McIntyre K, Greco-Hiranaka C, Bayle KM
… +1 more, Morelli P
Cardiol Young
· 2026 Mar · PMID 41891164
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Anomalous aortic origin of the right coronary artery poses serious risks when involving high-risk features such as a long intramural course or a slit-like orifice, with demand ischaemia as the likely pathophysiology of s...Anomalous aortic origin of the right coronary artery poses serious risks when involving high-risk features such as a long intramural course or a slit-like orifice, with demand ischaemia as the likely pathophysiology of sudden cardiac arrest. This case links sudden cardiac arrest to demand ischaemia, confirmed by cardiac MRI showing a transmural infarct in the right coronary artery territory. This is a rare case demonstrating transmural infarction in a patient with an anomalous aortic origin of the right coronary artery, as demonstrated by cardiac MRI findings.
Bayram Ö, Ramoğlu MG, Çelebioğlu EC
… +7 more, Bakhtiyarzada J, Aydın A, Murt B, Yilmaz MM, Bilgiç MS, Fitoz S, Ucar T
Cardiol Young
· 2026 Mar · PMID 41879618
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The ductus venosus plays a critical role in fetal circulation. Postnatal persistence of the ductus venosus (PDV) is associated with secondary portal vein hypoplasia and results in a porto-systemic shunt. In this extremel...The ductus venosus plays a critical role in fetal circulation. Postnatal persistence of the ductus venosus (PDV) is associated with secondary portal vein hypoplasia and results in a porto-systemic shunt. In this extremely rare case, we present a 6-year-old male diagnosed with PDV, who had a history of elevated liver enzymes and mild hepatic dysfunction first detected at 11 months of age. Due to the presence of PDV, endovascular closure was planned. Portal venous pressure was measured as 10 mmHg both before and after balloon occlusion. Percutaneous occlusion was successfully performed using a vascular plug. Post-intervention ultrasonography confirmed complete occlusion of the ductus venosus and increased portal vein flow. During follow-up, liver function tests returned to normal; a slight elevation in transaminases persists. PDV is a rare congenital vascular anomaly that may present with a wide spectrum of clinical symptoms. While some patients may be diagnosed during early infancy due to cholestatic jaundice, hepatic dysfunction, or hyperammonaemia, others may remain asymptomatic and undiagnosed for years. Endovascular closure represents a minimally invasive treatment option. A balloon occlusion test to measure portal venous pressure is recommended before and after the procedure to evaluate the safety of shunt closure.
Cardiol Young
· 2026 Mar · PMID 41878929
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We report a 13-year follow-up of an infant with severe Kawasaki disease complicated by bilateral axillary artery aneurysms. Right-sided occlusion led to upper limb hypoplasia, while progressive changes in the contralater...We report a 13-year follow-up of an infant with severe Kawasaki disease complicated by bilateral axillary artery aneurysms. Right-sided occlusion led to upper limb hypoplasia, while progressive changes in the contralateral aneurysm produced unilateral digital clubbing. This unique combination of contralateral limb hypoplasia and unilateral clubbing, documented through serial imaging, morphometric measurements, and microvascular assessment, highlights how long-term arterial flow disturbances can result in asymmetric peripheral outcomes. This case underscores the need for extended vascular screening in severe Kawasaki disease.
Cardiol Young
· 2026 Mar · PMID 41878901
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A congenital left atrial appendage aneurysm represents a very rare entity. CT angiography proved to be a valuable diagnostic tool, allowing for effective diagnosis and precise visualisation of spatial relationships.A congenital left atrial appendage aneurysm represents a very rare entity. CT angiography proved to be a valuable diagnostic tool, allowing for effective diagnosis and precise visualisation of spatial relationships.
