CHiP Network Congenital Heart Journal Watch – June / July 2020
Pediatric Cardiology Featured Articles
Pediatric Cardiology Reviews of April 2020 Manuscripts
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Pediatric Cardiology Reviews of April 2020
El Assaad I, Gauvreau K, Rizwan R, Margossian R, Colan S, Chen MH.
J Am Soc Echocardiogr. 2020 Apr 9. pii: S0894-7317(20)30067-5. doi: 10.1016/j.echo.2020.01.020. [Epub ahead of print]
PMID: 32279939
Select item 32271829
Take Home Points
- Exercise stress echocardiography (ESE) is a safe and feasible modality in children with hypertrophic cardiomyopathy.
- In children without rest LVOT gradient 44% develop gradients > 30 mm Hg with exercise.
- ESE-derived rest and exercise gradients correlated with risk of cardiac outcome.
- Children with LVOT gradients <30 mm Hg have lowest risk of CV events.
- Children with LVOT gradients ≥30 mm Hg have 5 times the risk of CV events.
Comment from Dr. Jennifer Johnson (Pittsburg, PA), Section Editor of Pediatric Cardiology Journal Watch: This is a single center retrospective chart review of all pediatric hypertrophic cardiomyopathy patients who underwent exercise stress echocardiography to determine if exercise stress echocardiography can be useful in risk stratifying hypertrophic cardiomyopathy subgroups and if LVOT obstruction occurs in the patients with nonobstructive hypertrophic cardiomyopathy.Methods: Data was collected on all pediatric hypertrophic cardiomyopathy patient who underwent exercise stress echocardiography from 2007-2018 at Boston Children’s Hospital. Subjects were assigned to one of three categories based on left ventricular outflow tract gradients: group 1: <30 mm Hg at rest and exercise; group 2: <30 mm Hg at rest and ≥30 mm Hg with exercise; and group 3: ≥ 30 mm Hg at rest and exercise. The composite adverse endpoints on follow-up included heart transplant, aborted cardiac arrest, and sudden cardiac death.
Results: A total of 91 (61% male), median age 12 years (6-24 years) with hypertrophic cardiomyopathy underwent exercise stress echocardiography; baseline patient characteristics are described in table 1. Median left ventricle wall thickness was 20 mm and median follow-up duration was 3 years. During ESE, only one child experienced an event and was resuscitated. Of the 91 children, 25 were classified as group 1, 40 as group 2, and 26 as group 3. Twenty-six patients met the composite endpoint, including two heart transplant, one aborted cardiac arrest, and one sudden cardiac death. Group 3 patients had a 5 times higher risk of developing symptoms and/or serious clinical outcome at any age (hazard ratio = 5.18; 95% CI, [1.39-19.2]; P = .014). During our short follow-up time, group 2 patients had a higher risk of outcome, but this did not achieve statistical significance (hazard ratio = 1.95; 95% CI, [0.5-7.6]; P = .33).
Exercise stress echocardiography data; table 2. Of the 40 patients in group 2 (resting LVOT <30 mmHg, exercise LVOT gradient ³ 30 mmHg) 20 had obstruction due to septal hypertrophy/systolic anterior motion, 13 patients mid cavitary obstruction and other 7 patients had a mixed obstruction etiology.
Of the total cohort, 73 (80%) subjects were free of cardiac events prior to the first exercise stress echocardiogram study. In the 3 year follow up data 26 patients had 31 cardiac events.
Discussion: In this cohort, 90 (99%) patients had an event-free exercise stress echocardiogram with one group 3 patient experiencing a fast-polymorphic ventricular fibrillation arrest requiring resuscitation during exercise stress test. This data showed pediatric exercise stress echocardiogram for hypertrophic cardiomyopathy can be performed safely with low risk to the patients.
Peyvandi S, Baer RJ, Chambers CD, Norton ME, Rajagopal S, Ryckman KK, Moon-Grady A, Jelliffe-Pawlowski LL, Steurer MA.
J Am Heart Assoc. 2020 Apr 21;9(8):e015255. doi: 10.1161/JAHA.119.015255. Epub 2020 Apr 19.
Take Home Points
- Adverse social and environmental factors at the neighborhood level may play an important role in the development of congenital heart disease (CHD).
- Worse social deprivation index (SDI) (6 measures of wealth and income) and environmental exposure index (EEI) (levels of exposure to pollutants) quartiles had higher odds of CHD.
- Maternal comorbidities explain some, but not all, of this socio-environmental relationship with development of CHD.
Commentary from Dr. Clifford Cua (Columbus, OH), Section Editor of Pediatric Cardiology Journal Watch: The California Office of Statewide Health Planning and Development database was used to obtain data on newborn patients born between 2007 – 2012. Maternal and infant data are linked in this database and ICD-9 codes were used for diagnostic classification. Significant congenital heart disease (CHD) was defined as a defect that would require surgery within the 1st year of life. A social deprivation index (SDI) (6 measures of wealth and income) and environmental exposure index (EEI) (levels of exposure to pollutants) were determined at the neighborhood level. Z-scores for both indexes were obtained for each patient and scores were categorized into 4 quartiles, with 1st quartile being the most ideal situation and 4th quartile being the least ideal situation.Hierarchical logistic regression was used to determine the association between the main predictors and the primary outcome after adjustment for maternal factors and age of cohort. Sensitivity analysis was conducted to determine the relationship after excluding single ventricle diagnosis in regions with high prenatal diagnosis. A mediation analysis was used to test if maternal comorbidities may be in the causal pathway of SDI and EEI.
During the time period studied, over 2 million live births were included in the study. All individual sociodemographic and environmental factor Z-scores were worse for in the CHD group (7698 infants with CHD studied) compared to the controls. The odds of live-born CHD were significantly higher among those with increasing SDI and EEI quartile. Odds were also significantly higher in mothers with comorbidities to have a child with CHD. These odds still were significant when excluding infants with known chromosomal abnormalities/syndromes (6120 infants with CHD studied). Odds were also still significant when excluding single ventricle patients to take into account possible bias when evaluating just live-born births. Odds were 1.48 (1.32 – 1.66) higher for having a child with CHD for those in the 4th quartile versus those in the 1st quartile. Causal mediation analysis showed that 13% (95% CI, 10 – 20%) of the total effect of SDI/EEI on the incidence of CHD is mediated through the presence of maternal comorbidities with race/ethnicity as confounders in the relationship between maternal conditions and incidence of CHD.
As the authors stated, this study is limited by the use of an administrative database where errors in entry may occur, ~20% of data were excluded due to incomplete data, only live-born infants were evaluated thus true incidence of CHD may be under-reported due to fetal demise/termination, misclassification of pollutants, and no data on timing of exposure to pollutants.
Despite these limitations, this is a large database study that provides intriguing data suggesting how multifactorial variables may play a role in the development of CHD. Improving the socioeconomic welfare and decreasing pollutant exposure may be another method to decrease the incidence of CHD in the overall population.
Pediatric Cardiology Abstracts of April 2020
Mariucci E, Spinardi L, Stagni S, Graziano C, Lovato L, Pacini D, Di Marco L, Careddu L, Angeli E, Ciuca C, Wischmeijer A, Gargiulo G, Donti A.
Am J Med Genet A. 2020 Apr 30. doi: 10.1002/ajmg.a.61608. [Epub ahead of print]
PMID: 32352226
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Izumida S, Kawano H, Tsuneto A, Doi Y, Maemura K.
Intern Med. 2020 Apr 30. doi: 10.2169/internalmedicine.4415-20. [Epub ahead of print]
PMID: 32350197 Free Article
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Lenz A, Petersen J, Riedel C, Weinrich JM, Kooijman H, Schoennagel BP, Adam G, von Kodolitsch Y, Reichenspurner H, Girdauskas E, Bannas P.
J Cardiovasc Magn Reson. 2020 Apr 30;22(1):29. doi: 10.1186/s12968-020-00608-0.
PMID: 32354361 Free PMC Article
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van der Mheen M, Utens EMWJ.
J Pediatr. 2020 Apr 30. pii: S0022-3476(20)30346-2. doi: 10.1016/j.jpeds.2020.03.018. [Epub ahead of print] No abstract available.
PMID: 32362410
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Hernandez-Gonzalez I, Tenorio J, Palomino-Doza J, Martinez Meñaca A, Morales Ruiz R, Lago-Docampo M, Valverde Gomez M, Gomez Roman J, Enguita Valls AB, Perez-Olivares C, Valverde D, Gil Carbonell J, Garrido-Lestache Rodríguez-Monte E, Del Cerro MJ, Lapunzina P, Escribano-Subias P.
PLoS One. 2020 Apr 29;15(4):e0232216. doi: 10.1371/journal.pone.0232216. eCollection 2020.
PMID: 32348326 Free PMC Article
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Saleh NY, Salem SS, Abo-El Fotoh WM, Soliman SE, Abo-Haded HM.
Birth Defects Res. 2020 Apr 28. doi: 10.1002/bdr2.1700. [Epub ahead of print]
PMID: 32343056
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Sallmon H, Metze B, Koehne P, Opgen-Rhein B, Weiss K, Will JC, Franke CV, Hansmann G, Koestenberger M, Bührer C, Berger F, Weber SC, Cremer M.
Cardiol Young. 2020 Apr 28:1-5. doi: 10.1017/S1047951120000943. [Epub ahead of print]
PMID: 32340633
Select item 32343465
Davies R, Babu-Narayan SV.
Heart. 2020 Apr 27. pii: heartjnl-2019-316496. doi: 10.1136/heartjnl-2019-316496. [Epub ahead of print] No abstract available.
PMID: 32341135
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Bektas İ, Kır M, Yıldız K, Genç Z, Bektas M, Ünal N.
J Pediatr Nurs. 2020 Apr 27. pii: S0882-5963(20)30165-2. doi: 10.1016/j.pedn.2020.04.012. [Epub ahead of print]
PMID: 32354457
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Ta HT, Alsaied T, Steele JM, Truong VT, Mazur W, Nagueh SF, Kutty S, Tretter JT.
Pediatr Cardiol. 2020 Apr 27. doi: 10.1007/s00246-020-02351-w. [Epub ahead of print] Review.
PMID: 32342149
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Ji W, Ferdman D, Copel J, Scheinost D, Shabanova V, Brueckner M, Khokha MK, Ment LR.
Sci Rep. 2020 Apr 27;10(1):7046. doi: 10.1038/s41598-020-63928-2.
PMID: 32341405 Free PMC Article
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Tang X, Chen W, Zeng Z, Ding K, Zhou Z.
Int J Cardiol. 2020 Apr 26. pii: S0167-5273(19)34800-4. doi: 10.1016/j.ijcard.2020.04.073. [Epub ahead of print]
PMID: 32348812
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Byl JL, Sholler R, Gosnell JM, Samuel BP, Vettukattil JJ.
Int J Cardiovasc Imaging. 2020 Apr 25. doi: 10.1007/s10554-020-01853-1. [Epub ahead of print] Review.
PMID: 32335820
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Ojha V, Ganga KP, Chandrashekhara SH, Kumar S.
J Card Surg. 2020 Apr 25. doi: 10.1111/jocs.14543. [Epub ahead of print] No abstract available.
PMID: 32333429
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Xu ZY, Li QQ, Zhang C, Zhang HS, Gu H.
Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Apr 24;48(4):315-322. doi: 10.3760/cma.j.cn112148-20190628-00364. Chinese.
PMID: 32370483
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Haynes D, Pollack L, Prasad C, Goobie S, Colaiacovo S, Wolfinger T, Lacassie Y.
Am J Med Genet A. 2020 Apr 23. doi: 10.1002/ajmg.a.61603. [Epub ahead of print]
PMID: 32324310
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Bu H, Gong X, Zhao T.
BMC Cardiovasc Disord. 2020 Apr 23;20(1):194. doi: 10.1186/s12872-020-01489-y.
PMID: 32326907 Free PMC Article
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Rao K, Bhaskaran A, Choudhary P, Tan TC.
Eur J Clin Invest. 2020 Apr 23:e13254. doi: 10.1111/eci.13254. [Epub ahead of print] Review.
PMID: 32329049
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Mabuchi A, Waratani M, Tanaka Y, Mori T, Kitawaki J.
J Med Ultrason (2001). 2020 Apr 23. doi: 10.1007/s10396-020-01020-y. [Epub ahead of print]
PMID: 32328807
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Löwensteyn YN, Phijffer EWEM, Simons JVL, Scheltema NM, Mazur NI, Nair H, Bont LJ; RSV GOLD Study Group.
Pediatr Infect Dis J. 2020 Apr 23. doi: 10.1097/INF.0000000000002666. [Epub ahead of print]
PMID: 32332221
Select item 32325482
Yaban B, Kikhney J, Musci M, Petrich A, Schmidt J, Hajduczenia M, Schoenrath F, Falk V, Moter A.
PLoS One. 2020 Apr 23;15(4):e0231827. doi: 10.1371/journal.pone.0231827. eCollection 2020.
PMID: 32325482 Free PMC Article
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Baban A, Olivini N, Cantarutti N, Calì F, Vitello C, Valentini D, Adorisio R, Calcagni G, Alesi V, Di Mambro C, Villani A, Dallapiccola B, Digilio MC, Marino B, Carotti A, Drago F.
Am J Med Genet A. 2020 Apr 22. doi: 10.1002/ajmg.a.61586. [Epub ahead of print]
PMID: 32319738
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Marelli A.
J Intern Med. 2020 Apr 22. doi: 10.1111/joim.13048. [Epub ahead of print]
PMID: 32323405
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Wu Y, Xia Y, Li P, Qu HQ, Liu Y, Yang Y, Lin J, Zheng M, Tian L, Wu Z, Huang S, Qin X, Zhou X, Chen S, Liu Y, Wang Y, Li X, Zeng H, Hakonarson H, Zhuang J.
Orphanet J Rare Dis. 2020 Apr 22;15(1):101. doi: 10.1186/s13023-020-01378-9.
PMID: 32321550 Free PMC Article
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Helle E, Priest JR.
J Am Heart Assoc. 2020 Apr 21;9(8):e011541. doi: 10.1161/JAHA.119.011541. Epub 2020 Apr 20.
PMID: 32308111 Free Article
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Peyvandi S, Baer RJ, Chambers CD, Norton ME, Rajagopal S, Ryckman KK, Moon-Grady A, Jelliffe-Pawlowski LL, Steurer MA.
J Am Heart Assoc. 2020 Apr 21;9(8):e015255. doi: 10.1161/JAHA.119.015255. Epub 2020 Apr 19.
PMID: 32306820 Free Article
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Bonafide CP, Xiao R, Brady PW, Landrigan CP, Brent C, Wolk CB, Bettencourt AP, McLeod L, Barg F, Beidas RS, Schondelmeyer A; Pediatric Research in Inpatient Settings (PRIS) Network.
JAMA. 2020 Apr 21;323(15):1467-1477. doi: 10.1001/jama.2020.2998.
PMID: 32315058
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Turkoglu S, Batur A, Yokuş A, Dündar İ, Akinci MB.
Radiol Case Rep. 2020 Apr 21;15(6):795-798. doi: 10.1016/j.radcr.2020.04.007. eCollection 2020 Jun.
PMID: 32346456 Free PMC Article
Morton L, Cogan N, Kornfält S, Porter Z, Georgiadis E.
Br J Health Psychol. 2020 Apr 20. doi: 10.1111/bjhp.12416. [Epub ahead of print]
PMID: 32314508
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Palm J, Hoffmann G, Klawonn F, Tutarel O, Palm H, Holdenrieder S, Ewert P.
Clin Chem Lab Med. 2020 Apr 18. pii: /j/cclm.ahead-of-print/cclm-2019-1185/cclm-2019-1185.xml. doi: 10.1515/cclm-2019-1185. [Epub ahead of print]
PMID: 32305952
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Patel J, Nembhard WN, Politis MD, Rocheleau CM, Langlois PH, Shaw GM, Romitti PA, Gilboa SM, Desrosiers TA, Insaf T, Lupo PJ; National Birth Defects Prevention Study.
Environ Res. 2020 Apr 18;186:109550. doi: 10.1016/j.envres.2020.109550. [Epub ahead of print]
PMID: 32335433
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Li W, Li B, Li T, Zhang E, Wang Q, Chen S, Sun K.
BMC Med Genet. 2020 Apr 15;21(1):78. doi: 10.1186/s12881-020-01009-x.
PMID: 32293321 Free PMC Article
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Abu-Halima M, Oberhoffer FS, El Rahman MA, Jung AM, Zemlin M, Rohrer TR, Kahraman M, Keller A, Meese E, Abdul-Khaliq H.
PLoS One. 2020 Apr 9;15(4):e0231402. doi: 10.1371/journal.pone.0231402. eCollection 2020.
PMID: 32271829 Free PMC Article
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Arvind B, Relan J, Kothari SS.
Pulm Circ. 2020 Apr 9;10(2):2045894020917885. doi: 10.1177/2045894020917885. eCollection 2020 Apr-Jun. Review.
PMID: 32313642 Free PMC Article
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Rettenmaier LA, Kirby PA, Reinking BE, Viaene AN, Hefti MM.
J Am Heart Assoc. 2020 Apr 7;9(7):e013575. doi: 10.1161/JAHA.119.013575. Epub 2020 Mar 23.
PMID: 32200729 Free Article
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De Almeida MC, Sanchez-Quintana D, Anderson RH.
Clin Anat. 2020 Apr 5. doi: 10.1002/ca.23599. [Epub ahead of print] Review.
PMID: 32249445
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Muir AM, Cohen JL, Sheppard SE, Guttipatti P, Lo TY, Weed N, Doherty D, DeMarzo D, Fagerberg CR, Kjærsgaard L, Larsen MJ, Rump P, Löhner K, Hirsch Y, Zeevi DA, Zackai EH, Bhoj E, Song Y, Mefford HC.
Am J Hum Genet. 2020 Apr 4. pii: S0002-9297(20)30085-9. doi: 10.1016/j.ajhg.2020.03.009. [Epub ahead of print]
PMID: 32275884
Select item 32248253
Hansson L, Wrigstad J, Wangel AM.
Intensive Crit Care Nurs. 2020 Apr 3:102855. doi: 10.1016/j.iccn.2020.102855. [Epub ahead of print]
PMID: 32253120
Select item 32243076
Chetboul V, Poissonnier C, Bomassi E, Jamin C, Pouchelon JL, Tissier R, Desquilbet L.
J Vet Cardiol. 2020 Apr 3;29:11-21. doi: 10.1016/j.jvc.2020.03.003. [Epub ahead of print]
PMID: 32348933
Select item 32242280
May LA, More SR, Masand PM, Ketwaroo PD, Krishnamurthy R, Jadhav SP.
Pediatr Radiol. 2020 Apr 3. doi: 10.1007/s00247-020-04659-4. [Epub ahead of print]
PMID: 32242280
Select item 32245513
Arita Y, Tanaka K, Kitabayashi K, Hasegawa S.
Intern Med. 2020 Apr 2. doi: 10.2169/internalmedicine.4575-20. [Epub ahead of print] No abstract available.
PMID: 32238728 Free Article
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Arjaans S, Wagner BD, Mourani PM, Mandell EW, Poindexter BB, Berger RMF, Abman SH.
Am J Physiol Lung Cell Mol Physiol. 2020 Apr 1;318(4):L644-L654. doi: 10.1152/ajplung.00131.2019. Epub 2020 Jan 22.
PMID: 31967847
Select item 32352408
Hou HT, Chen HX, Wang XL, Yuan C, Yang Q, Liu ZG, He GW.
Arch Dis Child. 2020 Apr;105(4):367-374. doi: 10.1136/archdischild-2018-316634. Epub 2019 Oct 30.
PMID: 31666243
Select item 32224822
Lorts A, Smyth L, Gajarski RJ, VanderPluym CJ, Mehegan M, Villa CR, Murray JM, Niebler RA, Almond CS, Thrush P, O’Connor MJ, Conway J, Sutcliffe DL, Lantz JE, Zafar F, Morales DLS, Peng DM, Rosenthal DN.
ASAIO J. 2020 Apr;66(4):441-446. doi: 10.1097/MAT.0000000000001133.
PMID: 32224822
Select item 31685414
Maagaard M, Eckerström F, Heiberg J, Asschenfeldt B, Ringgaard S, Hjortdal VE.
Cardiol Young. 2020 Apr;30(4):526-532. doi: 10.1017/S1047951120000505. Epub 2020 Mar 25.
PMID: 32209161
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Charisopoulou D, Bini RM, Riley G, Janagarajan K, Moledina S, Marek J.
Cardiol Young. 2020 Apr;30(4):511-520. doi: 10.1017/S1047951120000463. Epub 2020 Mar 16.
PMID: 32172702
Select item 32131918
Lasa JJ, Gaies M, Bush L, Zhang W, Banerjee M, Alten JA, Butts RJ, Cabrera AG, Checchia PA, Elhoff J, Lorts A, Rossano JW, Schumacher K, Shekerdemian LS, Price JF.
Circ Heart Fail. 2020 Apr;13(4):e006101. doi: 10.1161/CIRCHEARTFAILURE.119.006101. Epub 2020 Apr 17.
PMID: 32301336
Select item 32301335
Hsu DT.
Circ Heart Fail. 2020 Apr;13(4):e006516. doi: 10.1161/CIRCHEARTFAILURE.120.006516. Epub 2020 Apr 17. No abstract available.
PMID: 32301335
Select item 31769098
Wei W, Li B, Li F, Sun K, Jiang X, Xu R.
Clin Genet. 2020 Apr;97(4):576-585. doi: 10.1111/cge.13710. Epub 2020 Feb 12.
PMID: 32003456
Select item 31302712
DiPaola F, Trout AT, Walther AE, Gupta A, Sheridan R, Campbell KM, Tiao G, Bezerra JA, Bove KE, Patel M, Nathan JD.
Dig Dis Sci. 2020 Apr;65(4):1239-1251. doi: 10.1007/s10620-019-05834-w. Epub 2019 Sep 23.
PMID: 31549332
Select item 32147955
Amedro P, Gavotto A, Abassi H, Picot MC, Matecki S, Malekzadeh-Milani S, Levy M, Ladouceur M, Ovaert C, Aldebert P, Thambo JB, Fraisse A, Humbert M, Cohen S, Baruteau AE, Karsenty C, Bonnet D, Hascoet S; SV-INHIBITION study investigators.
ESC Heart Fail. 2020 Apr;7(2):747-756. doi: 10.1002/ehf2.12630. Epub 2020 Mar 9.
PMID: 32147955 Free PMC Article
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Yamamoto M, Takashio S, Nakashima N, Hanatani S, Arima Y, Sakamoto K, Yamamoto E, Kaikita K, Aoki Y, Tsujita K.
ESC Heart Fail. 2020 Apr;7(2):721-726. doi: 10.1002/ehf2.12650. Epub 2020 Feb 20.
