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Article ; Online: The effects of percutaneous branch pulmonary artery interventions on exercise capacity, lung perfusion, and right ventricular function in biventricular CHD: a systematic review.

Joosen, Renée S / Frissen, Jules P B / van den Hoogen, Agnes / Krings, Gregor J / Voskuil, Michiel / Slieker, Martijn G / Breur, Johannes M P J

Cardiology in the young

2024 Volume 34, Issue 3, Page(s) 473–482

Abstract: Background: Branch pulmonary artery stenosis is common after surgical repair in patients with biventricular CHD and often requires reinterventions. However, (long-term) effects of percutaneous branch pulmonary artery interventions on exercise capacity, ... ...

Abstract	Background: Branch pulmonary artery stenosis is common after surgical repair in patients with biventricular CHD and often requires reinterventions. However, (long-term) effects of percutaneous branch pulmonary artery interventions on exercise capacity, right ventricular function, and lung perfusion remain unclear. This review describes the (long-term) effects of percutaneous branch pulmonary artery interventions on exercise capacity, right ventricular function, and lung perfusion following PRISMA guidelines. Methods: We performed a systematic search in PubMed, Embase, and Cochrane including studies about right ventricular function, exercise capacity, and lung perfusion after percutaneous branch pulmonary artery interventions. Study selection, data extraction, and quality assessment were performed by two researchers independently. Results: In total, 7 eligible studies with low (n = 2) and moderate (n = 5) risk of bias with in total 330 patients reported on right ventricular function (n = 1), exercise capacity (n = 2), and lung perfusion (n = 7). Exercise capacity and lung perfusion seem to improve after a percutaneous intervention for branch pulmonary artery stenosis. No conclusions about right ventricular function or remodelling, differences between balloon and stent angioplasty or specific CHD populations could be made. Conclusion: Although pulmonary artery interventions are frequently performed in biventricular CHD, data on relevant outcome parameters such as exercise capacity, lung perfusion, and right ventricular function are largely lacking. An increase in exercise capacity and improvement of lung perfusion to the affected lung has been described in case of mild to more severe pulmonary artery stenosis during relatively short follow-up. However, there is need for future studies to evaluate the effect of pulmonary artery interventions in various CHD populations.
MeSH term(s)	Humans ; Pulmonary Artery/surgery ; Stenosis, Pulmonary Artery/surgery ; Ventricular Function, Right ; Exercise Tolerance ; Lung ; Perfusion
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1078466-4
ISSN	1467-1107 ; 1047-9511
ISSN (online)	1467-1107
ISSN	1047-9511
DOI	10.1017/S1047951124000015
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Zs.A 4050: Show issues

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Article ; Online: The impact of unilateral pulmonary artery stenosis on right ventricular to pulmonary arterial coupling in patients with transposition of the great arteries.

Joosen, Renée S / Voskuil, Michiel / Krings, Gregor J / Handoko, M Louis / Dickinson, Michael G / van de Veerdonk, Marielle C / Breur, Johannes M P J

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

2024 Volume 103, Issue 6, Page(s) 943–948

Abstract: Background: Unilateral pulmonary artery (PA) stenosis is common in the transposition of the great arteries (TGA) after arterial switch operation (ASO) but the effects on the right ventricle (RV) remain unclear.: Aims: To assess the effects of ... ...

