RESUMO
INTRODUCTION AND OBJECTIVES: Bicuspid aortic valve (BAV) disorder is the most common congenital heart disease. The aim of this study was to describe the characteristics of 0- to 18-year olds with BAV in a population-based registry. METHODS: Data from all pediatric patients were obtained from the Spanish registry for pediatric patients with bicuspid aortic valve (REVAB) (< 18 years). For data analysis, patients with BAV were divided into 2 groups by their features: isolated BAV and BAV with associated congenital heart disease. RESULTS: We included 1681 patients from 33 hospitals. Males accounted for 69.6% (n = 1158). Valve morphology was horizontal in 63.4% (n = 1012) and pure (Sievers type 0) in 28.4% (n=469). Isolated BAV was present in 63.7% (n=1060), and concomitant left-sided obstructive lesions in 23.4% (n=390). Interventions were required in 8.6% (n=145). CONCLUSION: These data represent the first large, population-based description of the clinical presentations and outcomes of patients enrolled in the Spanish registry for pediatric patients with bicuspid aortic valve.
Assuntos
Estenose da Valva Aórtica , Doença da Válvula Aórtica Bicúspide , Cardiopatias Congênitas , Doenças das Valvas Cardíacas , Masculino , Humanos , Criança , Doença da Válvula Aórtica Bicúspide/complicações , Doença da Válvula Aórtica Bicúspide/patologia , Valva Aórtica , Doenças das Valvas Cardíacas/epidemiologia , Doenças das Valvas Cardíacas/patologia , Estudos Retrospectivos , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/complicações , Sistema de Registros , Estenose da Valva Aórtica/complicaçõesRESUMO
INTRODUCTION: The most widespread venous sites of access for implantation intravenous implantable cardiac electronic device (CIED) are the cephalic and subclavian vein. Fluoroscopy-guided axillary venous access is an alternative, but efficacy and safety have not been studied under equal conditions. The aim of the present study is to compare the efficacy and safety of fluoroscopy-guided axillary vs cephalic vein access in CIED implant. METHODS AND RESULTS: Two hundred and forty patients were randomized to receive CIED implantation by the fluoroscopy-guided axillary vein access vs cephalic vein access. The implantation success, the procedure times and the complications were recorded. A comparison of the results of operators was made. The success rate of the randomized venous access was superior in the axillary group than in cephalic (98.3% vs 76.7%, P < .001). Time to access (6.8 ± 3.1 minute vs 13.1 ± 5.8 minutes, P < .001) and implantation duration was significantly shorter in the axillary group than in the cephalic group (42.3 ± 11.6 minutes vs 50.5 ± 13.3 minutes, P < .001). There was no difference in the incidence of complication and inter-operator success rate, complications rate and time to access. CONCLUSION: The fluoroscopy-guided axillary venous access is safe and has a better success rate and faster execution time compared with the cephalic vein access. When the results were compared among the study operators, neither in the axillary nor in the cephalic group there were differences in the success rate, the complication rate, and the time to access. TRIAL REGISTRATION: www.clinicaltrials.gov, NCT03860090.
Assuntos
Veia Axilar/diagnóstico por imagem , Cateterismo Periférico , Desfibriladores Implantáveis , Marca-Passo Artificial , Flebografia , Implantação de Prótese/instrumentação , Radiografia Intervencionista , Idoso , Idoso de 80 Anos ou mais , Cateterismo Periférico/efeitos adversos , Feminino , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Flebografia/efeitos adversos , Implantação de Prótese/efeitos adversos , Punções , Radiografia Intervencionista/efeitos adversos , Espanha , Fatores de Tempo , Resultado do TratamentoAssuntos
DNA/genética , Fibrilina-1/genética , Prolapso da Valva Mitral/genética , Mutação , Miopia/genética , Dermatopatias/genética , Adolescente , Adulto , Criança , Análise Mutacional de DNA , Feminino , Fibrilina-1/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Prolapso da Valva Mitral/diagnóstico , Prolapso da Valva Mitral/metabolismo , Miopia/diagnóstico , Miopia/metabolismo , Linhagem , Fenótipo , Dermatopatias/diagnóstico , Dermatopatias/metabolismo , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
A 41-year-old man with a history of tachycardia refractory to multiple antiarrhythmic drugs was sent to our institution. His 12-lead electrocardiogram demonstrated incessant narrow QRS complex tachycardia with negative P waves in the inferior leads and long RP interval. Occasionally, the tachycardia terminated after a P wave and then was restarted after a sinusal beat. An EP study was performed during tachycardia. Intracardiac electrograms during tachycardia and response to pacing maneuvers are shown. What is the tachycardia mechanism?
RESUMO
La ventana aortopulmonar es una causa poco frecuente de insuficiencia cardiaca en el neonato. Debe ser descartada en caso de existir edema pulmonar sin los shunts izquierda-derecha más frecuentes. Presentamos las imágenes ecocardiográficas de un recién nacido que ingresó con clínica de insuficiencia cardiaca en nuestra institución.
The aortopulmonary window is a rare cause of heart failure in the neonate. It must be ruled out if there are signs of pulmonary edema without the most frequents left-right shunts. We report the echocardiographic images of a newborn who was admitted with symptoms of heart failure at our institution.
Assuntos
Humanos , Feminino , Recém-Nascido , Defeito do Septo Aortopulmonar/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico por imagem , Defeito do Septo Aortopulmonar/complicações , Ultrassonografia , Insuficiência Cardíaca/etiologiaRESUMO
The aortopulmonary window is a rare cause of heart failure in the neonate. It must be ruled out if there are signs of pulmonary edema without the most frequent left-right shunts. We report the echocardiographic images of a newborn who was admitted with symptoms of heart failure at our institution.