Ghosh A, Malloy-Walton L, Sherman AK
… +1 more, Gelatt M
Cardiol Young
· 2026 Mar · PMID 41878900
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This study examined the incidence, type of electrocardiogram abnormalities, and associated risk factors in healthy paediatric athletes. A single-centre retrospective cohort study was conducted on a local male youth compe...This study examined the incidence, type of electrocardiogram abnormalities, and associated risk factors in healthy paediatric athletes. A single-centre retrospective cohort study was conducted on a local male youth competitive soccer programme, ages 11-18. The primary outcome was the incidence of electrocardiogram abnormalities. The secondary outcomes were recurrence and the type of electrocardiogram abnormalities. Covariables were age, race, family history, and current medications. Statistical analysis program was used for analysis. There was a total of 368 electrocardiograms reviewed from 2021-2024, of which 68 (18.5%) had at least one abnormality. 182 unique athletes were screened. A higher proportion of multi-racial and African American athletes had electrocardiogram abnormalities (-value 0.02). In our sample of healthy paediatric athletes, electrocardiogram abnormality incidence was similar to that noted in other studies. There were no significant cardiac findings noted after further evaluation on any of the athletes with abnormal electrocardiogram findings. Our data support that universal electrocardiogram screening of healthy paediatric athletes is not beneficial.
Adamson ME, West Z, John M
… +6 more, Nayi P, Deshpande SR, Ferguson ME, Maher K, Chai P, Beshish A
Cardiol Young
· 2026 Mar · PMID 41878897
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BACKGROUND: As patients progress through single-ventricle palliation, changing haemodynamics and patient conditions can prevent progression to Fontan. We sought to determine the incidence of Fontan completion at our inst...BACKGROUND: As patients progress through single-ventricle palliation, changing haemodynamics and patient conditions can prevent progression to Fontan. We sought to determine the incidence of Fontan completion at our institution and to investigate the reasons for non-Fontan candidacy. METHODS: Patients who underwent superior cavopulmonary anastomosis from 2010 to 2020 at a single institution were included. Pre-Fontan testing was reviewed for all patients, and the primary reason for non-candidacy was determined based on a review of the electronic medical records. RESULTS: Of the 427 patients included, 396 (93%) underwent Fontan or were referred for Fontan at the time of the study. Reasons for non-Fontan candidacy in the remaining 31 patients included cardiac reasons ( = 26), mainly univentricular dysfunction or atrioventricular valve regurgitation, respiratory conditions ( = 3), or miscellaneous reasons ( = 2). The patients who were non-Fontan candidates due to respiratory conditions and miscellaneous reasons are all alive without further palliation at the time of the study. There are 17 patients (17/31; 55%) in the non-candidacy group who had a heart transplant or were listed for transplant at the time of the study. Non-Fontan candidates had a higher incidence of moderate or severe atrioventricular valve regurgitation prior to superior cavopulmonary anastomosis. DISCUSSION: Thirty-one patients (31/427; 7%) were not Fontan candidates at our centre. Our results demonstrate that the reasons for non-Fontan candidacy after completion of stage 2 are broadly due to echocardiographic findings and respiratory concerns. Predicting non-Fontan candidacy prior to superior cavopulmonary anastomosis remains difficult.
Riley C, Harlow A, Mastropietro CW
… +4 more, Darcy-Mahoney A, Pintz C, Zhou QP, Hinds PS
Cardiol Young
· 2026 Mar · PMID 41878893
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Stressful encounters within the neonatal or early infant period are harmful both acutely and longitudinally. Prior research on stress exposure in hospitalised infants excludes infants with CHD, limiting our understanding...Stressful encounters within the neonatal or early infant period are harmful both acutely and longitudinally. Prior research on stress exposure in hospitalised infants excludes infants with CHD, limiting our understanding of stress exposure in this uniquely vulnerable population. This study aimed to identify and describe sources of stress, stress cues, stress responses, and clinical implications in neonates and infants undergoing cardiac surgery. Conducted at tertiary cardiac centres, 17 expert clinicians in nursing, anaesthesia, surgery, and intensive care medicine were included. Participants represented two care areas (cardiac intensive care unit, operating room) and three phases of care (preoperative, operative, postoperative). Using individual semi-structured interviews informed by Selye's General Adaptation Syndrome, clinicians were asked about their perceptions of sources of infant stress within each phase of care and signs or cues of overwhelming stress or of stress tolerance. Utilising semantic content analysis, responses were analysed thematically and by frequency. Seven themes were identified involving sources of infant stress (Clinical Environment, Operative Stress, Disrupted Bonding, Cardiac Physiology), and clinician recognition and response to infant stress (Cognitive Integration, Infant Protection, Balance of Care). Perceived sources of infant stress were identified and together describe infant stress burden related to cardiac surgery. This study highlights the concept of infant stress specific to cardiac surgical intervention and offers a foundation to recognise and address infant stress as part of comprehensive cardiac care. The results may inform future research evaluating stress exposure and determining whether stress reduction strategies can improve outcomes in this high-risk population.
