Cardiology in the young
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Cardiology in the young · Mar 2019
LetterBalloon atrial septostomy at the bedside versus the catheterisation laboratory.
A shorter umbilical venous approach provides an opportunity for balloon atrial septostomy in the younger neonate as opposed to those who present at the end of first week of life. However, the ideal choice of access for a bedside balloon atrial septostomy is not well established. Wouldn't prostaglandin infusion be a safer option for transport of babies with dextro-transposition in the neonatal period, when the arterial duct can be kept open? A prenatal diagnosis of dextro-transposition facilitates monitoring and planning of septostomy in the early neonatal period explaining why babies underwent bedside procedures more often.
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Cardiology in the young · Feb 2019
Case ReportsCellular fraction analysis of pericardial effusion helps the diagnosis of eosinophilic myocarditis.
Eosinophilic myocarditis is rare in children, and consequently, it is difficult to diagnose eosinophilic myocarditis rapidly. We report the clinical course of acute eosinophilic myocarditis with pericarditis in two adolescent boys and their associated electrocardiograms. The two patients, 13- and 14-year-old boys, developed cardiomegaly and chest pain with vomiting. ⋯ Some serial changes in the electrocardiogram occur during each stage of acute eosinophilic myocarditis. They are induced by eosinophilic granules, which are capable of inducing tissue damage and dysfunction, and those changes in the electrocardiogram resemble the changes after an acute myocardial infarction. It is important to know the characteristics of eosinophilic myocarditis in order to prevent lethal complications.
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Cardiology in the young · Feb 2019
Increased asymmetric dimethylarginine in vitamin B12 deficient adolescents.
Vitamin B12 deficiency induces hyper-hyperhomocysteinemia by inhibiting intracellular methionine re-methylation. Hyper-hyperhomocysteinemia increases the risk of atherosclerosis. Asymmetric dimethylarginine is an endogenous inhibitor of nitric oxide synthase and its level elevates in cardiovascular diseases. In this study, we aimed to examine the relationship between asymmetric dimethylarginine and arterial stiffness and atherosclerosis in adolescents with vitamin B12 deficiency. ⋯ Our results suggest that endothelial dysfunction starts in the early stage of adolescent vitamin B12 deficiency, and vitamin B12-deficient adolescents have increased circulating asymmetric dimethylarginine, showing that endothelial dysfunction and increased carotid artery intima media thickness be related to atherosclerosis.
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Cardiology in the young · Jan 2019
Risk factors for mortality in paediatric cardiac ICU patients managed with extracorporeal membrane oxygenation.
Veno-arterial extracorporeal membrane oxygenation is frequently used in patients with cardiac disease. We evaluated short-term outcomes and identified factors associated with hospital mortality in cardiac patients supported with veno-arterial extracorporeal membrane oxygenation. ⋯ We report improvement in survival compared with an earlier era in cardiac patients supported with extracorporeal membrane oxygenation. Single-ventricle physiology continues to negatively impact survival, along with evidence of organ dysfunction during extracorporeal membrane oxygenation, duration of extracorporeal membrane oxygenation, and length of stay.
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Cardiology in the young · Dec 2018
Comparative StudyNo difference found in safety or efficacy of balloon atrial septostomy performed at the bedside versus the catheterisation laboratory.
Balloon atrial septostomy is performed in infants with dextro-transposition of the great arteries to improve oxygenation before surgery. It is performed in the catheterisation laboratory with fluoroscopy or at the bedside using echocardiography. It is unclear whether procedural safety and efficacy is superior in one location versus the other, although the bedside procedure may improve resource utilisation and present an opportunity for reducing cost. This study compares safety and efficacy of atrial septostomy performed at the patient's bedside versus the catheterisation laboratory. ⋯ Septostomy performed at the bedside and in the catheterisation laboratory had similar outcomes and efficacy. Further, bedside septostomy has the advantage of no radiation exposure, and obviating risks with patient transfer from the ICU to the catheterisation laboratory.