Iron deficiency and anemia in pediatric dilated cardiomyopathy are associated with clinical, biochemical, and hematological markers of severe disease and adverse outcomes.

Background: There is limited evidence regarding the prevalence and impact of iron deficiency (ID) in children with dilated cardiomyopathy (DCM).

Methods: Retrospective single-center review of all children between 2010 and 2020 with a diagnosis of DCM and complete iron studies. ID was defined as ≥2 of ferritin <20 μg/liter, iron <9 μmol/liter, transferrin >3 g/liter, or transferrin saturation (TSat) <15%.

Effect of persistent versus transient donor-specific HLA antibodies on graft outcomes in pediatric cardiac transplantation.

Background: De novo donor-specific HLA antibodies (DSA) are a risk for poor graft outcomes, but there is little evidence of their long-term effect in pediatric cardiac transplantation or of the effect of transient versus persistent DSA found using newer antibody testing methods.

Methods: Archived serum samples were obtained from patients <18 years of age who underwent primary cardiac transplantation during the period from 1996 to 2009. Luminex antibody testing was performed at 3 months, 6 months and 1 year post-transplant, and then annually.

ABO-incompatible cardiac transplantation in pediatric patients with high isohemagglutinin titers.

Background: ABO-incompatible (ABOi) cardiac transplantation is now used widely in infants with isohemagglutinin titers <1:4, but there is increasing evidence that ABOi transplantation can also be used in children with significantly higher titers. We reviewed our high-titer ABOi transplants and report our results here.

Methods: Patients who underwent ABOi cardiac transplantation from 2000 to 2013 with pre-existing isohemagglutinin titers of ≥1:16 were identified from departmental databases.

Cardiovascular abnormalities in Down's syndrome: spectrum, management and survival over 22 years.

Background: The prevalence of cardiovascular anomalies in Down's syndrome is well described, but there are few data on spectrum, management and outcome. The authors aimed to provide this information for infants with Down's syndrome in a defined population over a 22-year period.

Methods: The regional paediatric cardiology database in Newcastle upon Tyne provided information on all cardiovascular anomalies, surgical treatment and outcome.

Mortality in infants with cardiovascular malformations.

Unlabelled: Cardiovascular malformations are an important cause of infant death and the major cause of death due to malformation. Our aims were to analyse and categorise all deaths in infants with cardiovascular malformations, and to analyse trends in mortality over time and influences on mortality. We obtained details of infant deaths and cardiovascular malformations from the population of one health region for 1987-2006.

Outcomes following more than two decades of paediatric cardiac transplantation.

Objective: There have been significant changes in the field of paediatric cardiac transplantation over the last two decades. We report experience of over 22 years from a single UK transplant centre.

Methods: A total of 189 orthotopic cardiac transplants were performed in 182 children aged <18 years between March 1987 and March 2009 in our institution.

Immunosuppression therapy for pediatric heart transplantation.

Outcomes following cardiac transplantation in childhood continue to improve. Advances in immunosuppressive therapy over the past two decades likely have contributed to this trend. The evolution in the management of immunosuppression in children has been based on clinical experience rather than on evidence-based medicine; indeed, there have been no pivotal randomized controlled trials of any form of immunosuppression in pediatric thoracic transplantation.

Successful medical treatment of bioprosthetic pulmonary valve endocarditis caused by methicillin-resistant Staphylococcus aureus.

The mortality risk of prosthetic valve endocarditis is known to be increased in cases in which staphylococci are the causative organisms. Previous recommendations have concentrated on early surgical management of this condition, but there are now reports that these infections can be treated medically, thus leaving prosthetic material in situ. We describe a case of methicillin-resistant Staphylococcus aureus endocarditis on a bovine pericardial pulmonary valve that responded to antibiotic therapy without the need for surgical intervention.

Successful bridge to transplant with the Berlin Heart after cavopulmonary shunt.

Mechanical cardiac assistance for infants and children may be accomplished using extracorporeal membrane oxygenation or ventricular assist device support, and are now well established as a bridge to cardiac transplantation or recovery in biventricular hearts, usually in the setting of low cardiac output states due to cardiomyopathy or acute myocarditis. Ventricular assist device support remains less well described in the setting of single ventricle physiology. We report the case of a 3-year-old girl who developed severe right ventricular failure 2 years after cavopulmonary shunt after an initial Stage I Norwood operation for hypoplastic left heart syndrome.

Fatal presentation of congenital isolated left ventricular apical hypoplasia.

Congenital isolated left ventricular apical hypoplasia has recently been recognised as a discrete clinical entity with well-defined diagnostic criteria on cardiac magnetic resonance imaging. This spectrum has been described in four previous cases, three of which presented with relatively mild symptoms and one with pulmonary oedema. All of these patients responded to standard medical management.