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Epicardial Versus Endocardial Pacemakers in the Pediatric Population:A Comparative Inquiry

congenital Heart Disease 2021年第6期16卷 573-584页

作者： Mohammadrafie Khorgami Ali Sadeghpour Tabaei Elio Caruso Silvia Farruggio Negar Omidi Maryam Moradian Behzad Mohammadpour Ahranjani Zahra Khajali Rahele Zamani Cardiovascular Medical and Research Center Iran University of Medical SciencesTehranIran Cardiovascular surgery Department Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran Department of Pediatric Cardiology Mediterranean Pediatric Cardiology Center“Bambin Gesù”San Vincenzo HospitalTaorminaItaly cardiac Primary Prevention Research Center Tehran Heart Center and Department of CardiologySchool of MedicineTehran University of Medical SciencesTehranIran Pediatric Cardiology Bahrami Children’s HospitalTehran University of Medical ScienceTehranIran Adult congenital Heart Disease Department Rajaie Cardiovascular Medical and Research CenterIran University of Medical SciencesTehranIran

Background:Most children in need of cardiac pacemakers remain dependent on the function of the permanent from childhood to *** sought to evaluate and compare the function between epicardial and endocardial pacemakers in pediatric groups with different ***:Between 2012 and 2018,this single-canter study evaluated 44 pediatric patients with indications for epicardial or endocardial ***:The 2 groups,at a median age of 5(0.1–16)years,were compared concerning the characteristics of the leads used(n=80:bipolar,unipolar,steroid-eluting,and non–steroid-eluting),survival data,and *** reason for pacemaker implantation was congenital complete heart block in 11(25%)cases and postoperative heart block in 33(75%)*** commonest congenital heart disease accompanied by postoperative block was the ventricular septal *** the endocardial lead group,the mean ventricular pacing threshold immediately after the implantation and during the follow-up was less than that in the epicardial lead group(0.75 vs.0.81 V;P=0.01 and 0.8 vs.2.4 V;P=0.001).During the follow-up,the mean battery longevity was better in the endocardial group(last visit:6.7 endocardial vs.3.3 years epicardial).Lead failure was commoner in the epicardial pacemaker,and chronic high-pacing threshold pattern was seen in 14 patients in this *** 3 years,freedom from lead failure was 94%and 63%in the endocardial and epicardial ***:Pacemakers with endocardial bipolar steroid-eluting leads showed better lead characteristics regarding survival and battery longevity than epicardial pacemakers without these lead *** appropriate pacemaker type should be selected based on the patient’s condition.

关键词： Pacemaker congenital heart defects cardiac pacing pediatrics

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A Fistula between Coronary and Main Pulmonary Arteries with Chest Tightness

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World Journal of Cardiovascular surgery 2015年第12期5卷 135-138页

作者： Masashi Kawabori Atsushi Kurata Division of cardiac surgery Brigham and Women’s Hospital Harvard Medical School Boston MA USA Division of Cardiovascular surgery Yamato Seiwa Hospital Yamato Japan

A 64-year-old woman presented to our facility with recurrent chest tightness. Angiography showed a dilated (10 mm) aneurysmal tortuous coronary artery fistula (CAF) to the main pulmonary arterial trunk occupying a large area of the anterior surface of the aortic root. Left and right heart catheterization showed high left-to-right shunt flow. Fissurectomy and coronary artery bypass grafting were performed. The patient had no postoperative complications and became asymptomatic. The outcome of our case shows that CAF should be a differential diagnosis of recurrent symptomatic cardiac ischemia. Intervention is indicated if symptoms or secondary complications develop.

关键词： congenital Coronary Aneurysm Coronary Fistula Angina

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surgery for Aneurysmal Right Coronary Fistula and Constrictive Pericarditis in an Adult: Case Report

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Case Reports in Clinical Medicine 2014年第3期3卷 180-174页

作者： Jaffar S. Shehatha Abdulsalam Y. Taha Department of cardiac surgery PAR Hospital Irbil Iraq School of surgery Western Australia University Perth Aus-tralia Department of Thoracic and Cardiovascular surgery School of Medicine and Sulaimania Teaching Hospital Sulaimania Iraq

Coronary artery fistula (CAF) is a direct communication between a coronary artery and the lumen of any of the cardiac chambers, i.e. the coronary sinus, the pulmonary artery, the superior vena cava or the proximal pulmonary veins. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. congenital CAF is a rare anomaly and aneurysmal formation in the fistula is even rarer. Majority of CAFs are isolated lesions, however, congenital or acquired heart diseases may co-exist. Herein, we report a case of huge congenital aneurysmal right CAF connected to the right atrium in an Iraqi man of 62 associated with tuberculous effusive-constrictive pericarditis to whom off pump pericardiectomy was performed followed by ligation of right coronary artery and vein graft implantation to its posterior descending branch under cardiopulmonary bypass. To the best of our knowledge, such association was not previously reported. CAF can be repaired surgically with minimum risk and excellent outcome. surgery is advised whenever coronary fistula is diagnosed unless it is very small to avoid the potential complications.

