Background: Covered stent correction for a sinus venosus atrial septal defect (SVASD) was first performed in 2009. This innovative approach was initially viewed as experimental and was reserved for highly selected patients with unusual anatomic variants. In 2016, increasing numbers of procedures began to be performed, and in several centers, it is now offered as a standard of care option alongside surgical repair.
View Article and Find Full Text PDFSemilunar valve regurgitation in single ventricular physiology is rare but portends a poor prognosis. Medical therapy is often ineffective particularly in the context of structural valve abnormality, and surgical valve repair or replacement can be associated with poor outcomes. We report an innovative use of a highly occlusive and conformable Gore Septal Occluder for transcatheter treatment of severe native aortic regurgitation in a symptomatic patient with hypoplastic left heart syndrome and severe systemic right ventricular dysfunction, resulting in safe and complete occlusion of the aortic regurgitant orifice and clinical benefit.
View Article and Find Full Text PDFArch Dis Child Fetal Neonatal Ed
June 2024
Objectives: UK single ventricle (SV) palliation outcomes after first postnatal procedure (FPP) are well documented. However, survival determinants from fetal diagnosis to FPP are lacking. To better inform parental-fetal counselling, we examined factors favouring survival at two large UK centres.
View Article and Find Full Text PDFEur Heart J Qual Care Clin Outcomes
August 2024
Background: Educational attainment in children with congenital heart disease (CHD) within the UK has not been reported, despite the possibility of school absences and disease-specific factors creating educational barriers.
Methods And Results: Children were prospectively recruited to the Born in Bradford birth cohort between March 2007 and December 2010. Diagnoses of CHD were identified through linkage to the congenital anomaly register and independently verified by clinicians.
Background And Aims: Transcatheter pulmonary valve implantation (TPVI) is indicated to treat right-ventricular outflow tract (RVOT) dysfunction related to congenital heart disease (CHD). Outcomes of TPVI with the SAPIEN 3 valve that are insufficiently documented were investigated in the EUROPULMS3 registry of SAPIEN 3-TPVI.
Methods: Patient-related, procedural, and follow-up outcome data were retrospectively assessed in this observational cohort from 35 centres in 15 countries.
Background: Chronic complete vascular occlusion causes significant morbidity and mortality in patients with congenital heart disease (CHD). The diversity of lesions, lack of dedicated equipment, and small number of procedures performed by individual operator continue to pose a challenge to congenital interventional cardiologists.
Case Summary: We report two cases of percutaneous recanalization in CHD using percutaneous coronary intervention (PCI) equipment for chronic total occlusion (CTO).
The GORE CARDIOFORM atrial septal defect (ASD) Occluder (GCA) is composed of a platinum-filled nitinol wire frame covered with expanded polytetrafluoroethylene, making it softer and more conformable compared with nitinol mesh devices. After the ASSURED clinical study confirmed the efficacy and safety of the device, it received U.S.
View Article and Find Full Text PDFLow fruit and vegetable consumption is a major modifiable risk factor for raised blood pressure (BP), but it is unknown how heterogeneity in national supply has contributed to BP trends. To address this, we characterised supply trends from 1975 to 2015 and whether it met WHO recommendations. We then examined associations with three metrics: systolic, diastolic and raised BP.
View Article and Find Full Text PDFBackground: Gore Cardioform Atrial Septal Defect Occluder (GCA) is composed of a platinum-filled nitinol wire frame covered with expanded polytetrafluoroethylene (ePTFE). This makes the device highly occlusive and resistant to residual shunts through the device, as well as conforming well to the surrounding anatomy. In defects with poor rims to hold a device for closure or where one of the 'rims' is the free wall of the left ventricle, such as in a post-infarct apical ventricular septal defect (VSD), successful closure with standard nitinol mesh devices can be unachievable.
View Article and Find Full Text PDFBackground: Contactless photoplethysmography (PPG) potentially affords the ability to obtain vital signs in pediatric populations without disturbing the child. Most validity studies have been conducted in laboratory settings or with healthy adult volunteers. This review aims to evaluate the current literature on contactless vital signs monitoring in pediatric populations and within a clinical setting.
View Article and Find Full Text PDFBackground: Refractory chylous effusions due to lymphatic dysplasia related to Noonan syndrome cause significant morbidity and mortality due to protein and immunoglobulin losses. Very few cases have been published reporting successful treatment of patients with trametinib where all conventional treatments had failed.