Abstract	Background: Unilateral pulmonary artery (PA) stenosis is common in the transposition of the great arteries (TGA) after arterial switch operation (ASO) but the effects on the right ventricle (RV) remain unclear. Aims: To assess the effects of unilateral PA stenosis on RV afterload and function in pediatric patients with TGA-ASO. Methods: In this retrospective study, eight TGA patients with unilateral PA stenosis underwent heart catheterization and cardiac magnetic resonance (CMR) imaging. RV pressures, RV afterload (arterial elastance [Ea]), PA compliance, RV contractility (end-systolic elastance [Ees]), RV-to-PA (RV-PA) coupling (Ees/Ea), and RV diastolic stiffness (end-diastolic elastance [Eed]) were analyzed and compared to normal values from the literature. Results: In all TGA patients (mean age 12 ± 3 years), RV afterload (Ea) and RV pressures were increased whereas PA compliance was reduced. RV contractility (Ees) was decreased resulting in RV-PA uncoupling. RV diastolic stiffness (Eed) was increased. CMR-derived RV volumes, mass, and ejection fraction were preserved. Conclusion: Unilateral PA stenosis results in an increased RV afterload in TGA patients after ASO. RV remodeling and function remain within normal limits when analyzed by CMR but RV pressure-volume loop analysis shows impaired RV diastolic stiffness and RV contractility leading to RV-PA uncoupling.
MeSH term(s)	Humans ; Transposition of Great Vessels/physiopathology ; Transposition of Great Vessels/surgery ; Transposition of Great Vessels/complications ; Transposition of Great Vessels/diagnostic imaging ; Retrospective Studies ; Stenosis, Pulmonary Artery/physiopathology ; Stenosis, Pulmonary Artery/diagnostic imaging ; Stenosis, Pulmonary Artery/etiology ; Child ; Ventricular Function, Right ; Pulmonary Artery/physiopathology ; Pulmonary Artery/diagnostic imaging ; Male ; Female ; Cardiac Catheterization ; Arterial Switch Operation/adverse effects ; Adolescent ; Ventricular Pressure ; Ventricular Dysfunction, Right/physiopathology ; Ventricular Dysfunction, Right/etiology ; Ventricular Dysfunction, Right/diagnostic imaging ; Treatment Outcome ; Myocardial Contraction ; Compliance ; Stroke Volume ; Vascular Stiffness
Language	English
Publishing date	2024-04-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1459995-8
ISSN	1522-726X ; 1522-1946
ISSN (online)	1522-726X
ISSN	1522-1946
DOI	10.1002/ccd.31036
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Zs.A 1226: Show issues

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Article ; Online: Influence of Age, Heart Failure and ACE Inhibitor Treatment on Plasma Renin Activity in Children: Insights from a Systematic Review and the European LENA Project.

Steichert, Melina / Cawello, Willi / Bajcetic, Milica / Breur, Johannes M P J / Dalinghaus, Michiel / Male, Christoph / de Wildt, Saskia N / Läer, Stephanie

Frontiers in bioscience (Landmark edition)

2024 Volume 28, Issue 12, Page(s) 335

Abstract: Background: Plasma renin activity (PRA) has gained relevance as prognostic marker in adults with heart failure. The use of PRA as a clinically meaningful parameter in children and children with heart failure requires a thorough knowledge of the factors ... ...

Abstract	Background: Plasma renin activity (PRA) has gained relevance as prognostic marker in adults with heart failure. The use of PRA as a clinically meaningful parameter in children and children with heart failure requires a thorough knowledge of the factors that influence PRA to correctly assess PRA levels. We aim to evaluate the influence of age, heart failure and angiotensin-converting enzyme inhibitor (ACEi) on PRA levels in children. Methods: We conducted a systematic literature search to identify studies on PRA levels in healthy children and in children with heart failure. In addition, we analysed PRA data measured before (n = 35, aged 25 days-2.1 years), 4 hours after (n = 34) and within the first 8 days of enalapril treatment (n = 29) in children with heart failure from the European project Labeling of Enalapril from Neonates up to Adolescents (LENA). Results: Age has a profound effect on PRA levels in healthy children, as PRA levels in the literature are up to about 7 times higher in neonates than in older children. Children with heart failure younger than 6 months showed 3-4 times higher PRA levels than healthy peers in both the literature and the LENA studies. In the LENA studies, the ACEi enalapril significantly increased median predose PRA by a factor of 4.5 in children with heart failure after 4.7 ± 1.6 days of treatment (n = 29, Conclusions: Age, heart failure and ACEi treatment have a notable influence on PRA and must be considered when assessing PRA as a clinically meaningful parameter. Clinical trial registration: The trials are registered on the EU Clinical Trials Register (https://www.clinicaltrialsregister.eu). Trial registration numbers: EudraCT 2015-002335-17, EudraCT 2015-002396-18.
MeSH term(s)	Humans ; Infant, Newborn ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/pharmacology ; Enalapril/therapeutic use ; Enalapril/pharmacology ; Heart Failure/drug therapy ; Renin/metabolism ; Renin-Angiotensin System ; Infant ; Child, Preschool
Chemical Substances	Angiotensin-Converting Enzyme Inhibitors ; Enalapril (69PN84IO1A) ; Renin (EC 3.4.23.15)
Language	English
Publishing date	2024-01-05
Publishing country	Singapore
Document type	Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	2704569-9
ISSN	2768-6698 ; 2768-6698
ISSN (online)	2768-6698
ISSN	2768-6698
DOI	10.31083/j.fbl2812335
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Article ; Online: Troubled Judging of Bronchus Compression Due to Contrast-Filled Balloon in Three-Dimensional Rotational Angiography.