PMID: 32078254 Free PMC Article
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Chang LY, Chiu SN, Wang CC, Weng WC, Chang HY.
Eur J Cardiovasc Nurs. 2020 Apr;19(4):301-309. doi: 10.1177/1474515119881871. Epub 2019 Oct 28.
PMID: 31656087
Select item 31999620
Pepe G, Corica D, De Sanctis L, Salerno M, Faienza MF, Tessaris D, Tuli G, Scala I, Penta L, Alibrandi A, Pajno GB, Aversa T, Wasniewska M; Thyroid Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED).
Eur J Endocrinol. 2020 Apr;182(4):385-392. doi: 10.1530/EJE-19-0823.
PMID: 31999620
Select item 31570783
Alanzi T, Alhashem A, Dagriri K, Alzahrani F, Alkuraya FS.
Eur J Hum Genet. 2020 Apr;28(4):525-528. doi: 10.1038/s41431-019-0524-0. Epub 2019 Sep 30.
PMID: 31570783
Select item 31902564
Permanyer E, Laurie S, Blasco-Lucas A, Maldonado G, Amador-Catalan A, Ferrer-Curriu G, Fuste B, Perez ML, Gonzalez-Alujas T, Beltran S, Comas-Riu J, Bardají A, Evangelista A, Galiñanes M.
Eur J Med Genet. 2020 Apr;63(4):103854. doi: 10.1016/j.ejmg.2020.103854. Epub 2020 Jan 23.
PMID: 31981616
Select item 31654754
Mastromoro G, Capalbo A, Guido CA, Torres B, Fabbretti M, Traversa A, Giancotti A, Ventriglia F, Bernardini L, Spalice A, Pizzuti A.
Eur J Med Genet. 2020 Apr;63(4):103772. doi: 10.1016/j.ejmg.2019.103772. Epub 2019 Sep 27.
PMID: 31568860
Select item 31865429
Rohit M, Budakoty S.
Indian J Pediatr. 2020 Apr;87(4):312-320. doi: 10.1007/s12098-020-03255-6. Review.
PMID: 32162150
Select item 32276772
Dalir Z, Heydari A, Kareshki H, Manzari ZS.
Int J Community Based Nurs Midwifery. 2020 Apr;8(2):127-139. doi: 10.30476/IJCBNM.2020.83029.1113.
PMID: 32309454 Free PMC Article
Select item 31968274
Barbosa MDG, Castelo PM, Ferreira CLP, Haddad DS, Chiari BM, Santana MV, Bommarito S.
Int J Pediatr Otorhinolaryngol. 2020 Apr;131:109883. doi: 10.1016/j.ijporl.2020.109883. Epub 2020 Jan 15. Review.
PMID: 31968274
Select item 32236557
Sachdeva R, Srivastava S.
J Am Soc Echocardiogr. 2020 Apr;33(4):A22. doi: 10.1016/j.echo.2020.02.006. No abstract available.
PMID: 32248910
Select item 31980926
Kalayinia S, Maleki M, Mahdavi M, Mahdieh N.
J Clin Lab Anal. 2020 Apr;34(4):e23147. doi: 10.1002/jcla.23147. Epub 2019 Dec 22.
PMID: 31867804 Free PMC Article
Select item 32088108
Agrawal H, Dokania G, Allen HD, Acosta S, Caracostis A, Havemann LM, Lara A, Riley AF, Seery TJ.
J Pediatr. 2020 Apr;219:83-88. doi: 10.1016/j.jpeds.2019.12.022. Epub 2020 Jan 24.
PMID: 31987651
Select item 31704054
Dao DT, Kamran A, Wilson JM, Sheils CA, Kharasch VS, Mullen MP, Rice-Townsend SE, Zalieckas JM, Morash D, Studley M, Staffa SJ, Zurakowski D, Becker RE, Smithers CJ, Buchmiller TL.
J Pediatr. 2020 Apr;219:160-166.e2. doi: 10.1016/j.jpeds.2019.09.053. Epub 2019 Nov 5.
PMID: 31704054
Select item 31793183
Pridham KF, Harrison TM, Brown R, Mussatto K.
J Spec Pediatr Nurs. 2020 Apr;25(2):e12283. doi: 10.1111/jspn.12283. Epub 2019 Dec 2.
PMID: 31793183
Select item 31706555
He Y, Xu W, Su Z, Liu K, Zhang H.
Lancet Child Adolesc Health. 2020 Apr;4(4):e7. doi: 10.1016/S2352-4642(20)30061-4. Epub 2020 Mar 17. No abstract available.
PMID: 32197102
Select item 32311999
Jinxiu L, Shuimei L, Ming X, Jonathan LC, Xiangju L, Wenyuan D.
Medicine (Baltimore). 2020 Apr;99(16):e19813. doi: 10.1097/MD.0000000000019813.
PMID: 32311999 Free Article
Select item 32311971
Li HP, Ye XW, Wang HT.
Medicine (Baltimore). 2020 Apr;99(16):e19748. doi: 10.1097/MD.0000000000019748.
PMID: 32311971 Free Article
Select item 32059087
Lazzaro G, Caciolo C, Menghini D, Cumbo F, Digilio MC, Capolino R, Zampino G, Tartaglia M, Vicari S, Alfieri P.
Mol Genet Genomic Med. 2020 Apr;8(4):e1069. doi: 10.1002/mgg3.1069. Epub 2020 Feb 14.
PMID: 32059087 Free PMC Article
Select item 31985165
Samudrala SSK, North LM, Stamm KD, Earing MG, Frommelt MA, Willes R, Tripathi S, Dsouza NR, Zimmermann MT, Mahnke DK, Liang HL, Lund M, Lin CW, Geddes GC, Mitchell ME, Tomita-Mitchell A.
Mol Genet Genomic Med. 2020 Apr;8(4):e1152. doi: 10.1002/mgg3.1152. Epub 2020 Jan 27.
PMID: 31985165 Free PMC Article
Select item 32265037
Ramprasad VH, Shaffer AD, Jabbour N.
Otolaryngol Head Neck Surg. 2020 Apr;162(4):554-558. doi: 10.1177/0194599820901351. Epub 2020 Jan 21.
PMID: 31959051
Select item 32040230
Avitabile CM, Vorhies EE, Ivy DD.
Paediatr Drugs. 2020 Apr;22(2):123-147. doi: 10.1007/s40272-019-00374-2. Review.
PMID: 31960361
Select item 31876555
Chou YY, Wang CJ, Lin CH, Chung HT, Lo FS.
Pediatr Neonatol. 2020 Apr;61(2):188-194. doi: 10.1016/j.pedneo.2019.10.001. Epub 2019 Oct 11.
PMID: 31672476 Free Article
Select item 31845058
Vézina K, Dipchand AI, Narang I.
Pediatr Pulmonol. 2020 Apr;55(4):E1-E2. doi: 10.1002/ppul.24695. Epub 2020 Feb 18.
PMID: 32068971
Select item 31711070
Ehrler M, Latal B, Polentarutti S, von Rhein M, Held L, Wehrle FM.
Pediatr Res. 2020 Apr;87(5):917-923. doi: 10.1038/s41390-019-0667-2. Epub 2019 Nov 11.
PMID: 31711070
Select item 31953255
Kang X, Zhao Y, Van Arsdell G, Nelson SF, Touma M.
RNA. 2020 Apr;26(4):481-491. doi: 10.1261/rna.073692.119. Epub 2020 Jan 17.
PMID: 31953255 Free PMC Article
Select item 31862220
Obiora UJ, Ekpebe PA, Okoye C, David-Idiapho CG.
West Afr J Med. 2020 Apr-Jun;37(2):113-117.
PMID: 32150628
Select item 31931249
Satış S, Alparslan N, Tuna M, Dere O, Yetişgin A.
World Neurosurg. 2020 Apr;136:62-65. doi: 10.1016/j.wneu.2020.01.010. Epub 2020 Jan 10.
PMID: 31931249
Walter K, Katharina SS, Martin C, Roland W.
Infection. 2020 Apr 30. doi: 10.1007/s15010-020-01433-4. [Epub ahead of print]
PMID: 32356253
Select item 32356163
Mărginean CO, Meliţ LE, Ghiga DV, Săsăran MO.
Sci Rep. 2020 Apr 29;10(1):7213. doi: 10.1038/s41598-020-64320-w.
PMID: 32350349 Free PMC Article
Select item 32360389
Peña-Trujillo V, Gallo-Bernal S, Forero Melo JF.
Cardiol Young. 2020 Apr 28:1-2. doi: 10.1017/S1047951120000906. [Epub ahead of print]
PMID: 32340649
Select item 32340633
Ghanchi A, Derridj N, Bonnet D, Bertille N, Salomon LJ, Khoshnood B.
Int J Environ Res Public Health. 2020 Apr 28;17(9). pii: E3056. doi: 10.3390/ijerph17093056. Review.
PMID: 32354021 Free Article
Select item 32343451
- Cardiac Function by Magnetic Resonance Imaging in Coronary Artery Occlusions After Kawasaki Disease.
Nakaoka H, Tsuda E, Morita Y, Kurosaki K.
Circ J. 2020 Apr 24;84(5):792-798. doi: 10.1253/circj.CJ-19-0511. Epub 2020 Mar 31.
PMID: 32238692 Free Article
Select item 32238643
Cantinotti M, Scalese M, Giordano R, Assanta N, Marchese P, Franchi E, Viacava C, Koestenberger M, Jani V, Kutty S.
Pediatr Res. 2020 Apr 24. doi: 10.1038/s41390-020-0900-z. [Epub ahead of print]
PMID: 32330930
Select item 32332807
Harahsheh AS, Dahdah N, Newburger JW, Portman MA, Piram M, Tulloh R, McCrindle BW, de Ferranti SD, Cimaz R, Truong DT, Burns JC.
J Pediatr. 2020 Apr 23. pii: S0022-3476(20)30556-4. doi: 10.1016/j.jpeds.2020.04.052. [Epub ahead of print] No abstract available.
PMID: 32370951 Free PMC Article
Select item 32361481
Herberg U, Czernik C, Höhn R, Kececioglu D, Riede FT, Robel-Tillig E, von der Wense A.
Z Geburtshilfe Neonatol. 2020 Apr 22. doi: 10.1055/a-1139-9470. [Epub ahead of print] German. No abstract available.
PMID: 32323281
Select item 32320658
Ba H, Xu L, Peng H, Lin Y, Li X, Qin Y, Wang H.
Front Pediatr. 2020 Apr 21;8:163. doi: 10.3389/fped.2020.00163. eCollection 2020.
PMID: 32373560 Free PMC Article
Select item 32299590
Koestenberger M, Avian A, Cantinotti M, Meinel K, Hansmann G.
Pediatr Int. 2020 Apr 17. doi: 10.1111/ped.14163. [Epub ahead of print] No abstract available.
PMID: 32304149
Select item 32299151
El Assaad I, Gauvreau K, Rizwan R, Margossian R, Colan S, Chen MH.
J Am Soc Echocardiogr. 2020 Apr 9. pii: S0894-7317(20)30067-5. doi: 10.1016/j.echo.2020.01.020. [Epub ahead of print]
PMID: 32279939
Select item 32271829
Malone SM, Seigel NS, Newland JG, Saito JM, McKay VR.
Infect Control Hosp Epidemiol. 2020 Apr 7:1-6. doi: 10.1017/ice.2020.71. [Epub ahead of print]
PMID: 32252848
Select item 32223393
Hansmann G, Meinel K, Bukova M, Chouvarine P, Wåhlander H, Koestenberger M; European Pediatric Pulmonary Vascular Disease Network (EPPVDN).
J Heart Lung Transplant. 2020 Apr 7. pii: S1053-2498(20)31490-X. doi: 10.1016/j.healun.2020.03.029. [Epub ahead of print]
PMID: 32362477 Free Article
Select item 32269016
Whalen E, Ely E, Brown A.
Pediatr Pulmonol. 2020 Apr 6. doi: 10.1002/ppul.24761. [Epub ahead of print] Review.
PMID: 32250064
Select item 32248201
Young G, Lensing AWA, Monagle P, Male C, Thelen K, Willmann S, Palumbo JS, Kumar R, Nurmeev I, Hege K, Bajolle F, Connor P, Hooimeijer HL, Torres M, Chan AKC, Kenet G, Holzhauer S, Santamaría A, Amedro P, Beyer-Westendorf J, Martinelli I, Patricia Massicotte M, Smith WT, Berkowitz SD, Schmidt S, Price V, Prins MH, Kubitza D; EINSTEIN-Jr. Phase 3 Investigators.
J Thromb Haemost. 2020 Apr 4. doi: 10.1111/jth.14813. [Epub ahead of print]
PMID: 32246743
Select item 32248280
Williams JL, Raees MA, Sunthankar S, Killen SAS, Bichell D, Parra DA, Soslow JH.
Pediatr Cardiol. 2020 Apr 4. doi: 10.1007/s00246-020-02342-x. [Epub ahead of print]
PMID: 32248280
Select item 32242738
Garcia AM, Beatty JT, Nakano SJ.
Am J Physiol Heart Circ Physiol. 2020 Apr 1;318(4):H947-H965. doi: 10.1152/ajpheart.00518.2019. Epub 2020 Feb 28.
PMID: 32108525
Select item 32159369
Raut MS, Hanjoora VM, Srivastava AR, Khangarot SS, Jyoti A, Mahajan V, Rawal N.
Ann Card Anaesth. 2020 Apr-Jun;23(2):230-231. doi: 10.4103/aca.ACA_181_18.
PMID: 32275044 Free Article
Select item 32246937
Asada D, Ito H.
Cardiol Young. 2020 Apr;30(4):582-584. doi: 10.1017/S1047951120000475. Epub 2020 Mar 5.
PMID: 32131919
Select item 32090726
Huertas-Quiñones VM, Mestra CF, Peña-Trujillo V, Gallo-Bernal S, Villaveces M, Alarcón-Forero LC.
Cardiol Young. 2020 Apr;30(4):462-467. doi: 10.1017/S1047951120000281. Epub 2020 Feb 17.
PMID: 32063255
Select item 31393559
Tissot C, Singh Y.
Curr Opin Pediatr. 2020 Apr;32(2):235-244. doi: 10.1097/MOP.0000000000000887.
PMID: 32068595
Select item 32200576
Gulati R, Smith T, Siow M, Batten L.
Echocardiography. 2020 Apr;37(4):641-645. doi: 10.1111/echo.14636. Epub 2020 Mar 22.
PMID: 32200576
Select item 32147955
Topal Y, Topal H, Doğan C, Tiryaki SB, Biteker M.
Eur J Pediatr. 2020 Apr;179(4):619-625. doi: 10.1007/s00431-019-03536-z. Epub 2019 Dec 21.
PMID: 31865427
Select item 32091595
Ahamed MZ, Rohit M.
Indian J Pediatr. 2020 Apr;87(4):287-288. doi: 10.1007/s12098-020-03266-3. Epub 2020 Mar 13. No abstract available.
PMID: 32166606
Select item 32162150
Rohit M, Budakoty S.
Indian J Pediatr. 2020 Apr;87(4):312-320. doi: 10.1007/s12098-020-03255-6. Review.
PMID: 32162150
Select item 31732966
Jacobs KG, Chan FP, Cheng JY, Vasanawala SS, Maskatia SA.
Int J Cardiovasc Imaging. 2020 Apr;36(4):657-669. doi: 10.1007/s10554-019-01751-1. Epub 2020 Jan 1.
PMID: 31894524
Select item 31912893
Iacobelli R, Ricci Z, Marinari E, Haiberger R, Di Molfetta A, Toscano A, Di Chiara L.
Interact Cardiovasc Thorac Surg. 2020 Apr 1;30(4):623-629. doi: 10.1093/icvts/ivz319.
PMID: 31986196
Select item 31821450
Naeem B, Ayub A, Aly AM, Malloy MH, Okorodudu AO, Jain SK.
J Perinatol. 2020 Apr;40(4):628-632. doi: 10.1038/s41372-019-0581-9. Epub 2020 Jan 7.
PMID: 31911650
Select item 31740116
Coleman RD, Chartan CA, Ivy DD.
Pediatr Crit Care Med. 2020 Apr;21(4):393-394. doi: 10.1097/PCC.0000000000002219. No abstract available.
PMID: 32251186
Select item 32084099
099
ACHD Featured Articles in association with ISACHD
Adult Congenital Heart Reviews of April 2020 Manuscripts
Adult Congenital Heart Reviews of April 2020 (sponsored by ISACHD)
Tran D, D’Ambrosio P, Verrall CE, Attard C, Briody J, D’Souza M, Fiatarone Singh M, Ayer J, d’Udekem Y, Twigg S, Davis GM, Celermajer DS, Cordina R.
J Am Heart Assoc. 2020 Apr 21;9(8):e015639. doi: 10.1161/JAHA.119.015639. Epub 2020 Apr 15.
PMID: 32290749 Free Article
Select item 32315058
Take Home Points:
- In this relatively healthy group of Fontan patients, low skeletal muscle mass was associated with reduced exercise capacity, ventricular dysfunction, and compensatory erythrocytosis as a marker of cyanosis.
- BMI overestimates skeletal muscle mass and underestimates adiposity in Fontan patients.
Commentary by Dr. Maan Jokhadar (Atlanta), section editor of ACHD Journal Watch: The Fontan circulation is associated with elevated central venous pressure, low cardiac output, and cyanosis. These abnormalities increase the risk of heart failure, arrhythmias, thromboembolic events, hepatic fibrosis, and protein using the neuropathy, to name a few. Prior studies have described role of skeletal muscle as a “muscle pump” that increases venous return and augments pulmonary blood flow, which improves cardiac output and improves exercise capacity in Fontan patients.
Cardiac dysfunction can cause neurohormonal derangement and associated skeletal muscle loss and myopenia. There is also a complicated and often paradoxical interrelationship between obesity and heart failure (obesity paradox) with obese patients more likely to develop heart failure but obese patients with heart failure having improved survival. Data are mixed regarding the presence of the obesity paradox failure in Fontan patients.
Derek Tran and colleagues from Sydney, Australia performed a cross-sectional study of 28 Fontan patients who were prospectively recruited. The mean age was 26 with a near even split between male and female and 57% had a systemic left ventricle. Extracardiac Fontan was present in 50%, lateral tunnel in 39%, and 11% (3 patients) with atriopulmonary Fontan. The median BMI was 22.4 kg/m2. Participants had dual energy x-ray absorptiometry (DXA) to assess Appendicular lean mass index (ALMI) Z score and total percent body fat (%BF). They also underwent cardiopulmonary stress testing, echocardiography, handgrip strength assessment, and biochemical assessments. This was a relatively healthy group with exclusion criteria that included NYHA class III-IV, major intellectual or physical disability, or current pregnancy.
– Fontan associated myopenia ( Z score: -2 or lower) : 11 patients (39%)
– Less pronounced skeletal muscle mass deficit (Z score: between -2 and -1) : 8 patients (29%)
– Normal range muscle mass (Z score: higher than -1) was present in only 9 patients (32%)
All participants with normal range skeletal muscle mass had normal ventricular systolic function. Whereas 80% participants with ventricular dysfunction had skeletal myopenia. Males had lower %BF. High adiposity was present in 32%, moderate adiposity and 14%, 50% had normal range adiposity, and 4% (1) had low adiposity. There were 3 patients who had both Fontan associated myopenia and high adiposity.
Vitamin D deficiency was not associated with myopenia. Above normal range PTH was present in 40%, even though only 7 patients had low vitamin D. Blood leptin was increased and 70% of patients, reflecting elevated adiposity.
ALMI was strongly associated with exercise capacity as measured by peak VO2. Fontan associated myopenia was strongly associated with reduced peak handgrip. There was no difference in spirometry measures between normal and reduced muscle mass groups.
This is the first study to characterize body composition using DXA in Fontan patients. This clinically stable group showed low skeletal muscle mass and adiposity predisposition, which can be unrecognized when looking at BMI alone. BMI may overestimate skeletal muscle mass and underestimate adiposity in Fontan patients. Low skeletal muscle mass was associated with reduced exercise capacity, ventricular dysfunction, and compensatory erythrocytosis as a marker of cyanosis. About two thirds of participant had reduced muscle mass. ALMI was independently associated with absolute peak VO2. Grip strength was positively associated with muscle mass and was lower in patients with Fontan associated myopenia.
Ventricular systolic dysfunction was associated with low muscle mass, which could be due to peripheral “muscle pump” impairment reducing venous return, pulmonary blood flow, and cardiac output. Ventricular dysfunction can also cause myopenia due to myriad physiologic and neurohormonal mechanisms.
Based in DXA analysis of Fontan patients, reduced muscle mass and increased adiposity is common.
Given that reduced muscle mass is associated with ventricular dysfunction and reduced exercise capacity, additional study is needed to determine the therapeutic strategies and potentially substantial benefits of building lean muscle mass in these patients.
Ghosh RM, Griffis HM, Glatz AC, Rome JJ, Smith CL, Gillespie MJ, Whitehead KK, O’Byrne ML, Biko DM, Ravishankar C, Dewitt AG, Dori Y.
J Am Heart Assoc. 2020 Apr 7;9(7):e015318. doi: 10.1161/JAHA.119.015318. Epub 2020 Mar 30.
PMID: 32223393 Free Article
Select item 32200729
Take Home Points:
- Nearly a third of patients developed complications in the first 6 months post Fontan completion.
- This was mainly driven by prolonged pleural effusions, readmission or unplanned cardiac catheterization.
- Prolonged cross-clamp time and prolonged bypass time emerged as risk factors for early Fontan morbidity.
- The presence and severity of AV valve regurgitation did not influence early outcomes.
- The presence of a type 3 or type 4 lymphatic drainage pattern on MRI (T2 -weighted) was associated with higher early failure rates (Odds ratio 6.28).
Commentary from Dr. Blanche Cupido (Cape Town, South Africa), section editor of ACHD Journal Watch: Recent studies implicated the role of lymphatic congestion in the pathogenesis of both protein-losing enteropathy and plastic bronchitis in patients with the Fontan circulation resulting in late Fontan failure. The role of lymphatic drainage in the development of early Fontan complications is not well described. This is a single center retrospective study at a tertiary paediatric center in the US, describing the prevalence and cause of early post-Fontan morbidity.
All patients who underwent a Fontan operation from June 2012 to July 2017 were included. Those presenting for a Fontan take-down, those for Fontan revision or those with a Kawashima operation, were excluded. Lymphatic patterns were characterized using T2-weighted images. Patterns included 4 types:
- Type 1: Little or no abnormalities of the thoracic duct
- Type 2: Enhancement of the supraclavicular area and dilatation and/or tortuosity of the thoracic duct
- Type 3: Enhancement of mediastinal and supraclavicular area
- Type 4: enhancement extending from the mediastinum into the lung parenchyma
The primary outcome was a composite of early Fontan complications (within 6 months of surgery) including death, Fontan take-down, ECMO, chest drain >14 days, cardiac catheterization, re-admission, heart transplant listing. Fontan failure is characterized into 4 groups: structural failure, pump failure, pleural (non-chylous) effusions despite lack of pump or structural failure, and lastly lymphatic failure – usually presenting with chylothorax or plastic bronchitis.