Case Summary: We present a girl with Noonan syndrome and hypertrophic cardiomyopathy who presented with life-threatening refractory chylothorax where all conventional treatment options failed.
Cardiac output monitoring enables physiology-directed management of critically ill children and aids in the early detection of clinical deterioration. Multiple invasive techniques have been developed and have demonstrated ability to improve clinical outcomes. However, all require invasive arterial or venous catheters, with associated risks of infection, thrombosis and vascular injury.
View Article and Find Full Text PDFGlobal food systems are developing rapidly, and have resulted in a large burden of disease and a high proportion of environmental resource use. We combined global data sources on food supply and trade, environmental footprints, burdens of disease, and vulnerability to climate change to explore patterns from 1990 to 2017. Four distinct patterns of food supply (animal sources and sugar, vegetables and nuts, starchy roots and fruits, and seafood and oils) were matched to health and environmental risks.
View Article and Find Full Text PDFObjective: To study the impact of out-of-hours delivery on outcome for neonates with antenatally diagnosed transposition of the great arteries.
Setting: Tertiary paediatric cardiology centre (Yorkshire, United Kingdom), with co-located tertiary neonatal unit.
Patients: Neonates with antenatally diagnosed simple transposition of the great arteries delivered out-of-hours (Monday to Friday 17:00-08:00 and weekends) in-hours between 2015 and 2020.
We present a case of right ventricle to pulmonary artery hybrid perforation and stenting in a patient with pulmonary atresia with ventricular septal defect major aortopulmonary collaterals and diminutive native pulmonary arteries, then discuss how it compares with established approaches. (.).
View Article and Find Full Text PDFAims: Post-infarction ventricular septal defect (PIVSD) is a mechanical complication of acute myocardial infarction (AMI) with a poor prognosis. Surgical repair is the mainstay of treatment, although percutaneous closure is increasingly undertaken.
Methods And Resuts: Patients treated with surgical or percutaneous repair of PIVSD (2010-2021) were identified at 16 UK centres.
Introduction And Background: Mortality between stages 1 and 2 single-ventricle palliation is significant. Home-monitoring programmes are suggested to reduce mortality. Outcomes and risk factors for adverse outcomes for European programmes have not been published.
View Article and Find Full Text PDFBackground: No established risk prediction tool exists in United Kingdom and Irish Paediatric Cardiology practice for patients undergoing cardiac catheterisation. The Catheterisation RISk score for Paediatrics is used primarily in North American practice to assess risk prior to cardiac catheterisation. Validating the utility and transferability of such a tool in practice provides the opportunity to employ an already established risk assessment tool in everyday practice.
View Article and Find Full Text PDFEur J Cardiothorac Surg
February 2022
Objectives: Since percutaneous pulmonary valve implantation (PPVI) was introduced to prolong the lifetime of surgically placed right ventricular to pulmonary artery conduits, valve technology has evolved and the indications for PPVI expanded to native and larger right ventricular outflow tracts. We explore how indications, patient populations and outcomes compare to surgical pulmonary valve replacement (PVR).
Methods: This is a retrospective cohort study of PPVI and PVR procedures between 1998 and 2020 at a single UK centre.
Catheter Cardiovasc Interv
September 2021
Infants with complex cyanotic CHD can become symptomatic from insufficient pulmonary blood supply following either ductal closure or due to outflow tract obstruction. Blalock-Taussig shunt mortality remains significant and recent studies have highlighted the advantages of using transcatheter alternatives. We present here our experience in changing our primary choice of palliation from the Blalock-Taussig shunt to transcatheter palliation with either a ductal stent or, if antegrade flow is present, a right ventricular outflow tract stent.
View Article and Find Full Text PDFBackground: Disrupted endothelial BMP9/10 signaling may contribute to the pathophysiology of both hereditary hemorrhagic telangiectasia (HHT) and pulmonary arterial hypertension (PAH), yet loss of circulating BMP9 has not been confirmed in individuals with ultra-rare homozygous GDF2 (BMP9 gene) nonsense mutations. We studied two pediatric patients homozygous for GDF2 (BMP9 gene) nonsense mutations: one with PAH (c.[76C>T];[76C>T] or p.
View Article and Find Full Text PDFBackground: In Iran, trends in breast cancer incidence and mortality have generally been monitored at national level. The purpose of this study is to examine province-level disparities in age-standardised breast cancer incidence versus mortality from 2000 to 2010 and their association with socioeconomic status.
Methods: In this study, data from Iran's national cancer and death registry systems, and covariates from census and household expenditure surveys were used.