1 (1.7%) patient. Forty-five patients (78.9%) had device closure through the retrograde route. The procedure was successful in 53 (93.0%) patients. Immediate shunt occlusion was achieved in 86.8% of patients. Major complications, namely, embolization (1) and moderate aortic regurgitation (1) in two patients were successfully managed by surgery. One patient with severe tricuspid regurgitation has been on close follow-up. There was no mortality. Late complications such as valve regurgitation or rhythm disturbance were not identified on a median follow-up of 6 (1.5-47) months.</p><p><strong>Conclusion: </strong>Transcatheter VSD closure using a Konar-MF occluder device is safe and effective, even in smaller children. The ability to deliver both anterogradely and retrogradely is a unique advantage.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Asplenia in left isomerism. 左侧同种异体症的胰腺增生症
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_4_24
Usnish Adhikari, Venkatesh Gurajala, Palanisamy Dinesh Raja, Anoop Ayyappan, Deepti Narasimhaiah, Arun Gopalakrishnan

Anatomical configurations where the viscero-atrial structures do not follow the usual arrangement or mirror-imaged arrangement is described conventionally as heterotaxy. Isomerism in the context of the congenitally malformed heart is a situation where some paired structures on opposite sides of the left-right axis of the body are, in morphologic terms, symmetrical mirror images of each other. It encompasses two separate entities, right and left isomerism, the former being usually associated with asplenia and the latter with polysplenia. We report herein a rare case of left isomerism that is associated with asplenia in a 4-year-old girl.

内脏-心房结构不按常规排列或镜像排列的解剖构型通常被描述为异位。就先天性畸形心脏而言,同轴异位是指身体左右轴两侧的一些成对结构在形态上互为对称镜像。它包括左右异位症两个独立的实体,前者通常与无脾脏症有关,后者则与多脾脏症有关。我们在此报告了一例罕见的左侧同种异体症病例,该病例发生在一名 4 岁女孩身上,同时伴有脾切除术。
{"title":"Asplenia in left isomerism.","authors":"Usnish Adhikari, Venkatesh Gurajala, Palanisamy Dinesh Raja, Anoop Ayyappan, Deepti Narasimhaiah, Arun Gopalakrishnan","doi":"10.4103/apc.apc_4_24","DOIUrl":"10.4103/apc.apc_4_24","url":null,"abstract":"<p><p>Anatomical configurations where the viscero-atrial structures do not follow the usual arrangement or mirror-imaged arrangement is described conventionally as heterotaxy. Isomerism in the context of the congenitally malformed heart is a situation where some paired structures on opposite sides of the left-right axis of the body are, in morphologic terms, symmetrical mirror images of each other. It encompasses two separate entities, right and left isomerism, the former being usually associated with asplenia and the latter with polysplenia. We report herein a rare case of left isomerism that is associated with asplenia in a 4-year-old girl.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of intranasal dexmedetomidine versus intranasal midazolam as premedication in children with tetralogy of Fallot undergoing corrective cardiac surgery: A randomized trial. 法洛四联症患儿接受心脏矫正手术时,鼻内注射右美托咪定与鼻内注射咪达唑仑作为术前用药的效果:随机试验。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_10_24
Sarvesh Srivastava, Sambhunath Das, Neeti Makhija, Sandeep Chauhan

Background: This prospective, randomized, double-blind trial was done to compare intranasal dexmedetomidine and intranasal midazolam as premedication for sedation and ease of child-parent separation in pediatric patients of tetralogy of Fallot (TOF) undergoing corrective cardiac surgery.

Materials and methods: Forty children with TOF, between 1 and 10 years, undergoing corrective cardiac surgery were included in the study and, after randomization, were given intranasal midazolam (0.2 mg/kg) or intranasal dexmedetomidine (1 µg/kg), 30 min before shifting to the operation room (OR). Patients were assessed for sedation and child-parent separation, along with hemodynamic parameters, respiratory rate, and oxygen saturation (SpO2) 30 min after drug administration, at the time of shifting inside the OR, and at the time of induction of anesthesia.

Results: Both groups had comparable child-parent scores, hemodynamic parameters, SpO2, and respiratory rate. However, the dexmedetomidine group had significantly better sedation levels than the midazolam group patients at the time of shifting inside the OR (dexmedetomidine group: 3.55 ± 0.82 vs. midazolam group: 2.80 ± 0.83; P = 0.007) and at the time of induction of anesthesia (dexmedetomidine group: 3.40 ± 0.75 vs. midazolam group: 2.70 ± 0.86; P = 0.009).

