Publications by authors named "E Binka"
Left Ventricular Outflow Tract Obstruction in Congenital Heart Disease: The Role of Cardiovascular Computed Tomography in Surgical Decision Making.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu
March 2024
Patients with many forms of congenital heart disease (CHD) and hypertrophic cardiomyopathy undergo surgical intervention to relieve left ventricular outflow tract obstruction (LVOTO). Cardiovascular Computed Tomography (CCT) defines the complex pathway from the ventricle to the outflow tract and can be visualized in 2D, 3D, and 4D (3D in motion) to help define the mechanism and physiologic significance of obstruction. Advanced cardiac visualization may aid in surgical planning to relieve obstruction in the left ventricular outflow tract, aortic or neo-aortic valve and the supravalvular space.
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- The study examines the use of left atrial strain (LAS) in children with multisystem inflammatory syndrome (MIS-C) and its relation to cardiac injury and inflammation.
- Results showed that LAS parameters were significantly lower in MIS-C patients compared to healthy controls and those with cardiac injury had even more reduced LAS metrics.
- The findings suggest that LAS could be a reliable diagnostic tool for detecting cardiac dysfunction in MIS-C and correlates with inflammatory markers, highlighting its potential use in clinical settings.
Article Synopsis
- The study examined the relationship between echocardiographic and laboratory findings at admission and the severity of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, focusing on vasoactive medication usage.
- Out of 118 patients, 48% were given vasoactive medication, with key indicators like elevated brain natriuretic peptide, C-reactive protein, and lower left ventricular ejection fraction linked to more severe disease.
- Results suggest that laboratory markers, particularly those indicating inflammation and heart injury, could be more effective in predicting MIS-C severity compared to strain parameters or LVEF, especially since many patients with a normal LVEF still required vasoactive support.
Article Synopsis
- The study reviews the risks of MRI scans in pediatric patients with cardiac implantable electronic devices (CIEDs), focusing on those with epicardial or abandoned leads, where guidelines discourage routine scans.
- A multicenter review analyzed 314 patients who underwent 389 MRIs from 2007 to 2022, assessing any adverse events or significant changes to their CIEDs post-scan.
- Results showed only a small incidence of symptoms or CIED changes (4.9% of MRIs), suggesting that MRIs can be safely conducted for these patients without major complications.
Cardiovascular computed tomography (CCT) is rated appropriate by published guidelines for the initial evaluation and follow up of congenital heart disease (CHD) and is an essential modality in cardiac imaging programs for patients of all ages. However, no recommended core competencies exist to guide CCT in CHD imaging training pathways, curricula development, or establishment of a more formal educational platform. To fill this gap, a group of experienced congenital cardiac imagers, intentionally inclusive of adult and pediatric cardiologists and radiologists, was formed to propose core competencies fundamental to the expert-level performance of CCT in pediatric acquired and congenital heart disease and adult CHD.
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