Moerdijk, Anouk S / Breur, Johannes M P J / Molenschot, Mirella M C / Krings, Gregor J

Pediatric cardiology

2022 Volume 43, Issue 3, Page(s) 704–708

Abstract: Three-dimensional rotational angiography (3DRA) is a suitable technique to detect the risk of left main bronchus (LMB) compression during left pulmonary artery (LPA) stenting in partial cavopulmonary connection and total cavopulmonary connection (TCPC). ... ...

Abstract	Three-dimensional rotational angiography (3DRA) is a suitable technique to detect the risk of left main bronchus (LMB) compression during left pulmonary artery (LPA) stenting in partial cavopulmonary connection and total cavopulmonary connection (TCPC). We report on a case of a 4-year-old boy with hypoplastic left heart syndrome and TCPC in which 3DRA and bronchoscopy gave conflicting information on airway patency during balloon interrogation. The balloon with high contrast concentration created a severe artifact impeding visibility of the LMB. Simultaneous flexible bronchoscopy revealed an unobstructed LMB. Repeated 3DRAs with lower contrast concentration had no artifact and showed a patent airway in accordance with the bronchoscopy. Conventional LPA stenting was performed without indication for stent ovalization. The benefit of low contrast concentration in the interrogation balloon was demonstrated in a second case of an 11-year-old boy with TCPC. The margins of the LPA and LMB were clearly visible without blank-out artifact. Oval stent procedure was necessary to prevent LMB compression. When 3DRA is used for vessel-airway interrogation, the balloon contrast concentration should be low in order to avoid artifacts. When in doubt, simultaneous flexible bronchoscopy can overcome the dilemma in airway judgment.
MeSH term(s)	Angiography/methods ; Bronchi/diagnostic imaging ; Child ; Child, Preschool ; Humans ; Hypoplastic Left Heart Syndrome ; Imaging, Three-Dimensional ; Male ; Pulmonary Artery ; Stents
Language	English
Publishing date	2022-01-16
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	800857-7
ISSN	1432-1971 ; 0172-0643
ISSN (online)	1432-1971
ISSN	0172-0643
DOI	10.1007/s00246-021-02775-y
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Article ; Online: Low profile vascular plug for transarterial occlusion of patent ductus arteriosus in small dogs.

Hulsman, Alma H / Breur, Johannes M P J / Szatmári, Viktor

Journal of veterinary internal medicine

2020 Volume 35, Issue 1, Page(s) 98–106

Abstract: Background: Minimally invasive transcatheter occlusion using Amplatz canine duct occluder (ACDO) is the treatment of choice for dogs with left-to-right shunting patent ductus arteriosus (PDA). However, in small dogs the femoral artery diameter is often ... ...

Abstract	Background: Minimally invasive transcatheter occlusion using Amplatz canine duct occluder (ACDO) is the treatment of choice for dogs with left-to-right shunting patent ductus arteriosus (PDA). However, in small dogs the femoral artery diameter is often too small to accommodate the guiding catheter required for ACDO deployment. Objective: Describe the effectiveness of transarterial implantation of Amplatzer Vascular Plug 4 (AVP-4), the only self-expandable nitinol mesh occlusion device which can be implanted through a 4 French diagnostic catheter, in small dogs with left-to-right shunting PDA. Animals: Seven client-owned dogs. Methods: Descriptive case series. Dogs with hemodynamically relevant left-to-right shunting PDA and a femoral artery diameter less than 2.0 mm measured preoperatively with ultrasonography were prospectively enrolled. Results: Angiography after releasing the device showed complete immediate PDA closure in 5 dogs, where the manufacturers' recommendation were strictly followed (30%-50% device oversizing of the ductal ampulla's diameter). Trivial residual flow on angiography in the 6th dog, whose device was slightly undersized, had resolved on echocardiography within 2 hours after placement. Marked device undersizing in the 7th dog resulted in severe residual shunting, which necessitated the addition of a coil. In this dog, the AVP-4 embolized into the pulmonary artery within 2 weeks after placement. Conclusions and clinical importance: Transarterial implantation of AVP-4 is a safe, effective and technically easy procedure for PDA occlusion in small dogs and offers a valuable alternative to coil implantation. Accurate PDA measurement and device sizing is essential to prevent residual shunting, inadvertent device embolization, and protrusion of the device into the aorta.
MeSH term(s)	Angiography/veterinary ; Animals ; Cardiac Catheterization/veterinary ; Dog Diseases/diagnostic imaging ; Dog Diseases/surgery ; Dogs ; Ductus Arteriosus, Patent/diagnostic imaging ; Ductus Arteriosus, Patent/surgery ; Ductus Arteriosus, Patent/veterinary ; Echocardiography ; Pulmonary Artery ; Treatment Outcome
Language	English
Publishing date	2020-11-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	92798-3
ISSN	1939-1676 ; 0891-6640
ISSN (online)	1939-1676
ISSN	0891-6640
DOI	10.1111/jvim.15966
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Zs.A 4095: Show issues

