Advances in the Diagnosis and Management of Congenital Heart Disease in Children

Rao, P. Syamasundar; Agarwal, Ankur

doi:10.3390/children9071056

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…Additionally, a ow-blocking membrane is incorporated within the mesh structure of the occluder to reinforce the sealing capability[Fig. 2.C] [35].Its potential as a minimally invasive option for TEF treatment has garnered increasing attention. However, there is currently limited evidence regarding the application of cardiac septal occluders for the treatment of mTEF.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder: case series analysis

Teng,

Zhou,

Xiong

et al. 2023

Preprint

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Tracheoesophageal fistula (TEF), especially advanced malignant TEF (mTEF), is commonly occurs in critically ill patients who require prolonged mechanical ventilation and are not suitable candidates for surgical intervention due to their compromised health status. The Management of these mTEF patients remain a significant challenge. This study aimed to evaluate the safety and efficacy of using a cardiac septal occluder for the closure of mTEF. 8 patients with mTEF underwent closure surgery using atrial/ventricular septal defect (ASD/VSD) septal occluders at the Respiratory Department of HuBei Yichang Central People's Hospital from 2021 to 2023. The procedure involved percutaneous placement of the occluder through the fistula to achieve closure. The study demonstrated that the use of cardiac septal occluder therapy in patients with mTEF can alleviate symptoms, improve quality of life, and enhance survival rates, with no significant complications observed. Furthermore, the study provided comprehensive details on surgical indications, preoperative evaluation and diagnosis, selection of occluder, methods of occlusion, and postoperative care. Our findings indicate that the application of cardiac septal occluder in the treatment of mTEF is a safe and effective palliative treatment. These findings provide valuable guidance for the clinical application of cardiac septal defect occluders in the management of TEF.

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Section: Discussionmentioning

confidence: 99%

Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder: case series analysis

Teng,

Zhou,

Xiong

et al. 2023

Preprint

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“…Importantly, the survival period exceeded the median survival period of 6 to 12 weeks. reinforce the sealing capability[Figure 1C] [35].Its potential as a minimally invasive option for TEF treatment has garnered increasing attention. However, there is currently limited evidence regarding the application of cardiac septal occluders for the treatment of mTEF.…”

Section: Postoperative Care and Follow-upmentioning

confidence: 99%

Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder

Teng,

Zhou,

Xiong

et al. 2024

Langenbecks Arch Surg

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Introduction Tracheoesophageal fistula (TEF) especially malignant TEF (mTEF) is an uncommon yet critical medical condition necessitating immediate intervention. This life-threatening condition frequently manifests in critically ill patients who are dependent on prolonged mechanical ventilation and are unsuitable candidates for thoracotomy due to their compromised health status. The Management of these mTEF patients remain a significant challenge.This study aimed to evaluate the safety and efficacy of using a cardiac septal occluder for the closure of mTEF. Methods 8 patients with mTEF underwent closure surgery using atrial/ventricular septal defect (ASD/VSD) septal occluders at the Respiratory Department of HuBei Yichang Central People’s Hospital from 2021 to 2023. The procedure involved percutaneous placement of the occluder through the fistula to achieve closure. Results The placement of the cardiac septal occluder was successfully achieved with ease and efficiency in all patients. The study demonstrated that the use of cardiac septal occluder therapy in patients with mTEF can alleviate symptoms, improve quality of life, and enhance survival rates, with no significant complications observed. Furthermore, the study provided comprehensive details on surgical indications, preoperative evaluation and diagnosis, selection of occluder, methods of occlusion, and postoperative care. Conclusions The application of cardiac septal occluder in the treatment of mTEF is a safe and effective palliative treatment. This approach may be particularly beneficial for patients with a high risk of complications and mortality associated with traditional surgical interventions.

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“…Although certain minor congenital heart defects spontaneously resolve, severe congenital heart disease may lead to poor health and quality of life (5)(6)(7)(8), diminished physical exercise capacity (9)(10)(11)(12)(13), impaired neurodevelopment (the most prevalent extracardiac manifestation in patients with a congenital heart defect) and brain damage (14)(15)(16)(17)(18), thromboembolic complications (19)(20)(21), acute renal injury and chronic kidney disease (22)(23)(24), hepatic dysfunction (25), pulmonary arterial hypertension (26)(27)(28), infective endocarditis (29)(30)(31), congestive cardiac failure (32)(33)(34), miscellaneous cardiac dysrhythmia (35)(36)(37) and cardiovascular demise (38)(39)(40). Improvement has been made in cardiovascular surgery and transcatheter interventional treatment, which has allowed >90% of children with congenital heart defects to survive to adulthood; adults living with various congenital heart defects outnumber children affected by congenital heart defects (41)(42)(43). However, despite the lifespan of these survivors being markedly prolonged, the long-term prognostic effects are suboptimal because of complications, including cerebrovascular infarction, chronic renal dys...…”

Section: Introductionmentioning

confidence: 99%

Somatic GATA4 mutation contributes to tetralogy of Fallot

Abhinav,

Li,

Huang

et al. 2024

Exp Ther Med

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Tetralogy of Fallot (TOF) is the most prevalent cyanotic congenital heart pathology and causes infant morbidity and mortality worldwide. GATA-binding protein 4 (GATA4) serves as a pivotal transcriptional factor for embryonic cardiogenesis and germline GATA4 mutations are causally linked to TOF. However, the effects of somatic GATA4 mutations on the pathogenesis of TOF remain to be ascertained. In the present study, sequencing assay of GATA4 was performed utilizing genomic DNA derived from resected heart tissue specimens as well as matched peripheral blood specimens of 62 patients with non-familial TOF who underwent surgical treatment for TOF. Sequencing of GATA4 was also performed using the heart tissue specimens as well as matched peripheral venous blood samples of 68 sporadic cases who underwent heart valve displacement because of rheumatic heart disorder and the peripheral venous whole blood samples of 216 healthy subjects. The function of the mutant was explored by dual-luciferase activity analysis. Consequently, a new GATA4 mutation, NM_002052.5:c.708T>G;p.(Tyr236*), was found in the heart tissue of one patient with TOF. No mutation was detected in the heart tissue of the 68 cases suffering from rheumatic heart disorder or in the venous blood samples of all 346 individuals. GATA4 mutant failed to transactivate its target gene, myosin heavy chain 6. Additionally, this mutation nullified the synergistic transactivation between GATA4 and T-box transcription factor 5 or NK2 homeobox 5, two genes causative for TOF. Somatic GATA4 mutation predisposes TOF, highlighting the significant contribution of somatic variations to the molecular pathogenesis underpinning TOF.

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Advances in the Diagnosis and Management of Congenital Heart Disease in Children

Abstract: The last five decades have witnessed an inordinate number of advances in the diagnosis and management of congenital heart defects (CHDs), as reviewed elsewhere [...]

Cited by 4 publications

References 6 publications

Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder: case series analysis

Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder: case series analysis

Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder

Somatic GATA4 mutation contributes to tetralogy of Fallot

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