Sourour W, Evans M, Le K
… +3 more, Flores S, Farias JS, Loomba RS
Cardiol Young
· 2026 Mar · PMID 41878889
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BACKGROUND: Non-code dose boluses of epinephrine are utilised in critically ill paediatric patients during periods of hemodynamic deterioration, often with the hopes of preventing a cardiac arrest. Data regarding the phy...BACKGROUND: Non-code dose boluses of epinephrine are utilised in critically ill paediatric patients during periods of hemodynamic deterioration, often with the hopes of preventing a cardiac arrest. Data regarding the physiologic effects of these administrations are limited. The primary aim of this study was to use high-fidelity physiologic data to characterise the effects of intravenous non-code dose bolus epinephrine. METHODS: Paediatric patients in the cardiac ICU who received non-code dose bolus epinephrine were identified. Those who received fluid boluses or chest compressions within 2 minutes of bolus epinephrine were excluded. Autoregressive integrated moving average analyses with exogenous variables were conducted to characterise the time-dependent changes in hemodynamic indices. Cluster analyses were then conducted to determine patterns in hemodynamic changes associated with bolus epinephrine. RESULTS: A total of 71 non-code dose bolus epinephrine administrations were included in the final analyses. Heart rate, blood pressure, and renal near infrared spectroscopy all demonstrated statistically significant changes after bolus epinephrine administration. Peak change in each was 40%, 52%, and 9%, respectively, with peaks occurring between 60 seconds and 120 seconds after administration. Three response-based clusters were identified. CONCLUSION: Non-code dose bolus epinephrine is associated with a significant increase in heart rate, blood pressure, and systemic oxygen delivery. Cluster analysis using the peak change identified distinct clinical clusters.
Cardiol Young
· 2026 Mar · PMID 41877612
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We present a 14-year-old female with a history of ventricular septal defect repair who presented with a striking complaint of a heartbeat sensation in the neck and was subsequently diagnosed with a rare cervical aortic a...We present a 14-year-old female with a history of ventricular septal defect repair who presented with a striking complaint of a heartbeat sensation in the neck and was subsequently diagnosed with a rare cervical aortic arch, classified as Zhong's B2 and Haughton's B type, associated with a Kommerell diverticulum. Comprehensive cross-sectional imaging and conventional angiography excluded true and pseudo-coarctation, highlighting the importance of meticulous anatomical assessment in directing treatment and preventing unnecessary interventions in asymptomatic or non-obstructive cases.
Cardiol Young
· 2026 Mar · PMID 41877609
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We report successful staged palliation of a rare cardiac anomaly: double outlet right ventricle with intact ventricular septum. Management included neonatal atrial septostomy, pulmonary artery banding, septectomy, lobect...We report successful staged palliation of a rare cardiac anomaly: double outlet right ventricle with intact ventricular septum. Management included neonatal atrial septostomy, pulmonary artery banding, septectomy, lobectomy for congenital emphysema, and left ventricular exclusion to decompress the left ventricle. The patient progressed to a bidirectional Glenn and to a Fontan circulation, demonstrating a rare favourable outcome.
