Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-26T05:30:41.692Z Has data issue: false hasContentIssue false
  • English
  • Français

Critical care of patients with paediatric valvar cardiac disease*

Published online by Cambridge University Press:  29 December 2014

Ryan A. Moore ,
Saul Flores  and
David S. Cooper
Ryan A. Moore
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
Saul Flores
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
David S. Cooper*
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
*
Correspondence to: D. S. Cooper, MD, MPH, The Heart Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 2003, Cincinnati, Ohio 45229, United States of America. Tel: +513 803 1801; Fax: 513-636-3847; E-mail: David.Cooper@cchmc.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Valvar cardiac disease accounts for a large percentage of heart lesions in the paediatric population. There are a variety of congenital and acquired valvar lesions produced by different mechanisms that produce unique physiologies. With the development of more advanced cardiac interventional procedures and congenital cardiac surgery techniques, most of these lesions can be repaired in a single or multi-stage approach. Given the potential for significant symptomatology before intervention, it is imperative to review the critical care management of paediatric valvar heart disease. The purpose of this article is to provide an overview of the current critical care management of valvar cardiac disease. We approach each cardiac valve individually in order to review the pathophysiology caused by valve dysfunction (obstruction and incompetence) and elaborate on the most frequent diagnoses, specific cardiac physiology, potential for other organ system associations, and perioperative management.

Keywords

Paediatric cardiac valve diseasemitral stenosismitral regurgitationtricuspid stenosistricuspid regurgitationpulmonary stenosis, and pulmonary regurgitation
Type
Original Article
Information
Cardiology in the Young , Volume 24 , Issue 6: HeartWeek 2014 , December 2014 , pp. 1071 - 1076
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Presented at All Children’s Hospital Johns Hopkins Medicine 14th International Symposium on Congenital Heart Disease, Saint Petersburg, Florida, United States of America, 15–18 February 2014, Special Focus: Diseases of the Cardiac Valves from the Fetus to the Adult, Co-Sponsor: The American Association for Thoracic Surgery (AATS).