Two hundred and thirty-eight patients were included in the study; 58 developed early Fontan complications (25.7%) – only 2 deaths occurred. Mean age at surgery was 3.4±1.7 years. An extra-cardiac fenestrated Fontan was present in 81% of the cohort.
The presence of a systemic RV (81% vs 67%, p0.047), a longer bypass time (median time 69.5 vs 64 minutes, p=0.025) and a longer cross-clamp time (median time 29 vs 25 min, p=0.002) was associated with a higher rate of early post-Fontan complications. The presence and severity of atrio-ventricular valve regurgitation did not have an effect on early outcomes.
Fontan failure was attributed to structural failure in 20 patients (35%), and to pump failure in 8 patients (14%). The presence of severe Fontan complications was only 4%. Fifteen patients (21.5%) had prolonged effusions and 15 patients (21.5%) had lymphatic failure as evidenced by plastic bronchitis or chylous effusions.
One hundred and ninety-five patients (82%) had pre-Fontan MRI’s. The systemic-pulmonary arterial collateral (APC) burden was quantified and expressed as a percentage of the total aortic flow. Of the 51 patients with a >35% APC burden, 43 had collateral embolization prior to Fontan completion. Only 126 patients had the correct T2 weighted sequences to establish lymphatic flow patterns: 39 had type 1, 41 had type 2, 35 had type 3. Only 7 had type 4 – thus rather rare.
Forty- three percent of those with type 3 pattern and all of those with the type 4 pattern developed early complications. Type 3 and type 4 patterns were combined and regarded as high-grade lymphatic abnormalities.
Type 3 and 4 combined subtended an odds-ratio of 6.05 (95% CI 2.10-17.46, p=0.001) for developing complications compared to those with a type 1 pattern. When controlling for a morphological RV, bypass and cross-clamp time, the odds ratio was 6.28 (95% CI 2.13 – 18.5, p=0.001) for developing early Fontan complications.
Arroyo-Rodríguez C, Fritche-Salazar JF, Posada-Martínez EL, Arías-Godínez JA, Ortiz-León XA, Calvillo-Arguelles O, Ruiz-Esparza ME, Sandoval JP, Sierra-Lara D, Araiza-Garaygordobil D, Picano E, Rodríguez-Zanella H.
Int J Cardiovasc Imaging. 2020 Apr;36(4):595-604. doi: 10.1007/s10554-019-01753-z. Epub 2020 Jan 1.
PMID: 31894525
Select item 31894524
Take home point:
- Right ventricular free wall longitudinal strain may be useful as a surrogate marker for low functional capacity in patients with repaired tetralogy of Fallot with severe pulmonary regurgitation (PR).
Commentary from Dr. Helen Parry (Leeds UK), section editor of ACHD Journal Watch: Functional capacity can be a useful guide to pulmonary valve replacement in patients with repaired tetralogy of Fallot who are on the borderline for intervention according to current guidelines. However, many patients are unable to exercise well due to non-cardiac reasons. This study looked at surrogate markers for impaired functional capacity to help guide management in borderline cases for pulmonary valve replacement.
Method:
Thirty-three patients were included in the study. Inclusion criteria were previous tetralogy of Fallot repair, NYHA class 1, no other significant cardiac abnormality such as AVSD and severe pulmonary regurgitation (PR). Severe PR was defined according to the following criteria:
- Jet: pulmonary annulus diameter >=0.7
- Pressure half time <100ms
- Diastolic flow reversal in the pulmonary branches
- PR index <0.77
The level of PR was classed as severe if 3 of the above criteria were fulfilled, or 2 if PR index<0.77.
Exercise echocardiography was performed using a bike with initial workload of 25W, increasing by 25 W every 2 mins. Patients who managed <7 METS were categorised as low functional capacity.
Strain imaging was performed using a GE machine and analysis was performed offline using the EchoPAC software. Inter-observer variability was assessed by repeat analysis by the same operator with a 2 week difference period.
Statistical analysis was performed by dividing the patients into 2 groups: low and normal functional capacity. Comparisons were made using the Students t-test for normally distributed variables and Wilcoxon sum rank test for non-parametric variables.
Results:
Twenty- two patients had normal functional capacity relative to 11 in the low functional capacity group.
The following variables were associated with low functional capacity, p value<0.05:
- Female gender
- Short stature
- Previous shunt palliation
- LV contractile reserve
- Right ventricular free wall longitudinal strain <17%
Conclusions:
Right ventricular free wall longitudinal strain may be useful as a surrogate marker for low functional capacity in patients with repaired tetralogy of Fallot with severe PR.
Strengths of the study:
- Timings for pulmonary valve replacement are a continued subject of debate- many clinicians believe we should be doing this at an earlier stage.
- Limited literature regarding the uses of newer echo techniques here, this study is an important contribution to the literature.
- Suggests a useful alternative to exercise testing in these borderline patients.
Weaknesses of the study:
- Very small sample size, only 11 patients in the low functional capacity group-can statistically meaningful associations genuinely be found in such a small sample?
- Strain imaging is both machine specific and supplier specific- many departments do not use GE systems, the cut-off for right ventricular wall strain is likely to be different across manufacturers.
- Many patients do not have adequate echo windows for reliable RV strain imaging.
- Inter-observer variability was tested by the same reporter reviewing the scans with 2 weeks difference. Two individuals performing analysis and testing agreement between the 2 would be a better way of looking at inter-observer variability.
ACHD Abstracts of April 2020
Greenway SC.
Can J Cardiol. 2020 Apr 24. pii: S0828-282X(20)30406-2. doi: 10.1016/j.cjca.2020.04.021. [Epub ahead of print] No abstract available.
PMID: 32339650
Select item 32238666
Tran D, D’Ambrosio P, Verrall CE, Attard C, Briody J, D’Souza M, Fiatarone Singh M, Ayer J, d’Udekem Y, Twigg S, Davis GM, Celermajer DS, Cordina R.
J Am Heart Assoc. 2020 Apr 21;9(8):e015639. doi: 10.1161/JAHA.119.015639. Epub 2020 Apr 15.
PMID: 32290749 Free Article
Select item 32315058
Kalinowski ME, Szulik M, Pawlak S, Rybus-Kalinowska B, Zembala M, Kalarus Z, Kukulski T.
Int J Cardiovasc Imaging. 2020 Apr 17. doi: 10.1007/s10554-020-01838-0. [Epub ahead of print]
PMID: 32303878
Select item 32302029
Henning RJ.
Future Cardiol. 2020 Apr 16. doi: 10.2217/fca-2019-0061. [Epub ahead of print]
PMID: 32297523
Select item 32305498
Desai R, Patel K, Dave H, Shah K, DeWitt N, Fong HK, Varma Y, Varma K, Mansuri Z, Sachdeva R, Khanna A, Kumar G.
Am J Cardiol. 2020 Apr 15;125(8):1256-1262. doi: 10.1016/j.amjcard.2020.01.024. Epub 2020 Jan 30.
PMID: 32085866
Select item 32355544
Fritz C, Müller J, Oberhoffer R, Ewert P, Hager A.
Int J Cardiol. 2020 Apr 15;305:50-55. doi: 10.1016/j.ijcard.2020.01.015. Epub 2020 Jan 9.
PMID: 31992463
Select item 31959411
Saraf A, De Staercke C, Everitt I, Haouzi A, Ko YA, Jennings S, Kim JH, Rodriguez FH, Kalogeropoulos AP, Quyyumi A, Book W.
Int J Cardiol. 2020 Apr 15;305:56-62. doi: 10.1016/j.ijcard.2020.01.012. Epub 2020 Jan 9.
PMID: 31959411
Select item 32295626
Ibrahim AM, Siddique MS.
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. 2020 Apr 14.
PMID: 30422578 Free Books & Documents
Select item 32284538
Gaydos SS, Chowdhury SM, Judd RN, McHugh KE.
Cardiol Young. 2020 Apr 13:1-8. doi: 10.1017/S1047951120000682. [Epub ahead of print]
PMID: 32279695
Select item 32285188
Chida-Nagai A, Sagawa K, Tsujioka T, Fujimoto T, Taniguchi K, Sasaki O, Izumi G, Yamazawa H, Masaki N, Manabe A, Takeda A.
Heart Vessels. 2020 Apr 13. doi: 10.1007/s00380-020-01604-1. [Epub ahead of print]
PMID: 32285188 Free PMC Article
Select item 32279354
Dinarti LK, Hartopo AB, Kusuma AD, Satwiko MG, Hadwiono MR, Pradana AD, Anggrahini DW.
BMC Cardiovasc Disord. 2020 Apr 7;20(1):163. doi: 10.1186/s12872-020-01434-z.
PMID: 32264836 Free PMC Article
Select item 32266496
Ghosh RM, Griffis HM, Glatz AC, Rome JJ, Smith CL, Gillespie MJ, Whitehead KK, O’Byrne ML, Biko DM, Ravishankar C, Dewitt AG, Dori Y.
J Am Heart Assoc. 2020 Apr 7;9(7):e015318. doi: 10.1161/JAHA.119.015318. Epub 2020 Mar 30.
PMID: 32223393 Free Article
Select item 32200729
Angelini A, di Gioia C, Doran H, Fedrigo M, Henriques de Gouveia R, Ho SY, Leone O, Sheppard MN, Thiene G, Dimopoulos K, Mulder B, Padalino M, van der Wal AC; Association for European Cardiovascular Pathology (AECVP).
Virchows Arch. 2020 Apr 7. doi: 10.1007/s00428-020-02779-8. [Epub ahead of print] Review.
PMID: 32266476
Select item 32249724
Emekli AS, Ekizoglu E, Yesilot N.
Cardiol Young. 2020 Apr 6:1-3. doi: 10.1017/S1047951120000669. [Epub ahead of print]
PMID: 32249724
Select item 32248856
Alsaied T, Possner M, Brown N, Almeneisi H, Szugye C, Trout AT, Niss O, Palermo JJ, Zafar F, Dillman JR, Veldtman GR, Opotowsky AR, Lubert AM.
Cardiol Young. 2020 Apr 6:1-8. doi: 10.1017/S1047951120000694. [Epub ahead of print]
PMID: 32248856
Select item 32328638
Nuche J, Montero-Cabezas JM, Lareo A, Huertas S, Jiménez López-Guarch C, Velázquez Martín M, Alonso Charterina S, Revilla Ostolaza Y, Delgado JF, Arribas Ynsaurriaga F, Escribano Subías P.
Heart Vessels. 2020 Apr 4. doi: 10.1007/s00380-020-01600-5. [Epub ahead of print]
PMID: 32248253
Select item 32245430
Shaaban M, Tantawy S, Elkafrawy F, Haroun D, Romeih S, Elmozy W.
Egypt Heart J. 2020 Apr 3;72(1):17. doi: 10.1186/s43044-020-00047-3. Review.
PMID: 32266511 Free PMC Article
Select item 32246195
Brida M, Chessa M, Gu H, Gatzoulis MA.
Int J Cardiol. 2020 Apr 3. pii: S0167-5273(20)31727-7. doi: 10.1016/j.ijcard.2020.04.006. [Epub ahead of print] No abstract available.
PMID: 32321654 Free PMC Article
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Sandoval J, Del Valle-Mondragón L, Masso F, Zayas N, Pulido T, Teijeiro R, Gonzalez-Pacheco H, Olmedo-Ocampo R, Sisniega C, Paez-Arenas A, Pastelin-Hernandez G, Gomez-Arroyo J, Voelkel NF.
Eur Respir J. 2020 Apr 2. pii: 1902416. doi: 10.1183/13993003.02416-2019. [Epub ahead of print]
PMID: 32241831
Select item 32238728
Oliver Ruiz JM, Dos Subirá L, González García A, Rueda Soriano J, Ávila Alonso P, Gallego P; Spanish Adult Congenital Heart Disease Network (RECCA).
Rev Esp Cardiol (Engl Ed). 2020 Apr 2. pii: S1885-5857(20)30097-9. doi: 10.1016/j.rec.2019.09.032. [Epub ahead of print] English, Spanish.
PMID: 32249097
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Gewillig M, Brown SC, van de Bruaene A, Rychik J.
Acta Paediatr. 2020 Apr;109(4):651-658. doi: 10.1111/apa.15098. Epub 2020 Jan 8. Review.
PMID: 31737940 Free PMC Article
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Gales J, Krasuski RA, Awerbach JD.
Am Heart J. 2020 Apr;222:191-198. doi: 10.1016/j.ahj.2020.02.001. Epub 2020 Feb 5.
PMID: 32105985
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Anderson KN, Tepper NK, Downing K, Ailes EC, Abarbanell G, Farr SL.
Am Heart J. 2020 Apr;222:38-45. doi: 10.1016/j.ahj.2020.01.008. Epub 2020 Jan 21.
PMID: 32014720
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Gross AM, Frone M, Gripp KW, Gelb BD, Schoyer L, Schill L, Stronach B, Biesecker LG, Esposito D, Hernandez ER, Legius E, Loh ML, Martin S, Morrison DK, Rauen KA, Wolters PL, Zand D, McCormick F, Savage SA, Stewart DR, Widemann BC, Yohe ME.
Am J Med Genet A. 2020 Apr;182(4):866-876. doi: 10.1002/ajmg.a.61485. Epub 2020 Jan 8.
PMID: 31913576
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Garcia AM, Beatty JT, Nakano SJ.
Am J Physiol Heart Circ Physiol. 2020 Apr 1;318(4):H947-H965. doi: 10.1152/ajpheart.00518.2019. Epub 2020 Feb 28.
PMID: 32108525
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Garcia AM, McPhaul JC, Sparagna GC, Jeffrey DA, Jonscher R, Patel SS, Sucharov CC, Stauffer BL, Miyamoto SD, Chatfield KC.
Am J Physiol Heart Circ Physiol. 2020 Apr 1;318(4):H787-H800. doi: 10.1152/ajpheart.00494.2019. Epub 2020 Feb 14.
PMID: 32056460
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Kemal HS, Kayıkçıoğlu M, Nalbantgil S, Can LH, Moğulkoç N, Kültürsay H.
Anatol J Cardiol. 2020 Apr;23(5):277-287. doi: 10.14744/AnatolJCardiol.2020.01379.
PMID: 32352408 Free Article
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Tajiri Y, Miyazaki A, Miyake M, Higaki R, Miki N, Misaki T, Doi H.
Can J Cardiol. 2020 Apr;36(4):590.e1-590.e2. doi: 10.1016/j.cjca.2019.10.024. Epub 2019 Nov 1. No abstract available.
PMID: 32144038
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Tretter JT, Windram J, Faulkner T, Hudgens M, Sendzikaite S, Blom NA, Hanseus K, Loomba RS, McMahon CJ, Zheleva B, Kumar RK, Jacobs JP, Oechslin EN, Webb GD, Redington AN.
Cardiol Young. 2020 Apr;30(4):560-567. doi: 10.1017/S1047951120000852. Epub 2020 Apr 13.
PMID: 32228736 Free PMC Article
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McLaughlin VV, Channick R, De Marco T, Farber HW, Gaine S, Galié N, Krasuski RA, Preston I, Souza R, Coghlan JG, Frantz RP, Hemnes A, Kim NH, Lang IM, Langleben D, Li M, Sitbon O, Tapson V, Frost A.
Chest. 2020 Apr;157(4):955-965. doi: 10.1016/j.chest.2019.10.043. Epub 2019 Nov 16. Review.
PMID: 31738929 Free Article
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Westaby JD, Cooper STE, Edwards KA, Anderson RH, Sheppard MN.
Clin Anat. 2020 Apr;33(3):394-404. doi: 10.1002/ca.23531. Epub 2019 Dec 9.
PMID: 31769098
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Stoiber L, Ghorbani N, Kelm M, Kuehne T, Rank N, Lapinskas T, Stehning C, Pieske B, Falk V, Gebker R, Kelle S.
Clin Res Cardiol. 2020 Apr;109(4):454-464. doi: 10.1007/s00392-019-01525-8. Epub 2019 Jul 13.
PMID: 31302712 Free PMC Article
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Moons P.
Eur J Cardiovasc Nurs. 2020 Apr;19(4):280-281. doi: 10.1177/1474515120909744. Epub 2020 Feb 29. No abstract available.
PMID: 32114792
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Leslie CE, Schofield K, Vannatta K, Jackson JL.
Eur J Cardiovasc Nurs. 2020 Apr;19(4):283-290. doi: 10.1177/1474515119885858. Epub 2019 Nov 13.
PMID: 31722548
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Arya P, Wilson TE, Parent JJ, Ware SM, Breman AM, Helm BM.
Eur J Med Genet. 2020 Apr;63(4):103797. doi: 10.1016/j.ejmg.2019.103797. Epub 2019 Oct 22.
PMID: 31654754
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Sueda S, Kohno H.
Heart Vessels. 2020 Apr;35(4):443-450. doi: 10.1007/s00380-019-01507-w. Epub 2019 Sep 16.
PMID: 31529177
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Warchol-Celinska E, Prejbisz A, Dobrowolski P, Klisiewicz A, Kadziela J, Florczak E, Michalowska I, Jozwik-Plebanek K, Kabat M, Kwiatek P, Nazarewski S, Madej K, Rowinski O, Swiatlowski L, Peczkowska M, Hanus K, Talarowska P, Smolski M, Kowalczyk K, Kurkowska-Jastrzebska I, Stefanczyk L, Wiecek A, Widecka K, Tykarski A, Stryczynski L, Litwin M, Hoffman P, Witkowski A, Szczerbo-Trojanowska M, Januszewicz M, Januszewicz A.
Hypertension. 2020 Apr;75(4):1102-1109. doi: 10.1161/HYPERTENSIONAHA.119.13239. Epub 2020 Mar 9.
PMID: 32148126
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Vonder Muhll I.
Int J Cardiol. 2020 Apr 1. pii: S0167-5273(20)30612-4. doi: 10.1016/j.ijcard.2020.03.073. [Epub ahead of print] No abstract available.
PMID: 32276772
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Toyoda S, Sakuma M, Abe S, Nakajima T, Inoue T.
Int J Cardiol. 2020 Apr 1;304:35-36. doi: 10.1016/j.ijcard.2020.01.011. Epub 2020 Jan 16. No abstract available.
PMID: 31982163
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Kuijpers JM, Vaartjes I, Bokma JP, van Melle JP, Sieswerda GT, Konings TC, Bakker-de Boo M, van der Bilt I, Voogel B, Zwinderman AH, Mulder BJM, Bouma BJ.
Int J Cardiol. 2020 Apr 1;304:39-42. doi: 10.1016/j.ijcard.2019.11.114. Epub 2019 Nov 18.
PMID: 31767384
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Arroyo-Rodríguez C, Fritche-Salazar JF, Posada-Martínez EL, Arías-Godínez JA, Ortiz-León XA, Calvillo-Arguelles O, Ruiz-Esparza ME, Sandoval JP, Sierra-Lara D, Araiza-Garaygordobil D, Picano E, Rodríguez-Zanella H.
Int J Cardiovasc Imaging. 2020 Apr;36(4):595-604. doi: 10.1007/s10554-019-01753-z. Epub 2020 Jan 1.
PMID: 31894525
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Jacobs KG, Chan FP, Cheng JY, Vasanawala SS, Maskatia SA.
Int J Cardiovasc Imaging. 2020 Apr;36(4):657-669. doi: 10.1007/s10554-019-01751-1. Epub 2020 Jan 1.
PMID: 31894524
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Wang TKM, Lowe B, Hlohovsky S, O’Donnell C.
Intern Med J. 2020 Apr;50(4):481-484. doi: 10.1111/imj.14810.
PMID: 32270622
Select item 32049329
Lewis MJ, Johansson Ramgren J, Hallbergson A, Liuba P, Sjöberg G, Malm T.
J Card Surg. 2020 Apr;35(4):868-874. doi: 10.1111/jocs.14494. Epub 2020 Mar 11.
PMID: 32160354
Select item 32115768
Medrek S, Sahay S, Zhao C, Selej M, Frost A.
J Heart Lung Transplant. 2020 Apr;39(4):321-330. doi: 10.1016/j.healun.2019.11.024. Epub 2020 Jan 24.
PMID: 32067864
Select item 31952977
Samokhin AO, Hsu S, Yu PB, Waxman AB, Alba GA, Wertheim BM, Hopkins CD, Bowman F, Channick RN, Nikolic I, Faria-Urbina M, Hassoun PM, Leopold JA, Tedford RJ, Ventetuolo CE, Leary PJ, Maron BA.
J Heart Lung Transplant. 2020 Apr;39(4):289-299. doi: 10.1016/j.healun.2019.12.002. Epub 2019 Dec 31.
PMID: 31952977
Select item 31726116
Téllez L, Rodríguez de Santiago E, Minguez B, Payance A, Clemente A, Baiges A, Morales-Arraez D, La Mura V, Llop E, Garrido E, Garrido-Lestache E, Tasayco S, Bruno O, Prieto R, Montserrat S, Pons M, Olavarría A, Dos L, Legendre A, Jesús Del Cerro M, Bañares R, García-Pagán JC, Rautou PE, Albillos A; VALDIG an EASL consortium.
J Hepatol. 2020 Apr;72(4):702-710. doi: 10.1016/j.jhep.2019.10.027. Epub 2019 Nov 11.
PMID: 31726116
Select item 31913220
Warchoł-Celińska E, Pieluszczak K, Pappaccogli M, Soplińska A, Prejbisz A, Dobrowolski P, Klisiewicz A, Kądziela J, Falkowski A, Śmigielski W, Florczak E, Jóźwik-Plebanek K, Michałowska I, Kabat M, Zgorzelski C, Madej K, Nazarewski S, Smólski M, Olewnik Ł, Litwin M, Szczerbo-Trojanowska M, Zieniewicz K, Drygas W, Rowiński O, Witkowski A, Adlam D, Van der Niepen P, Persu A, Januszewicz A, Januszewicz M.
J Hypertens. 2020 Apr;38(4):737-744. doi: 10.1097/HJH.0000000000002327.
PMID: 31913220
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van der Palen RLF, Deurvorst QS, Kroft LJM, van den Boogaard PJ, Hazekamp MG, Blom NA, Lamb HJ, Westenberg JJM, Roest AAW.
J Magn Reson Imaging. 2020 Apr;51(4):1105-1116. doi: 10.1002/jmri.26934. Epub 2019 Oct 7.