关键词： Coronary Artery Fistula Ectasia Aneurysm Pericarditis Pericardiectomy

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GATA4 and NKX2.5 gene analysis in Chinese Uygur patients with congenital heart disease

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Chinese Medical Journal 2009年第4期122卷 416-419页

作者： ZHANG Wei-min LI Xiao-feng MA Zhong-yuan ZHANG Jing ZHOU Si-hai LI Tao SHI Lin LI Zhong-zhi cardiac Center Beijing Children's Hospital Affiliated to CapitalMedical University Beijing100045 China Department of cardiac surgery People's General Hospital of Xinjiang Autonomous Region Urumqi Xinjiang 830001 China Department of surgery Urumqi First Hospital Urumqi Xinjiang830002 China Department of General surgery First Hospital Affiliated to Xinjiang Medical University Urumqi Xinjiang 830054 China Department of Cardiology Capital Institute of PediatricsBeijing 100020 China

Background congenital heart disease （CHD） is the most common developmental anomaly in newborns. The germline mutations in GATA4 and NKX2.5 genes have been identified as responsible for CHD. The frequency of GATA4 and NKX2.5 mutations in Chinese Uygur patients with CHD and the correlation between their genotype and CHD phenotype are unknown. Methods We examined the coding region of GATA4 and NKX2,5genes in 62 Chinese Uygur patients with CHD and 117 Chinese Uygur individuals as the controls by denaturing high pedormance liquid chromatography （DHPLC） and sequencing. Results Two heterozygous missense mutations of c.1220C〉A and c.1273G〉A in GATA4 gene, which cause the amino acid residue changes of P407Q and D425N in GATA4, were found in a patient with tetralogy of Fallot and a patient with ventricular septal defect, respectively. The two patients did not have atrioventricular conduct defects or non-cardiac abnormalities. The two mutations are expected to affect the protein function. There were no reported NKX2.5 mutations in the patients. Conclusion Our results provided the primary data on CHD phenotype associated with GATA4 mutation in the Chinese Uygur population.

关键词： GATA4 NKX2.5 congenital heart disease gene mutation

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Incidence of congenital heart disease in Beijing, China

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Chinese Medical Journal 2009年第10期122卷 1128-1132页

作者： YANG Xue-yong LI Xiao-feng LV Xiao-dong LIU Ying-long Pediatric cardiac Center Department of Surgery Cardiovascular Institute and Fu Wai Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100037 China

Background The incidence of congenital heart disease has been studied in developed countries for many years, but rarely in the mainland of China. Fetal echocardiographic screening for congenital heart disease was first performed in Beijing in the early 2000s, but the impact was not clear. The current study was undertaken to determine the incidence of congenital heart disease in Beijing, China and to estimate the impact of fetal echocardiography on the incidence of liveborn congenital heart disease.Methods The study involved all infants with congenital heart disease among the 84 062 total births in Beijing during the period of January 1 and December 31, 2007. An echocardiographic examination was performed on every baby suspected to have congenital heart disease, prenatally or/and postnatally.Results A total of 686 infants were shown to have congenital heart disease among 84 062 total births. The overall incidence was 8.2/1000 total births. Mothers of 128 of 151 babies diagnosed prenatally were chosen to terminate the pregnancy. Two of the 151 infants died in utero. A specific lesion was identified for each infant and the frequencies of lesions were determined for each class of infants （total births, stillbirths and live births）. The incidence of congenital heart disease in stillbirths and live births was 168.8/1000 and 6.7/1000, respectively. The difference between the incidence of total birth and the incidence of live birth was statistically significant （P 〈0.001）. Conclusions The incidence of liveborn congenital heart disease in Beijing is within the range reported in developed countries. Fetal echocardiography reduce significantly the incidence of liveborn congenital heart disease.

