When High-Risk Ductal Stenting Goes Wrong: Use of Percutaneous VV ECMO Support and Acute Left Pulmonary Artery Loss.

Patent ductus arteriosus (PDA) stenting is a vital intervention for neonates with ductal-dependent blood flow, offering an attractive alternative to surgical shunt placement. Despite its benefits, the procedure poses risks such as ductal spasm, branch pulmonary artery compromise, and pseudoaneurysm formation. This report presents two complex neonatal cases with distinct outcomes.

Quantitative plasma proteomic analysis in children after superior cavopulmonary anastomosis with pulmonary arteriovenous malformations.

Approximately 1000 children are born every year in the United States with one effective cardiac pumping chamber, or single ventricle heart disease. One of the early causes of mortality in this population is pulmonary arteriovenous malformations (PAVMs), which allow blood to bypass gas exchange in the lungs. PAVMs most frequently occur in children after superior cavopulmonary anastomosis (SCPA), a procedure that redirects venous blood from the upper body to the lungs.

Transcatheter patent ductus arteriosus closure in premature infants requiring high-frequency ventilation.

Transcatheter closure has become a common treatment method for patent ductus arteriosus in premature infants at many centres; however, many remain uncertain about the ability to perform the procedure in the catheterisation laboratory for infants requiring high-frequency ventilation. This study presents our centre's experience following the implementation of neonatal ventilatory guidelines, which resulted in 100% procedural success without any procedural or respiratory adverse events.

Percutaneous device closure of hemodynamically significant coronary fistula following endomyocardial biopsy in a pediatric heart transplant patient.

Coronary artery fistula is a rare but well-documented complication of right ventricular endomyocardial biopsy, particularly in the adult population. Typically, these fistulae never reach clinical or hemodynamic significance, but some may cause coronary steal and ventricular dysfunction. We report a case of a significant coronary artery fistula requiring device closure in the cardiac catheterization laboratory with subsequent improvement of clinical symptoms and cardiac function.

Follow the MAPCA: an unusual source of right pulmonary artery flow.

Major aortopulmonary collateral arteries in the setting of pulmonary atresia with intact ventricular septum are very rarely encountered, having been documented in only a handful of case reports. We present the right ventriculogram of a patient found to have this rare combination of findings along with right ventricular-dependent coronary artery circulation and unusual supply of the right pulmonary artery.

Cutting balloon angioplasty on branch pulmonary artery stenosis in pediatric patients.

Objectives: To identify medium-term results following cutting balloon angioplasty (CBA) for branch pulmonary artery stenosis (PAS) and predictors of successful intervention.

Background: CBA has emerged as a successful alternative therapy for PAS resistant to conventional balloon angioplasty techniques but there is little information on medium and long-term outcomes.

Methods: This is a descriptive, single center, retrospective chart review of pediatric patients who underwent CBA for PAS at Arkansas Children's Hospital between May 2005 and December 2020.

Advanced imaging improves detection of baffle leaks and stenoses after atrial switch compared with transthoracic echocardiography.

Current guidelines for adults with atrial switch repair recommend baseline cardiovascular magnetic resonance (CMR) for assessment of ventricular size and function, systemic and venous baffle obstruction and leaks, and valvular function. It also recommends transthoracic echocardiography (TTE) for outpatient follow up. Many such patients with implanted cardiac devices may need cardiac computed tomography (CCT) when CMR is not feasible.

Transcatheter Versus Surgical Pulmonary Valve Replacement in Repaired Tetralogy of Fallot.

Transcatheter pulmonary valve replacement (TC-PVR) is an alternative to surgical PVR (S-PVR) in repaired Tetralogy of Fallot (TOF). The purpose of this study is to compare in-hospital outcomes, hospital costs, and projected 5-year total costs of S-PVR to TC-PVR in patients with repaired TOF. We performed a multicenter, retrospective cohort study of children and adults with TOF ≥ 8 years of age who underwent PVR from January 1, 2010 to December 31, 2016 at 46 centers contributing to the Pediatric Health Information Systems database.

Post-market surveillance to detect adverse events associated with Melody® valve implantation.

Objective: The aim of this study was to describe previously unrecognised or under-recognised adverse events associated with Melody® valve implantation.

Background: In rare diseases and conditions, it is typically not feasible to conduct large-scale safety trials before drug or device approval. Therefore, post-market surveillance mechanisms are necessary to detect rare but potentially serious adverse events.

Alternative repair strategies for ductal-dependent tetralogy of fallot and short-term postoperative outcomes, a multicenter analysis.

Our aim was to evaluate postoperative morbidity and mortality following initial intervention, comparing primary repair versus palliative shunt in the setting of ductal-dependent tetralogy of Fallot. When neonatal surgical intervention is required, controversy and cross-center variability exists with regard to surgical strategy. The multicenter Pediatric Health Information System database was queried to identify patients with TOF and ductal-dependent physiology, excluding pulmonary atresia.

Early detection of cardiac dysfunction by strain and strain rate imaging in children and young adults with marfan syndrome.

Objectives: Strain and strain rate imaging have been reported to detect cardiac dysfunction more accurately than conventional methods in adults with Marfan syndrome, but their utility has not been proven in younger patients. We sought to determine whether strain and strain rate imaging would allow early detection of cardiac dysfunction in children and young adults with Marfan syndrome.

Methods: Unoperated patients (<30 years) with Marfan syndrome and healthy control participants were prospectively enrolled.

Noninvasive estimation of diastolic pulmonary artery pressure by Doppler analysis of tricuspid regurgitation velocity in pediatric patients.

Purpose: Diastolic pulmonary artery pressure (dPAP) is equal to right ventricular pressure at the time of pulmonary valve opening. We studied the accuracy of dPAP estimated from Doppler profile of tricuspid regurgitation (TR) jet in pediatric patients.

Methods: Echocardiograms were prospectively performed on consecutive pediatric heart transplant recipients undergoing right-heart catheterization and endomyocardial biopsy.

Aortopulmonary index as a novel morphologic correlate of early recurrence of coarctation of aorta after surgical repair in infancy.

Background: The aim of this study was to determine morphologic correlates of early reintervention for recurrent coarctation in infants undergoing surgical repair in the current era.

Methods: Medical records of infants who underwent repair of coarctation were retrospectively reviewed. Z scores for aortic segments, relative aortic arch segmental dimensions (indexed to ascending or descending aortic dimension), and aortopulmonary index (the ratio of aortic to pulmonary annular diameter) were derived from preoperative echocardiograms.

Long-term outcomes of intraoperative pulmonary artery stent placement for congenital heart disease.

Objective: Our objective was to examine long-term outcomes of intraoperative pulmonary artery stents and determine risk factors for reintervention

Background: Short-term outcomes of intraoperative pulmonary artery stents have been reported previously. However, long-term results are unknown.

Methods: We conducted a retrospective review of patients who underwent intraoperative pulmonary artery stent placement for branch pulmonary artery stenosis.

Sonographic physical diagnosis 101: teaching senior medical students basic ultrasound scanning skills using a compact ultrasound system.

This project was designed to test the feasibility of introducing ultrasound to senior medical students as a primary diagnostic tool in the evaluation of patients. Specifically, its aim was to determine if it is possible for medical students untrained in sonography to gain basic competence in performing abdominal ultrasound with limited didactic and hands-on instructions. Registered sonographers provided the students with hands-on instructions on the use of a compact ultrasound system.