Reports have suggested a transient increase in ventricular ectopy early after percutaneous pulmonary valve implantation (PPVI). Little is known about the potential for more serious ventricular arrhythmias (VA) in children who undergo PPVI. We sought to evaluate the incidence of severe VA following PPVI in a pediatric population and to explore potential predictive factors. A retrospective cohort study was conducted of patients who underwent PPVI under 20 years of age in our institution from January 2007 to December 2019. The primary outcome of severe VA was defined as sustained and/or hemodynamically unstable ventricular tachycardia (VT), inducible sustained VT, or sudden death of presumed arrhythmic etiology. A total of 21 patients (mean age 16.2 ± 2.1 years; 66.7% male) underwent PPVI. The majority of patients (N = 15; 71.4%) had tetralogy of Fallot (TOF) or TOF-like physiology, with the most common indication being pulmonary insufficiency (N = 10; 47.6%). During a median follow-up of 29.6 months (IQR 10.9-44.0), severe VA occurred in 3 (14.3%) patients aged 15.6 (IQR 14.7-16.1) a median of 12.3 months (IQR 11.2-22.3) after PPVI. All events occurred in patients with TOF-like physiology following Melody valve implant. In conclusion, severe VA can occur long after PPVI in a pediatric population, particularly in those with TOF-like physiology. Further studies are required to elucidate underlying mechanisms and assess strategies to mitigate risks.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489556 | PMC |
| http://dx.doi.org/10.1007/s00246-022-02881-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Ongoing Debate: Longevity of Biological Valves in Pulmonary Position.
Thorac Cardiovasc Surg
January 2024
Bereich Kinderherzchirurgie/Chirurgie angeborener Herzfehler, Klinik für Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universitäres Herz- und Gefäßzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Article Synopsis
- The study investigates factors affecting the durability of biological valves used in patients with tetralogy of Fallot (ToF) over a follow-up period of nearly a decade.
- 79 patients aged 0.2 to 56.1 years underwent surgery for valve implantation, with various types of conduits being utilized.
- Results indicate that younger age, smaller valve size, and higher z-scores are linked to decreased valve longevity, emphasizing patient age as a key factor in graft lifespan.
Ventricular Arrhythmias and Sudden Death Following Percutaneous Pulmonary Valve Implantation in Pediatric Patients.
Pediatr Cardiol
October 2022
Division of Cardiology, Department of Pediatrics, CHU Mère-Enfants Sainte-Justine, Université de Montréal, Montreal, QC, Canada.
Reports have suggested a transient increase in ventricular ectopy early after percutaneous pulmonary valve implantation (PPVI). Little is known about the potential for more serious ventricular arrhythmias (VA) in children who undergo PPVI. We sought to evaluate the incidence of severe VA following PPVI in a pediatric population and to explore potential predictive factors.
View Article and Find Full Text PDFDiscriminating phenotypic signatures identified for tocilizumab, adalimumab, and tofacitinib monotherapy and their combinations with methotrexate.
J Transl Med
June 2018
Division of Infection and Immunity, CREATE Centre, Cardiff University, Cardiff, CF10 3AT, UK.
Article Synopsis
- Clinical trials show that combining anti-TNF biologicals with methotrexate (MTX) is more effective for rheumatoid arthritis than using biologicals alone, but this is not the case for tocilizumab (TCZ) combined with MTX.
- A study using the BioMAP platform evaluated the effects of TCZ, adalimumab (ADA), and tofacitinib (TOF) on biomarkers when used alone or with MTX, finding significant interactions for ADA and TOF with MTX, unlike TCZ.
- The results imply that MTX enhances the efficacy of certain RA therapies but not all, highlighting that factors beyond immunogenicity can influence treatment effectiveness.
Importance of Non-invasive Right and Left Ventricular Variables on Exercise Capacity in Patients with Tetralogy of Fallot Hemodynamics.
Pediatr Cardiol
December 2017
Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University of Munich, Munich, Germany.
Good quality of life correlates with a good exercise capacity in daily life in patients with tetralogy of Fallot (ToF). Patients after correction of ToF usually develop residual defects such as pulmonary regurgitation or stenosis of variable severity. However, the importance of different hemodynamic parameters and their impact on exercise capacity is unclear.
View Article and Find Full Text PDFAltered Tbx1 gene expression is associated with abnormal oesophageal development in the adriamycin mouse model of oesophageal atresia/tracheo-oesophageal fistula.
Pediatr Surg Int
February 2014
School of Natural Sciences, Trinity College Dublin, Dublin, Ireland.
Introduction: Oesophageal atresia/tracheo-oesophageal atresia (OA/TOF) frequently arises with associated anomalies and has been clinically linked with 22q11 deletion syndromes, a group of conditions due to Tbx1 gene mutation which include Di George syndrome. Tbx1 and Tbx2 genes modulate pharyngeal and cardiac development, but are also expressed in the developing foregut and are known to interact with key signalling pathways described in oesophageal formation including bone morphogenic proteins. The adriamycin mouse model (AMM) reliably displays OA/TOF-like foregut malformations providing a powerful system for investigating the disturbances in gene regulation and morphology involved in tracheo-oesophageal malformations.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!