Conclusion: Intranasal dexmedetomidine provides better sedation than midazolam, with similar child-parent separation scores and hemodynamic parameters, respiratory rate, and SpO2. No adverse events were observed in both groups. A study on a larger population will help in further establishing the safety and superiority of dexmedetomidine and will further its regular use as an intranasal premedication.

研究背景这项前瞻性、随机、双盲试验旨在比较鼻内注射右美托咪定和鼻内注射咪达唑仑作为接受心脏矫正手术的法洛氏四联症(TOF)小儿患者的镇静预处理药物,以及儿童与父母分离的便利性:研究纳入了40名接受心脏矫正手术的1至10岁法洛氏四联症患儿,随机分组后,在转入手术室(OR)前30分钟给予鼻内咪达唑仑(0.2毫克/千克)或鼻内右美托咪定(1微克/千克)。在用药后 30 分钟、转入手术室时和麻醉诱导时,对患者的镇静效果、子女与父母的分离情况以及血液动力学参数、呼吸频率和血氧饱和度(SpO2)进行评估:结果:两组患儿的家长评分、血液动力学参数、SpO2 和呼吸频率相当。右美托咪定组:3.55 ± 0.82 vs. 咪达唑仑组:2.80 ± 0.83;P = 0.007)和麻醉诱导时(右美托咪定组:3.40 ± 0.75 vs. 咪达唑仑组:2.80 ± 0.83;P = 0.007):结论:结论:与咪达唑仑相比,右美托咪定鞘内注射能提供更好的镇静效果,且儿童与家长的分离评分、血液动力学参数、呼吸频率和SpO2相似。两组患者均未出现不良反应。对更多人群进行研究将有助于进一步确定右美托咪定的安全性和优越性,并促进其作为鼻内预处理药物的常规使用。
{"title":"Effects of intranasal dexmedetomidine versus intranasal midazolam as premedication in children with tetralogy of Fallot undergoing corrective cardiac surgery: A randomized trial.","authors":"Sarvesh Srivastava, Sambhunath Das, Neeti Makhija, Sandeep Chauhan","doi":"10.4103/apc.apc_10_24","DOIUrl":"10.4103/apc.apc_10_24","url":null,"abstract":"<p><strong>Background: </strong>This prospective, randomized, double-blind trial was done to compare intranasal dexmedetomidine and intranasal midazolam as premedication for sedation and ease of child-parent separation in pediatric patients of tetralogy of Fallot (TOF) undergoing corrective cardiac surgery.</p><p><strong>Materials and methods: </strong>Forty children with TOF, between 1 and 10 years, undergoing corrective cardiac surgery were included in the study and, after randomization, were given intranasal midazolam (0.2 mg/kg) or intranasal dexmedetomidine (1 µg/kg), 30 min before shifting to the operation room (OR). Patients were assessed for sedation and child-parent separation, along with hemodynamic parameters, respiratory rate, and oxygen saturation (SpO2) 30 min after drug administration, at the time of shifting inside the OR, and at the time of induction of anesthesia.</p><p><strong>Results: </strong>Both groups had comparable child-parent scores, hemodynamic parameters, SpO2, and respiratory rate. However, the dexmedetomidine group had significantly better sedation levels than the midazolam group patients at the time of shifting inside the OR (dexmedetomidine group: 3.55 ± 0.82 vs. midazolam group: 2.80 ± 0.83; <i>P</i> = 0.007) and at the time of induction of anesthesia (dexmedetomidine group: 3.40 ± 0.75 vs. midazolam group: 2.70 ± 0.86; P = 0.009).</p><p><strong>Conclusion: </strong>Intranasal dexmedetomidine provides better sedation than midazolam, with similar child-parent separation scores and hemodynamic parameters, respiratory rate, and SpO2. No adverse events were observed in both groups. A study on a larger population will help in further establishing the safety and superiority of dexmedetomidine and will further its regular use as an intranasal premedication.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Zero-contrast transcatheter closure of sinus venosus defect in advanced renal failure. 晚期肾衰竭患者窦静脉缺损的零对比经导管闭合术。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_29_24
Puthiyedath Thejaswi, Pramod Sagar, Kothandam Sivakumar

Transcatheter closure of sinus venosus defect (SVD) is an emerging intervention that utilizes a covered stent to redirect the right upper pulmonary vein to the left atrium. Preprocedural computed tomography analysis, as well as the interventional procedure, necessitates the use of radiographic contrast media. Contrast use is prohibited in patients with advanced kidney disease, who also carry high surgical risks of cardiopulmonary bypass. Transesophageal echocardiography-guided catheter intervention with zero contrast use is presented in this report, along with technical details about planning the procedure. Covered stent exclusion of SVD without contrast use has not been reported in the literature so far.