关键词： incidence congenital heart disease prenatal diagnosis fetal echocardiography pregnancy termination

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Correlation of neutrophil-to-lymphocyte ratio with prolonged ICU stayin infants undergoing cardiac surgery

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South China Journal of Cardiology 2024年第2期25卷 67-75页

作者：李思敏廖秋凤刘琦 Department of Cardiothoracic Intensive Care unit Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhou 510080GuangdongChina Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences) Southern Medical UniversityGuangzhou 510080GuangdongChina

Background The neutrophil-to-lymphocyte ratio(NLR)stands as a valuable marker for assessing inflammation and predicting adverse outcomes post-cardiac *** study aimed to ascertain the prognostic relevance of preoperative NLR concerning prolonged ICU stay among infants undergoing congenital heart surgery employing cardiopulmonary *** A retrospective review was conducted involving 187 consecutive infants(≤1 year)who underwent congenital heart disease surgery between January and April 2019,stratified into two groups based on NLR(NLRunit(ICU)length of stay,defined patients with ICU stays duration higher than the third *** between preoperative NLR and clinical outcomes were *** operating characteristic curve analysis,multivariable Logistic regression,and restricted cube plots were utilized to gauge the association of preoperative NLR with prolonged ICU *** The area under the receiver operating characteristic curve of NLRpredictive capability for prolonged ICU length of staywas *** analyses revealed poorer prognoses among patients with high NLR(≥0.484).Multivariable Logistic regression analysis indicated that heightened preoperative NLR(OR:2.63,95%CI:1.18-5.83,P=0.018)independently was correlated with prolonged ICU length of stay in infants'post-cardiac *** In summary,the NLR emerges as a significant predictive factor for prolonged ICU stay in infants undergoing cardiac ***,further research is warranted to comprehensively grasp the relationship between the NLR and prolonged ICU stay.

关键词： congenital heart disease Infants Neutrophil-to-lymphocyte ratio Cardiopulmonary bypass Intensive care unit cardiac surgery Prolonged ICU stay

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Surgical correction of postductal aortic coarctation in 40 adolescents and adults： A ten-year single institution experience

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South China Journal of Cardiology 2017年第2期18卷 106-113页

作者：李欣杨珏于长江卿洪琨范瑞新 Department of cardiac surgery Guangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou 510080 Guangdong China

Background In clinical practice, there are different surgical approaches for postductal coarctation of the aor- ta （CoA）, with their advantages and disadvantages. Limited studies have reported the surgical outcomes of post- ductal CoA in adolescents and adults. Methods From January 2005 to December 2014, a total of 40 patients aged over 14 years underwent surgical corrections of postductal CoA in our institution. The surgical outcomes as reflected by cardiac function and differences in mean blood pressure of upper and lower extremities both preoper- ative and postoperative were recorded and evaluated. Results Among the 40 patients underwent successful sur- gical corrections, 1 patient complicated by acute aortic dissection and died, while the remainings survived to hos- pital discharge. During the 12-36 month follow-up period, postoperative mean blood pressure differences of upper and lower extremities were significantly reduced as compared with the preoperative data. Postoperative evalu- ation of cardiac function was conducted in all patients with New York Heart Association （NYHA） Ⅰ-Ⅱ. Conclusion For adolescent and adult patients with postductal aortic coarctation, surgical correction is highly recom- mended. Surgical approach should be based on the specific anatomy of the coarctation lesion, concomitant mal- formations, and expected grown-up height. Those complicated with other intracardiac malformations should be treated with extra-anatomical bypass technique and simultaneous surgical correction of CoA, which is effective with desirable postoperative prognosis.

关键词： coarctation of the aorta (CoA) congenital heart disease in adult extra-anatomical bypass tech- nique surgical treatment

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Efficacy of Bosentan in Patients after Fontan Procedures：a Double-blind, Randomized Controlled Trial

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第4期36卷 534-540页

作者：尚小珂卢蓉张喜张长东肖书娜柳梅王斌董念国 cardiac surgery Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China SinoScript LLC Vernon Connecticut 06066 USA Department of Intervention Wuhan Asia Heart Hospital Wuhan 430022 China Department of Radiology The Keck School of Medicine University of Southern California California 90033 USA

Fontan surgery is a widely used palliative procedure that significantly improves the survival period of patients with complex congenital heart disease（CHD）. However, it does not decrease postoperative complication rate. Previous studies suggested that elevated mean pulmonary artery pressure（m PAP） and vascular resistance lead to decreased exercise tolerance and myocardial dysfunction. Therapy with endothelial receptor antagonists（Bosentan） has been demonstrated to improve the patients＇ prognosis. A double-blind, randomized controlled trial was performed to explore the efficacy of Bosentan in treating patients who underwent the Fontan procedure. Eligible participants were randomly divided into Bosentan group and control group. Liver function was tested at a local hospital and the results were reported to the phone inspector every month. If the results suggested abnormal liver function, treatment would be adjusted or terminated. All the participants finished the follow-up study, with no patients lost to follow-up. Unblinding after 2-year follow-up, no mortality was observed in either group. However, secondary end-points were found to be significantly different in the comparable groups. The cardiac function and 6-min walking distance in the Bosentan group were significantly superior to those in the control group（P=0.018 and P=0.027）. Bosentan could improve New York Heart Association（NYHA） functional status and improve the results of the 6-min walking test（6MWT） in Fontan patients post-surgery, and no other benefits were observed. Furthermore, a primary meta-analysis study systematically reviewed all the similar clinical trails worldwide and concluded an overall NYHA class improvement in Fontan patients who received Bosentan treatments.

