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2.
Front Cardiovasc Med ; 10: 1212882, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37731527

RESUMEN

Aims: Limited data exist on risk factors for the long-term outcome of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH). We focused on the index of pulmonary vascular disease (IPVD), an assessment system for pulmonary artery pathology specimens. The IPVD classifies pulmonary vascular lesions into four categories based on severity: (1) no intimal thickening, (2) cellular thickening of the intima, (3) fibrous thickening of the intima, and (4) destruction of the tunica media, with the overall grade expressed as an additive mean of these scores. This study aimed to investigate the relationship between IPVD and the long-term outcome of CHD-PAH. Methods: This retrospective study examined lung pathology images of 764 patients with CHD-PAH aged <20 years whose lung specimens were submitted to the Japanese Research Institute of Pulmonary Vasculature for pulmonary pathological review between 2001 and 2020. Clinical information was collected retrospectively by each attending physician. The primary endpoint was cardiovascular death. Results: The 5-year, 10-year, 15-year, and 20-year cardiovascular death-free survival rates for all patients were 92.0%, 90.4%, 87.3%, and 86.1%, respectively. The group with an IPVD of ≥2.0 had significantly poorer survival than the group with an IPVD <2.0 (P = .037). The Cox proportional hazards model adjusted for the presence of congenital anomaly syndromes associated with pulmonary hypertension, and age at lung biopsy showed similar results (hazard ratio 4.46; 95% confidence interval: 1.45-13.73; P = .009). Conclusions: The IPVD scoring system is useful for predicting the long-term outcome of CHD-PAH. For patients with an IPVD of ≥2.0, treatment strategies, including choosing palliative procedures such as pulmonary artery banding to restrict pulmonary blood flow and postponement of intracardiac repair, should be more carefully considered.

3.
Nagoya J Med Sci ; 84(4): 871-876, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36544606

RESUMEN

Recent advances in molecular and genetic approaches have identified a number of genes responsible for Noonan syndrome (NS). However, there has been limited analysis of the genotype-phenotype correlation of NS patients. Here, we report the case of a Japanese patient with NS possessing a c.853T>C (p.Phe285Leu) mutation in the gene encoding protein-tyrosine phosphatase, nonreceptor-type 11 (PTPN11). To clarify genotype-phenotype correlations, the accumulation of data on the clinical course of patients with genetically confirmed NS is important. We summarized the cases with mutations at PTPN11 position 285 and found that c854T>C (p.Phe285Ser) is the most common mutation at this position. In these reports, although little is mentioned about the genotype-phenotype correlation, two patients with NS possessing the PTPN11 c854T>C (p.Phe285Ser) mutation accompanied by chylothorax are described. There is still a lack of detailed information about the phenotype associated with the c.853T>C (p.Phe285Leu) mutation observed in this case. More research is needed to better understand these cases.


Asunto(s)
Quilotórax , Síndrome de Noonan , Humanos , Síndrome de Noonan/genética , Síndrome de Noonan/complicaciones , Quilotórax/genética , Proteína Tirosina Fosfatasa no Receptora Tipo 11/genética , Mutación/genética , Fenotipo
4.
Clin Case Rep ; 10(11): e6577, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36397849

RESUMEN

Acquired cystic lung disease in premature infants is a serious respiratory complication, and pulmonary interstitial emphysema (PIE) has been widely reported. We report a rare case of giant pulmonary bulla in an infant treated with bullectomy where chest computed tomography was useful in directing treatment.

5.
Circ J ; 73(6): 1045-8, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19359814

RESUMEN

BACKGROUND: The shortage of heart transplantation donors is a problem, but partial left ventriculectomy (PLV) and mitral valve replacement (MVR) are feasible at the optimal timing, even in young children. METHODS AND RESULTS: From May 1998 to May 2008, 11 children under the age of 3 years were diagnosed with severe dilated cardiomyopathy (DCM). Indications and outcomes of non-transplant surgical strategies were evaluated and 8 procedures were performed in 6 children: 5 PLV and 3 MVR. Two of them underwent MVR after PLV because of deterioration of mitral regurgitation (MR). Age at surgery ranged from 8 months to 2 years 11 months. Four are alive, of whom 1 eventually underwent a heart transplant overseas. Two children died during the study period: 1 who underwent only MVR died of intracranial bleeding during thrombolytic therapy for a thrombus stack valve and the other child died of congestive heart failure because of progressive MR 2 months after PLV. Follow-up after PLV ranged from 2 months to 8 years, and after MVR ranged from 1 month to 4 years. CONCLUSIONS: PLV and MVR are feasible and effective and should be considered when heart failure resists conventional therapy.


Asunto(s)
Cardiomiopatía Dilatada/cirugía , Procedimientos Quirúrgicos Cardiovasculares/métodos , Ventrículos Cardíacos/cirugía , Cardiomiopatía Dilatada/fisiopatología , Preescolar , Femenino , Implantación de Prótesis de Válvulas Cardíacas , Ventrículos Cardíacos/fisiopatología , Humanos , Lactante , Recién Nacido , Japón , Masculino , Válvula Mitral/fisiopatología , Válvula Mitral/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
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