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Uke P, Gaikwad SB, Swarnkar K, Lamture V, Khartade P. Neurodevelopmental assessment of children with congenital heart diseases using Trivandrum developmental screening chart. J Neurosci Rural Pract 2023; 14:692-697. [PMID: 38059228 PMCID: PMC10696322 DOI: 10.25259/jnrp_46_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 07/14/2023] [Indexed: 12/08/2023] Open
Abstract
Objectives Congenital heart diseases (CHDs) are one of the most important congenital anomalies in children which have high-risk for neurodevelopment delay. This study was conducted to determine the proportion of developmental delay in children with CHD and comparison of delay between acyanotic and cyanotic heart diseases in children. Materials and Methods A cross-sectional study was conducted on children admitted in pediatric ward of rural hospital from 6 month to 6 years of age who are diagnosed with CHD by 2D ECHO and further classified into acyanotic congenital heart disease (ACHD) and cyanotic congenital heart disease (CCHD). Neurodevelopmental assessment was done using Trivandrum development screening chart (TDSC). Results Out of total 50 children in study population, 24 children had TDSC delay, distribution as 11 (22%) ACHD and 13 (26%) CCHD. Out of 24 children in the age group of 0-3 years, 13 (54.2%) were ACHD and 11 (45.8%) were CCHD. Out of 26 children in the age group of 3-6 years, 15 (57.7%) were ACHD and 11 (42.3%) were CCHD. Among different ACHD included in the study population (0-3 years) children with ventricular septal defect (VSD) were maximum (n = 5) next in the decreasing order was atrial septal defect (ASD) (n = 3). ACHD included in the study population (3-6 years) children with VSD was maximum (n = 6) next in the order was ASD (n = 4). Proportion of delay in children with ACHD was 22% as compared to 26% in children with CCHD. Conclusion There is a high proportion of neurodevelopmental delay in children with CHD which can be detected using TDSC which is a simple screening tool and can be used by any health-care professional without training for the assessment of neurodevelopmental outcome in these children. Delay was more in children with CCHD than ACHD.
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Affiliation(s)
- Punam Uke
- Department of Pediatrics, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | | | - Keerti Swarnkar
- Department of Pediatrics, AIIMS, Bhopal, Madhya Pradesh, India
| | - Varsha Lamture
- Department of Pediatrics, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | - Prashant Khartade
- Department of Pediatrics, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
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Ucar Z, Akbaba TH, Aydinoglu AT, Onder SC, Balci-Peynircioglu B, Demircin M, Balci-Hayta B. Mitochondrial Dysfunction in Cyanotic Congenital Heart Disease: A Promising Therapeutic Approach for the Future. Pediatr Cardiol 2022; 43:1870-1878. [PMID: 35538321 DOI: 10.1007/s00246-022-02926-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
Congenital heart disease (CHD) is one of the most specific and yet challenging fields of heart surgery. Apart from the known clinical approaches, including surgery, a significant scale of regenerative therapeutic options is available, which increase the number of cardiomyocytes and restore cardiac function. Although it has been revealed in recent years that mitochondrial transplantation can be used as a promising treatment option in this disease group, there is no clinical evidence for the significance of mitochondrial function in myocardial tissue of patients with CHD regarding cardiac surgery. In this study, mitochondrial morphology and function, myocardial fibrosis, and myocyte atypia were evaluated in myocardial biopsy tissue of pediatric patients with cyanotic and acyanotic CHD, five from each group. After histopathological evaluation of myocardial tissue specimens, mitochondrial morphology and network were analyzed by immunofluorescence staining using an anti-Tom20 antibody, electron transport chain complexes of myocardium were examined by cytochrome c oxidase/succinate dehydrogenase staining, and the amount of ATP was measured by bioluminescence assay. In addition, cardiac markers have been tested to be reviewed as a potential indicator for postoperative follow-up. Myocyte atypia and fibrosis were classified on a scale of 1 to 4. In this study, unlike patients with acyanotic CHD, alterations in mitochondrial network and reduction in ATP production were detected in all pediatric patients with cyanotic CHD. A statistically significant correlation was also determined between mitochondrial dysfunction and cardiac markers. These findings may be assumed as a promising pathway for evaluating the relationship between mitochondrial dysfunction and cyanotic CHD.
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Affiliation(s)
- Zeynep Ucar
- Department of Cardiovascular Surgery, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey.
