Annals of Pediatric Cardiology
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  Citation statistics : Table of Contents
   2009| January-June  | Volume 2 | Issue 1  
    Online since June 17, 2009

 
 
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STATE-OF-THE-ART PAPER
The role of stents in the treatment of congenital heart disease: Current status and future perspectives
Bjoern Peters, Peter Ewert, Felix Berger
January-June 2009, 2(1):3-23
DOI:10.4103/0974-2069.52802  PMID:20300265
Intravascular or intracardiac stenoses occur in many forms of congenital heart disease (CHD). Therefore, the implantation of stents has become an accepted interventional procedure for stenotic lesions in pediatric cardiology. Furthermore, stents are know to be used to exclude vessel aneurysm or to ensure patency of existing or newly created intracardiac communications. With the further refinement of the first generation of devices, a variety of "modern" stents with different design characteristics have evolved. Despite the tremendous technical improvement over the last 20 years, the "ideal stent" has not yet been developed. Therefore, the pediatric interventionalist has to decide which stent is suitable for each lesion. On this basis, currently available stents are discussed in regard to their advantages and disadvantages for common application in CHD. New concepts and designs developed to overcome some of the existing problems, like the failure of adaptation to somatic growth, are presented. Thus, in the future, biodegradable or growth stents might replace the currently used generation of stents. This might truly lead to widening indications for the use of stents in the treatment of CHD.
  35 11,878 1,709
PERSPECTIVE
Impact of fetal echocardiography
John M Simpson
January-June 2009, 2(1):41-50
DOI:10.4103/0974-2069.52806  PMID:20300268
Prenatal diagnosis of congenital heart disease is now well established for a wide range of cardiac anomalies. Diagnosis of congenital heart disease during fetal life not only identifies the cardiac lesion but may also lead to detection of associated abnormalities. This information allows a detailed discussion of the prognosis with parents. For continuing pregnancies, appropriate preparation can be made to optimize the postnatal outcome. Reduced morbidity and mortality, following antenatal diagnosis, has been reported for coarctation of the aorta, hypoplastic left heart syndrome, and transposition of the great arteries. With regard to screening policy, most affected fetuses are in the "low risk" population, emphasizing the importance of appropriate training for those who undertake such obstetric anomaly scans. As a minimum, the four chamber view of the fetal heart should be incorporated into midtrimester anomaly scans, and where feasible, views of the outflow tracts should also be included, to increase the diagnostic yield. Newer screening techniques, such as measurement of nuchal translucency, may contribute to identification of fetuses at high risk for congenital heart disease and prompt referral for detailed cardiac assessment.
  20 6,652 1,342
CLINICO-MORPHOLOGICAL CORRELATIONS
Sequential segmental analysis
Robert H Anderson, Girish Shirali
January-June 2009, 2(1):24-35
DOI:10.4103/0974-2069.52803  PMID:20300266
  18 7,983 1,931
ORIGINAL ARTICLE
Transcatheter closure of patent ductus arteriosus: Evaluating the effect of the learning curve on the outcome
Ahmad S Azhar, Ayman A Abd El-Azim, Hamed S Habib
January-June 2009, 2(1):36-40
DOI:10.4103/0974-2069.52804  PMID:20300267
Background and Objectives : Initial experience with transcatheter closure of patent ductus arteriosus (PDA) using detachable coils and Amplatzer duct occluder devices is reported. We evaluated the outcome, complications, and influence of the learning curve, and also assessed the need of surgical backup for such interventional procedures. Methods: From January 2000 to December 2004, 121 patients underwent transcatheter closure of PDA. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for appropriately choosing the occluder device type and size. A second aortic angiogram was performed 10 minutes after device deployment. Echocardiography was repeated at intervals of 24 hours, then at 1, 3, and 6 months after the procedure to assess complications. Stepwise multiple regression analysis was used to assess the role of experience in improving the outcome of the procedure. Results: Of 121 cases, four patients had pulmonary artery embolization of the occluder device which was successfully retrieved in the catheterization laboratory, while two others had embolization that required surgical intervention. Four patients had temporary residual leak, nine had protrusion of the device into the aorta without significant Doppler pressure gradient or hemolysis on follow-up, and five had partial hemodynamically insignificant obstruction to the left pulmonary artery. Statistical analysis showed that the effect of the learning curve and experience was responsible for 93% improvement in the procedural outcome over the five-year study period. Conclusion: Transcatheter occlusion of PDA is safe and effective alternative to surgery. Complications occurred in those with unfavorable duct anatomy and with the use of multiple coils. Surgical backup was important for such interventional procedures. Experience played a major role in the proper choice of device type and size which greatly influenced the outcome of the procedure.
  11 6,725 872
BRIEF COMMUNICATION
Transcatheter device closure of ruptured sinus of Valsalva: Immediate results and short term follow up
Supratim Sen, Amitabha Chattopadhyay, Mily Ray, Biswajit Bandyopadhyay
January-June 2009, 2(1):79-82
DOI:10.4103/0974-2069.52817  PMID:20300275
This is a retrospective, observational study comprising of eight patients with isolated rupture of the sinus of Valsalva (RSOV) who underwent transcatheter device closure. The mean age of presentation was 32.8 10.0 years. New York Heart Association (NYHA) class at the time of presentation was II (six patients) and III (two patients). The RSOVs were all closed using a patent ductus arteriosus device. The mean procedural time was 42.3 5.4 minutes, while the fluoroscopic time was 24.5 6.9 minutes. All had complete closure of the shunt. The average hospital stay was 2.9 1.1 days. There were no major complications. The patients were followed up for a mean of 11.3 4.1 months. At the time of the last follow up all the patients were in NYHA class I. We conclude that in the short term, transcatheter closure of isolated RSOV is a viable alternative to surgical repair.
