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Interventions in Complex Congenital Heart Defects in Newborns and Infants
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Interventions in Complex Congenital Heart Defects in Newborns and Infants

A special issue of Hearts (ISSN 2673-3846).

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 9698

Special Issue Editor

Prof. Dr. Shakeel Ahmed Qureshi

E-Mail Website
Guest Editor
Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
Interests: interventional techniques in paediatric and adult congenital heart disease interventions; evaluating new techniques as well as safety and outcomes

Special Issue Information

Congenital heart disease incidence is 8 per 1000 livebirths. The defects vary from simple to complex. Many of the complex defects present with cyanosis in the newborn period or early infancy, and present with management challenges. Their treatment is challenging, even in the modern era. The issue will focus on various interventions in these newborns. A variety of interventions will be discussed, as well as the impact of some on surgical techniques. The focus of the topics is predominantly in duct-dependent cyanotic congenital heart disease in the newborns, and their palliative treatment, either by balloon dilation or right ventricular outflow tract stenting or ductal stenting. In addition, interventions on the atrial septum will be discussed, such as atrial septal stenting and how to control interatrial shunting in older children. There should be a wide interest in all of these topics, which are currently still hot topics in our specialty.

Prof. Dr. Shakeel Ahmed Qureshi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Hearts is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Balloon dilation in tetralogy of Fallot 
  • Right ventricular outflow tract stenting 
  • Surgical repair after right ventricular outflow tract stenting 
  • Technical modifications for ductal stenting in neonates 
  • Outcomes of ductal stenting 
  • Atrial septal stenting in newborns and infants 
  • Methods of controlling interatrial shunting

Published Papers (3 papers)

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Review

10 pages, 6076 KiB  
Review
Right Ventricular Outflow Tract Stenting as Palliation of Critical Tetralogy of Fallot: Techniques and Results
by Alessandra Pizzuto, Magdalena Cuman, Nadia Assanta, Eliana Franchi, Chiara Marrone, Vitali Pak and Giuseppe Santoro
Hearts 2021, 2(2), 278-287; https://doi.org/10.3390/hearts2020022 - 20 May 2021
Cited by 3 | Viewed by 3232
Abstract
Background. Despite current trends toward early primary repair, the surgical systemic-to-pulmonary shunt is still considered the first-choice palliation in patients with critical tetralogy of Fallot (TOF) and duct-dependent pulmonary circulation unsuitable for primary repair. However, stenting of the right ventricular outflow tract (RVOT) [...] Read more.
Background. Despite current trends toward early primary repair, the surgical systemic-to-pulmonary shunt is still considered the first-choice palliation in patients with critical tetralogy of Fallot (TOF) and duct-dependent pulmonary circulation unsuitable for primary repair. However, stenting of the right ventricular outflow tract (RVOT) is nowadays emerging as an effective alternative to surgical palliation in selected patients. Methods and results. RVOT stenting is usually performed from a venous route, either femoral or, in selected cases, the right internal jugular vein. Less frequently, mostly in pulmonary infundibular/valvar atresia, this procedure can be performed using a hybrid surgical/interventional approach by surgical exposure of the RVOT, puncture of the atretic valve, and stent deployment under direct vision. The size and type of the most appropriate stent may be chosen, based on ultrasound measurements of the RVOT, to cover the right ventricular infundibulum completely and, at the same time, sparing the pulmonary valve, unless significant pulmonary valve annulus hypoplasia and/or supra-valvular stenosis is a significant component of the obstruction. In the large series so far published, early mortality of RVOT stenting is less than 2%, comparing favourably with either Blalock-Thomas-Taussig shunt or early primary repair. In addition, morbidity and clinical sequelae of this approach do not significantly differ from surgical palliation, even if RVOT stenting shows lesser durability and a higher rate of trans-catheter re-interventions over a mid-term follow-up. Finally, similar but more balanced pulmonary artery growth than surgical palliation following RVOT stenting is reported over a mid-term follow-up. Conclusions. RVOT stenting is a technically feasible, well-tolerated, and effective palliation in critical TOF. This approach is cost-effective with respect to surgical palliation either in high-risk neonates or whenever a short-term pulmonary blood flow source is anticipated due to the early surgical repair. It effectively increases pulmonary blood flow, improves arterial saturation, and promotes balanced pulmonary artery growth over a mid-term follow-up. Full article
(This article belongs to the Special Issue Interventions in Complex Congenital Heart Defects in Newborns and Infants)
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10 pages, 225 KiB  
Review
Palliative Balloon Pulmonary Valvotomy in Tetralogy of Fallot: Is There a Role in 2021?
by Supratim Sen and Bharat Dalvi
Hearts 2021, 2(2), 224-233; https://doi.org/10.3390/hearts2020018 - 20 Apr 2021
Cited by 1 | Viewed by 2298
Abstract
The current treatment practice for Tetralogy of Fallot (TOF) is to undertake complete surgical repair between 6–9 months of age with excellent immediate and long-term results. In patients with increased cyanosis or frequent cyanotic spells, younger age of complete repair as early as [...] Read more.
The current treatment practice for Tetralogy of Fallot (TOF) is to undertake complete surgical repair between 6–9 months of age with excellent immediate and long-term results. In patients with increased cyanosis or frequent cyanotic spells, younger age of complete repair as early as 3 months is usually acceptable. Although neonatal TOF repair is reported with good immediate survival from a few centres, post-operative morbidity is significant, and the hospital stay is prolonged. Hence, in neonates and small term and preterm infants with severe cyanosis, palliative procedures such as modified Blalock-Taussig (BT) shunt, ductal stenting, right ventricular outflow tract (RVOT) stenting and balloon pulmonary valvotomy (BPV) have been reported. With the development of low-profile stents, an increasing clinician experience and more predictable outcome with both duct and RVOT stenting, these procedures have gained popularity as the preferred palliations for TOF at most centres. We reviewed the literature to analyse whether BPV for TOF palliation, a technique first reported three decades ago, still has a role in the present era of paediatric cardiac care. In this review, we have concluded that BPV has very specific indications in patients with TOF, with predominantly valvar pulmonary stenosis, and may be a preferred option over other palliative strategies in hypoxemic preterm or low-birth weight infants. Full article
(This article belongs to the Special Issue Interventions in Complex Congenital Heart Defects in Newborns and Infants)
14 pages, 7757 KiB  
Review
Technical Modifications for Ductal Stenting in Neonates with Duct-Dependent Pulmonary Circulation
by Worakan Promphan and Shakeel A. Qureshi
Hearts 2021, 2(2), 188-201; https://doi.org/10.3390/hearts2020015 - 26 Mar 2021
Cited by 5 | Viewed by 3542
Abstract
The ductal stenting (DS) is currently an acceptable palliative treatment in newborns suffering with duct-dependent pulmonary circulation. However, this procedure remains technically a challenge in complex ductal morphology, which may eventually lead to detrimental outcomes. This review is mainly focused on pre-procedural planning, [...] Read more.
The ductal stenting (DS) is currently an acceptable palliative treatment in newborns suffering with duct-dependent pulmonary circulation. However, this procedure remains technically a challenge in complex ductal morphology, which may eventually lead to detrimental outcomes. This review is mainly focused on pre-procedural planning, essential instruments and practical approaches for DS, and post-procedural care. Full article
(This article belongs to the Special Issue Interventions in Complex Congenital Heart Defects in Newborns and Infants)
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