Surveillance for transplant coronary artery disease in infant, child and adolescent heart transplant recipients: an intravascular ultrasound study.

Background: Transplant coronary arteriopathy (TCAD) limits graft survival after heart transplantation in adult and pediatric heart transplant recipients. Intravascular ultrasound (IVUS) provides a highly sensitive technique to detect TCAD. However, its use to determine factors associated with TCAD in pediatric recipients has been limited and its utility in surveillance for symptomatic TCAD in this population is uncertain.

Relation of age, severity of illness, and hemodynamics with brain natriuretic peptide levels in patients <20 years of age with heart disease.

Brain natriuretic peptide (BNP) levels were obtained before cardiac catheterization in 193 pediatric patients with a variety of cardiac lesions. Age and functional status had strong relations to BNP values, with elevations of BNP levels associated with increasing functional disability and decreasing age. Mild but statistically significant correlations were found between BNP levels and right-sided cardiac pressures.

Amplatzer atrial septal defect occluder for pediatric patients: radiographic appearance.

Purpose: To describe the chest radiographic appearance of the Amplatzer septal occluder (ASO) (AGA Medical Corporation, Golden Valley, Minn) for atrial septal defects (ASDs) in pediatric patients.

Materials And Methods: Two radiologists independently reviewed frontal and lateral chest radiographs obtained in young patients 24 hours after transcatheter ASD closure with the ASO. The appearance (flat disks or dots) and location of the ASO were recorded.

Novel use of the Amplatzer duct occluder to close perivalvar leak involving a prosthetic mitral valve.

Perivalvar leak following atrioventricular valve replacement can result in heart failure or hemolytic anemia. These patients may be poor surgical candidates given a complex clinical condition. We describe transcatheter closure of a perivalvar leak in a 3-month infant who had undergone left atrioventricular valve replacement with a St.

Radiofrequency perforation in the treatment of acquired left pulmonary artery atresia following repair of tetralogy of Fallot.

Acquired pulmonary artery discontinuity can complicate operative repair of certain congenital heart defects. We describe successful recanalization of acquired left pulmonary artery atresia using radiofrequency energy in a 14-month-old child who had previously undergone repair of tetralogy of Fallot with pulmonary atresia.

Inhaled Nitric Oxide as a Preoperative Test (INOP Test I): the INOP Test Study Group.

Background: This study was performed to determine whether a preoperative hemodynamic evaluation with oxygen and inhaled nitric oxide identifies patients with pulmonary hypertension who are appropriate candidates for corrective cardiac surgery or transplantation more accurately than an evaluation with oxygen alone.

Methods And Results: At 10 institutions, 124 patients with heart disease and severe pulmonary hypertension underwent cardiac catheterization to determine operability. The ratio of pulmonary and systemic vascular resistance (Rp:Rs) was determined at baseline while breathing approximately 21% to 30% oxygen, and in approximately 100% oxygen and approximately 100% oxygen with 10 to 80 parts per million nitric oxide to evaluate pulmonary vascular reactivity.