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Article ; Online: Placental Pathology Contributes to Impaired Volumetric Brain Development in Neonates With Congenital Heart Disease.

Nijman, Maaike / van der Meeren, Lotte E / Nikkels, Peter G J / Stegeman, Raymond / Breur, Johannes M P J / Jansen, Nicolaas J G / Ter Heide, Henriette / Steenhuis, Trinette J / de Heus, Roel / Bekker, Mireille N / Claessens, Nathalie H P / Benders, Manon J N L

Journal of the American Heart Association

2024 Volume 13, Issue 5, Page(s) e033189

Abstract: Background: Neonates with congenital heart disease are at risk for impaired brain development in utero, predisposing children to postnatal brain injury and adverse long-term neurodevelopmental outcomes. Given the vital role of the placenta in fetal ... ...

Abstract	Background: Neonates with congenital heart disease are at risk for impaired brain development in utero, predisposing children to postnatal brain injury and adverse long-term neurodevelopmental outcomes. Given the vital role of the placenta in fetal growth, we assessed the incidence of placental pathology in fetal congenital heart disease and explored its association with total and regional brain volumes, gyrification, and brain injury after birth. Methods and results: Placentas from 96 term singleton pregnancies with severe fetal congenital heart disease were prospectively analyzed for macroscopic and microscopic pathology. We applied a placental pathology severity score to relate placental abnormalities to neurological outcome. Postnatal, presurgical magnetic resonance imaging was used to analyze brain volumes, gyrification, and brain injuries. Placental analyses revealed the following abnormalities: maternal vascular malperfusion lesions in 46%, nucleated red blood cells in 37%, chronic inflammatory lesions in 35%, delayed maturation in 30%, and placental weight below the 10th percentile in 28%. Severity of placental pathology was negatively correlated with cortical gray matter, deep gray matter, brainstem, cerebellar, and total brain volumes ( Conclusions: Placental pathology occurs frequently in neonates with severe congenital heart disease and may contribute to impaired brain development, indicated by the association between placental pathology severity and reductions in postnatal cortical, cerebellar, and total brain volumes.
MeSH term(s)	Infant, Newborn ; Child ; Pregnancy ; Humans ; Female ; Placenta/diagnostic imaging ; Placenta/pathology ; Fetal Development ; Brain/pathology ; Heart Defects, Congenital/complications ; Fetal Diseases ; Brain Injuries
Language	English
Publishing date	2024-02-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.033189
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Article ; Online: Early and midterm outcomes of bare metal stenting in small children with recurrent aortic coarctation.

van Kalsbeek, Rebecca J / Krings, Gregor J / Molenschot, Mirella M C / Breur, Johannes M P J

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology

2021 Volume 16, Issue 15, Page(s) e1281–e1287

Abstract: Aims: The aim of this study was to report our experience with the Cook Formula stent in the treatment of (recurrent) coarctation of the aorta in children below 12 kg.: Methods and results: In vitro study of the Cook Formula 418 (8 mm) and 535 (8 and ... ...

