Heart Defects,Congenital/surgery

ABC

Editorial

Treatment Evolution and the Impact of Pre-Surgical Predictors on Outcomes of Patients with Congenital Heart Disease

Congenital heart disease (CHD) is the most common class among malformations. These are important malformations that can compromise the patient’s survival and quality of life. Although there is slight variation among many population-based studies, CHD occurs in approximately 1% of live births (data range from 4 to 10 per 1000 live births), with a similar prevalence worldwide. It is also the main cause of mortality from birth, and its incidence is considered high given its severity.^–

Critical CHD is often lethal in the absence of treatment. Since the first repair using cardiopulmonary bypass in 1953, accurate diagnosis and effective treatment have become feasible, even in the case of more complex congenital heart lesions. Effective surgical therapies have increased life expectancy.

[…]

Read Full Article

ABC

Original Article

Current Use of Pediatric Cardiac Magnetic Resonance Imaging in Brazil

Marcelo Felipe Kozak et al. Jorge Yussef Afiune Lars Grosse-Wortmann

Abstract

Background

Data on the use of cardiac magnetic resonance imaging (CMR) on children in Brazil is lacking.

Objectives

This study sought to provide information on current pediatric CMR practices in Brazil.

Methods

A questionnaire was sent out to referring physicians around the country. It covered information on the respondents, their CMR practices, the clinical context of the patients, and barriers to CMR use among children. For statistical analysis, two-sided p < 0.05 was considered significant.

Results

The survey received 142 replies. CMR was reported to be available to 79% of the respondents, of whom, 52% rarely or never use CMR. The most common indications were found to be cardiomyopathies (84%), status of post-tetralogy of Fallot repair (81%), and aortic arch malformations (53%). Exam complexity correlated with CMR-to-surgery ratio (Rho = 0.48, 95% CI = 0.32-0.62, p < 0.0001) and with the number of CMR exams (Rho = 0.52, 95% CI = 0.38-0.64, p < 0.0001). Further, a high CMR complexity score was associated with pediatric cardiologists conducting the exams (OR 2.14, 95% CI 1.2-3.89, p < 0.01). The main barriers to a more frequent use of CMR were its high cost (65%), the need for sedation (60%), and an insufficient number of qualified professionals (55%).

Conclusion

Pediatric CMR is not used frequently in Brazil. The presence of a pediatric cardiologist who can perform CMR exams is associated with CMR use on more complex patients. Training pediatric CMR specialists and educating referring providers are important steps toward a broader use of CMR in Brazil. (Arq Bras Cardiol. 2021; 116(2):305-312)

Read Full Article

ABC

Case Report

Image Diagnosis: An Anomalous Origin of Left Coronary Artery from the Pulmonary Artery

Haisong Bu et al. Tianli Zhao

Introduction

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly with a mortality of 90% by 1 year of age without surgical intervention. Nowadays the procedure of choice for correction of ALCAPA depends on the establishment of a dual coronary artery system by direct reimplantation of the anomalous left coronary artery (LCA) into the ascending aorta. However, anatomic variations of the origin of the anomalous LCA often make this aim difficult to achieve, especially in patients undergoing reoperation.

Chronic ischemic mitral regurgitation (MR) develops as a consequence of coronary artery disease in the absence of primary leaflet abnormalities or chordal pathology: ischemic cardiopathy causes remodeling of left ventricular geometry, displacement of papillary muscles, leaflet tethering and annular dilatation, leading to functional mitral insufficiency. The outcome of these patients represents a challenging problem for both cardiologists and cardiac surgeons. In fact, the role of mitral valve surgery (MVS) associated with coronary artery revascularization is still debated.

[…]

Read Full Article

Treatment Evolution and the Impact of Pre-Surgical Predictors on Outcomes of Patients with Congenital Heart Disease

Current Use of Pediatric Cardiac Magnetic Resonance Imaging in Brazil

Abstract

Background

Objectives

Methods

Results

Conclusion

Image Diagnosis: An Anomalous Origin of Left Coronary Artery from the Pulmonary Artery

Introduction

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)