Retrospective Studies – ABC CARDIOL

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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.

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Original Article

Pacemaker Implants in Children and Adolescents with Chagas Disease in Brazil: 18-Year Incidence

Carolina Christianini Mizzaci et al. Thiago Gonçalves Schroder e Souza Gabriel Pelegrineti Targueta Ana Paula Frederico Tótora … Juan Carlos Pachón Mateos José Carlos Pachon Mateos

Abstract

Background:

Chagas disease continues to be a serious public health problem, and accounts for 25-30% of the indications for cardiac stimulation in Brazil.

Objective:

To assess clinical and epidemiological characteristics of patients with Chagas disease, younger than 18 years, who had undergone pacemaker implantation in Brazil between 1994 and 2011, and its temporal trend.

Methods:

This was a cross-sectional analysis of data from the Brazilian Pacemaker Registry database. The following variables were analyzed: year when pacemaker was implanted, location, age, sex, ethnic group, functional class and the main electrocardiographic findings at baseline.

Results:

In a total of 183,123 implants performed between 1994 and 2011, 214 implants of cardiac stimulation device in Chagas disease patients aged younger than 18 years were identified. Mean age at implantation was 5.6 ± 6.2 years. Second- and third-degree atrioventricular blocks corresponded to 71% of indications for pacemaker implantation. Fifty-six percent of the procedures were performed in the southeast region. Regarding the total number of pacemaker implants per year, there was a remarkable increase in the implants for all causes. However, time series analysis of the implants in Chagas disease patients younger than 18 years revealed a significant reduction in the annual number of implants.

Conclusion:

There has been an important reduction in the number of pacemaker implantations among children and adolescents with Chagas disease, suggesting a reduction in the vertical transmission of the parasite.

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Artigo Original

Heart neoplasms in children: retrospective analysis

Juliano Gomes Penha et al. Leina Zorzanelli Antônio Augusto Barbosa-Lopes Vera Demarchi Aiello … Vitor Oliveira Carvalho Luiz Fernando Caneo Arlindo de Almeida Riso Carla Tanamati Edimar Atik Marcelo Biscegli Jatene

BACKGROUND: The advancement of noninvasive imaging methods has resulted in the increase in diagnosis of heart neoplasms. However, the literature has few studies involving primary cardiac neoplasms in children. OBJECTIVE: To retrospectively review cases of primary heart neoplasms in children, considering the initial clinical manifestations, diagnostic tests used, surgical indication, histopathological types and immediate postoperative course. METHODS: The retrospective study was based on the assessment of medical records from 1983 to 2011. Only cases that were referred for surgical treatment during that period were included. Age at admission, prenatal diagnosis, family history, initial symptoms and the results of performed tests were assessed. Moreover, the date and indication of the surgery, intraoperative findings, the result of the histopathological analysis, as well as the immediate postoperative complications were recorded. RESULTS: Of the 18 patients studied, the most frequent clinical manifestations were dyspnea and heart murmur (7 and 6 patients, respectively); the most often used adjunct diagnostic method was echocardiography (18 patients); cavitary obstruction or ventricular inflow or outflow tract obstruction was the main indication for surgery (12 cases); the most common histological profile was rhabdomyoma (7 patients) and most patients showed good clinical outcome. CONCLUSIONS: In this study, imaging diagnosis was basically attained through echocardiography, with good correlation with intraoperative findings. Histopathological findings were consistent with the literature, with rhabdomyoma being the most common neoplasm in children. The evolution after surgical treatment was favorable in most cases.

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

Pacemaker Implants in Children and Adolescents with Chagas Disease in Brazil: 18-Year Incidence

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Heart neoplasms in children: retrospective analysis

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