Abstract	Aims: The aim of this study was to report our experience with the Cook Formula stent in the treatment of (recurrent) coarctation of the aorta in children below 12 kg. Methods and results: In vitro study of the Cook Formula 418 (8 mm) and 535 (8 and 10 mm) stents demonstrated successful down-crimping on smaller balloons and predictable fracturing patterns. Between November 2012 and January 2019, one patient with native, one patient with post-interventional and thirteen patients with post-surgical coarctation of the aorta underwent implantation of a Cook Formula stent. Patient and procedural characteristics were obtained as well as procedural success, complications, and follow-up. Median age was 4.3 months and median weight 5.5 kg. Arterial sheath size ranged from 5 to 7 Fr. In-stent diameters of 3.7 to 8.8 mm were obtained with a median residual gradient of 0 mmHg. Major complications consisted of periprocedural haemodynamic instability (n=1), dissection of the iliac artery (n=1) and non-deployment with surgical removal (n=1). Re-dilations were performed after a median interval of 24.3 months. Median follow-up was 31.7 months. Conclusions: The bare metal Cook Formula stent provides a durable and effective alternative to reoperation and balloon dilatation for native as well as post-surgical aortic coarctation in children below 12 kg.
MeSH term(s)	Aorta ; Aortic Coarctation/diagnostic imaging ; Aortic Coarctation/surgery ; Catheterization ; Child ; Humans ; Infant ; Stents ; Treatment Outcome
Language	English
Publishing date	2021-02-05
Publishing country	France
Document type	Journal Article
ZDB-ID	2457174-X
ISSN	1969-6213 ; 1774-024X
ISSN (online)	1969-6213
ISSN	1774-024X
DOI	10.4244/EIJ-D-19-00157
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Zs.A 6680: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 571: Show issues

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Article ; Online: Mental Health of School-Aged Children Treated with Propranolol or Atenolol for Infantile Hemangioma and Their Parents.

Hermans, Mireille M / Schappin, Renske / de Laat, Peter C J / Mendels, Elodie J / Breur, Johannes M P J / Langeveld, Hester R / Raphael, Martine F / de Graaf, Marlies / Breugem, Corstiaan C / de Wildt, Saskia N / Okkerse, Jolanda M E / Pasmans, Suzanne G M A / Rietman, André B

Dermatology (Basel, Switzerland)

2024 Volume 240, Issue 2, Page(s) 216–225

Abstract: Background: Infants with infantile hemangioma (IH) have been effectively treated with propranolol or atenolol. Concerns were raised about the mental health of these children at school age, due to central nervous system effects of propranolol and visible ...

Abstract	Background: Infants with infantile hemangioma (IH) have been effectively treated with propranolol or atenolol. Concerns were raised about the mental health of these children at school age, due to central nervous system effects of propranolol and visible nature of IH. Objective: This study aimed to compare the mental health at school age of children treated with propranolol to children treated with atenolol for IHs and their parents. Methods: This two-centered cross-sectional study included children aged ≥6 years and treated with either propranolol or atenolol for IH during infancy. Children's outcomes were performance-based affect recognition (Dutch version of the Developmental Neuropsychological Assessment-II [NEPSY-II-NL]), parent-reported emotional and behavioral functioning (Child Behavioral Checklist [CBCL]), and health-related quality of life (KIDSCREEN-27). Parents' outcome was parenting stress (Parenting Stress Questionnaire [OBVL]). Results: Data of 105 children (36 propranolol, 69 atenolol; 6.0-11.8 years) were analyzed. Mental health outcomes did not differ between both β-blocker groups. Although overall functioning was in line with norms, children presented specific problems concerning affect recognition, parent-reported attention, and social quality of life. Parents showed increased physical symptoms, depressive symptoms, and parent-child relationship problems. Conclusion: No difference in mental health at school age was found between children treated with propranolol or atenolol for IH. Although few overall mental health problems were found, specific problems require follow-up. Follow-up of children should be directed toward affect recognition, attention, and social functioning in daily life. Problems reported by parents could be ameliorated by mental health support during and after their infant's β-blocker treatment.
MeSH term(s)	Infant ; Humans ; Child ; Atenolol/therapeutic use ; Propranolol/therapeutic use ; Mental Health ; Cross-Sectional Studies ; Quality of Life ; Hemangioma, Capillary/drug therapy ; Adrenergic beta-Antagonists/therapeutic use ; Parents
Chemical Substances	Atenolol (50VV3VW0TI) ; Propranolol (9Y8NXQ24VQ) ; Adrenergic beta-Antagonists
Language	English
Publishing date	2024-01-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1099692-8
ISSN	1421-9832 ; 1018-8665
ISSN (online)	1421-9832
ISSN	1018-8665
DOI	10.1159/000536144
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Article ; Online: Role of patent ductus arteriosus in preterms in long-term outcome.

Veldhuis, Moniek S / Dix, Laura M L / Breur, Johannes M P J / de Vries, Willem B / Koopman, Corine / Eijsermans, Maria J C / Swanenburg de Veye, Henriette F N / Molenschot, Mirella C / Lemmers, Petra M A / van Bel, Frank / Vijlbrief, Daniel C

Early human development

2024 Volume 190, Page(s) 105953

Abstract: ... versus 62.8 % ±7.0 %; p = 0.01). At 5 years, impaired motor outcome occurred more often in infants ... with hsPDA (17 (53 %) vs. 7 (23 %); p = 0.01). In multivariate analysis existence of hsPDA remained ...