PMID: 31591799
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Romeo JLR, Papageorgiou G, Takkenberg JJM, Roos-Hesselink JW, van Leeuwen WJ, Cornette JMJ, Rizopoulos D, Bogers AJJC, Mokhles MM.
J Thorac Cardiovasc Surg. 2020 Apr;159(4):1508-1516.e1. doi: 10.1016/j.jtcvs.2019.08.083. Epub 2019 Oct 4.
PMID: 31706555
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Chouvarine P, Geldner J, Giagnorio R, Legchenko E, Bertram H, Hansmann G.
Pediatr Crit Care Med. 2020 Apr;21(4):340-349. doi: 10.1097/PCC.0000000000002207.
PMID: 31876555
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Lopes BS, Coats L, Anderson RH.
Semin Thorac Cardiovasc Surg. 2020 Spring;32(1):143-144. doi: 10.1053/j.semtcvs.2019.09.013. Epub 2019 Oct 2. No abstract available.
PMID: 31586467
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Inciyildirim A, Karaagac A.
Indian Pediatr. 2020 Apr 30. pii: S097475591600170. [Epub ahead of print] No abstract available.
PMID: 32358229 Free Article
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Lianza AC, Rodrigues ACT, Mercer-Rosa L, Vieira MLC, de Oliveira WAA, Afonso TR, Nomura CH, da Silva JP, da Silva LDF, Szarf G, Tavares GMP, Fischer CH, Morhy SS.
Pediatr Cardiol. 2020 Apr 25. doi: 10.1007/s00246-020-02347-6. [Epub ahead of print]
PMID: 32335735
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Frank BS, Schafer M, Thomas TM, Haxel C, Ivy DD, Jone PN.
J Am Soc Echocardiogr. 2020 Apr 23. pii: S0894-7317(20)30131-0. doi: 10.1016/j.echo.2020.02.015. [Epub ahead of print]
PMID: 32336608
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Bonura ED, Bos JM, Abdelsalam MA, Araoz PA, Ommen SR, Ackerman MJ, Geske JB.
Am J Cardiol. 2020 Apr 15;125(8):1249-1255. doi: 10.1016/j.amjcard.2020.01.027. Epub 2020 Jan 28.
PMID: 32088002
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Aypar E, Alehan D, Karagöz T, Aykan H, Ertugrul İ.
Cardiol Young. 2020 Apr 15:1-5. doi: 10.1017/S1047951120000773. [Epub ahead of print]
PMID: 32290885
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Schmiegelow MD, Idorn L, Gislason G, Hlatky M, Køber L, Torp-Pedersen C, Søndergaard L.
Int J Cardiol. 2020 Apr 15;305:120-126. doi: 10.1016/j.ijcard.2019.12.062. Epub 2019 Dec 30.
PMID: 32001036
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Toprak B, Szöcs K, Zengin-Sahm E, Sinning C, Hot A, Bannas P, Hecher K, Hüneke B, Mir TS, Rybczynski M, Girdauskas E, Blankenberg S, von Kodolitsch Y.
J Clin Med. 2020 Apr 15;9(4). pii: E1124. doi: 10.3390/jcm9041124.
PMID: 32326432 Free Article
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Chida-Nagai A, Sagawa K, Tsujioka T, Fujimoto T, Taniguchi K, Sasaki O, Izumi G, Yamazawa H, Masaki N, Manabe A, Takeda A.
Heart Vessels. 2020 Apr 13. doi: 10.1007/s00380-020-01604-1. [Epub ahead of print]
PMID: 32285188 Free PMC Article
Select item 32287102
Tavazzi G, Pellegrini C, Maurelli M, Belliato M, Sciutti F, Bottazzi A, Sepe PA, Resasco T, Camporotondo R, Bruno R, Baldanti F, Paolucci S, Pelenghi S, Iotti GA, Mojoli F, Arbustini E.
Eur J Heart Fail. 2020 Apr 10. doi: 10.1002/ejhf.1828. [Epub ahead of print]
PMID: 32275347
Select item 32290313
Congenital Heart and Pediatric Cardiac Electrophysiology Featured Articles
Congenital and Pediatric Cardiac EP Review of April 2020 Manuscripts
Congenital and Pediatric Cardiac EP Review of April 2020 Manuscripts
Chubb H, Rosenthal DN, Almond CS, Ceresnak SR, Motonaga KS, Arunamata AA, Long J, Trela AV, Hanisch D, McElhinney DB, Dubin AM.
Circ Arrhythm Electrophysiol. 2020 Apr;13(4):e007925. doi: 10.1161/CIRCEP.119.007925. Epub 2020 Mar 22.
PMID: 32202126
Select item 32301336
Take Home Points:
- Cardiac Resynchronization Therapy (CRT) has become a mainstay in adult heart failure management and a potential option in children with and without congenital heart disease.
- CRT is associated with improved transplant-free survival in those patients with symptomatic heart failure (AHA Stage C or D), ventricular dysfunction (systemic ventricular EF <45%), and electrical dyssynchrony (QRS duration Z-score ≥ 3 or ventricular paced ≥ 40%).
- Heart transplantation or death was significantly lower in the CRT group compared to controls, 19% vs 58% (hazard ratio, 0.24, p<0.001).
- CRT was effective in pediatric patients with congenital heart disease, cardiomyopathy, and systemic RV failure.
- CRT was associated with sustained improvements in ejection fraction at 5 years
Comment from Dr. Akash Patel (San Francisco), section editor of Congenital Electrophysiology Journal Watch. Heart failure among pediatric patients with and without congenital heart disease continues to provide challenges due to varying efficacy of anti-congestive therapy and limitations on advanced therapies such as heart transplantation. Cardiac resynchronization therapy (CRT) for the treatment of heart failure in adults without congenital heart disease (ACHD) is well established and has shown improvements in ventricular function, functional status, and mortality. The role of CRT in pediatric patients with and without congenital heart disease remains limited due to the small numbers of patients. In particular, the pediatric cohort is impacted by the large heterogeneity of congenital heart disease lesions, morphology of the systemic failing ventricle (right vs. left), variations in circulation (univentricular vs. biventricular), variations in patient size during childhood, and limited follow-up. In addition, the primary outcomes of CRT studies in pediatrics has focused on improvements in ventricular function and not on long term survival. This study aimed to assess the impact of CRT in pediatric patients with and without congenital heart disease on transplant-free survival.
This was a retrospective case-control single center study of pediatric patients (≤ 21 years) with and without congenital heart disease from 2004-2017 who had reduced systemic ventricular function (ejection fraction < 45%), symptomatic heart failure (AHA Stage C or D), and electrical dyssynchrony (unpaced QRS duration z-score ≥ 3 or ventricular pacing ≥ 40%). Cases were enrolled at time of implant and defined as patients who underwent CRT implantation during this time frame with ≥ 1 lead on the systemic ventricle. Controls were enrolled at first outpatient visit meeting inclusion criteria and were subsequently matched using propensity scoring. Exclusion criteria included Eisenmenger syndrome, current VAD, previous heart transplant, and weight <4 kg. See Figure Below
The clinical practice for determining who underwent CRT placement during this time period was made on an individual basis through a multidisciplinary approach involving the heart failure, electrophysiology, and surgical teams. After implantation, optimization of device programming was based on routine clinical practice which changed in 2016. Pre-2016, optimization was focused primarily on echocardiographic assessment for mechanical dyssynchrony and cardiac output. Post-2016, optimization was focused primarily on electrocardiographic assessment of electrical dyssynchrony. Baseline clinical, device, electrocardiographic, and echocardiographic data were obtained. Follow-up data was obtained at 6 (±3) months, 1 (±0.5) years, 2 (±0.5) years and 5 (±1) year when available. Outcome measures included death or heart transplantation, overall survival, time to first transplant listing, and time to first heart failure hospitalization.
The study group included 86 with CRT, 133 controls, and 63 propensity score matched (PSM) pairs. Of note, 6 cases (10%) had CRT turned off in > 1month for reason other than death or transplant. These patients were included in the CRT group for analysis. See Figure Below.
The median age of the CRT-PSM cohort was 11 years with 62% male and 81% with congenital heart disease. The systemic ventricle was left in 81% with a mean systemic EF of 32%. The mean QRS duration z-score was 8.1. The median NHYA Class was 2. Only 5% were listed for transplant at baseline. There was no significant difference with controls across a total of 21 indices used match cases and controls (only 10 shown in table below).
There was no difference in type of circulation (biventricular vs univentricular) and systemic ventricle (left vs right) between the PSM-CRT and control groups.
The median follow-up was 2.7 (0.8 – 6.1) years overall and 2.4 (0.6 – 5.1) years for non-transplanted survivors.
The CRT approach was affected by size and anatomy with the majority of devices implanted being epicardial CRT-P. See Figure Below.
| Device implantation | |
| Approach | |
| Transvenous | 17 (27%) |
| Epicardial | 43 (68%) |
| Hybrid | 3 (5%) |
| Device Type in CRT Group | |
| CRT-P at baseline | 44 (70%) |
| CRT-D at baseline | 19 (30%) |
| CRT-P to D upgrade during follow-up | 1 (2%) |
| Device Type in Control Group | |
| ICD at baseline | 12 (19%) |
| ICD during follow-up | 2 (3%) |
Overall, heart transplantation or death was significantly lower in the CRT group compared to controls, 12 (19%) vs. 37 (58%), [HR of 0.24, (95% CI, 0.12–0.46), p <0.001]. In addition, the CRT group had a higher rate of overall survival and survival without heart failure hospitalization or transplant listing. See Figures Below.
Risk factors associated with death or transplantation after multivariate analysis included increased risk with higher NHYA/Ross Class and decreased risk with use of CRT and presence of congenital heart disease.
Subgroup analysis showed CRT was effective in improving transplant-free survival in those with and without congenital heart disease, in those without and without the need for bradycardia pacing, and those with systemic right ventricles. In this cohort, CRT in univentricular anatomy did not demonstrate significant improvement upon transplant-free survival.
Longitudinal follow-up showed the median QRS duration decreased 23 msec (95% CI, −38 to −6 msec) in the PSM-CRT group and increased 1 msec (95% CI, −4 to +8 msec) in the PSM-control group at 6 months (P<0.001). Of note, there was a disproportionate decline in PSM controls over time, but a significant increase in absolute QRS duration from baseline over time. There was no mention of Z-score change over time. See Figure Below.
Longitudinal follow-up showed a significant increase in median systemic ventricular EF at 6 months, 11% (95% CI, +0.5% to +21%) in the PSM-CRT group compared to 0.1% (95% CI, −9.8% to +3.2%) in the PSM-control group (P<0.001). Of note, there was a disproportionate decline in PSM controls over time, but a significant increase in absolute and change from baseline EF over time.
Device complications were noted in 5% (acute) and 31% (chronic) with lead issues as the most common complication. There was no mortality with CRT procedures. See Table below.
Device therapy was noted in both groups. Appropriate shocks for VF/VT was seen in 4 patients in the CRT-D group and 2 in the control group with ICDs. Inappropriate shocks were seen in 2 patients in CRT-D group and none in the control group with ICDs.
This study demonstrates the improved transplant-free survival for pediatric patients with and without congenital heart disease who received CRT for symptomatic heart failure (AHA Stage C or D and systemic EF < 45%) with electrical dyssynchrony (QRS duration z-score ≥ 3 or ventricular pacing ≥ 40%). The design of this study allowed for a more robust retrospective analysis of CRT therapy in pediatric patients than prior studies using propensity score matching and providing a longer term of follow-up with a median of 2.7 years
Overall, there was improvement in ventricular function seen at 6 months and throughout follow-up to 5 years. However, a limitation of this study was the assessment of ventricular function with LV EF extrapolated from shortening fraction when EF by Simpson method was not available. In addition, the RV EF was estimated from fractional area change for the systemic RV. In addition, there was attrition during follow-up limiting data over time. Of further interest would be the assessment of CRT on longitudinal function (EF) in the univentricular heart which was not associated with survival benefit and in the systemic right ventricle which was associated with survival benefit in this cohort.
Heart failure functional status also plays a key role due to its impact on management decisions and survival outcomes. A lower function status at baseline was associated with a reduced risk for death or transplantation in this study. In addition, the presence of CRT was associated with improved survival to first heart failure hospitalization or transplant listing. Due to sample size and objectives, subgroup analysis was not performed to assess risk factors for heart failure hospitalization or transplant listing.
QRS duration has been an important predictor of response to CRT in adults without congenital heart disease. All patients in this study had significant conduction disease and CRT resulted in a significant decrease in QRS duration. However, it appears that the paced QRS duration remained >120 msec in the majority potentially impacting the degree of response. The varied response to CRT is multifactorial based on variations in bundle morphology (i.e. left vs right ventricular dyssynchrony), anatomy, lead locations, and optimization protocols. In this study, the location of multisite ventricular pacing positions was not standardized or analyzed. In addition, the optimization prior to 2016 was based on echocardiographic assessments thus resulting in limited follow-up using electrocardiographic optimization. Despite these variations, CRT showed improvement in overall transplant-free survival.
Overall, this study showed that 81% of those who had CRT were alive without heart transplantation compared to the 42% in the control group. This association between CRT and transplant-free survival remained significant when controlling for confounders. However, due to the heterogeneity of patients and approaches in this study, not all groups may demonstrate similar findings in a generalizable population.
This study provides additional data regarding the potential benefits of CRT in pediatric heart failure with and without congenital heart disease. However, more data is needed with homogenous congenital populations, standardized approaches, and longer term follow-up to determine those who will respond to CRT that can be used to ultimately refine existing guidelines.
Management of heart failure in pediatric patients is important to reduce mortality, transplantations, hospitalizations, and comorbidities. As mentioned in this study, a multidisciplinary approach is needed when determining who and how one should receive CRT therapy. In addition, medical and device optimization management will continue to require an individualized approach.
Congenital Heart and Pediatric Cardiac EP Abstracts of April 2020
Lempersz C, van Laar JO, Clur SB, Verdurmen KM, Warmerdam GJ, van der Post J, Blom NA, Delhaas T, Oei SG, Vullings R.
PLoS One. 2020 Apr 30;15(4):e0232606. doi: 10.1371/journal.pone.0232606. eCollection 2020.
PMID: 32353083 Free Article
Select item 32347120
Manolis TA, Manolis AA, Apostolopoulos EJ, Papatheou D, Melita H, Manolis AS.
Curr Med Res Opin. 2020 Apr 29:1. doi: 10.1080/03007995.2020.1762555. [Epub ahead of print]
PMID: 32347120
Select item 32347569
Huang J, Zhou R, Pan Y, Yang B.
J Cardiovasc Electrophysiol. 2020 Apr 26. doi: 10.1111/jce.14520. [Epub ahead of print]
PMID: 32337777
Select item 32338186
Dionne A, Kheir JN, Gauvreau K, Triedman JK, Abrams DJ, Alexander ME, DeWitt ES, Mah DY, Walsh EP, Bezzerides VJ.
Pacing Clin Electrophysiol. 2020 Apr 24. doi: 10.1111/pace.13925. [Epub ahead of print]
PMID: 32329521
Select item 32332807
Angelini P, Muthupillai R, Cheong B, Paisley R.
J Am Heart Assoc. 2020 Apr 21;9(8):e014368. doi: 10.1161/JAHA.119.014368. Epub 2020 Apr 20. No abstract available.
PMID: 32306825 Free Article
Select item 32306820
Sakhi R, Kauling RM, Theuns DA, Szili-Torok T, Bhagwandien RE, van den Bosch AE, Cuypers JAAE, Roos-Hesselink JW, Yap SC.
Int J Cardiol. 2020 Apr 15;305:63-69. doi: 10.1016/j.ijcard.2020.02.009. Epub 2020 Feb 4.
PMID: 32057477 Free Article
Select item 31992463
Barracano R, Brida M, Guarguagli S, Palmieri R, Diller GP, Gatzoulis MA, Wong T.
Heart. 2020 Apr 8. pii: heartjnl-2019-316202. doi: 10.1136/heartjnl-2019-316202. [Epub ahead of print] Review.
PMID: 32269130
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Lau LY, So EK, Chow PC, Cheung YF.
Heart Vessels. 2020 Apr 3. doi: 10.1007/s00380-020-01601-4. [Epub ahead of print]
PMID: 32246195
Select item 32321654
Wainwright B, Bhan R, Trad C, Cohen R, Saxena A, Buyon J, Izmirly P.
Best Pract Res Clin Obstet Gynaecol. 2020 Apr;64:41-51. doi: 10.1016/j.bpobgyn.2019.09.001. Epub 2019 Oct 8. Review.
PMID: 31685414
Select item 32247068
Chubb H, Rosenthal DN, Almond CS, Ceresnak SR, Motonaga KS, Arunamata AA, Long J, Trela AV, Hanisch D, McElhinney DB, Dubin AM.
Circ Arrhythm Electrophysiol. 2020 Apr;13(4):e007925. doi: 10.1161/CIRCEP.119.007925. Epub 2020 Mar 22.
PMID: 32202126
Select item 32301336
Mulkey SB, Govindan R, Metzler M, Swisher CB, Hitchings L, Wang Y, Baker R, Larry Maxwell G, Krishnan A, du Plessis AJ.
Clin Auton Res. 2020 Apr;30(2):165-172. doi: 10.1007/s10286-019-00616-w. Epub 2019 Jun 25.
PMID: 31240423
Select item 32003456
Winbo A, Paterson DJ.
Heart Lung Circ. 2020 Apr;29(4):529-537. doi: 10.1016/j.hlc.2019.11.002. Epub 2019 Dec 16. Review.
PMID: 31959550
Select item 31529177
Khairy P.
Int J Cardiol. 2020 Apr 1;304:38. doi: 10.1016/j.ijcard.2020.01.004. No abstract available.
PMID: 32178797
Select item 32178796
Pasqualin G.
Int J Cardiol. 2020 Apr 1;304:37. doi: 10.1016/j.ijcard.2019.11.124. No abstract available.
PMID: 32178796
Select item 31982163
El-Shabrawi M, Lotfy W, Hegazy R, Abdelaziz O, Sobhy R, Abdelmohsen G, Ibrahim H, Dohain AM.
J Card Surg. 2020 Apr;35(4):831-839. doi: 10.1111/jocs.14477. Epub 2020 Feb 24.
PMID: 32092198
Select item 31983510
Borquez AA, Aljohani OA, Williams MR, Perry JC.
JACC Clin Electrophysiol. 2020 Apr;6(4):425-432. doi: 10.1016/j.jacep.2019.11.019. Epub 2020 Feb 26.
PMID: 32327076
Select item 32157831
Morgan RW, Topjian AA, Wang Y, Atkin NJ, Kilbaugh TJ, McGowan FX, Berg RA, Mercer-Rosa L, Sutton RM, Himebauch AS.
Pediatr Crit Care Med. 2020 Apr;21(4):305-313. doi: 10.1097/PCC.0000000000002187.
PMID: 31688674
Select item 31658187
Zhang Y, Li XM, Jiang H, Cui J, Ge HY, Liu HJ, Li MT.
J Cardiovasc Electrophysiol. 2020 Apr 28. doi: 10.1111/jce.14521. [Epub ahead of print]
PMID: 32343451
Select item 32354144
Gando I, Campana C, Tan RB, Cecchin F, Sobie EA, Coetzee WA.
J Mol Cell Cardiol. 2020 Apr 24;144:1-11. doi: 10.1016/j.yjmcc.2020.04.027. [Epub ahead of print]
PMID: 32339567
Select item 32329521
Grassi S, Campuzano O, Coll M, Brión M, Arena V, Iglesias A, Carracedo Á, Brugada R, Oliva A.
Leg Med (Tokyo). 2020 Apr 23;45:101712. doi: 10.1016/j.legalmed.2020.101712. [Epub ahead of print]
PMID: 32361481 Free Article
Select item 32328669
Ackerman MJ, Giudicessi JR.
J Am Coll Cardiol. 2020 Apr 21;75(15):1785-1787. doi: 10.1016/j.jacc.2020.03.005. No abstract available.
PMID: 32299590
Select item 32308111
Zhang Y, Li H, Wang J, Wang G, Tan X, Lei M.
Stem Cell Res. 2020 Apr 20;45:101798. doi: 10.1016/j.scr.2020.101798. [Epub ahead of print]
PMID: 32344329 Free Article
Select item 32315641
Dasgupta S, Kelleman M, Whitehill R, Fischbach P.
Indian Pacing Electrophysiol J. 2020 Apr 18. pii: S0972-6292(20)30044-9. doi: 10.1016/j.ipej.2020.04.007. [Epub ahead of print]
PMID: 32311435 Free Article
Select item 32312518
Chin CG, Chung FP, Lin YJ, Chang SL, Lo LW, Hu YF, Tuan TC, Chao TF, Liao JN, Lin CY, Chang TY, Vicera JJB, Chen CC, Chuang CM, Cheng WH, Liu SH, Hsieh MH, Chen SA.
Int J Cardiol. 2020 Apr 15;305:70-75. doi: 10.1016/j.ijcard.2020.02.007. Epub 2020 Feb 4.
PMID: 32059994
Select item 32001036
Prutkin JM, Wang Y, Escudero CA, Stephenson EA, Minges KE, Curtis JP, Hsu JC.
Int J Cardiol. 2020 Apr 15;305:44-49. doi: 10.1016/j.ijcard.2020.01.027. Epub 2020 Jan 15.
PMID: 31980272
Select item 32326588
Czaja AS, Collins K, Valuck RJ, Anderson HD, Ghosh D, Davidson JA.
Pharmacoepidemiol Drug Saf. 2020 Apr 13. doi: 10.1002/pds.5001. [Epub ahead of print]
PMID: 32283564
Select item 32282083
Kaltman JR.
Heart Rhythm. 2020 Apr 8. pii: S1547-5271(20)30291-5. doi: 10.1016/j.hrthm.2020.03.029. [Epub ahead of print] No abstract available.
PMID: 32278073
Select item 32276050
Han J, Ackerman MJ, Moir C, Cai C, Xiao PL, Zhang P, Briske KA, Zheng LR, Chen PS, Cha YM.
Heart Rhythm. 2020 Apr 8. pii: S1547-5271(20)30284-8. doi: 10.1016/j.hrthm.2020.03.023. [Epub ahead of print]
PMID: 32276050
Select item 32300638
Giudicessi JR, Noseworthy PA, Friedman PA, Ackerman MJ.
Mayo Clin Proc. 2020 Apr 7. pii: S0025-6196(20)30313-X. doi: 10.1016/j.mayocp.2020.03.024. [Epub ahead of print]
PMID: 32359771 Free PMC Article
Select item 32259298
Kohli U, Aziz Z, Beaser AD, Nayak HM.
Pacing Clin Electrophysiol. 2020 Apr 7. doi: 10.1111/pace.13913. [Epub ahead of print]
PMID: 32259298
Select item 32272111
Young ML, Lam S.