Kurt H, Ulger Z, Öztürk T
… +2 more, Levent E, Doğan E
Cardiol Young
· 2026 Mar · PMID 41875970
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Restrictive cardiomyopathy is a rare paediatric myocardial disorder causing diastolic dysfunction with preserved systolic function. We report a 14-year-old girl with idiopathic restrictive cardiomyopathy and recurrent sy...Restrictive cardiomyopathy is a rare paediatric myocardial disorder causing diastolic dysfunction with preserved systolic function. We report a 14-year-old girl with idiopathic restrictive cardiomyopathy and recurrent systemic thromboemboli (stroke, limb ischaemia, renal infarction, and intracardiac thrombi) despite sinus rhythm. Anticoagulation resolved thrombi. She is currently awaiting heart transplantation. Early recognition, prompt anticoagulation, genetic evaluation, and consideration for transplantation are essential to optimise outcomes.
Cardiol Young
· 2026 Mar · PMID 41873097
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Takotsubo cardiomyopathy can be triggered by stress. We report a 2-year-old boy with a single right ventricle after bidirectional Glenn surgery who developed Takotsubo cardiomyopathy following coil embolisation of collat...Takotsubo cardiomyopathy can be triggered by stress. We report a 2-year-old boy with a single right ventricle after bidirectional Glenn surgery who developed Takotsubo cardiomyopathy following coil embolisation of collateral arteries and subsequently underwent successful Fontan completion.
Cardiol Young
· 2026 Mar · PMID 41804909
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Echocardiography and computed tomographic angiography in a three-month-old boy confirmed a right coronary artery fistula and a right coronary artery aneurysm. The patient was successfully operated via right axillary thor...Echocardiography and computed tomographic angiography in a three-month-old boy confirmed a right coronary artery fistula and a right coronary artery aneurysm. The patient was successfully operated via right axillary thoracotomy approach.
Wasner J, Ono M, Adam M
… +10 more, Palm J, Schaeffer T, Ruda C, Piber N, Matsubara M, Heinisch PP, Hager A, Ewert P, Hörer J, Lemmer J
Cardiol Young
· 2026 Mar · PMID 41804896
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OBJECTIVE: This study aimed to evaluate the results of interstage home monitoring program and its impact on outcomes after initial univentricular palliation. METHODS: Patients with univentricular hearts who survived the...OBJECTIVE: This study aimed to evaluate the results of interstage home monitoring program and its impact on outcomes after initial univentricular palliation. METHODS: Patients with univentricular hearts who survived the initial palliation and were discharged from the hospital between 2013 and 2022 were included. The interstage outcomes in patients who received home monitoring program were evaluated, and survival was compared with those who did not. RESULTS: Among 207 patients included, initial palliation consisted of 117 Norwood procedures, 58 aortopulmonary shunts, 28 ductal stents, and 7 pulmonary artery bandings. Home monitoring program was feasible in 187 (90.3%) patients. Survival after hospital discharge was higher in patients with home monitoring program compared to those without (93.0 vs. 82.9% at 180 days, = 0.012). In 187 home monitoring program patients, events occurred in 98 patients (52.4%), including 77 low oxygen saturations (41.2%), 22 infections (11.7%), 10 stagnations of weight gains (5.3%), 6 hypoxaemic attacks (3.2%), and 4 side effects of vaccinations (2.1%). Additionally, 62 patients (37.1%) needed an unplanned hospital readmission. They were more frequent after ductal stent than other procedures (22.6 vs. 10.5%, = 0.034) and had a lower weight at the time of bidirectional cavopulmonary shunt (5.0 vs. 5.4 kg, = 0.021). Among them, 32 patients (47.1%) needed catheter interventions, and 10 (14.7%) underwent additional surgical procedures prior to bidirectional cavopulmonary shunt. Survival after bidirectional cavopulmonary shunt was similar between the groups (94.4 vs. 96.6% at 360 days, = 0.807). CONCLUSIONS: Home monitoring program improved interstage survival between stages I and II. However, unanticipated readmissions were frequent during this period, and various catheter and surgical interventions were mandatory before bidirectional cavopulmonary shunt.