经导管窦静脉缺损(SVD)闭合术是一种新兴的介入治疗方法,它利用有盖支架将右上肺静脉改道至左心房。手术前的计算机断层扫描分析和介入手术都需要使用放射造影剂。晚期肾病患者禁止使用造影剂,因为他们还面临心肺旁路手术的高风险。本报告介绍了在经食道超声心动图引导下的导管介入治疗,不使用任何造影剂,并提供了有关手术规划的技术细节。迄今为止,文献中还没有关于不使用造影剂的覆盖支架排除 SVD 的报道。
{"title":"Zero-contrast transcatheter closure of sinus venosus defect in advanced renal failure.","authors":"Puthiyedath Thejaswi, Pramod Sagar, Kothandam Sivakumar","doi":"10.4103/apc.apc_29_24","DOIUrl":"10.4103/apc.apc_29_24","url":null,"abstract":"<p><p>Transcatheter closure of sinus venosus defect (SVD) is an emerging intervention that utilizes a covered stent to redirect the right upper pulmonary vein to the left atrium. Preprocedural computed tomography analysis, as well as the interventional procedure, necessitates the use of radiographic contrast media. Contrast use is prohibited in patients with advanced kidney disease, who also carry high surgical risks of cardiopulmonary bypass. Transesophageal echocardiography-guided catheter intervention with zero contrast use is presented in this report, along with technical details about planning the procedure. Covered stent exclusion of SVD without contrast use has not been reported in the literature so far.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial intelligence-based model for automatic real-time and noninvasive estimation of blood potassium levels in pediatric patients. 基于人工智能的儿科患者血钾水平实时无创自动估算模型。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_54_24
Hamid Mokhtari Torshizi, Negar Omidi, Mohammad Rafie Khorgami, Razieh Jamali, Mohsen Ahmadi

Background: An abnormal variation in blood electrolytes, such as potassium, contributes to mortality in children admitted to intensive care units. Continuous and real-time monitoring of potassium serum levels can prevent fatal arrhythmias, but this is not currently practical. The study aims to use machine learning to estimate blood potassium levels with accuracy in real time noninvasively.

Methods: Hospitalized patients in the Pediatric Department of the Rajaie Cardiology and Medical Research Center and Tehran Heart Center were recruited from December 2021 to June 2022. The electrocardiographic (ECG) features of patients were evaluated. We defined 16 features for each signal and extracted them automatically. The dimension reduction operation was performed with the assistance of the correlation matrix. Linear regression, polynomials, decision trees, random forests, and support vector machine algorithms have been used to find the relationship between characteristics and serum potassium levels. Finally, we used a scatter plot and mean square error (MSE) to display the results.

Results: Of 463 patients (mean age: 8 ± 1 year; 56% boys) hospitalized, 428 patients met the inclusion criteria, with 35 patients having a high noise of ECG were excluded. After the dimension reduction step, 11 features were selected from each cardiac signal. The random forest regression algorithm showed the best performance with an MSE of 0.3.

Conclusion: The accurate estimation of serum potassium levels based on ECG signals is possible using machine learning algorithms. This can be potentially useful in predicting serum potassium levels in specific clinical scenarios.