Am J Case Rep. 2020 Apr 5;21:e920692. doi: 10.12659/AJCR.920692.
PMID: 32248201 Free PMC Article
Select item 32303417
Bove T, Alipour Symakani R, Verbeke J, Vral A, El Haddad M, De Wilde H, Stroobandt R, De Pooter J.
Interact Cardiovasc Thorac Surg. 2020 Apr 3. pii: ivaa047. doi: 10.1093/icvts/ivaa047. [Epub ahead of print]
PMID: 32243531
Select item 32243076
Borquez AA, Aljohani OA, Williams MR, Perry JC.
JACC Clin Electrophysiol. 2020 Apr;6(4):425-432. doi: 10.1016/j.jacep.2019.11.019. Epub 2020 Feb 26.
PMID: 32327076
Select item 32157831
Holmberg MJ, Ross CE, Atkins DL, Valdes SO, Donnino MW, Andersen LW; American Heart Association’s for the AHA’s Get With The Guidelines®-Resuscitation Pediatric Research Task Force.
Resuscitation. 2020 Apr;149:191-201. doi: 10.1016/j.resuscitation.2019.12.033. Epub 2020 Jan 16.
PMID: 31954741
Select item 31518703
Giudicessi JR, Ye D, Stutzman MJ, Zhou W, Tester DJ, Ackerman MJ.
Europace. 2020 Apr 1;22(4):622-631. doi: 10.1093/europace/euz337.
PMID: 32091595
Select item 32034906
Savastano S, Pugliese L, Baldi E, Dusi V, Tavazzi G, De Ferrari GM.
Europace. 2020 Apr 1;22(4):606. doi: 10.1093/europace/euaa007. No abstract available.
PMID: 32034906
Select item 31821488
Sharma N, Cortez D, Disori K, Imundo JR, Beck M.
Hosp Pediatr. 2020 Apr;10(4):369-375. doi: 10.1542/hpeds.2019-0139. Epub 2020 Mar 6. Review.
PMID: 32144177
Select item 32055997
Rohit M, Kasinadhuni G.
Indian J Pediatr. 2020 Apr;87(4):295-304. doi: 10.1007/s12098-020-03267-2. Epub 2020 Mar 13. Review.
PMID: 32166608
Select item 32166606
Lucchini M, Wapner RJ, Chia-Ling NC, Torres C, Yang J, Williams IA, Fifer WP.
Int J Gynaecol Obstet. 2020 Apr;149(1):82-87. doi: 10.1002/ijgo.13096. Epub 2020 Jan 30.
PMID: 31912893
Select item 31986196
Kapa S, Mehra N, Deshmukh AJ, Friedman PA, Asirvatham SJ.
J Cardiovasc Electrophysiol. 2020 Apr;31(4):952-959. doi: 10.1111/jce.14388. Epub 2020 Feb 18.
PMID: 32048387
Select item 32000202
Sugrue A, Vaidya VR, Padmanabhan D, Yasin O, Abudan A, Isath A, Killu AM, Naksuk N, Bolon B, Friedman PA, Asirvatham SJ.
J Interv Card Electrophysiol. 2020 Apr;57(3):453-464. doi: 10.1007/s10840-019-00553-8. Epub 2019 Jun 6.
PMID: 31172420
Select item 31591799
Etheridge SP, Asaki SY.
JACC Clin Electrophysiol. 2020 Apr;6(4):433-435. doi: 10.1016/j.jacep.2019.12.016. No abstract available.
PMID: 32327077
Select item 32327076
Congenital Heart Interventions Featured Articles
Interventional Cardiology Reviews of April 2020 Manuscripts
Congenital Heart Interventions Review of April 2020 Manuscripts
Gordon BM, Abudayyeh I, Goble J, Collado NA, Paolillo J.Catheter Cardiovasc Interv. 2020 Apr 1;95(5):932-936. doi: 10.1002/ccd.28666. Epub 2019 Dec 26.PMID: 31876383
Take Home Points:
- Residual leaks following device closure of secundum atrial septal defects, particularly when using the GORE CARDIOFORM Septal Occluder, are poorly understood.
- Patients with larger defects, smaller aortic rims, and with the presence of multiple fenestrations are more likely to have residual leaks following ASD device closure with the GSO.
- Residual leaks following ASD device closure with the GSO frequently disappear within the first year following implantation.
Commentary from Dr. Arash Salavitabar (Ann Arbor, MI), section editor of Congenital Heart Disease Interventions Journal Watch: In this retrospective, multicenter study, the authors aimed to review experiences with outcomes of residual leaks following device closure of secundum atrial septal defects (ASD) with the GORE CARDIOFORM Septal Occluder (GSO) during the pivotal and continued access study. This is a well-known potential issue post-device closure of ASDs and the expectant course is not well-described, particularly with this device. One important characteristic of the GSO device is that it is not “self-centering”, and so it has the ability to shift as it conforms to the septal anatomy. This can lead to potential small leaks around the edge of the device. The authors sought to characterize the medium-term outcomes of residual leaks noted with the GSO and to report on potential risk factors associated with eventual closure rates.
This study included 69 patients who had a residual leak following device implantation, out of 374 total patients who underwent ASD closure with the GSO for the pivotal and continued access U.S. trials. Sixty-five (17.5%) patients met inclusion criteria following retrospective review of their echocardiograms. When comparing those with and without residual leak, those with residual leaks had larger defects (10.33 ± 3.05 mm vs. 9.13 ± 2.89 mm, p = .006), larger stop flow balloon sizes (12.91 ± 3.02 mm vs. 11.43 ± 2.89 mm, p < .001), smaller aortic rims (4.87 ± 3.33 mm vs. 6.17 ± 3.78 mm, p = .019), the presence of multiple fenestrations (43.08% vs. 18.69%, p < .001), and increased fluoroscopic time (16.02 ± 9.65 min vs. 13.17 ± 9.03 min, p = .004). Larger devices tended to be implanted and more devices per case were utilized in the residual leak cohort as compared to those without leak. There was no significant differences between procedural time, device- to-defect ratio, or type of anesthesia among groups.
Importantly, there was a significant decrease in the leak size over 1 year in those patients with residual leak, from 1.55 ± 0.75mm to 0.25 ± 0.74mm (p < 0.001), with the majority disappearing by that 1 year follow-up (Figure 1).
The authors postulate that residual shunts adjacent to ASD closure devices disappear over time due to remodeling of the right atrium with subsequent normalization of right atrial size following removal of the volume load caused by the ASD. This is thought to augment the endothelialization that occurs from adjacent tissue.
While this study is limited by its retrospective nature, it provides important information regarding risk factors for residual leak following ASD device closure, particularly with the GSO. It is also valuable to understand that these residual leaks frequently completely disappear over the first year following implantation, which can affect patient counseling, frequency of follow-up, and potential need for future interventions.
Tomasulo CE, Gillespie MJ, Munson D, Demkin T, O’Byrne ML, Dori Y, Smith CL, Rome JJ, Glatz AC.
Catheter Cardiovasc Interv. 2020 Apr 27. doi: 10.1002/ccd.28942. [Epub ahead of print]
PMID: 32339400
Select item 32338402
Take Home Points:
- Transcatheter PDA closure is the preferred treatment option for nearly all patients with PDAs, even those near 1 kg, at most centers
- LPA stenosis and aortic coarctation are known risk factors in infants undergoing PDA closure
- This study supports that the majority of LPA and aortic obstruction tend to improve over time
Commentary from Dr. Ryan Romans (Kansas City, MO), section editor of Congenital Heart Disease Interventions Journal Watch: Transcatheter PDA closure (TC-PDA) is at least as safe and as efficacious as surgical ligation and offers a lower morbidity option. It has long been the standard for larger infants, children, and adults. The number of available devices that are able to be delivered through small sheaths has led to improved outcomes in TC-PDA and allowed for closure in smaller infants who were previously routinely referred for surgical PDA ligation. Left pulmonary artery (LPA) stenosis and aortic coarctation are known concerns in this patient population and are well described. However, longer term outcomes of these complications are not known.
Tomasulo et al. report on a retrospective analysis of all infants ≤ 4 kg who underwent TC-PDA from 2007-2018. A total of 44 infants met inclusion criteria and had successful TC-PDA. The median weight was 2.8 kg (range 1.2-4 kg), with a trend towards lower weights later in the study time frame (6/10 from 2018 weighed <2 kg). The majority of patients (30/44) underwent PDA closure with an Amplatzer Vascular Plug II (AVP-II), 10 with an Amplatzer Duct Occluder II-Additional sizes (ADOII-AS, now known as the Piccolo device), 3 with an Amplatzer Duct Occluder I (ADO1), and 1 with an Amplatzer Vascular Plug I filled with 3 Cook embolization coils. The devices were placed via an antegrade approach from the femoral vein in all patients. Arterial access was obtained in 59% of patients, though in only 3/17 patients since 2017 (and none who had an ADOII-AS device placed). Type F (61%) and Type C (23%) PDAs made up the large majority of cases.
Of the 44 patients, 39 had post procedure echocardiograms performed, all of which showed complete closure of the PDA. Angiography showed mild or less residual shunt in the other 5. Median follow up was 0.7 years (range 2 days-7 years) with 38 patients having assessment for LPA stenosis and aortic coarctation. Of these 38 patients, 21 patients (55%) had obstruction in at least 1 vessel. A total of 17 patients had mild flow acceleration (defined as an echocardiographic flow velocity of 1.5-2 m/sec) or stenosis (flow velocity >2 m/sec) in the LPA (though 3 of these already had flow acceleration/stenosis on their pre procedure echocardiogram). The majority of these improved as shown below. Those who developed LPA obstruction were younger, had larger PDAs, and were less likely to have an AVP II device placed.
A total of 4 patients developed flow acceleration in the aorta (flow velocity 1.5-2 m/sec) and 3 developed mild aortic coarctation (flow velocity >2 m/sec). Of these, 4/7 had improved at the time of last follow up as detailed below. Lower birth weight was the only statistically significant factor associated with aortic obstruction, though there was a trend towards later gestational age and shorter PDAs.
This study confirms that LPA and aortic obstruction are frequently seen in TC-PDA in small infants. However, the amount of obstruction seen is typically quite mild and likely clinically irrelevant. Additionally, most of the obstruction improves over time and none of the patients in this cohort required additional intervention (though other studies on TC-PDA closure in small infants have shown a small number requiring intervention). While this study adds reassuring information to the literature, the types of devices being used in this population is changing. The Piccolo device now has FDA approval for TC-PDA in this patient population and is now most interventionalists go to device. Additionally, the MVP microvascular plug (Medtronic) has frequently been used for TC-PDA closure in small infants and is not reported on in this study. Future studies are warranted to evaluate these known problems with the devices that are more frequently used today.
CHD Interventions Abstracts of April 2020
Tannous P, Popescu A, Forbess L, Nugent A.
Catheter Cardiovasc Interv. 2020 Apr 28. doi: 10.1002/ccd.28920. [Epub ahead of print]
PMID: 32343465
Select item 32353822
Tomasulo CE, Gillespie MJ, Munson D, Demkin T, O’Byrne ML, Dori Y, Smith CL, Rome JJ, Glatz AC.
Catheter Cardiovasc Interv. 2020 Apr 27. doi: 10.1002/ccd.28942. [Epub ahead of print]
PMID: 32339400
Select item 32338402
Jone PN, Sandoval JP, Haak A, Hammers J, Rodriguez-Zanella H, Quaife RA, Salcedo EE, Carroll JD, Gill E.
Echocardiography. 2020 Apr 27. doi: 10.1111/echo.14670. [Epub ahead of print] Review.
PMID: 32338402
Select item 32341135
Menon PJ, Walsh K.
Vasc Endovascular Surg. 2020 Apr 26:1538574420921280. doi: 10.1177/1538574420921280. [Epub ahead of print]
PMID: 32338186
Select item 32344201
de Gregorio C, Ceresa F, Ferrazzo G, Patanè F.
J Clin Ultrasound. 2020 Apr 25. doi: 10.1002/jcu.22845. [Epub ahead of print]
PMID: 32333791
Select item 32339650
Takahashi S, Ibrahim N, Yasukochi S, Ringel R, Ing F, Tomita H, Sugiyama H, Yamagishi M, Forbes TJ, Kim SH, Ho M, Gillette N, Nakamura Y, Mineta K, Fearnot N, Dineen D, Vang E, Haskin R, Becker LAM, Sekiguchi K, Sakamoto K, Ruiz CE; Harmonization by Doing for Children Working Group.
Circ J. 2020 Apr 24;84(5):786-791. doi: 10.1253/circj.CJ-19-1092. Epub 2020 Apr 1.
PMID: 32238666 Free Article
Select item 32336071
Söder S, Wällisch W, Dittrich S, Cesnjevar R, Pfammatter JP, Glöckler M.
Sci Rep. 2020 Apr 24;10(1):6973. doi: 10.1038/s41598-020-63903-x.
PMID: 32332807 Free PMC Article
Select item 32370483
Shu Y, Guo Y, Wang X, Zhou D.
J Cardiothorac Surg. 2020 Apr 22;15(1):68. doi: 10.1186/s13019-020-01110-5.
PMID: 32321548 Free PMC Article
Select item 32323405
Promphan W, Han Siang K, Prachasilchai P, Jarutach J, Makonkawkeyoon K, Siwaprapakorn W, Chutimapongrat N, Sueachim P, Butchan Y.
Catheter Cardiovasc Interv. 2020 Apr 16. doi: 10.1002/ccd.28892. [Epub ahead of print]
PMID: 32299151
Select item 32297523
Barry OM, Ali F, Ronderos M, Sudhaker A, Kumar RK, Mood MC, Corona-Villalobos C, Nguyen DT, Doherty-Schmeck K, Bergersen L, Gauvreau K, Jenkins KJ, Hasan BS.
Catheter Cardiovasc Interv. 2020 Apr 15. doi: 10.1002/ccd.28908. [Epub ahead of print]
PMID: 32294315
Select item 32294303
Shibbani K, De Lima E Silva Bagno L, Poulin MF, Matella T, Diab K, Kavinsky C, Ramesh N, Bhat V, Hijazi ZM, Kenny D.
Catheter Cardiovasc Interv. 2020 Apr 15. doi: 10.1002/ccd.28893. [Epub ahead of print]
PMID: 32294303
Select item 32057477
Jung SY, Shin JI, Choi JY, Park SJ, Kim NK.
J Clin Med. 2020 Apr 15;9(4). pii: E1132. doi: 10.3390/jcm9041132.
PMID: 32326588 Free Article
Select item 30422578
Aboulhosn JA, Hijazi ZM, Kavinsky CJ, McElhinney DB, Asgar AW, Benson LN, Daniels CJ, Ghobrial J, Horlick E, Ing FF, Inglessis I, Kay J, Levi DS.
Catheter Cardiovasc Interv. 2020 Apr 9. doi: 10.1002/ccd.28885. [Epub ahead of print] No abstract available.
PMID: 32272495
Select item 32271829
Hummel J, Kubicki R, Pingpoh C, Stiller B, Sigler M, Siepe M, Grohmann J.
Catheter Cardiovasc Interv. 2020 Apr 8. doi: 10.1002/ccd.28891. [Epub ahead of print]
PMID: 32267611
Select item 32269130
Subahi A, Forbes T, Ali OE.
Int J Cardiol Heart Vasc. 2020 Apr 8;28:100511. doi: 10.1016/j.ijcha.2020.100511. eCollection 2020 Jun.
PMID: 32300638 Free PMC Article
Select item 32368696
Li N, Zhao P, Wu D, Liang C.
Br J Radiol. 2020 Apr;93(1108):20190523. doi: 10.1259/bjr.20190523. Epub 2019 Oct 31.
PMID: 31638419
Select item 32369291
Butera G, Lucchese G, Austin C, Frigiola A.
Catheter Cardiovasc Interv. 2020 Apr 1;95(5):950-953. doi: 10.1002/ccd.28714. Epub 2020 Jan 8.
PMID: 31912986
Select item 31876383
Gordon BM, Abudayyeh I, Goble J, Collado NA, Paolillo J.
Catheter Cardiovasc Interv. 2020 Apr 1;95(5):932-936. doi: 10.1002/ccd.28666. Epub 2019 Dec 26.
PMID: 31876383
Select item 31738929
Rigatelli G, Zuin M, Dell’Avvocata F, Roncon L, Vassilev D, Nghia N.
Eur J Intern Med. 2020 Apr;74:42-48. doi: 10.1016/j.ejim.2019.12.010. Epub 2020 Jan 3.
PMID: 31902564
Select item 31981616
Giugno L, Faccini A, Carminati M.
Korean Circ J. 2020 Apr;50(4):302-316. doi: 10.4070/kcj.2019.0291. Review.
PMID: 32157831 Free PMC Article
Select item 32197102
Gao Y, Wang P, Su Y, Wang Z, Han L, Li J, Fu Y, Zhao F, Sun Q, Lyu Y.
Mutat Res. 2020 Apr;852:503163. doi: 10.1016/j.mrgentox.2020.503163. Epub 2020 Feb 25.
PMID: 32265037
Select item 31959051
Abu-Anza O, Carr K, Aldoss O.
Cardiol Young. 2020 Apr 27:1-3. doi: 10.1017/S1047951120000724. [Epub ahead of print]
PMID: 32336315
Select item 32339400
Tomasulo CE, Gillespie MJ, Munson D, Demkin T, O’Byrne ML, Dori Y, Smith CL, Rome JJ, Glatz AC.
Catheter Cardiovasc Interv. 2020 Apr 27. doi: 10.1002/ccd.28942. [Epub ahead of print]
PMID: 32339400
Select item 32338402
Morgan GJ, Narayan SA, Goreczny S, Chubb H, Krasemann T, Rosenthal E, Qureshi SA.
Cardiol Young. 2020 Apr 23:1-7. doi: 10.1017/S1047951120000700. [Epub ahead of print]
PMID: 32321616
Select item 32323311
Gokalp S, Ugan Atik S, Saltik IL.
Cardiol Young. 2020 Apr 20:1-3. doi: 10.1017/S1047951120000815. [Epub ahead of print]
PMID: 32308169
Select item 32325371
Abu-Anza O, Nakamura Y, Aldoss O.
Cardiol Young. 2020 Apr 17:1-3. doi: 10.1017/S1047951120000827. [Epub ahead of print]
PMID: 32301405
Select item 32202295
Arar Y, Reddy SRV, Kim H, Dimas VV, Zellers TM, Abou Zahr R, Vamsee R, Greer JS, Tandon A, Pontiki A, Dillenbeck J, Zabala L, Greil G, Nugent AW, Hussain T.
Cardiol Young. 2020 Apr 15:1-7. doi: 10.1017/S1047951120000712. [Epub ahead of print]
PMID: 32290877
Select item 32294315
Jung SY, Shin JI, Choi JY, Park SJ, Kim NK.
J Clin Med. 2020 Apr 15;9(4). pii: E1132. doi: 10.3390/jcm9041132.
PMID: 32326588 Free Article
Select item 32326432
Sigler M, Hofbeck M.
Eur Heart J. 2020 Apr 14;41(15):1478. doi: 10.1093/eurheartj/ehz338. No abstract available.
PMID: 31132082
Select item 32291873
Gal DB, Char DS.
Circulation. 2020 Apr 13. doi: 10.1161/CIRCULATIONAHA.120.047087. [Epub ahead of print] No abstract available.
PMID: 32282242
Select item 32285188
McGill M, Aggarwal V, Hiremath G.
JACC Cardiovasc Interv. 2020 Apr 13;13(7):897-898. doi: 10.1016/j.jcin.2019.10.011. Epub 2019 Dec 25. No abstract available.
PMID: 31883718
Select item 32282016
Schmiady M, Kretschmar O, Hübler M, Sigler M.
Eur Heart J. 2020 Apr 7;41(14):1410. doi: 10.1093/eurheartj/ehz617. No abstract available.
PMID: 32259267
Select item 32281525
- Interventional cardiac catheterization in neonatal age: results in a multicentre Italian experience.
Giordano M, Santoro G, Agnoletti G, Carminati M, Donti A, Guccione P, Marasini M, Milanesi O, Russo MG, Castaldi B, Cheli M, Formigari R, Gaio G, Giugno L, Lunardini A, Pepino C, Spadoni I.
Int J Cardiol. 2020 Apr 5. pii: S0167-5273(20)30384-3. doi: 10.1016/j.ijcard.2020.04.013. [Epub ahead of print]
PMID: 32303417
Select item 32309207
Anderson JH, Adamson T, Migliati E, Herlihy J, Danieu P, Daly J, Allen C, Hua K, Inglessis I.
Catheter Cardiovasc Interv. 2020 Apr 2. doi: 10.1002/ccd.28884. [Epub ahead of print]
PMID: 32239801
Select item 32249125
Cox K, Algaze-Yojay C, Punn R, Silverman N.
J Am Soc Echocardiogr. 2020 Apr 2. pii: S0894-7317(20)30035-3. doi: 10.1016/j.echo.2020.01.013. [Epub ahead of print]
PMID: 32249125 Free Article
Select item 32234207
Zaban NB, Herrmann JL, Hoyer MH, Brown JW, Alexy RD.
Cardiol Young. 2020 Apr;30(4):489-492. doi: 10.1017/S1047951120000372. Epub 2020 Feb 24.
PMID: 32090726
Select item 32063255
Momenah TS, Alsahari A, Ahmed E, Al Khalaf K.
Catheter Cardiovasc Interv. 2020 Apr 1;95(5):1062-1065. doi: 10.1002/ccd.28390. Epub 2019 Jul 11.
PMID: 31293050
Select item 32202126
O’Byrne ML, Peyvandi S.
Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006636. doi: 10.1161/CIRCOUTCOMES.120.006636. Epub 2020 Apr 7. No abstract available.
PMID: 32252550
Select item 32252549
Pickard SS, Wong JB, Bucholz EM, Newburger JW, Tworetzky W, Lafranchi T, Benson CB, Wilkins-Haug LE, Porras D, Callahan R, Friedman KG.
Circ Cardiovasc Qual Outcomes. 2020 Apr;13(4):e006127. doi: 10.1161/CIRCOUTCOMES.119.006127. Epub 2020 Apr 7.
PMID: 32252549
Select item 32167373
Lei C, Huang Y, Yuan S, Chen W, Liu H, Yang M, Shen Z, Fang L, Fang Q, Song H, Tian X, Zeng X, Guo X, Zhang S.
Can J Cardiol. 2020 Apr;36(4):535-542. doi: 10.1016/j.cjca.2019.08.039. Epub 2019 Sep 6.
PMID: 31924450
Select item 32256914
Yilmazer MM, Meşe T.
Cardiol Young. 2020 Apr;30(4):591-593. doi: 10.1017/S1047951120000542. Epub 2020 Mar 19.