Wilson HC, Hashemi S, Kuo JA
… +4 more, Kim D, Slesnick T, McEachern WA, Ligon RA
Cardiol Young
· 2026 Mar · PMID 41804876
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Cardiovascular MRI with magnetic resonance angiography supports clinical indication for transcatheter pulmonary valve replacement. We aimed to: (1) assess the feasibility of generating virtual right ventricular outflow t...Cardiovascular MRI with magnetic resonance angiography supports clinical indication for transcatheter pulmonary valve replacement. We aimed to: (1) assess the feasibility of generating virtual right ventricular outflow tract models directly from magnetic resonance angiography datasets and (2) compare transcatheter pulmonary valve replacement candidacy based on visualisation of anatomic and valve models in virtual reality to outcomes and dispositions suggested by industry fit analysis derived from cardiac CT. Patients with native or surgically palliated right ventricular outflow tracts considered for transcatheter pulmonary valve replacement with temporally related magnetic resonance angiography and cardiac CT were included. Magnetic resonance angiography models were generated using commercial software; virtual valves were created using industry dimensions. A blinded interventional cardiologist determined pulmonary valve replacement candidacy using virtual reality review. A total of 16 patients ( = 7 males, 44%) with a median age 15.5 years (interquartile range [IQR] 13.9, 17.8) were identified. Median time for model generation was 20.6 minutes (IQR 18.5, 22.0). 11/16 (69%) patients passed industry screening fit analysis; 14/16 (88%) ultimately underwent transcatheter pulmonary valve replacement. Four patients who passed virtual reality screening failed industry screening but underwent successful transcatheter pulmonary valve replacement. One patient passed virtual reality and industry screening but did not undergo transcatheter pulmonary valve replacement. One patient passed virtual reality screening but failed industry screening and was not offered transcatheter pulmonary valve replacement. In conclusion, generating virtual models from clinical magnetic resonance angiography datasets is feasible. Modelling may help evaluate transcatheter pulmonary valve replacement candidacy, but must be used in conjunction with other data.
Cardiol Young
· 2026 Mar · PMID 41804874
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We report an extremely low birth weight infant (494 g, 23 weeks + 1 day) with transient right ventricular hypertrophy, initially suspected as pulmonary atresia with ductus-dependent circulation. Patent ductus arteriosus...We report an extremely low birth weight infant (494 g, 23 weeks + 1 day) with transient right ventricular hypertrophy, initially suspected as pulmonary atresia with ductus-dependent circulation. Patent ductus arteriosus management was complicated, requiring low-dose PGE1 and eventual surgical ligation. Serial echocardiography revealed progressive right ventricular dilation and normalisation of function, confirming transient hypertrophy. This case highlights diagnostic challenges and the importance of repeated cardiac assessment in extremely preterm infants.
Martis L, Desai L, Coons K
… +5 more, Cloutier D, Sherman AK, Hockstad E, Flint J, Malloy-Walton L
Cardiol Young
· 2026 Mar · PMID 41804170
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Acute myocardial infarction is rare in paediatric patients, with limited published data on incidence, diagnosis, management strategies, and outcomes. A systematic retrospective review was conducted on patients aged 1 day...Acute myocardial infarction is rare in paediatric patients, with limited published data on incidence, diagnosis, management strategies, and outcomes. A systematic retrospective review was conducted on patients aged 1 day to 21 years who presented with concerns for ST-elevation myocardial infarction at a paediatric institution and an affiliated adult hospital (1/2013-12/2023). Out of 965 screened patients, 13 met the inclusion criteria. The cohort had a mean age of 15 years (standard deviation ± 4 years), with the youngest patient being 11 months old. The study population consisted of 12 males (92%) and 1 female (8%), with ethnic distribution as follows: Caucasian (69%), African American (15%), and Hispanic (15%). An electrocardiogram with ST-segment changes was observed in all patients. Echocardiography revealed a normal ejection fraction in 54% of patients. Most patients (54%) had CHD, with three patients (23%) being undiagnosed at the time of the initial presentation. Seven patients (54%) underwent cardiac catheterization at the adult hospital, while 2 patients (15%) had coronary evaluation at the paediatric facility. One percutaneous catheter intervention was performed in a patient with known coronary stenosis at the paediatric facility. Three patients (23%), all with congenital heart disease, had cardiac arrest during cardiac catheterisation, resulting in extracorporeal membrane oxygenation cannulation. These findings suggest evaluation of pediatric patients presenting with ST-segment elevation can be performed at a pediatric center to rule out congenital heart disease, especially prior to referral to an adult facility for coronary intervention.
