Tag Archives: congenital heart disease

Blood biomarkers predicting adverse clinical
outcomes in congenital heart disease patients, with consideration for pulmonary valve replacement

Milla Marika Kainlauri1, Irina-Bianca Kosovski2

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2023-0009

Objective: This review aims to make a brief overview of blood biomarkers’ clinical decision limits, possibly aiding in outcome prediction in all-aged Tetralogy of Fallot patients. Potentially, these biomarkers could also assist in necessity and timing of pulmonary valve replacement. Methods: Studies with all-aged patients with Tetralogy or Pentalogy of Fallot and blood biomarkers, BNP, NT-proBNP and hs-cTn, usage in clinical outcome prediction were included. Additionally, pulmonary valve replacement indications were considered. Other congenital heart diseases, biomarkers irrelevant to clinical outcome and associated pathologies or physiological status were the exclusion criteria. Keywords, Tetralogy and Pentalogy of Fallot, pulmonary valve replacement, blood biomarkers, yielded 69 suitable studies from Google Scholar, PubMed and Web-of-Science. 30 studies were selected. Results: Blood biomarkers were increased in TOF patients in comparison to controls; the higher the values, the worse adverse outcomes. Blood biomarkers combined with other biomarkers, imagistic methods or parameters showed promising results in outcome prediction. Conclusions: Blood biomarkers are validated as follow-up predictors in congenital heart disease paediatric patients. Further research is required to establish age-appropriate clinical decision limits. Pulmonary valve replacement timing remains controversial.

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Comparative Study Between Echocardiography and Autopsy Results of Congenital Heart Defects

Imre Ágnes1, Egyed-Zs Imre2, Togănel Rodica2, Cotoi Ovidiu1, Pasc Ana Sorina3, Cucerea Manuela4

1 Morphopathology Departament of County Emergency Clinic Hospital of Tîrgu Mureş
2 University of Medicine and Pharmacy of Tîrgu Mureș
3 Pediatric Cardiology Department of the Emergency Clinic Hospital of Tîrgu Mureş
4 Neonatology Departament of County Emergency Clinic Hospital of Tîrgu Mureş

Background: Congenital heart disease is currently the world’s leading birth defect, with incidence estimated at 8 per 1000 live births. Confidence in the images obtained using echocardiography has continued to increase, with many patients referred for corrective or palliative surgery on the basis of echocardiographic imaging alone. This review outlines the manner in which echocardiography is used to plan and guide congenital heart surgery or intervention, along with some of the advantages and disadvantages of which to be aware.
Aim: To assess the degree of harmonization of echocardiography with postmortem diagnosis in congenital heart disease.
Material and method: We examined the morphology of congenital heart diseases by autopsy in the Morphopathology Department of the County Hospital of Tîrgu Mureş in 2008 and 2009. We analyzed the components of the congenital heart disease and we compared the echocardiographic results with the autopsy results also.
Results: In 2008 and 2009 621 necropsies were carried out, from which 49, meaning 7.89% were diagnosed with simple or complex cardiac malformations; the male-female ration was 1:0.9. We found a few differences between the echocardiography and autopsy results on the following malformations: total anomalous pulmonary venous connection, double outlet ventricle, univentricular heart.
Conclusions: Echocardiography is accepted as the first-line imaging modality for diagnosing most types of congenital heart defects but in some difficult cases surgeons must always keep in mind the possibility of the presence of other heart malformation too.

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Nutritional Approach of Pediatric Patients Diagnosed with Congenital Heart Disease

Togănel Rodica

II Pediatric Cardiology Clinic, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

 

DOI: 10.2478/amma-2013-0029

Congenital heart defects are among the most frequent anomalies present at birth, representing a heterogeneous group of malformations, both in terms of pathogenesis and clinical significance of the lesion. Failure to grow is well documented in infants with complex congenital heart defects; the presence of associated chromosomal abnormalities, cyanosis, and cardiac failure adds to the complexity and challenge. Malnutrition etiology can be grouped into the following three categories: inadequate intake, inefficient absorption and utilization, and/or increased energy needs. The consequences of malnutrition are both short and long term, timely nutritional intervention being necessary in order to maintain an adequate nutritional state. Because there are several types of congenital heart defects and multiple mechanisms by which they produce failure to thrive, no single strategy will be adequate to treat all cases. Medical complications such as chylotorax, necrotizing enterocolitis, laryngeal and neurological dysfunction play a major role in the requisite nutrition therapy in infants with congenital heart defect; limited access to human milk and parenteral concerns, as well as stress about feeding are also factors that can contribute to poor outcomes concerning nutrition and growth. Protocols are being considered and designed, and a systematic approach is always needed. The quality of life for patient and family, as well as getting the child back on track for age-appropriate development are always at the fore-front of each care plan.

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