PMID: 32188522
Select item 32180543
Congenital Heart Surgery
Congenital Heart Surgery Reviews of MApril 2020 Manuscripts
-
CHD Surgery April 2020
Bozso SJ, Evans B, Chu MWA.
J Card Surg. 2020 Apr 30. doi: 10.1111/jocs.14591. [Epub ahead of print]
PMID: 32353904
Select item 32354361
Xiaobing L, Yan J, Wangping Z, Rufang Z, Jia L, Rong W.
Biomed Pharmacother. 2020 Apr 27;127:110180. doi: 10.1016/j.biopha.2020.110180. [Epub ahead of print]
PMID: 32353822 Free Article
Select item 32339400
Sun Y, Shen SE, Deng XM, Cai Y, Du Y.
Paediatr Anaesth. 2020 Apr 27. doi: 10.1111/pan.13894. [Epub ahead of print]
PMID: 32338441
Select item 32342149
Diephuis E, de Borgie C, Tomšič A, Winkelman J, van Boven WJ, Bouma B, Eberl S, Juffermans N, Schultz M, Henriques JP, Koolbergen D.
EBioMedicine. 2020 Apr 25;55:102744. doi: 10.1016/j.ebiom.2020.102744. [Epub ahead of print]
PMID: 32344201 Free PMC Article
Select item 32335820
Siddiqi UA, Hibino N, Combs PS, Baker T, Song T, Kim G, Jeevanandam V.
J Card Surg. 2020 Apr 25. doi: 10.1111/jocs.14561. [Epub ahead of print]
PMID: 32333435
Select item 32333429
Kluin J.
Future Cardiol. 2020 Apr 23. doi: 10.2217/fca-2020-0041. [Epub ahead of print]
PMID: 32323578 Free Article
Select item 32328807
Levy E, Blumenthal J, Chiotos K, Dearani JA.
World J Pediatr Congenit Heart Surg. 2020 Apr 21:2150135120924653. doi: 10.1177/2150135120924653. [Epub ahead of print] No abstract available.
PMID: 32316830
Select item 32382545
- Computational Evaluation of Surgical Design for Multisegmental Complex Congenital Tracheal Stenosis.
Zhu L, Gong X, Liu J, Li Y, Zhong Y, Shen J, Xu Z.
Biomed Res Int. 2020 Apr 20;2020:3509814. doi: 10.1155/2020/3509814. eCollection 2020.
PMID: 32382545 Free Article
Select item 32314508
Khanna S, Mahajan S, Halder V, Gowda N.
J Card Surg. 2020 Apr 19. doi: 10.1111/jocs.14569. [Epub ahead of print]
PMID: 32306468
Select item 32315647
Kato N, Tachibana T, Asai H, Ebuoka N, Shingu Y, Ooka T, Kato H, Wakasa S.
Ann Thorac Surg. 2020 Apr 18. pii: S0003-4975(20)30562-2. doi: 10.1016/j.athoracsur.2020.03.039. [Epub ahead of print]
PMID: 32315647
Select item 32315641
Widenka H, Stoller F, Glöckler M, Erdös G, Carrel T, Kadner A.
Ann Thorac Surg. 2020 Apr 18. pii: S0003-4975(20)30571-3. doi: 10.1016/j.athoracsur.2020.03.045. [Epub ahead of print]
PMID: 32315641
Select item 32305952
Pierson RN 3rd, Burdorf L, Madsen JC, Lewis GD, D’Alessandro DA.
Am J Transplant. 2020 Apr 17. doi: 10.1111/ajt.15916. [Epub ahead of print]
PMID: 32301262
Select item 32305978
Raimondi F, Secinaro A, Boddaert N, Bonnet D.
Diagn Interv Imaging. 2020 Apr 17. pii: S2211-5684(20)30056-5. doi: 10.1016/j.diii.2020.02.009. [Epub ahead of print] No abstract available.
PMID: 32312564
Select item 32303878
S H C, Verma M, Ojha V, Sharma A, Kumar S.
J Card Surg. 2020 Apr 17. doi: 10.1111/jocs.14540. [Epub ahead of print] No abstract available.
PMID: 32302029
Select item 32299151
He GW, Hou HT, Xuan C, Wang J, Liu LX, Zhang JF, Liu XC, Yang Q.
Am J Transl Res. 2020 Apr 15;12(4):1319-1337. eCollection 2020.
PMID: 32355544 Free PMC Article
Select item 32293321
Hofbeck M, Wiegand G, Michel J, Schlensak C.
J Cardiothorac Surg. 2020 Apr 15;15(1):59. doi: 10.1186/s13019-020-01099-x.
PMID: 32295626 Free PMC Article
Select item 32326588
Nordmeyer S, Krettek S, Nordmeyer J, Schafstedde M, Rehm K, Photiadis J, Berger F, Ovroutski S.
Cardiol Young. 2020 Apr 13:1-4. doi: 10.1017/S1047951120000670. [Epub ahead of print]
PMID: 32279698
Select item 32279695
Pan HZ, Zhang LJ, Liu YW, Li YN, Su ZH, Meng J, Zhang H.
Artif Organs. 2020 Apr 12. doi: 10.1111/aor.13695. [Epub ahead of print]
PMID: 32279354
Select item 32290605
Grünert SC, Tucci S, Schumann A, Schwendt M, Gramer G, Hoffmann GF, Erbel M, Stiller B, Spiekerkoetter U.
Orphanet J Rare Dis. 2020 Apr 10;15(1):87. doi: 10.1186/s13023-020-01371-2.
PMID: 32276632 Free PMC Article
Select item 32272495
Reddy S, Handler SS, Wu S, Rabinovitch M, Wright G.
J Am Heart Assoc. 2020 Apr 7;9(7):e015871. doi: 10.1161/JAHA.119.015871. Epub 2020 Mar 19.
PMID: 32188306 Free Article
Select item 32266476
Lewis RA, Billings CG, Bolger A, Bowater S, Charalampopoulos A, Clift P, Elliot CA, English K, Hamilton N, Hill C, Hurdman J, Jenkins PJ, Johns C, MacDonald S, Oliver J, Papaioannou V, Rajaram S, Sabroe I, Swift AJ, Thompson AAR, Kiely DG, Condliffe R.
Respirology. 2020 Apr 6. doi: 10.1111/resp.13815. [Epub ahead of print]
PMID: 32249494 Free Article
Select item 32249445
Shin YR, Lee H, Park YH, Park HK.
Korean J Thorac Cardiovasc Surg. 2020 Apr 5;53(2):41-48. doi: 10.5090/kjtcs.2020.53.2.41.
PMID: 32309201 Free PMC Article
Select item 32275884
Hanser A, Neunhoeffer F, Hayer T, Hofbeck M, Schlensak C, Mustafi M, Kumpf M, Michel J.
J Spec Pediatr Nurs. 2020 Apr 3:e12291. doi: 10.1111/jspn.12291. [Epub ahead of print]
PMID: 32243076
Select item 32348933
Borthakur B, Hanjoora VM, Mahajan V, Srivastava AR, Jyoti A, Raut M, Nawal A.
Ann Card Anaesth. 2020 Apr-Jun;23(2):237-240. doi: 10.4103/aca.ACA_227_18.
PMID: 32275047 Free Article
Select item 32246937
- ST2 predicts risk of unplanned readmission within one year after pediatric congenital heart surgery.
Parker DM, Everett AD, Stabler ME, Jacobs ML, Jacobs JP, Vricella L, Thiessen-Philbrook H, Parikh CR, Manlhiot C, Brown JR.
Ann Thorac Surg. 2020 Apr 1. pii: S0003-4975(20)30431-8. doi: 10.1016/j.athoracsur.2020.02.056. [Epub ahead of print]
PMID: 32246937
Select item 31580857
Li Q, Hara H, Banks CA, Yamamoto T, Ayares D, Mauchley DC, Dabal RJ, Padilla L, Carlo WF, Rhodes LA, Cooper DKC, Cleveland DC.
Ann Thorac Surg. 2020 Apr;109(4):1268-1273. doi: 10.1016/j.athoracsur.2019.08.061. Epub 2019 Sep 30.
PMID: 31580857
Select item 32199055
Guimarães DP, Caneo LF, Matte G, Carletto LP, Policarpo VC, Castro AVCX, Miranda MHC, Costa PS, Jatene MB, Cestari I, Jatene FB.
Braz J Cardiovasc Surg. 2020 Apr 1;35(2):134-140. doi: 10.21470/1678-9741-2019-0311.
PMID: 32369291 Free PMC Article
Select item 32144038
Iliopoulos I, Alder MN, Cooper DS, Villarreal EG, Loomba R, Sahay RD, Fei L, Steele PE, Flores S.
Cardiol Young. 2020 Apr;30(4):521-525. doi: 10.1017/S1047951120000487. Epub 2020 Mar 5.
PMID: 32131918
Select item 31912986
Liu X, Yuan H, Chen J, Cen J, Nie Z, Xu G, Wen S, Zhuang J.
Eur J Cardiothorac Surg. 2020 Apr 1;57(4):628-634. doi: 10.1093/ejcts/ezz310.
PMID: 31740945
Select item 32114792
Dohain AM, Almogati J, Al-Radi OO, Elassal AA, Zaher ZF, Fatani TH, Abdulgawad A, Abdelmohsen G.
Eur J Pediatr. 2020 Apr;179(4):635-643. doi: 10.1007/s00431-019-03538-x. Epub 2019 Dec 21.
PMID: 31865429
Select item 32236547
- Neck cannulation for bypass in redo sternotomy in children and adults with congenital heart disease.
Mustafa MR, Neijenhuis RML, Furci B, Tsang VT.
Interact Cardiovasc Thorac Surg. 2020 Apr 1. pii: ivaa045. doi: 10.1093/icvts/ivaa045. [Epub ahead of print]
PMID: 32236557
Select item 31821450
Vitanova K, Georgiev S, Lange R, Cleuziou J.
Interact Cardiovasc Thorac Surg. 2020 Apr 1;30(4):630-635. doi: 10.1093/icvts/ivz294.
PMID: 31821450
Select item 32270622
Nappi F, Avtaar Singh SS, Spadaccio C, Acar C.
J Card Surg. 2020 Apr;35(4):952-956. doi: 10.1111/jocs.14489. Epub 2020 Mar 1.
PMID: 32115768
Select item 32115762
Yokoyama S, Fukuba R, Mitani K, Tonomura R, Uemura H.
J Card Surg. 2020 Apr;35(4):957-960. doi: 10.1111/jocs.14488. Epub 2020 Mar 1.
PMID: 32115762
Select item 32092198
Luo Q, Su Z, Jia Y, Liu Y, Wang H, Zhang L, Li Y, Wu X, Liu Q, Yan F.
J Cardiothorac Vasc Anesth. 2020 Apr;34(4):940-948. doi: 10.1053/j.jvca.2019.10.043. Epub 2019 Nov 2.
PMID: 31983510
Select item 31899144
Cantinotti M, Giordano R, Marchese P, Franchi E, Viacava C, Pak V, Murzi B, Arcieri L, Poli V, Federici D, Koestenberger M, Assanta N.
J Cardiothorac Vasc Anesth. 2020 Apr;34(4):951-955. doi: 10.1053/j.jvca.2019.11.009. Epub 2019 Nov 18.
PMID: 31812566
Select item 31543295
Dolcino A, Gaudin R, Pontailler M, Raisky O, Vouhé P, Bojan M.
J Cardiothorac Vasc Anesth. 2020 Apr;34(4):959-965. doi: 10.1053/j.jvca.2019.08.039. Epub 2019 Aug 27.
PMID: 31543295
Select item 31515190
Kaushal B, Chauhan S, Magoon R, Krishna NS, Saini K, Bhoi D, Bisoi AK.
J Cardiothorac Vasc Anesth. 2020 Apr;34(4):981-986. doi: 10.1053/j.jvca.2019.08.009. Epub 2019 Aug 12.
PMID: 31515190
Select item 31732917
Zloto K, Tirosh-Wagner T, Bolkier Y, Bar-Yosef O, Vardi A, Mishali D, Paret G, Nevo-Caspi Y.
J Cardiovasc Transl Res. 2020 Apr;13(2):245-252. doi: 10.1007/s12265-019-09921-1. Epub 2019 Nov 15.
PMID: 31732917
Select item 31867804
Kirk R, Dipchand AI, Davies RR, Miera O, Chapman G, Conway J, Denfield S, Gossett JG, Johnson J, McCulloch M, Schweiger M, Zimpfer D, Ablonczy L, Adachi I, Albert D, Alexander P, Amdani S, Amodeo A, Azeka E, Ballweg J, Beasley G, Böhmer J, Butler A, Camino M, Castro J, Chen S, Chrisant M, Christen U, Danziger-Isakov L, Das B, Everitt M, Feingold B, Fenton M, Garcia-Guereta L, Godown J, Gupta D, Irving C, Joong A, Kemna M, Khulbey SK, Kindel S, Knecht K, Lal AK, Lin K, Lord K, Möller T, Nandi D, Niesse O, Peng DM, Pérez-Blanco A, Punnoose A, Reinhardt Z, Rosenthal D, Scales A, Scheel J, Shih R, Smith J, Smits J, Thul J, Weintraub R, Zangwill S, Zuckerman WA.
J Heart Lung Transplant. 2020 Apr;39(4):331-341. doi: 10.1016/j.healun.2020.01.1345. Epub 2020 Jan 31.
PMID: 32088108
Select item 32067864
Amirnovin R, Lieu P, Imperial-Perez F, Taketomo C, Markovitz BP, Moromisato DY.
J Intensive Care Med. 2020 Apr;35(4):371-377. doi: 10.1177/0885066617752659. Epub 2018 Jan 22.
PMID: 29357785
Select item 31591799
Stoica SC, Dorobantu DM, Vardeu A, Biglino G, Ford KL, Bruno DV, Zakkar M, Mumford A, Angelini GD, Caputo M, Emanueli C.
J Thorac Cardiovasc Surg. 2020 Apr;159(4):1532-1540.e7. doi: 10.1016/j.jtcvs.2019.03.062. Epub 2019 Apr 4.
PMID: 31043318
Select item 32327076
Nair AG, Sleeper LA, Smoot LB, Wigmore D, Mecklosky J, Andren K, Bastardi HJ, Blume ED, Fynn-Thompson F, Thiagarajan RR, Alexander PMA.
Pediatr Crit Care Med. 2020 Apr;21(4):332-339. doi: 10.1097/PCC.0000000000002192.
PMID: 31658187
Select item 31672476
Flores S, Loomba RS, Checchia PA, Graham EM, Bronicki RA.
Semin Thorac Cardiovasc Surg. 2020 Spring;32(1):87-95. doi: 10.1053/j.semtcvs.2019.05.020. Epub 2019 May 22.
PMID: 31128253
Select item 32150628
Seese L, Aranda-Michel E, Sultan I, Morell VO, Mathier MA, Mulukutla SR, Saba S, Dueweke EJ, Levenson JE, Kilic A.
Ann Thorac Surg. 2020 Apr 28. pii: S0003-4975(20)30617-2. doi: 10.1016/j.athoracsur.2020.04.014. [Epub ahead of print] No abstract available.
PMID: 32360389 Free PMC Article
Select item 32360386
Santens B, Van De Bruaene A, De Meester P, Gewillig M, Troost E, Claus P, Bogaert J, Budts W.
Int J Cardiol. 2020 Apr 26. pii: S0167-5273(19)36246-1. doi: 10.1016/j.ijcard.2020.04.072. [Epub ahead of print]
PMID: 32348813
Yoneyama F, Maruo K.
Pediatr Cardiol. 2020 Apr 26. doi: 10.1007/s00246-020-02350-x. [Epub ahead of print] No abstract available.
PMID: 32337624
Select item 32337623
Gong CL, Song AY, Horak R, Friedlich PS, Lakshmanan A, Pruetz JD, Yieh L, Ram Kumar S, Williams RG.
Pediatr Cardiol. 2020 Apr 26. doi: 10.1007/s00246-020-02348-5. [Epub ahead of print]
PMID: 32337623
Select item 32339638
Najm HK, Ahmad M, Salam Y, Klein J, Hasan SM, Majdalany D, Stewart RD, Pettersson G, Karamlou T.
Ann Thorac Surg. 2020 Apr 24. pii: S0003-4975(20)30596-8. doi: 10.1016/j.athoracsur.2020.03.063. [Epub ahead of print]
PMID: 32339505
Select item 32238692
Liu FK, Xue FS.
Pediatr Cardiol. 2020 Apr 24. doi: 10.1007/s00246-020-02349-4. [Epub ahead of print] No abstract available.
PMID: 32333036
Select item 32330930
Aslan N, Yildizdas D, Horoz OO, Coban Y, Demir F, Erdem S, Sertdemir Y.
Ital J Pediatr. 2020 Apr 16;46(1):47. doi: 10.1186/s13052-020-0803-y.
PMID: 32299455 Free PMC Article
Select item 32316278
Zajonz T, Cupka P, Koerner C, Mann V, Menges T, Akintuerk H, Valeske K, Thul J, Schranz D, Mueller M.
Paediatr Anaesth. 2020 Apr 14. doi: 10.1111/pan.13876. [Epub ahead of print]
PMID: 32291873
Select item 32279698
Mantell B, Addonizio L, Jain N, LaPar D, Chai P, Bacha E, Kalfa D, McAllister J, Zuckerman W, Lee T, Richmond M, Law S.
Artif Organs. 2020 Apr 12. doi: 10.1111/aor.13696. [Epub ahead of print]
PMID: 32279327
Select item 32277716
Shin JH, Park HK, Jung SY, Kim AY, Jung JW, Shin YR.
Korean J Thorac Cardiovasc Surg. 2020 Apr 5;53(2):79-81. doi: 10.5090/kjtcs.2020.53.2.79.
PMID: 32309207 Free PMC Article
Select item 32246743
Smith M, El-Said H, Pretorius V, Mendenhall M, Thomas T, Reeves RR, Silva Enciso J, Alshawabkeh L, Nigro J, Adler ED, Urey MA.
Circ Heart Fail. 2020 Apr;13(4):e006473. doi: 10.1161/CIRCHEARTFAILURE.119.006473. Epub 2020 Apr 6. No abstract available.
PMID: 32248696
Select item 31240423
van den Bosch E, Bogers AJJC, Roos-Hesselink JW, van Dijk APJ, van Wijngaarden MHEJ, Boersma E, Nijveld A, Luijten LWG, Tanke R, Koopman LP, Helbing WA.
Eur J Cardiothorac Surg. 2020 Apr 1;57(4):635-643. doi: 10.1093/ejcts/ezz331.
PMID: 31872208 Free PMC Article
Select item 31651943
IJsselhof RJ, Duchateau SDR, Schouten RM, Freund MW, Heuser J, Fejzic Z, Haas F, Schoof PH, Slieker MG.
Eur J Cardiothorac Surg. 2020 Apr 1;57(4):644-651. doi: 10.1093/ejcts/ezz293.
PMID: 31651943
Select item 31778856
Lewis MJ, Johansson Ramgren J, Hallbergson A, Liuba P, Sjöberg G, Malm T.
J Card Surg. 2020 Apr;35(4):868-874. doi: 10.1111/jocs.14494. Epub 2020 Mar 11.
PMID: 32160354
Select item 32112668
Arcieri L, Provost B, Charbonneau P, Fournier E, Hascoet S, Le Bret E.
J Card Surg. 2020 Apr;35(4):912-915. doi: 10.1111/jocs.14479. Epub 2020 Feb 24.
PMID: 32092176
Select item 32073683
Kilcoyne MF, Stevens RM, Mahan V, Gray P, Moulick AN.
J Card Surg. 2020 Apr;35(4):738-739. doi: 10.1111/jocs.14462. Epub 2020 Feb 19.
PMID: 32073683
Select item 31615743
Knecht M, LaRochelle J, Barkemeyer B, Gupta R, Brumund M, Mumphrey C.
J Med Toxicol. 2020 Apr;16(2):230-235. doi: 10.1007/s13181-019-00742-x. Epub 2019 Nov 26.
PMID: 31773636
Select item 30150137
Devlin PJ, Jegatheeswaran A, McCrindle BW, Karamlou T, Blackstone EH, Williams WG, DeCampli WM, Mertens L, Fackoury CT, Eghtesady P, Jacobs JP, Baffa JM, Fleishman CE, Dodge-Khatami A, Pizarro C, Pourmoghadam K, Cohen MS, Meyer DB, Overman DM.
J Thorac Cardiovasc Surg. 2020 Apr;159(4):1493-1503.e3. doi: 10.1016/j.jtcvs.2019.09.019. Epub 2019 Sep 24.
PMID: 31669019
Select item 31043318
Nair AG, Sleeper LA, Smoot LB, Wigmore D, Mecklosky J, Andren K, Bastardi HJ, Blume ED, Fynn-Thompson F, Thiagarajan RR, Alexander PMA.
Pediatr Crit Care Med. 2020 Apr;21(4):332-339. doi: 10.1097/PCC.0000000000002192.
PMID: 31658187
Select item 31672476
Welke KF, Pasquali SK, Lin P, Backer CL, Overman DM, Romano JC, Karamlou T.
Semin Thorac Cardiovasc Surg. 2020 Spring;32(1):128-137. doi: 10.1053/j.semtcvs.2019.09.005. Epub 2019 Sep 10.
PMID: 31518703
Select item 31292677
Zolfi-Gol A, Radvar M, Sedokani A.
Vasc Health Risk Manag. 2020 Apr 1;16:99-101. doi: 10.2147/VHRM.S245033. eCollection 2020.
PMID: 32280232 Free PMC Article
Select item 32070767
Fetal Cardiology Featured Articles
Fetal Cardiology Reviews of April 2020 Manuscripts
Telediagnosis system for congenital heart disease in a Japanese prefecture.
Mabuchi A, Waratani M, Tanaka Y, Mori T, Kitawaki J.J Med Ultrason (2001). 2020 Apr 23. doi: 10.1007/s10396-020-01020-y. Online ahead of print.PMID: 32328807
Take Home Points
- Fetal diagnosis via telehealth using 3D images transferred via an optical fiber network system is feasible and reliable.
- In 161 cases screened, cardiac defects were noted in 24 fetal scans. Though there were some discrepancies in prenatal cardiac diagnosis versus post-natal diagnosis, no significant cardiac abnormalities were missed.
- Appropriate post-natal planning was performed using the telehealth fetal images with significant cardiac defects birthed at a tertiary pediatric hospital whereas minor cardiac defects were birthed at the home hospital.
Commentary from Dr. Clifford Cua (Columbus, OH), Section Editor of Pediatric Cardiology Journal Watch: In this retrospective study from a single institution, Kyoto Prefectural University of Medicine, a spatio-temporal image correlation (STIC) based tele-diagnosis system was created for remote fetal diagnostic purposes. STIC is a 3D technique of acquiring structural and temporal data using a single scan. Data are digitized and cross-sectional images can be reconstructed to be reviewed at a later date. This system was created to help screen fetal cardiac exams from distant locations from the main pediatric cardiac hospital to maximize care and minimize unnecessary travel for the families.