Aslan M, Benli O, Gocen U
… +7 more, Atalay A, Yüksel M, Poyrazoglu H, Topcuoglu MS, Yaliniz H, Erdem S, Salih O
Cardiol Young
· 2026 Mar · PMID 41797708
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OBJECTIVE: Right ventricular outflow tract reconstruction frequently leads to long-term pulmonary failure and ventricular dilation. This study aims to investigate the dynamics of matrix metalloproteinase-2, matrix metall...OBJECTIVE: Right ventricular outflow tract reconstruction frequently leads to long-term pulmonary failure and ventricular dilation. This study aims to investigate the dynamics of matrix metalloproteinase-2, matrix metalloproteinase-9, and procollagen type-1 -terminal propeptide in predicting postoperative remodelling and to evaluate the "protective" potential of restrictive right ventricular physiology. METHODS: This prospective comparative cohort study included 20 patients undergoing right ventricular outflow tract reconstruction (Research Group) and 20 patients undergoing atrial or ventricular septal defect repair via transatrial approach (Control Group). Biomarker levels were measured using ELISA at preoperative, early postoperative (24-48 hours), and 6-month intervals. Right ventricular geometry was assessed with cross-sectional snapshots at 6 months and 10 years. Right ventricular dilation was defined as right ventricular end-diastolic volume index > 150 ml/m or diameter -score > 2, while preserved geometry was defined as right ventricular end-diastolic volume index < 100 ml/m or diameter -score < 1.5. RESULTS: Early postoperative biomarker increases were similar ( = 0.310) but differed significantly at 6 months. In the study group, matrix metalloproteinase-2 ( < 0.001) and procollagen type-1 -terminal propeptide ( = 0.001) levels remained significantly elevated, independent of pulmonary regurgitation severity ( > 0.05). Ten years later, restrictive physiology was observed in 10 patients (50%), representing a progression compared to the 8 patients identified at 6 months. CONCLUSION: Persistent elevation of matrix metalloproteinase-2 and procollagen type-1 -terminal propeptide reflects an active "remodeling" process. Restrictive physiology is associated with the "Biological Banding" mechanism. By increasing myocardial stiffness, this adaptive process is linked to protecting the right ventricle from irreversible dilation under chronic volume overload.
Cardiol Young
· 2026 Mar · PMID 41797707
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Middle aortic syndrome is a rare vascular disorder characterised by segmental narrowing of the distal thoracic aorta and/or proximal abdominal aorta, often accompanied by renal artery involvement. The condition may arise...Middle aortic syndrome is a rare vascular disorder characterised by segmental narrowing of the distal thoracic aorta and/or proximal abdominal aorta, often accompanied by renal artery involvement. The condition may arise from genetic abnormalities, acquired factors, or idiopathic causes. In this study, we report the case of a 9-year-old boy who was found to have hypertension during a routine school health examination. Computed tomography angiography confirmed the diagnosis of middle aortic syndrome, revealing long-segment stenosis of the distal thoracic aorta. Following a comprehensive assessment, the patient underwent descending aortic reconstruction with a 14 mm Intergard knitted vascular graft. At the 6-month follow-up, imaging demonstrated satisfactory graft patency, and the patient's blood pressure remained well-controlled without the need for antihypertensive medications.