关键词： Fontan procedure Bosentan prognosis pulmonary hypertension pulmonary vascular resistance

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Short-Term Outcomes of Two Surgical Techniques for the Treatment of Coarctation of the Aorta in Infants: Subclavian Flap Repair and Resection with Extended End-to-End Anastomosis Technique

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World Journal of Cardiovascular Diseases 2015年第1期5卷 1-8页

作者： Mustafa Karacelik¹ Burcin Abud Ugur Karagoz¹ Pelin Ozturk¹ Gokhan Albayrak Onur Doyurgan Koray Aykut Mehmet Guzeloglu Eyup Hazan Osman Nejat Sarıosmanoglu Department of Pediatric cardiac surgery Behcet Uz Children’s HospitalIzmirTurkey Department of Cardiovascular surgery Izmir Tepecik Research and Training HospitalIzmirTurkey Department of Cardiovascular surgery Izmir University School of MedicineIzmirTurkey

Background: The aims of the study were to analyze the importance of two different surgical procedures, and to determine outcomes for neonates with coarctation of the aorta in two newly established centers. Methods: Outcomes of two different surgical repairs for coarctation of the aorta in 43 infants were evaluated retrospectively. The study was designed as a nonrandomized, cross-sectional study. The subclavian flap repair was applied to 22 patients (51%) and resection with extended end-to-end anastomosis technique to 21 patients (49%). After all operative survivors were followed up with a mean follow-up of 1.8 ± 0.8 years, data analyzed with t-test and the p value cardiac defects analyzed. The first-year survival rate was 100% in both groups in isolated coarctation (p = 0.965), however;such rate was found as 100% and 93.25% in Waldhausen Group and Resection Group, respectively in complex coarctation (p = 0.294). Conclusions: Both the subclavian flap repair and resection with extended end-to-end anastomosis for coarctation of the aorta in infants provide excellent short-term outcomes with lower recurrence rates requiring surgery or angioplasty.

关键词： congenital Heart Disease Coarctation of Aorta Infant

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Early cardiac Catheterizations within 30 Days Post congenital Heart surgery in Children

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congenital Heart Disease 2023年第1期18卷 79-95页

作者： Daniel Quandt Alessia Callegari Oliver Niesse Martin Christmann Anke Meinhold Hitendu Dave Walter Knirsch Oliver Kretschmar Pediatric Heart Centre-Division of Pediatric Cardiology University Children’s Hospital ZurichZurichSwitzerland Department Neonatology and Pediatric Intensive Care University Children’s Hospital ZurichZurichSwitzerland Department of congenital Cardiothoracic surgery University Children’s Hospital ZurichZurichSwitzerland Children’s Research Centre ZurichSwitzerlandUniversity Children’s Hospital ZurichZurichSwitzerland University of Zurich ZurichSwitzerland

Background:This study set out to assess the indications,feasibility,safety,and outcome of early cardiac catheterizations(CC)within 30 days after congenital heart surgery(CHS)in *** and Results:This is a retrospective,single-center case review study of all CC within 30 days after CHS between 1/2010-12/2020.A total of 317(138 diagnostic,179 interventional)CC were performed in 245 patients at a median of 4 days(IQR 13)after *** median age was 3 months(IQR 6),and body weight was 5 kg(IQR 4).A total of 194(61.2%)CC were performed in patients with univentricular *** revealed significant pathologies leading to early redo-surgery in 37 patients(12%).The transcatheter interventions primarily were needed in patients after cavo-pulmonary connection(n=69%,21.8%),right ventricle to pulmonary artery conduit(n=39%,12.3%),and Norwood-I surgery(n=34%,10.7%)presenting with hypoxemia,prolonged postoperative course,and suspected arterial stenosis on *** clinical impact of an early postoperative transcatheter intervention for the following clinical course was high in most *** were nine(2.8%)major and 20(6.3%)minor intra-procedural *** factor analysis revealed no difference for the occurrence of complications for patients’age,weight,and time from initial CHS,underlying *** heart disease,or ***:Early CC within 30 days after CHS in children can be performed safely with a high diagnostic and therapeutic *** rate of complications is low,while the therapeutic consequence is relevant.

关键词： Early postoperative cardiac catheterization congenital heart surgery children

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