A total of 182 fetal scans over a nine-year period (2009 – 2018) were referred for evaluation from six hospitals within the Kyoto Prefecture. 21 cases were excluded (10 – error in transmission, 11 – no postnatal diagnosis available), therefore 161 cases were studied. Images were obtained via a Voluson E7, E8, or E10 (GE Medical Systems) and transferred images were reviewed by a pediatric cardiologist within 24 to 72 hours from transmission. Images were evaluated using a standard protocol to assess the cardiac anatomy.
Cardiac disease was noted 14.9% of cases (24/161) and accuracy of diagnosis was 95.0% (153/161). In four cases, the cardiac diagnosis changed from prenatal to post-natal: (1) double outlet right ventricle (DORV) to ventricular septal defect (VSD); (2) DORV and pulmonary artery stenosis (PS) to single ventricular and tricuspid atresia; (3) transposition of the great arteries (TGA) to DORV and PS; and (4) total anomalous pulmonary venous connection to normal heart after the visit. In another four cases, the prenatal diagnosis was thought to be normal, but postnatally, two patients had a VSD, one had an ASD, and one patient an aneurysm of the PDA. Seven cases suspected of having severe cardiac issues were delivered at the tertiary pediatric hospital whereas the other patients birthed at their respective home hospitals experienced no adverse outcomes.
This study is limited by its retrospective nature, single center evaluation, and relatively small cases evaluated. That being said, this paper adds more evidence that tele-health for fetal cardiac screening purposes is feasible and allows for efficiency of medical care for both the family and health professional.
Ronai C, Freud LR, Brown DW, Tworetzky W.
Prenat Diagn. 2020 Apr 20. doi: 10.1002/pd.5715. [Epub ahead of print]
PMID: 32314369
Select item 32354651]
Take Home Points
- Despite routine prenatal cardiac screening ultrasounds, congenital heart disease lesions with normal four chamber view has low sensitivity in prenatal detection.
- Prenatal diagnosis of pulmonary valve stenosis maybe improved with the use of cine clips to define the valve mobility and color flow Doppler to detect valvar flow acceleration.
- Unlike pulmonary atresia and intact ventricular septum, fetuses with pulmonary stenosis has near normal appearing tricuspid valve and pulmonary valve size making the diagnosis of pulmonary stenosis without cine clips and Doppler imaging challenging.
Comment from Dr. Jennifer Johnson (Pittsburgh, PA), Section Editor of Pediatric Cardiology Journal Watch: This is a single center retrospective chart review of all neonates who underwent cardiac catherization for critical pulmonary valve stenosis or pulmonary atresia intact ventricular septum. The cohort was evaluated for prenatal diagnosis of congenital heart disease and those patient’s fetal echocardiograms were reviewed.
Methods: Data was collected on all neonates who underwent cardiac catheterization from 2000-2014 at Boston Children’s Hospital with the diagnosis of critical pulmonary valve stenosis or pulmonary atresia intact ventricular septum.
Results: A total of 178 patients met inclusion criteria with 91 patients having critical pulmonary valve stenosis and 87 patients have pulmonary atresia intact ventricular septum. Prenatal diagnosis was significant lower in those neonates with critical pulmonary valve stenosis at 37% compared to those with pulmonary atresia intact ventricular septum 60% (p=0.003).
Tricuspid and pulmonary valve measurements were evaluated for those patients with fetal echocardiograms and all patients with postnatal transthoracic echocardiograms. The tricuspid and pulmonary valve z score was significantly higher in those patients with critical pulmonary stenosis compared to those with pulmonary atresia intact ventricular septum (p = <0.001 and p =0.004). Comparison of the transthoracic tricuspid and pulmonary valve z score of those patients prenatally and postnatally diagnosed showed no statically significance.
Discussion: In this cohort, as the authors proposed the prenatal detection of critical pulmonary valve stenosis would be significantly lower than those patients with pulmonary atresia intact ventricular septum. The decreased detection for those patients with critical pulmonary valve stenosis was thought to be linked to a normal appearing tricuspid valve and right ventricular on the obstetric screening four chamber view, obstetric imaging of the right ventricular outflow tract was not routinely recommended until 2013 and the decreased obstetric use of cine/color flow mapping imaging. Lastly, critical pulmonary valve stenosis may progress in severity over pregnancy therefore being undetected in routine obstetric ultrasound.
Limitations: Single center, retrospective study.
Next Steps: It would be of interest to see how many of the critical pulmonary valve stenosis patients had progressive pulmonary valve disease with a normal screening obstetric ultrasound at 18-20 weeks of gestation.
Figure 1 Kawasaki disease emergency management of suspected myocardial ischaemia in children with previous Kawasaki disease and possible coronary artery aneurysms. CAA, coronary artery aneurysms; nSTEMI, non-STEMI; PSP, person-specific protocol; STEMI, ST-elevation myocardial infarction.
Figure 2 Kawasaki disease emergency management of suspected myocardial ischaemia in adults with previous Kawasaki disease and possible coronary artery aneurysms. nSTEMI, non-STEMI; STEMI, ST-elevation myocardial infarction.
Fetal Cardiology Abstracts of April 2020
Hou YS, Wang JZ, Shi S, Han Y, Zhang Y, Zhi JX, Xu C, Li FF, Wang GY, Liu SL.
Biosci Rep. 2020 Apr 30;40(4). pii: BSR20191779. doi: 10.1042/BSR20191779.
PMID: 32239175 Free PMC Article
Select item 32350197
Mustafa HJ, Cross SN, Jacobs KM, Tessier KM, Tofte AN, McCarter AR, Narasimhan SL.
Pediatr Cardiol. 2020 Apr 30. doi: 10.1007/s00246-020-02345-8. [Epub ahead of print]
PMID: 32356015
Select item 32353083
Tang H, Wang Y, Sun X, Zhang Y.
Echocardiography. 2020 Apr 29. doi: 10.1111/echo.14666. [Epub ahead of print]
PMID: 32347569
Select item 32349777
Hsieh A, Morton SU, Willcox JAL, Gorham JM, Tai AC, Qi H, DePalma S, McKean D, Griffin E, Manheimer KB, Bernstein D, Kim RW, Newburger JW, Porter GA Jr, Srivastava D, Tristani-Firouzi M, Brueckner M, Lifton RP, Goldmuntz E, Gelb BD, Chung WK, Seidman CE, Seidman JG, Shen Y.
Genome Med. 2020 Apr 29;12(1):42. doi: 10.1186/s13073-020-00738-1.
PMID: 32349777 Free PMC Article
Select item 32348326
- Good at heart: Developing a tertiary perinatal cardiac service; the first eight years of experience.
Heland S, de Chellis A, Rieder W, Sleeman M, Johns J, Lancefield T, Robinson A, Fung A, Walker S.
Aust N Z J Obstet Gynaecol. 2020 Apr 23. doi: 10.1111/ajo.13160. [Epub ahead of print]
PMID: 32323865
Select item 32326907
Inamura N, Taniguchi T, Yamada T, Tanaka T, Watanabe K, Kumagaya K, Ishii Y, Ishii T, Hayashi G, Shiono N, Ikeda T; Osaka Fetal Cardiology Group.
Pediatr Cardiol. 2020 Apr 23. doi: 10.1007/s00246-020-02346-7. [Epub ahead of print]
PMID: 32328669
Select item 32332221
Edwards JJ, Rouillard AD, Fernandez NF, Wang Z, Lachmann A, Shankaran SS, Bisgrove BW, Demarest B, Turan N, Srivastava D, Bernstein D, Deanfield J, Giardini A, Porter G, Kim R, Roberts AE, Newburger JW, Goldmuntz E, Brueckner M, Lifton RP, Seidman CE, Chung WK, Tristani-Firouzi M, Yost HJ, Ma’ayan A, Gelb BD.
JACC Basic Transl Sci. 2020 Apr 8;5(4):376-386. doi: 10.1016/j.jacbts.2020.01.012. eCollection 2020 Apr.
PMID: 32368696 Free PMC Article
Select item 32264836
Kamel H, Yehia A.
Egypt Heart J. 2020 Apr 7;72(1):16. doi: 10.1186/s43044-020-00049-1.
PMID: 32266496 Free PMC Article
Select item 32238316
Hu WY, Zhou JH, Tao XY, Li SY, Wang B, Zhao BW.
BMC Med Imaging. 2020 Apr 3;20(1):33. doi: 10.1186/s12880-020-00429-8.
PMID: 32245426 Free PMC Article
Select item 32266511
Meller CH, Grinenco S, Aiello H, Córdoba A, Sáenz-Tejeira MM, Marantz P, Otaño L.
Arch Argent Pediatr. 2020 Apr;118(2):e149-e161. doi: 10.5546/aap.2020.eng.e149. English, Spanish.
PMID: 32199055 Free Article
Select item 31666243
Gong Y, Zhang Y, Zhu H, Lv J, Cheng Q, Zhang H, He Y, Wang S.
IEEE Trans Med Imaging. 2020 Apr;39(4):1206-1222. doi: 10.1109/TMI.2019.2946059. Epub 2019 Oct 7.
PMID: 31603775
Select item 32162150
Marini D, van Amerom J, Saini BS, Sun L, Seed M.
J Magn Reson Imaging. 2020 Apr;51(4):1030-1044. doi: 10.1002/jmri.26815. Epub 2019 Jun 13. Review.
PMID: 31190452
Select item 30149741
Lin M, Zheng J, Peng R, Du L, Zheng Q, Lei T, Xie H.
J Matern Fetal Neonatal Med. 2020 Apr;33(7):1211-1217. doi: 10.1080/14767058.2018.1517316. Epub 2018 Sep 20.
PMID: 30149741
Select item 30130989
Brun S, L’Ecuyer E, Dore A, Mongeon FP, Guedon AC, Leduc L.
J Matern Fetal Neonatal Med. 2020 Apr;33(7):1100-1106. doi: 10.1080/14767058.2018.1514492. Epub 2018 Sep 19.
PMID: 30130989
Select item 31455124
Lytzen R, Vejlstrup N, Bjerre J, Bjørn Petersen O, Leenskjold S, Keith Dodd J, Stener Jørgensen F, Søndergaard L.
J Obstet Gynaecol. 2020 Apr;40(3):308-315. doi: 10.1080/01443615.2019.1621814. Epub 2019 Aug 28.
PMID: 31455124
Select item 31987651
Witman N, Zhou C, Grote Beverborg N, Sahara M, Chien KR.
Semin Cell Dev Biol. 2020 Apr;100:29-51. doi: 10.1016/j.semcdb.2019.10.011. Epub 2019 Dec 18. Review.
PMID: 31862220 Free Article
Select item 31586467
Inamura N, Taniguchi T, Yamada T, Tanaka T, Watanabe K, Kumagaya K, Ishii Y, Ishii T, Hayashi G, Shiono N, Ikeda T; Osaka Fetal Cardiology Group.
Pediatr Cardiol. 2020 Apr 23. doi: 10.1007/s00246-020-02346-7. [Epub ahead of print]
PMID: 32328669
Select item 32319738
Ge CJ, Mahle AC, Burd I, Jelin EB, Sekar P, Jelin AC.
Cardiol Young. 2020 Apr 20:1-6. doi: 10.1017/S1047951120000785. [Epub ahead of print]
PMID: 32308170
Select item 32308169
Ronai C, Freud LR, Brown DW, Tworetzky W.
Prenat Diagn. 2020 Apr 20. doi: 10.1002/pd.5715. [Epub ahead of print]
PMID: 32314369
Select item 32354651
Limaye MA, Buyon JP, Cuneo BF, Mehta-Lee SS.
Prenat Diagn. 2020 Apr 13. doi: 10.1002/pd.5709. [Epub ahead of print]
PMID: 32282083
Select item 32279327
Hede SV, DeVore G, Satou G, Sklansky M.
Prenat Diagn. 2020 Apr 11. doi: 10.1002/pd.5696. [Epub ahead of print]
PMID: 32277716
Select item 32283087
Congenital Heart Anesthesia and Intensive Care
CHD Anesthesia April 2020
-
Congenital Heart and Pediatric Cardiac Anesthesia and Intensive Care Review of Early 2020 Manuscripts
-
Section Editors Section
Viviane Nasr – Boston
Rania Abbasi – Indianapolis
- Conngenital Heart and Pediatric Cardiac Anesthesia and Intensive Care Review of Early 2020 Manuscripts
Krishna SN, Chauhan S, Bhoi D, Kaushal B, Hasija S, Sangdup T, Bisoi AK. Krishna SN, et al. J Cardiothorac Vasc Anesth. 2019 Feb;33(2):368-375. doi: 10.1053/j.jvca.2018.05.050. Epub 2018 Jun 4.J Cardiothorac Vasc Anesth. 2019. PMID: 30055991 Clinical Trial.
Take Home Points:
- Postoperative pain management following pediatric cardiac surgery is largely dependent on parenteral opioid medications. Novel regional anesthetic techniques offer the promise of improved postoperative pain with reduced opioid consumption.
- The authors conducted a single-center, single-blind, randomized controlled trial of preoperative erector spinae plane blocks compared to standard medical management. They found improved pain scores in the first 10 hours post-extubation, lower overall fentanyl consumption in the first 12 hours, longer time to first rescue analgesia, and lower sedation scores.
- The study is limited by the fact that it includes only otherwise healthy patients undergoing relatively simple cardiac surgeries, and who were extubated in the immediate post-operative period. Though the results demonstrated statistically significant differences in the outcomes measured, their clinical relevance and generalizability remains unclear.
Commentary by Richard Hubbard, MD and Nischal Gautam, MD, pediatric cardiac anesthesiologists at the McGovern Medical School/Children’s Memorial Hermann Hospital in Houston, Texas.
For anesthesiologists caring for children with congenital heart disease (CHD), the challenge of balancing adequate analgesia with over sedation in the acute postoperative period is well-known. Neuraxial anesthesia can significantly improve pain control, lower opioid requirements, and improve respiratory function; however, the specter of epidural hematoma in patients requiring full anticoagulation for surgery is a major concern.1 Paravertebral blocks are a valid alternative, but they carry the risk of pneumothorax.2 Fascial plane blocks offer the benefit of an improved safety profile while still providing significant analgesia for major thoracic, abdominal, pelvic, and lower extremity surgery.
The erector spinae block (ESB) is one such technique. Utilizing ultrasound guidance, local anesthetic is deposited deep to the erector spinae muscle and superficial to the transverse process.3 The resulting multi-dermatomal sensory block is believed to be caused by migration of local anesthetic to the paravertebral space, blocking the dorsal and ventral rami of the spinal nerves.3,4 Both single-shot and catheter-based techniques have been described.3-5 The ESB has been used with success in pediatric patients undergoing major thoracic, abdominal, and even lower extremity procedures.3,5,6 It has also shown promise in reducing postoperative pain following sternotomy for cardiac surgery in adults.2,7
Kaushal and colleagues attempted to determine if presurgical single-shot, bilateral ESBs were effective in reducing postoperative pain and sedation in pediatric patients undergoing cardiac surgery via midline sternotomy. This was a single-center, randomized, observer-blinded study. Exclusion criteria included the following: need for redo or emergency surgery, intubation for three or more hours postoperatively, ASA class III and above, heart failure, inotropic support requirement, history of ventricular arrhythmias, and allergy to amide anesthetics. Patients were randomized into a control group (scheduled intravenous (IV) acetaminophen and rescue fentanyl) and a block intervention group (bilateral ESBs plus scheduled IV acetaminophen and rescue fentanyl). The blocks were conducted with ultrasound guidance at the T3 level, with 1.5 mg/kg of 0.2% ropivacaine deposited on each side. Outcomes included pain scores using the Modified Objective Pain Scale (MOPS) for the first 12 hours postoperatively, intraoperative and postoperative fentanyl requirements, time to first rescue analgesic medication, extubation time, Ramsay sedation score, intensive care unit (ICU) length of stay, and adverse events. The MOPS grades crying, movement, agitation, posture, and verbal for a maximum of 10 points (0-2 points per category). To provide a perspective on the pain assessment using this scale, the following patients could be graded as such:
- An asleep, calm, comfortable child is graded 0
- A consolable, restless, mildly agitated child is graded 3
- A consolable, restless, mildly agitated child complaining of non-localizing pain is graded 4
- A consolable, restless, mildly agitated child complaining and localizing pain is graded 6
- A non-consolable, thrashing, hysterical child, localizing pain with breath-holding is graded 10.
Out of 100 patients recruited, 80 met inclusion criteria, and 40 patients were included in each control and block group. Groups were similar in terms of patient age (just over two years), surgery type (mix of atrial septal defect (ASDs) and ventricular septal defect (VSDs)), and short bypass and cross clamp times (approximately 40 and 20 minutes, respectively). Statistically, the block group had lower pain scores up to (but not including) 12 hour after extubation, longer time to rescue analgesia, lower postoperative fentanyl requirement, lower sedation scores, and shorter ICU length of stay.
Clinically, the most impressive differences between the two groups was that while all the patients in the control group received fentanyl within 12 hours after extubation, 30% of patients in the block group did not receive any fentanyl during this period. The block group also had a longer period free from the first analgesic rescue (1.8 hrs. vs 4.5 hrs.) and had a lower fentanyl requirement (1.1 versus 5.5μg/kg). Within the first 12 hours after extubation, none of the patients in either group were noted to have a pain score of more than 5, indicating good pain control with either therapy. There were no differences seen in major postoperative complications.
What This Means for Our Practice
The authors showed that single-shot, bilateral ESBs reduced opioid requirements with slightly lower pain scores in the initial postoperative period. Although pain scores were lower in the block group, the efficacy of the block lasted for only 10 hours. This may be explained by the limited duration of action of single-shot fascial plane blocks when compared to indwelling catheters. A major critique of this work is its generalizability to the majority of pediatric patients presenting for congenital heart surgery. The exclusion criteria essentially eliminated all but the healthiest patients, and the surgeries performed were the simplest and fastest cardiopulmonary bypass cases performed in children. While the authors in this study show that single-shot ESBs appear to be helpful in patients who will be fast-tracked for extubation their validity for post-sternotomy pain in a diverse group of patients, particularly those with borderline cardiopulmonary reserve (cyanotic patients for Glenn, Fontan procedure), requires significantly more investigation before it can be adopted broadly. This block may have limited utility in more complex, longer duration procedures in which children are likely to require continued intubation in the immediate postoperative period. Many of these less complex cardiac lesions can be corrected without the need for a sternotomy, either via device closure in the catheterization laboratory or via a minimally invasive approach, which may also limit the utility of the ESB. Additionally, outcomes 12 hours after the procedure and other metrics until hospital discharge were not presented in the manuscript.
The ESB remains a promising modality to prevent post-sternotomy pain. The attractiveness of the block is the ease of its performance under ultrasound guidance. The target is easy to visualize, fast to perform, and the needle trajectory is straightforward. In addition, the risk of injury to nerves, dura, pleura, lungs, or vascular structures is minimal, as none of these structures are in the needle path or adjacent to the plane of injection. The idea of bilateral erector spinae continuous block with dual catheters for longer analgesia in post-sternotomy pain is promising, and provides an avenue for future research in this area.
References:
- Rosen D, Hawkinberry D, Rosen K, et al. An epidural hematoma in an adolescent patient after cardiac surgery. Anesth Analg. 2004; 98(4): 966-969.
- Muñoz-Leyva F, Chin J, Mendiola W, et al. Bilateral Continuous Erector Spinae Plane (ESP) Blockade for Perioperative Opioid-Sparing in Median Sternotomy. J Cardiothorac Vasc An. 2019; 33(6): 1698-1703.
- Muñoz, F., Cubillos, J., Bonilla, A.J. et al. Erector spinae plane block for postoperative analgesia in pediatric oncological thoracic surgery. Can J Anesth/J Can Anesth 2017; 64: 880–882.
- Kaushal B, Chauhan S, Magoon R, Krishna NS, et al. Efficacy of bilateral erector spinae plane block in management of acute postoperative surgical pain after pediatric cardiac surgeries through a midline sternotomy. J Cardiothorac Vasc An. 2020; 34: 981-986.
- De la Cuadra-Fontaine JC, Concha M, Vuletin F, Arancibia H. Continuous Erector Spinae Plane block for thoracic surgery in a pediatric patient. Paediatr Anaesth. 2018; 28(1): 74-75.
6.Munshey F, Caruso T, Wang E, Tsui B. Programmed Intermittent Bolus Regimen for Erector Spinae Plane Blocks in Children: A Retrospective Review of a Single-Institution Experience. Anesth Analg. 2020; 130(3): e63-e66.
- Krishna NS, Chauhan S, Bhoi D, et al. Bilateral Erector Spinae Plane Block for Acute Post-Surgical Pain in Adult Cardiac Surgical Patients: A Randomized Controlled Trial. J Cardiothorac Vasc An. 2019; 33: 368-375
Alp H, Elmacı AM, Alp EK, Say B.Cardiol Young. 2019 Sep;29(9):1189-1195. doi: 10.1017/S1047951119001835.PMID: 31451130
Take Home Points:
- Intranasal midazolam, intranasal ketamine, and oral chloral hydrate all provide adequate sedation for transthoracic echocardiography in acyanotic children ages 9 – 38 months with a failed sedation rate of 4.1%, 4.1% and 5.5%, respectively.
- Midazolam had the shortest onset of action at 14 (range 7-65) minutes.
- Ketamine had the shortest duration of sedation at 55 (range 25-75) minutes.
- Each of the sedatives had modest side effects, including agitation (midazolam), respiratory (midazolam and chloral hydrate) and gastrointestinal (ketamine and chloral hydrate).
Commentary by Lori Q. Riegger MD, Associate Professor, Mott Children’s Hospital, Michigan Medicine in Ann Arbor, Michigan.
Young children often require sedation to obtain high quality diagnostic images during transthoracic echocardiography. Midazolam, ketamine, and chloral hydrate are used for sedation in varying doses and with various routes of administration. Onset, duration, side effects and success of the sedatives are key elements in choice of appropriate medication for sedation and were the focus of this study.