Abstract	Objective: This study aimed to determine long-term neurodevelopmental outcome and cerebral oxygenation in extremely preterm infants, comparing those with a hemodynamic significant patent ductus arteriosus (hsPDA) to those without. Study design: We included infants born before 28 weeks of gestation from 2008 to 2010 with routine echocardiography. Prior to echocardiography, regional cerebral oxygen saturation was measured. At 5 years of age, we evaluated neurodevelopmental outcomes using the Movement Assessment Battery for Children 2nd Dutch edition for motor skills and the Wechsler Preschool and Primary Scale of Intelligence 3rd Dutch edition for cognition. Results: A total of 66 infants (gestational age 26.6 ± 0.9 weeks, birth weight 912 ± 176 g) were included, 34 infants with a hsPDA (including treatment). The group infants with hsPDA showed lower pre-closure cerebral saturation levels (58.2 % ±7.8 % versus 62.8 % ±7.0 %; p = 0.01). At 5 years, impaired motor outcome occurred more often in infants with hsPDA (17 (53 %) vs. 7 (23 %); p = 0.01). In multivariate analysis existence of hsPDA remained unfavourably related to the motor subdomain "aiming and catching". There were no potential effects of hsPDA on cognitive performance at 5 years of age. Conclusion: Treatment-receiving infants with hsPDA appear to exhibit motor deficits, specifically in "aiming and catching", by the age 5. Persistent ductal patency could be a contributing factor.
MeSH term(s)	Infant ; Child, Preschool ; Child ; Infant, Newborn ; Humans ; Ductus Arteriosus, Patent/diagnostic imaging ; Ductus Arteriosus, Patent/therapy ; Birth Weight ; Gestational Age ; Infant, Extremely Premature ; Hemodynamics
Language	English
Publishing date	2024-02-01
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	752532-1
ISSN	1872-6232 ; 0378-3782
ISSN (online)	1872-6232
ISSN	0378-3782
DOI	10.1016/j.earlhumdev.2024.105953
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Zs.A 1373: Show issues

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Article ; Online: The Efficacy, Safety, and Side Effects of Intrapericardial Triamcinolone Treatment in Children with Post-surgical Pericardial Effusion: A Case Series.

van der Werff, Manon H / van der Kamp, Hetty J / Breur, Johannes M P J

Pediatric cardiology

2021 Volume 43, Issue 1, Page(s) 142–146

Abstract: Intrapericardial triamcinolone can be used to treat chronic pericardial effusion (PE) in adults; however, pediatric data are lacking. In this case series we aim to evaluate the efficacy, safety, and side effects of intrapericardial triamcinolone in ... ...

Abstract	Intrapericardial triamcinolone can be used to treat chronic pericardial effusion (PE) in adults; however, pediatric data are lacking. In this case series we aim to evaluate the efficacy, safety, and side effects of intrapericardial triamcinolone in children with PE. The incidence and treatment of post-surgical PE from 2009 to 2019 were determined using the institutional surgical database and electronic patient records. Furthermore, a retrospective analysis of efficacy, safety, and side effects of intrapericardial triamcinolone treatment for chronic post-surgical PE was performed. The incidence of postoperative PE requiring treatment was highest after atrial septal defect (ASD) closure when compared to other types of cardiac surgery (9.7% vs 4.3%). Intrapericardial treatment with triamcinolone resolved pericardial effusion in 3 out of 4 patients. All patients developed significant systemic side effects. Surgical ASD closure is associated with an increased risk of development of PE requiring treatment. Intrapericardial triamcinolone is an effective treatment for chronic postoperative PE in children, but is always associated with significant systemic side effects. Close monitoring and treatment of adrenal insufficiency are mandatory in these cases.
MeSH term(s)	Adult ; Child ; Heart Septal Defects, Atrial ; Humans ; Pericardial Effusion/chemically induced ; Pericardial Effusion/drug therapy ; Pericarditis ; Retrospective Studies ; Triamcinolone/adverse effects
Chemical Substances	Triamcinolone (1ZK20VI6TY)
Language	English
Publishing date	2021-08-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	800857-7
ISSN	1432-1971 ; 0172-0643
ISSN (online)	1432-1971
ISSN	0172-0643
DOI	10.1007/s00246-021-02704-z
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Zs.A 1528: Show issues

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