  7 4,189 521
INVITED COMMENT
Ruptured sinus of Valsalva aneurysm: Yet another hole to plug!
Prafulla G Kerkar
January-June 2009, 2(1):83-84
DOI:10.4103/0974-2069.52818  PMID:20300276
  5 5,172 537
POINT OF VIEW
Cardiac care for the economically challenged: What are the options?
Sunita Maheshwari, VS Kiran
January-June 2009, 2(1):91-94
DOI:10.4103/0974-2069.52813  PMID:20300280
  5 3,277 487
INVITED COMMENTS
Pediatric cardiac care for the economically disadvantaged in India: Problems and prospects
Shyam S Kothari
January-June 2009, 2(1):95-98
DOI:10.4103/0974-2069.52810  PMID:20300281
  4 2,747 352
UNRESOLVED ISSUES
Echocardiography in acute rheumatic fever
S Ramakrishnan
January-June 2009, 2(1):61-64
DOI:10.4103/0974-2069.52812  PMID:20300272
  4 4,133 988
HOW I DO IT?
Modified single-patch technique: Repairing complete atrioventricular septal defect
Carl Lewis Backer, Sunjay Kaushal, Constantine Mavroudis
January-June 2009, 2(1):51-54
DOI:10.4103/0974-2069.52808  PMID:20300269
  3 3,634 468
INVITED COMMENTS
The nuts and bolts of pediatric cardiac care for the economically challenged
R Krishna Kumar
January-June 2009, 2(1):99-101
DOI:10.4103/0974-2069.52807  PMID:20300282
  2 2,008 330
REVIEW ARTICLE
Vasopressin in the pediatric cardiac intensive care unit: Myth or reality
Vishal K Singh, Rajesh Sharma, Amit Agrawal, Amit Varma
January-June 2009, 2(1):65-73
DOI:10.4103/0974-2069.52814  PMID:20300273
Pediatric cardiac surgery is undergoing a metamorphosis, with more and more critical patients being operated in our country today. Although the principles of physiology have not changed, it is imperative that care providers continue to stay abreast with developments and newer drugs that may help modify the outcome. The team dynamics have also become more complex, which necessitates the need for all care providers (surgeons, cardiologists, anesthesiologists, and intensivists) to better understand the interactions and benefits of newer drugs. Vasopressin has been used in our adult patients for more than a decade and recently has found its rightful place in the pediatric armoury. The objective of this article is to review the physiology of vasopressin and the rationale of its use in critically ill children with shock, in context of the available published data.
  2 6,678 834
CASE REPORTS
Transcatether closure of an atrial redirection baffle leak
Brian D Soriano, Karen K Stout, Colleen D Cailes, Thomas K Jones
January-June 2009, 2(1):85-86
DOI:10.4103/0974-2069.52819  PMID:20300277
We present the case of a woman born with transposition of the great arteries, who was surgically repaired with the Mustard technique. Because of interatrial shunting, she was brought to the cardiac catheterization laboratory for device closure. Matrix-array 3D transesophageal echocardiography enabled visualization of both baffle leaks and demonstrated its orientation in a fashion superior to 2D imaging, had it been used alone. The leaks were successfully closed with a single transcatheter device.
  1 3,074 294
INVITED COMMENTS
The modified single patch technique
Ralph S Mosca, Jan M Quaegebeur
January-June 2009, 2(1):55-57
DOI:10.4103/0974-2069.52809  PMID:20300270
  1 2,429 303
CASE REPORTS
Constrictive pericarditis in a patient with sinus venosus atrial septal defect and anomalous right upper pulmonary venous return
Santosh C Uppu, Sruti Chandrasekaran, Kiran K Mallula
January-June 2009, 2(1):87-88
DOI:10.4103/0974-2069.52820  PMID:20300278
This is a report of a 49-year-old male, who presented with typical signs and symptoms of constrictive pericarditis. He was diagnosed with sinus venosus atrial septal defect (ASD) and anomalous right upper pulmonary venous return during his adolescence, which was elected not to be repaired. During the attempted repair of the ASD it was noted there was a thick fibrous material covering the heart, which had progressed over time leading to frank constrictive pericarditis. His ASD spontaneously closed over time. There have been less than 10 cases reported with constrictive pericarditis of nonsurgical etiology in a patient with ASD, and none with sinus venosus ASD.
  - 2,864 300
EDITORIAL
The 'Lost' frontier of clinical medicine: Have we reached a point of no return?
Bharat Dalvi
January-June 2009, 2(1):1-2
DOI:10.4103/0974-2069.52801  PMID:20300264
  - 2,931 430
IMAGES
Echocardiographic detection of intracardiac thrombus complicating ventriculoatrial shunt
Neeraj Awasthy, S Radhakrishnan, Savitri Shrivastava
January-June 2009, 2(1):89-90
DOI:10.4103/0974-2069.52815  PMID:20300279
  - 2,608 308
INVITED COMMENTS
Surgery for complete atrioventricular septal defect: Is a uniform strategy applicable?
Sachin Talwar, Shiv Kumar Choudhary, Balram Airan
January-June 2009, 2(1):58-60
DOI:10.4103/0974-2069.52811  PMID:20300271
  - 2,551 365
OPINION POLL
Is there a role for carvedilol in the management of pediatric heart failure? A meta analysis and e-mail survey of expert opinion
Balu Vaidyanathan
January-June 2009, 2(1):74-78
DOI:10.4103/0974-2069.52816  PMID:20300274
  - 5,882 848
SELECTED SUMMARIES
Selected Summaries
Sachin Talwar, Shiv Kumar Choudhary, Balram Airan
January-June 2009, 2(1):102-105
  - 2,259 338