References

1.Spencer, FC, Neill, CA, Sank, L, et al. Anatomical variations in 46 patients with congenital aortic stenosis. Am Surg 1960; 26: 204–216.Google Scholar
2.Hoffman, JI, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
3.Massell, BF, Chute, CG, Walker, AM, et al. Penicillin and the marked decrease in morbidity and mortality from rheumatic fever in the United States. N Engl J Med 1988; 318: 280–286.CrossRefGoogle ScholarPubMed
4.Ruckman, RN, Van Praagh, R. Anatomic types of congenital mitral stenosis: report of 49 autopsy cases with consideration of diagnosis and surgical implications. Am J Cardiol 1978; 42: 592–601.CrossRefGoogle ScholarPubMed
5.David, D, Lang, RM, Marcus, RH, et al. Doppler echocardiographic estimation of transmitral pressure gradients and correlations with micromanometer gradients in mitral stenosis. Am J Cardiol 1991; 67: 1161–1164.CrossRefGoogle ScholarPubMed
6.Nishimura, RA, Rihal, CS, Tajik, AJ, et al. Accurate measurement of the transmitral gradient in patients with mitral stenosis: a simultaneous catheterization and Doppler echocardiographic study. J Am Coll Cardiol 1994; 24: 152–158.CrossRefGoogle ScholarPubMed
7.Reddy, G, Ahmed, M, Alli, O. Percutaneous valvuloplasty for severe bioprosthetic tricuspid valve stenosis in the setting of infective endocarditis. Catheter Cardiovasc Interv 2014 [Epub ahead of print, http://dx.doi.org/10.1002/ccd.25372].CrossRefGoogle Scholar
8.Cullen, MW, Cabalka, AK, Alli, OO, et al. Transvenous, antegrade Melody valve-in-valve implantation for bioprosthetic mitral and tricuspid valve dysfunction: a case series in children and adults. JACC Cardiovasc Interv 2013; 6: 598–605.CrossRefGoogle ScholarPubMed
9.Tzifa, A, Momenah, T, Al Sahari, A, et al. Transcatheter valve-in-valve implantation in the tricuspid position. EuroIntervention 2014 [Epub ahead of print, pii: 20130315-01].CrossRefGoogle ScholarPubMed
10.Songur, CM, Simsek, E, Ozen, A, et al. Long term results comparing mechanical and biological prostheses in the tricuspid valve position: which valve types are better – mechanical or biological prostheses? Heart Lung Circ 2014 [Epub ahead of print, http://dx.doi.org/10.1016/j.hlc.2014.05.015].CrossRefGoogle ScholarPubMed
11.Wald, RM, Adatia, I, Van Arsdell, GS, et al. Relation of limiting ductal patency to survival in neonatal Ebstein’s anomaly. Am J Cardiol 2005; 96: 851–856.CrossRefGoogle ScholarPubMed
12.Rome, JJ. Balloon pulmonary valvuloplasty. Pediatr Cardiol 1998; 19 18–24; discussion 25–26.CrossRefGoogle ScholarPubMed
13.Hayes, CJ, Gersony, WM, Driscoll, DJ, et al. Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis. Circulation 1993; 87 (Suppl 2): I28–I37.Google ScholarPubMed
14.Driscoll, DJ, Michels, VV, Gersony, WM, et al. Occurrence risk for congenital heart defects in relatives of patients with aortic stenosis, pulmonary stenosis, or ventricular septal defect. Circulation 1993; 87 (Suppl 2): I114–I120.Google ScholarPubMed
15.Cho, MJ, Bah, KH, Kim, MJ, et al. Catheter-based treatment in patients with critical pulmonary stenosis or pulmonary atresia with intact ventricular septum: a single institute experience with comparison between patients with and without additional procedure for pulmonary flow. Congenit Heart Dis 2013; 8: 440–449.Google ScholarPubMed
16.Nugent, EW, Freedom, RM, Nora, JJ, et al. Clinical course in pulmonary stenosis. Circulation 1977; 56 (Suppl 1): I38–I47.Google ScholarPubMed
17.Thapar, MK, Rao, PS. Use of propranolol for severe dynamic infundibular obstruction prior to balloon pulmonary valvuloplasty (a brief communication). Cathet Cardiovasc Diagn 1990; 19: 240–241.CrossRefGoogle ScholarPubMed
18.Pierpont, ME, Magoulas, PL, Adi, S, et al. Cardio-Facio-Cutaneous Syndrome: Clinical Features, Diagnosis, and Management Guidelines. Pediatrics 2014; 134: e1149–e1162.CrossRefGoogle Scholar
19.Rauen, KA. The RASopathies. Annu Rev Genomics Hum Genet 2013; 14: 355–369.CrossRefGoogle ScholarPubMed
20.Weber, SL, Souza, RB, Ribeiro, LG, et al. Williams syndrome: ophthalmological examination and review of systemic manifestations. J Pediatr Ophthalmol Strabismus 2014; 51: 209–213.CrossRefGoogle ScholarPubMed
21.Zarate, YA, Lepard, T, Sellars, E, et al. Cardiovascular and genitourinary anomalies in patients with duplications within the Williams syndrome critical region: phenotypic expansion and review of the literature. Am J Med Genet A 2014; 164a: 1998–2002.CrossRefGoogle ScholarPubMed
22.Kamath, BM, Podkameni, G, Hutchinson, AL, et al. Renal anomalies in Alagille syndrome: a disease-defining feature. Am J Med Genet A 2012; 158a: 85–89.CrossRefGoogle ScholarPubMed
23.Arya, S, Kovach, J, Singh, H, et al. Arrhythmias and sudden death among older children and young adults following tetralogy of Fallot repair in the current era: are previously reported risk factors still applicable? Congenit Heart Dis 2013; 9: 407–414.CrossRefGoogle Scholar