| | - Tayfun Hilmi Akbaba
- Department of Medical Biology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Ayse Tulay Aydinoglu
- Department of Medical Biology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Sevgen Celik Onder
- Department of Pathology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Banu Balci-Peynircioglu
- Department of Medical Biology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Metin Demircin
- Department of Cardiovascular Surgery, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Burcu Balci-Hayta
- Department of Medical Biology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
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Mohammadi H, Mohammadpour Ahranjani B, Aghaei Moghadam E, Kompani F, Mirbeyk M, Rezaei N. Hematological indices in pediatric patients with acyanotic congenital heart disease: a cross-sectional study of 248 patients. Egypt J Med Hum Genet 2022; 23:47. [PMID: 37521840 PMCID: PMC8901268 DOI: 10.1186/s43042-022-00262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/30/2022] [Indexed: 11/30/2022] Open
Abstract
Background Congenital heart disease CHD is a significant cause of mortality and morbidity in children worldwide. Patients with congenital heart disease may develop hematological problems, including thrombocytopenia and neutropenia. In addition, several studies indicate the higher frailty of patients with CHDs to infections and malignancies. Nevertheless, the mechanisms of immune system changes in these patients have remained in the shadow of uncertainty. Moreover, very few studies have worked on cytopenia in CHD. This study has assessed the frequency of thrombocytopenia, neutropenia, lymphopenia, and anemia in pediatric patients with acyanotic congenital heart disease ACHD prior to open-heart surgery. Methods This cross-sectional study was handled in the Pediatric Cardiology Clinic, Tehran University of Medical Sciences, during pre-operation visits from 2014 till 2019. Two hundred forty-eight children and adolescents with acyanotic congenital heart disease before open-heart surgery met the criteria to enter the study. Results A total of 191 (76.7%) patients with Ventricular Septal Defects (VSD), 37 (14.85%) patients with Atrial Septal Defects (ASD), and 20 (8.11%) patients with Patent Ductus Arteriosus (PDA) were enrolled in this study. The median age was 23.87 months. Thrombocytopenia and neutropenia were found, respectively, in 3 (1.2) and 23 (9.2%) patients. Hemoglobin level and lymphocyte count were significantly lower in patients with neutropenia than patients with normal neutrophil count (P value = 0.024 and P value = 0.000). Significant positive correlations were found between neutropenia and anemia. There were no correlations between neutrophil count and Platelets. Also, anemia was found in 48 patients (19.3%). The study also found a statistically significant correlation between the co-existence of VSD and neutropenia in the patients (P value = 0.000). Conclusion Although most were mildly neutropenic, there was a significant correlation between neutropenia and Ventricular Septal Defect compared to PDA and ASD groups. Regarding the importance of neutropenia to affect the prognosis of congenital heart defects in infections, it is important to consider further studies on the status of immune system function in these patients.
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Affiliation(s)
- Hanieh Mohammadi
- Resident Research Committee, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Behzad Mohammadpour Ahranjani
- Department of Pediatric Cardiology, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Aghaei Moghadam
- Pediatric Department, Children Medical Center, Pediatric and Adolescent Cardiovascular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Division of Hematology and Oncology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Mirbeyk
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Dr Qarib St, Keshavarz Blvd, 14194 Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Dr Qarib St, Keshavarz Blvd, 14194 Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Barwad P, Prasad K, Dinakar B, Bhargav A, Santosh K, Naganur S. Percutaneous closure of small subpulmonic ventricular septal defect with an ADO I PDA occluder in a child. Ann Pediatr Cardiol 2020; 13:349-352. [PMID: 33311927 PMCID: PMC7727912 DOI: 10.4103/apc.apc_159_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 11/04/2022] Open
Abstract
Ventricular septal defects (VSDs) comprise the most common congenital heart defect at birth. The chances of spontaneous closure of VSD depend on the size and location of the defect. Subpulmonic location is an unlikely site for the VSD to close spontaneously and known to have complications such as aortic valve prolapse and regurgitation. Percutaneous closure has become the preferred strategy for small-moderate-sized VSDs located in muscular, perimembranous areas. Subpulmonic location poses concerns due to the close proximity to the aortic valve. Herein, we present a case of percutaneous device closure of a subpulmonic VSD using ADO I occluder device.
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Affiliation(s)
- Parag Barwad
- Department of Cardiology, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Krishna Prasad
- Department of Cardiology, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - B Dinakar
- Department of Cardiology, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Anish Bhargav
- Department of Cardiology, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Krishna Santosh
- Department of Cardiology, Post Graduate Institute for Medical Education and Research, Chandigarh, India
| | - Sanjeev Naganur
- Department of Cardiology, Post Graduate Institute for Medical Education and Research, Chandigarh, India
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Abstract
There has been tremendous progress in treatment of heart disease in children. Device therapy is increasingly being used in acyanotic congenital heart disease, while surgical results have improved significantly to give smile to many cyanotic heart disease children and their parents. This article makes an attempt to increase awareness of general pediatricians about common congenital heart diseases.
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Affiliation(s)
- Manojkumar Rohit
- Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Smit Shrivastava
- Department of Cardiology, B R Ambedkar Medical College, Raipur, Chattisgarh, India
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Abstract
We report a case of a high-risk neonate with interrupted aortic arch (IAA) and ventricular septal defect who underwent a successful hybrid palliative procedure using a ductal stent and bilateral branch pulmonary artery banding. This case represents not only a successful use of hybrid approach in high-risk neonates with IAA, but also introduces an alternative and safe access for ductal stent insertion through the right ventricular infundibulum.
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Affiliation(s)
- Mohsen Karimi
- Division of Pediatric Cardiothoracic Surgery, Medical College of Georgia, Children's Medical Center, Augusta, Georgia, USA
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