背景:血液电解质(如钾)的异常变化是导致重症监护病房患儿死亡的原因之一。对血清钾水平进行连续、实时监测可预防致命性心律失常,但目前还不现实。本研究旨在利用机器学习,以无创方式实时准确地估算血钾水平。方法:2021 年 12 月至 2022 年 6 月期间,招募了 Rajaie心脏病学和医学研究中心儿科及德黑兰心脏中心的住院患者。评估了患者的心电图(ECG)特征。我们为每个信号定义了 16 个特征,并自动提取了这些特征。在相关矩阵的帮助下进行了降维操作。我们使用线性回归、多项式、决策树、随机森林和支持向量机算法来寻找特征与血清钾水平之间的关系。最后,我们使用散点图和均方误差(MSE)来显示结果:在住院的 463 名患者(平均年龄:8 ± 1 岁;56% 为男孩)中,有 428 名患者符合纳入标准,其中 35 名患者的心电图噪声较高,被排除在外。经过降维步骤后,从每个心电信号中选取了 11 个特征。随机森林回归算法表现最佳,MSE 为 0.3:结论:使用机器学习算法可以根据心电信号准确估计血清钾水平。这可能有助于预测特定临床场景中的血清钾水平。
{"title":"Artificial intelligence-based model for automatic real-time and noninvasive estimation of blood potassium levels in pediatric patients.","authors":"Hamid Mokhtari Torshizi, Negar Omidi, Mohammad Rafie Khorgami, Razieh Jamali, Mohsen Ahmadi","doi":"10.4103/apc.apc_54_24","DOIUrl":"10.4103/apc.apc_54_24","url":null,"abstract":"<p><strong>Background: </strong>An abnormal variation in blood electrolytes, such as potassium, contributes to mortality in children admitted to intensive care units. Continuous and real-time monitoring of potassium serum levels can prevent fatal arrhythmias, but this is not currently practical. The study aims to use machine learning to estimate blood potassium levels with accuracy in real time noninvasively.</p><p><strong>Methods: </strong>Hospitalized patients in the Pediatric Department of the Rajaie Cardiology and Medical Research Center and Tehran Heart Center were recruited from December 2021 to June 2022. The electrocardiographic (ECG) features of patients were evaluated. We defined 16 features for each signal and extracted them automatically. The dimension reduction operation was performed with the assistance of the correlation matrix. Linear regression, polynomials, decision trees, random forests, and support vector machine algorithms have been used to find the relationship between characteristics and serum potassium levels. Finally, we used a scatter plot and mean square error (MSE) to display the results.</p><p><strong>Results: </strong>Of 463 patients (mean age: 8 ± 1 year; 56% boys) hospitalized, 428 patients met the inclusion criteria, with 35 patients having a high noise of ECG were excluded. After the dimension reduction step, 11 features were selected from each cardiac signal. The random forest regression algorithm showed the best performance with an MSE of 0.3.</p><p><strong>Conclusion: </strong>The accurate estimation of serum potassium levels based on ECG signals is possible using machine learning algorithms. This can be potentially useful in predicting serum potassium levels in specific clinical scenarios.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rescue one-stage hybrid perventricular and percutaneous device closure of multiple muscular ventricular septal defects using the new multifunctional occluder. 使用新型多功能闭塞器对多发肌性室间隔缺损进行一期混合室间隔和经皮装置闭合的抢救性治疗。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_16_24
Paul Padovani, Mohamedou Ly, Alban-Elouen Baruteau

Data on the safety and efficiency of perventricular device closure of complex ventricular septal defects (VSDs) are scarce. We report successful one-stage combined hybrid perventricular and percutaneous closure of the muscular VSDs in a critically ill 4-kg infant, using the new multifunctional occluder.

有关经心室装置闭合复杂室间隔缺损(VSD)的安全性和效率的数据很少。我们报告了使用新型多功能闭塞器成功对一名重达 4 千克的重症婴儿进行了一期混合经心室和经皮闭塞肌肉型室间隔缺损的手术。
{"title":"Rescue one-stage hybrid perventricular and percutaneous device closure of multiple muscular ventricular septal defects using the new multifunctional occluder.","authors":"Paul Padovani, Mohamedou Ly, Alban-Elouen Baruteau","doi":"10.4103/apc.apc_16_24","DOIUrl":"10.4103/apc.apc_16_24","url":null,"abstract":"<p><p>Data on the safety and efficiency of perventricular device closure of complex ventricular septal defects (VSDs) are scarce. We report successful one-stage combined hybrid perventricular and percutaneous closure of the muscular VSDs in a critically ill 4-kg infant, using the new multifunctional occluder.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dual-drainage pulmonary venous return of the left upper lobe. 左上叶双引流肺静脉回流。
IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-03-01 Epub Date: 2024-07-20 DOI: 10.4103/apc.apc_8_24
Yeka W Nmadu, Robert F English

Dual drainage of a pulmonary vein is an unusual anomaly of pulmonary venous drainage. While being evaluated for hypertension, a child was found with dual drainage of the upper left lobe through a vertical vein that connects to the normal pulmonary vein as well as the innominate vein with no symptoms from his effective left-to-right shunt.

肺静脉双重引流是一种不常见的肺静脉引流异常。在对一名儿童进行高血压评估时,发现他的左上叶通过一条连接正常肺静脉和腹股沟静脉的垂直静脉有双重引流,但其有效的左向右分流没有造成任何症状。
{"title":"Dual-drainage pulmonary venous return of the left upper lobe.","authors":"Yeka W Nmadu, Robert F English","doi":"10.4103/apc.apc_8_24","DOIUrl":"10.4103/apc.apc_8_24","url":null,"abstract":"<p><p>Dual drainage of a pulmonary vein is an unusual anomaly of pulmonary venous drainage. While being evaluated for hypertension, a child was found with dual drainage of the upper left lobe through a vertical vein that connects to the normal pulmonary vein as well as the innominate vein with no symptoms from his effective left-to-right shunt.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Annals of Pediatric Cardiology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1