Standardizing Radiation Exposure during Cardiac Catheterization in Children with Congenital Heart Disease: Data from a Multicenter Brazilian Registry.

Background: In recent years the increasing number of interventional procedures has resulted in growing concerns regarding radiation exposure for patients and staff. The evaluation of radiation exposure in children is difficult due to the great variability in body weight. Therefore, reference levels of radiation are not well defined for this population.

Covered-stent implantation to treat aortic coarctation.

Aortic coarctation comprises approximately 7% of all known congenital heart defects. Surgery and balloon angioplasty have been performed for many years but are associated with a significant incidence of recoarctation and aneurysm formation. Although bare-stent implantation decreases the incidence of recoarctation, the risk of aortic dissection or aneurysm formation is not eliminated.

Dynamics of the septum primum in fetuses with intrauterine growth restriction.

Purpose: To test the hypothesis that the linear displacement of the septum primum (SP) is lower in fetuses with intrauterine growth restriction (IUGR) than in fetuses with appropriate growth for gestational age (AGA).

Methods: In a cross-sectional study, the ratio between the SP displacement and left atrial diameter (excursion index [EI]) was compared in 27 fetuses with IUGR (group 1), 24 fetuses with AGA of hypertensive mothers (group 2), and 35 controls (group 3). Flow through the atrioventricular (AV) valves and the umbilical artery resistance index (RI) were also compared.

Assessment of diastolic ventricular function in fetuses of diabetic mothers using tissue Doppler.

Objective: To identify the presence of ventricular diastolic dysfunction by tissue Doppler in fetuses of diabetic mothers, with or without septal hypertrophy, in comparison to fetuses of nondiabetic mothers.

Methods: A contemporary transverse study in fetuses with a gestational age between 25 weeks to term, studying diastolic function by assessment using tissue Doppler and pulsed wave Doppler of the atrioventricular diastolic flow. The mothers of the fetuses all had previous or gestational diabetes, and were referred to the Fetal Cardiology Unit of the Institute of Cardiology in Porto Alegre, Brazil.

Morphological basis for the study of the interatrial septum in the human fetus.

Objective: To describe morphological features of the interatrial septum in normal fetuses, especially foramen ovale (FO) and septum primum (SP), in order to compare septum primum excursion with foramen ovale diameter.

Methods: Septum primum excursion (SPE) toward the left atrium (LA) and foramen ovale diameter (FOD) were measured in the hearts of ten formaldehyde-fixed human fetuses ranging from 28 to 36 weeks of gestation. Histological sections were obtained from the foramen ovale (FO), septum primum (SP), septum secundum (SS), left atrium (LA), and right atrium (RA).

Study of global left atrial shortening in fetuses of diabetic mothers.

Objective: To test the hypothesis that left atrial shortening fraction is lower in fetuses of diabetic mothers than in fetuses of mothers with no systemic disease.

Methods: Forty-two fetuses of mothers with previous diabetes or gestational diabetes and 39 healthy fetuses of mothers with no systemic disease (controls) underwent echocardiographic examination. Their gestational ages ranged from 25 weeks to term.

Mobility of the Septum primum does not depend on the foramen ovale diameter in normal fetuses.

Objective: To test the hypothesis that a correlation exists between the maximum foramen ovale diastolic diameter and the excursion index (EI) of the septum primum in normal fetuses.

Methods: One hundred and two normal fetuses with gestational ages ranging from 20 to 40 weeks were submitted to echocardiography. The foramen ovale diameter and the "maximal excursion" of the septum primum were measured in a 4-chamber view.

Ductus venosus flow and myocardial hypertrophy in fetuses of diabetic mothers.

Objective: To test the hypothesis that the pulsatility index of ductus venosus (PIDV) is greater in the fetuses of diabetic mothers (FDM) with myocardial hypertrophy (MH) than in the FDM with no MH and in the control fetuses of nondiabetic mothers (FNDM). Comparing the results with mitral and tricuspid diastolic peak flows.

Methods: The cross-sectional study included fetuses with gestational ages ranging from 20 weeks to term, divided into the following 3 groups: 56 FDM with MH (group I), 36 FDM with no MH (group II), and 53 FNDM (group III, control).

Dynamics of the pulmonary venous flow in the fetus and its association with vascular diameter.

Background: The usual positioning of the Doppler sample volume to assess fetal pulmonary vein flow is in the distal portion of the vein, where the vessel diameter is maximal. This study was performed to test the association of the pulmonary vein pulsatility index (PVPI) with the vessel diameter.

Methods And Results: Twenty-three normal fetuses (mean gestational age, 28.