This prospective randomized study compared the efficacy of three sedatives: intranasal midazolam, intranasal ketamine and oral chloral hydrate in acyanotic children aged 9 – 38 months, undergoing a transthoracic echocardiogram to assess a cardiac murmur. The goal was to determine the ideal sedative, defined as providing adequate sedation (as evidenced by high quality images), rapid onset, optimal duration and low incidence of side effects. Two-hundred seventeen children, with median age 22 months (range 9 – 38 months), were included. There were no statistically significant differences in age, weight or gender between the groups. All subjects were awake for at least 6 hours prior to sedation. They were randomized to one of the three groups; 73 received midazolam (0.2 mg/kg, max 5 mg), 72 received ketamine, (4 mg/kg, max 100 mg), 72 received chloral hydrate (50 mg/kg, max 1 gram). After the medication was given, depth of sedation was assessed using the Richmond Agitation Sedation Scale (RASS) at 15, 30, 45 and 60 minutes by two blinded pediatricians, using 1) calm, 2) drowsy or 3) sedated, to assess the level of sedation. Sedation was defined as complete unconsciousness and lack of movement. Rescue medications were not used during the study. Success was defined by RASS scores and ability to obtain high quality echocardiographic images.
Vitals, including temperature, blood pressure, heart rate, respiratory rate and oxygen saturation, showed no statistically significant differences between the groups during the sedated and non-sedated phases. Echocardiography could not be performed due to failed sedation in three children each in the midazolam and ketamine groups and four in the chloral hydrate group. Successful sedation thus occurred in 95.9% of the midazolam, 95.9% of the ketamine, and 94.5% of the chloral hydrate cohorts.
Fifteen minutes after administration midazolam demonstrated the shortest onset of action with 37.1% drowsy and 35.8% sedated, while ketamine had 34.7% drowsy and none sedated, and chloral hydrate had 23.6% drowsy and none sedated. The median onset of sedation was 14 (range 7-65) minutes (p < 0.001) for midazolam, 34 (range 12-56) minutes for ketamine (p < 0.001), and 40 (range 25-57) minutes for chloral hydrate (p < 0.001). At 60 minutes all of the midazolam and ketamine patients and 92.7% of the chloral hydrate patients were sedated. Median duration of sedation was 68 (range 20-75) minutes for patients receiving midazolam (p = 0.023), 55 (range 25-75) minutes for ketamine (p = 0.712), and 61 (range of 34-78) minutes for chloral hydrate (p= 0.045).
One patient in the midazolam group and one in the chloral hydrate group required oxygen to maintain saturation > 95%, and in both patients, the oxygen was weaned off during the first 60 minutes of sedation. Other side effects included agitation in 3 midazolam patients, and nausea and vomiting in two ketamine and eight chloral hydrate patients.
What does this mean for us?
In this study, intranasal midazolam, intranasal ketamine and oral chloral hydrate were all demonstrated to be efficacious in providing adequate sedation with a low side effect profile in acyanotic young children undergoing transthoracic echocardiography. A limitation of this study is that it did not include children with cyanotic cardiac disease and therefore, these findings cannot be extrapolated to that population.
Although midazolam provided the shortest onset of sedation at 14 (7-65) minutes, ketamine patients spent less time sedated at 55 (25-75) minutes, which the authors concluded to be optimal. This should be enough time for all but the most difficult echocardiograms. Each of the sedatives had side effects including agitation (midazolam), respiratory (midazolam and chloral hydrate), and gastrointestinal (ketamine and chloral hydrate), all of which have been reported previously with these medications. The side effects involved few patients and were minor.
The authors do not comment on the overall length of time from administration to complete recovery, but if one assesses the median time of onset of sedation and the median duration of sedation, it appears that patients who received chloral hydrate required monitoring for longer periods of time compared with the patients who had received midazolam or ketamine. In fact, it is somewhat surprising that the study did not demonstrate any prolonged sedative effects of chloral hydrate, including lack of muscle tone and coordination, which have been previously reported. Also, chloral hydrate has become scarce in the United States, so the chloral hydrate arm of the study is likely to be more pertinent for those outside that country. A similar study involving the more commonly used intranasal dexmedetomidine compared with midazolam and ketamine may be more relevant for those who practice in the United States.
Robinson JD, Caruso TJ, Wu M, Kleiman ZI, Kwiatkowski DM.
Journal of Cardiothoracic and Vascular Anesthesia 2020; 34: 335-341.
DOI: 10.1053/j.jvca.2019.09.033
PMID: 31699597
Take Home Points:
- Intraoperative methadone was associated with a decrease of total opioid exposure during the early postoperative period with comparable analgesic efficacy and no increase in adverse events compared to the control group.
- Corrected QTc prolongation was not increased in the methadone group when compared to the control group.
Commentary by Destiny F. Chau MD, pediatric cardiac anesthesiologist at Arkansas Children’s Hospital in Little Rock, Arkansas.
Opioids have a critical role in the pain management of pediatric patients undergoing congenital heart surgery. The advantages of perioperative opioids are eclipsed by their associated risks of short-term and long-term adverse events, including concerns for persistent opioid use and undue exposure in the setting of the current opioid crisis. Efforts continue in the search for effective opioid-sparing strategies for perioperative pain management, and also for maximizing the benefits of the chosen opioids while minimizing their side effects. The available literature, mostly from adult studies, suggest that the intraoperative use of long-acting opioids such as methadone, may decrease total perioperative opioid exposure without an increase in complications.
The authors of this single-center retrospective, case-matched cohort study primarily aimed to evaluate the association of intraoperative methadone use on total perioperative opioid exposure in children undergoing congenital heart surgery. Secondary outcomes included the association of intraoperative methadone with adverse events, clinical outcomes and dose-dependent effect on total opioid use. Pediatric patients receiving intraoperative methadone during congenital heart surgery from November 2017 to July 2018 were retrospectively identified via a pharmaceutical electronic database. Each of them was matched according to age and surgical procedure with a control who did not receive methadone. Patients were excluded if they received opioids the day before the surgery, had postoperative nerve blocks, had delayed sternal closure, required additional procedures during the first postoperative 24 h or had not found a matched control. A total of 37 patients were matched 1:1 with a control patient. The intraoperative use and dosing of methadone was at the discretion of the attending anesthesiologist. Anesthetic managements were not standardized, including use of other opioids and sedatives. Postoperatively, analgesic control followed the cardiac intensive care unit’s (ICU) multimodal pain management protocols. For analysis purposes, all intravenous and enteral opioids were converted to morphine equivalents per kilogram and were compared in 12 h blocks until 36 h postoperatively. Also, patients in the methadone group were divided into low-dose (N = 22; 0.2 mg/kg or less) and high-dose (N = 15; over 0.2 mg/kg) to study dose-dependent effects.
Both cohorts were similar in demographics and surgical bypass times. Median age and weight were 8.9 years and 22.9 kg for the methadone and 7.4 years and 26.3 kg for the control groups. Surgical procedures had a median complexity category of 3 and interquartile range of 2 to 4 per the Society of Thoracic Surgeons-European Association of Cardio-Thoracic Surgery (STAT) system. Cardiopulmonary bypass (CPB) was used in 33 patients (89%). Methadone dosages ranged from 0.1 to 0.4 mg/kg with a maximum of 30 mg, with the majority of the overall dose given during the earlier parts of the case and administered prior to commencement of CPB. Use of nonopioid sedatives and anesthetics, including inhaled agents were comparable between cohorts. Two patients in each group were extubated in the operating room. More patients in the methadone group received intraoperative morphine, while none received benzodiazepines in the ICU period as compared to the control group.
Primary outcome results showed decreased total opioid dose in the methadone group versus the control group intraoperatively (2.51 v 4.39 mg morphine equivalent/kg), during the initial 12 h postoperatively (0.43 v 1.28 mg morphine equivalent/kg), and cumulatively during the entire postoperative 36 h (0.83 v 1.91 morphine equivalents/kg). No difference was found during the second and third 12 h time blocks. For secondary outcomes, intraoperative methadone was not associated with time to extubation, postoperative pain scores, postoperative nausea and vomiting, ICU length of stay, rate of extubation failure or in-hospital mortality. Corrected QTc prolongation was not increased in the methadone group when compared to the control group. No difference was observed in total opioid exposure based on high or low methadone dosing.
What does this mean for us?
Retrospective study limitations aside, the authors are commended for studying the use of intraoperative methadone in this patient population in the quest of achieving adequate analgesia with lower opioid exposure and minimal adverse effects.
Although the results report a total opioid exposure reduction during the first postoperative 12 h period that was not sustained through the second and third 12 h blocks, the total cumulative dose (intraoperatively through the postoperative 36 h) were reduced with comparable analgesic effectiveness and without an observed increase in complications. This is promising data for methadone’s role as part of the armamentarium to improve safe effective care for all patients while combating the opioid epidemic and navigating through different periodic opioid shortages.
Methadone is a synthetic μ-opioid agonist with N -methyl-D-aspartate receptor antagonism properties, whose pharmacokinetics and pharmacodynamics in children are not well studied. Methadone is described to have a rapid onset and long elimination half-life, which would clinically suggest a relatively fast onset of action with prolonged effect and less frequent redosing. Sharma and his group found that the pharmacokinetics of methadone in adolescents undergoing non-cardiac surgery were comparable to those in adults. The Society for Pediatric Anesthesia, providing guidance for perioperative opioid use in children, reports that “methadone pharmacodynamics effects are prolonged compared to morphine and the pharmacokinetic profile appears to be consistent across pediatric age ranges”. In this study, an important factor to highlight is that most of the methadone dosing occurred prior to starting CPB; CPB would alter methadone’s pharmacokinetics due to the added volume of distribution from the prime and exposure to the bypass circuit surfaces. As a speculation, dosing methadone after CPB separation has the potential to confer a longer postoperative opioid-sparing time period.
In conclusion, this single-center retrospective cohort-matched study explored the opioid-sparing effect of intraoperative methadone use on pediatric patients undergoing congenital cardiac surgery. The results showed that intraoperative methadone was associated with a decrease of total opioid exposure during the early postoperative period with comparable analgesic efficacy and no increase in adverse events compared to the control group. This promising concept should be further investigated with prospective trials including larger number of patients and expanded age range to better characterize methadone’s role during congenital cardiac surgery.
References:
- Robinson JD, Caruso TJ, Wu M, Kleiman ZI, Kwiatkowski DM. Intraoperative Methadone Is Associated with Decreased Perioperative Opioid Use Without Adverse Events: A Case-Matched Cohort Study. J Cardiothorac Vasc Anesth. 2020; 34(2): 335–341.
- Sharma A, Tallchief D, Blood J, Kim T, London A, Kharasch ED. Perioperative Pharmacokinetics of Methadone in Adolescents. Anesthesiology2011; 115(6): 1153-1161.
- Cravero JP, Agarwal R, Breed C, et al. The Society for Pediatric Anesthesia recommendations for the use of opioids in children during the perioperative period. Paediatr Anaesth. 2019; 29(6): 547–571.
- Valencia E, Nasr VG. Is Methadone an Opioid Sparing Strategy? J Cardiothorac Vasc Anesth. 2020 Feb; 34(2):342-343. Nov 16.
Congenital Heart and Pediatric Cardiac Anesthesia and Intensive Care Abstracts of April 2020
Houska NM, Schwartz LI.
Semin Cardiothorac Vasc Anesth. 2020 Apr 29:1089253220920476. doi: 10.1177/1089253220920476. [Epub ahead of print]
PMID: 32347188
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Kan Z, Siyuan W, Mengqi L, Chi W, Liping S, Sen Z, Jie B, Mazhong Z, Jijian Z.
Minerva Anestesiol. 2020 Apr 6. doi: 10.23736/S0375-9393.20.14293-7. [Epub ahead of print]
PMID: 32251574
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Devroe S, Devriese L, Debuck F, Fieuws S, Cools B, Gewillig M, Van de Velde M, Rex S.
Trials. 2020 Apr 3;21(1):310. doi: 10.1186/s13063-020-4231-5.
PMID: 32245513 Free PMC Article
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Shionoya Y, Yamamoto M, Sunada K, Nakamura K.
Anesth Prog. 2020 Spring;67(1):45-47. doi: 10.2344/anpr-67-01-07.
PMID: 32191511
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Yang F, Li S, Shi Y, Liu L, Ye M, Zhang J, Liu H, Liu F, Yu Q, Sun M, Tian Q, Tu S.
J Cardiothorac Vasc Anesth. 2020 Apr;34(4):966-971. doi: 10.1053/j.jvca.2019.11.037. Epub 2019 Dec 6.
PMID: 31899144
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Hubbard R, Edmonds K, Rydalch E, Pawelek O, Griffin E, Gautam N.
Paediatr Anaesth. 2020 Apr;30(4):506-510. doi: 10.1111/pan.13838. Epub 2020 Feb 24.
PMID: 32040230
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Klugman D, Melton K, Maynord PO, Dawson A, Madhavan G, Montgomery VL, Nock M, Lee A, Lyren A.
JAMA Pediatr. 2020 Apr 13:e200268. doi: 10.1001/jamapediatrics.2020.0268. [Epub ahead of print]
PMID: 32282029
Select item 32281310
Wright GT, Ashworth L, Pettey S.
AANA J. 2020 Apr;88(2):149-157.
PMID: 32234207
Select item 31737940
The CHIP Network Journal Watch Team
Konstantin Averin, MD, MS is an Associate Professor of Pediatrics at the University of Alberta and an Interventional Pediatric Cardiologist at the Stollery Children’s Hospital in Edmonton, Alberta. He received his medical degree from the Feinberg School of Medicine at Northwestern University in Chicago, IL. After medical school, he completed pediatrics residency, pediatric cardiology fellowship and sub-specialty training in pediatric and adult interventional cardiology at the Cincinnati Children’s Hospital in Cincinnati, OH. His clinical and research interests are focused on the percutaneous treatment of pediatric patients with congenital and acquired heart disease with a focus on patients with single ventricle physiology, transcatheter pulmonary valves, and pulmonary hypertension.
Dr. Leong Ming Chern “MC” is an adult congenital heart disease specialist at the National Heart Institute, Kuala Lumpur, Malaysia. He received his medical training at the University of Malaya and pediatric cardiology training at the National Heart Institute. His area of interest includes treatment of adult patients with congenital heart disease and pulmonary hypertension in congenital heart disease.
Dr. Damien Cullington, MBChB MRCP MD FESC is a consultant adult congenital cardiologist who works at Leeds General Infirmary, UK. In summer 2019, he will move over to the newly commissioned North West ACHD Service based in Liverpool, UK. Damien qualified in 2002 from the University of Liverpool and became a substantive consultant in 2016. Prior to this, he worked throughout the North of England and Yorkshire as a cardiology trainee. Damien was awarded a doctorate in medicine (MD) from the University of Hull in 2013 for his work in heart rate in patients with heart failure. He is a member of the Royal College of Physicians (London), Fellow of the European Society of Cardiology and honorary senior lecturer for the University of Leeds. His ACHD subspecialty clinical interests are heart failure, imaging and palliative care. He is regional organiser for ACHD training at Leeds and clinical governance lead for the Leeds congenital cardiac unit. His research interests and wide and far but particularly epidemiology, chronic heart failure in ACHD patients in all its guises, the systemic RV and the univentricle
Dr. Blanche Cupido is a consultant adult cardiologist working at Groote Schuur Hospital, UCT Private Academic Hospital and the University of Cape Town(UCT), South Africa. She completed her physician training in 2009 and her cardiology subspecialist training in 2013. She recently returned to SA after doing a Fellowship in Adult Congenital Heart Disease in Leeds, United Kingdom under the guidance of Dr Kate English. She has established a dedicated unit for Grown Up Congenital Heart Disease in Cape Town, South Africa. Her aim is to grow ACHD services in Sub-Saharan Africa and embark on GUCH research on the African continent.
Dr. Jeremy L. Herrmann is an Assistant Professor of Surgery in the Division of Thoracic and Cardiovascular Surgery at Indiana University. He specializes in pediatric and adult congenital cardiac surgery, and his clinical interests also include heart transplantation and mechanical circulatory support. His hospital affiliations include Indiana University Health Riley Hospital for Children and Methodist Hospital as well as Peyton Manning Children’s Hospital at St. Vincent Hospital in Indianapolis
Maan Jokhadar is a cardiologist and associate professor of medicine at Emory University in Atlanta, Georgia. He is board certified in internal medicine, cardiovascular disease, advanced heart failure/transplantation, adult congenital heart disease, and echocardiography. He is fellowship director for the Emory Adult Congenital Heart Disease training program and Core Curriculum Director for the Emory general cardiology fellowship program. Dr Jokhadar graduated from the University Damascus School of Medicine in Syria and then went to Mayo Clinic in Rochester, Minnesota for internal medicine residency. He then completed cardiology and subspecialty training at Emory University, where he currently on faculty. Dr. Jokhadar has been the recipient of numerous teaching awards. He is married with 3 children.
Michael Ma, MD is an Assistant Professor in Cardiothoracic Surgery in the Division of Pediatric Cardiac Surgery at Stanford University. He specializes in pediatric and adult congenital cardiac surgery, with an emphasis on neonates, complex biventricular repair, and pulmonary artery reconstruction. His research lab investigates ex and in vivo translational models for complex congenital heart disease, to optimize future surgical and endovascular repair strategies.
Jeremy P. Moore MD MS FHRS is the Director of Clinical Research and faculty in Pediatric Cardiology and Adult Congenital Heart Disease at the University of California, Los Angeles. Dr. Moore received his medical degree from the Medical College of Virginia in 2003. He completed residency and fellowship at UCLA before pursuing his subspecialty training in Pediatric Electrophysiology at Vanderbilt University in 2009. Dr. Moore has been faculty at UCLA since 2010 and has since published numerous research manuscripts dealing with electrophysiologic aspects pertinent to congenital heart disease. Dr. Moore’s primary interest is the study of mechanisms of arrhythmia, and the development of novel electrophysiologic techniques for management of the adult patient with congenital heart disease
Dr. Mehul Patel MD, is a structural and adult congenital heart disease specialist and an interventional cardiologist. Dr. Patel earned his undergraduate and medical education from the Mumbai University, India. After completing his post-graduate training in Internal Medicine and Cardiology, he further trained in interventional cardiology at the Mount Sinai Medical Center, NYC, NY and Adult Congenital Heart Disease at the Texas Children’s Hospital, Texas Heart Institute, Baylor College of Medicine, Houston, TX. Dr. Patel worked as Chief of adult congenital heart disease, Assistant Professor at the Michigan State University, Grand Rapids, MI where he not only expanded the program, performing complex interventions and device implantations but also established the percutaneous pulmonary valve implantation (Melody Valve) Program. Due to his passion for treating structurally abnormal hearts, he did a dedicated year of Structural Heart Disease fellowship at Henry Ford Hospital, Detroit, MI where he worked with pioneers in this field before moving to North Carolina. He is proficient in performing transcatheter aortic valve replacement (TAVR), MitraClip, Watchman device implantation, percutaneous Mitral, Tricuspid and Pulmonary valve replacements along with a variety of interventions on congenital heart disease and pulmonary hypertension. Dr. Patel is ABIM board certified in Internal Medicine, Cardiology, Interventional cardiology and Adult Congenital Heart Disease. Dr. Patel has more than 50 peer reviewed publications and numerous abstracts to his credit. He serves as a Co-Editor-in-Chief for the CHiP Network journal watch. His wife, Khyati is a pediatric cardiac Electrophysiologist and they have a 9-year-old daughter. Dr. Patel is also an artist, likes music, yoga and plays badminton. His clinical areas of expertise and interests are: 1) Transcatheter therapies for Structural and Adult Congenital heart disease. 2) Complex device implantations.
Dr. Timothy Pirolli is an Assistant Professor of Surgery in the Division of Pediatric Cardiothoracic Surgery at University of Texas Southwestern Medical Center. He specializes in pediatric and adult congenital cardiac surgery. His hospital affiliations include Children’s Medical Center in Dallas, Parkland Memorial Hospital, and Clements University Hospital (UTSW).
Dr. Inga Voges, M.D. Consultant in Pediatric Cardiology, Lead Consultant Cardiovascular MRI. I trained in General Pediatrics and Pediatric Cardiology in Rostock (Germany) and Kiel (Germany) from 2002-2010 and did additional training in Adult Congenital Heart Disease (ACHD) in Kiel (Germany) which I finished in 2014. I specialized in Cardiovascular Magnetic Resonance Imaging (CMR) and have a further special interest in cardiomyopathies. Currently, I am working as a consultant pediatric and ACHD cardiologist at the University Hospital Schleswig-Holstein (Kiel, Germany) where I am responsible for the CMR imaging program in pediatric and ACHD patients and contribute to the care of patients with acquired and congenital heart disease. I received my MD from the Medical University Luebeck in 2006 (Germany) and finished my “Habilitation” (PhD equivalent; University Hospital Kiel, Germany) in 2014. Since 2016, I am the secretary of the Association for European Paediatric and Congenital Cardiology Imaging Working Group.
Dr. Gary Webb, M.D. is an Emeritus Professor of Pediatrics and Internal Medicine at the University of Cincinnati College of Medicine and,
from 2009-2016, the Director of the Adult Congenital Heart Program at Cincinnati Children’s Hospital Heart Institute. A graduate of McGill
University in Montréal, he interned at the Royal Victoria Hospital, and then trained in internal medicine and cardiology at the University of Toronto. From 1980-2004, he was co-director and then director of the Toronto Congenital Cardiac Center for Adults at Toronto General Hospital. He is a Fellow of the Royal College of Physicians and Surgeons of Canada in both internal medicine and cardiology. From 2004-2009, he was director of the Philadelphia Adult Congenital Heart Center at the University of Pennsylvania. Since 2016, he has been a consultant to Cincinnati Children’s Hospital, and has been responsible for the ACHD Learning Center, the Cardiology Fellow Testing Center, and the Congenital Heart Professionals International (CHIP) Network. Since 2017, he has resumed seeing patients on a part-time basis at the Toronto Congenital Cardiac Centre for Adults.
Wendy Whiteside, MD Wendy is Assistant Professor of Pediatrics and Associate Director of Interventional Pediatric Cardiology at the University of Michigan Congenital Heart Center, C.S. Mott Children’s Hospital. She obtained her medical degree from Albert Einstein College of Medicine in 2006 then completed pediatric residency at Children’s Hospital Oakland in Oakland, CA in 2009. She received
both her categorical and interventional pediatric cardiology training at the University of Michigan in Ann Arbor, MI. Her clinical and research interests include single ventricle physiology, transcatheter
pulmonary valves, and quality improvement within the cardiac catheterization laboratory.
About the Congenital Heart and Pediatric Cardiac Journal Watch
Congenital heart and pediatric cardiac Journal Watch was designed to make it easier for congenital heart and pediatric cardiac professionals to keep up with the literature in 6 subsections of congenital heart disease abstracts on a monthly basis: pediatric cardiology; congenital heart surgery; congenital heart interventions; congenital/pediatric electrophysiology; fetal cardiology; and adult congenital heart disease.
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Sincerely,
Dr. Gary Webb, MD and Dr. Mehul Patel
CHiP Network
Congenital Heart and Pediatic Cardiac Journal Watch Editorial Board
The Chip Network, the Congenital Heart International Professionals Network, aims to develop a single global list of all congenital and pediatric cardiac professionals.
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