Peculiarities of physical development and neurodevelopmental status of children of first year of life with congenital heart diseases

The aim of the research is to study the morbidity by appealability and some characteristics of congenital heart diseases in children of Zabaikalsky Territory. Material and methods. A retrospective clinical and anamnestic analysis of children with congenital heart diseases without surgical treatment, who were hospitalized, was carried out. The analysis included 3 year-observation. CHD diagnosed is an inclusion criterion; while surgical treatment of heart diseases is exclusion criterion. Statistical data processing was carried out using Microsoft Excel 2007, Statistica v.10.0 software package. χ2 test (Pearson) was used to compare two independent groups by qualitative characteristics. The results were considered statistically significant (reliable) at the achieved significance level of p <0.05. Results. In Zabaikalsky Territory, approximately 200 children with congenital heart disease without surgical treatment are hospitalized annually; the average age is 3 years. Fifty-three per cent of children applied for inpatient care for the first time, 44% of them were children at their first year. Gender distribution indicates the highest incidence of the pathology in girls. In CHD structure, atrial septal defects are on the first place, while interventricular septal defects are on the second. Combination of ASD and IVSD was observed with approximately equal frequency. Chronic heart failure associated with CHD was registered in 77% of children. In most cases CHF, stage 1, was diagnosed (63%). In 2/3 of cases, pulmonary hypertension of various severity was detected. Analysis of place of residence of children with CHD in the Zabaikalsky Territory shows that children from areas with the highest population density are hospitalized more often. Conclusion. The problem of congenital heart diseases in children of Zabaikalsky Territory is of current importance due to the widespread prevalence and high specific gravity among all internal organ defects in children of this region.

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Influence of congenital heart disease-caused hypoxia on intrathymic development of t-lymphocytes in children of first year of life

Perm Medical Journal ◽

10.17816/pmj36446-54 ◽

2019 ◽

Vol 36 (4) ◽

pp. 46-54

Author(s):

N. P. Loginova ◽

V. A. Chetvertnykh ◽

G. A. Khromtsova ◽

R. M. Shekhmametyev ◽

L. A. Chetvertnykh

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

T Lymphocytes ◽

T Lymphocyte ◽

Congenital Heart ◽

Heart Diseases ◽

Immunological Methods ◽

First Year ◽

First Year Of Life ◽

Degree Of Severity

Aim. To study the influence of hypoxia, caused by congenital heart disease, on the intrathymic development of T-lymphocytes and provision of the organism with T-cellular resource in children with cardiac pathology of different degree of severity. Materials and methods. The paper presents the results of complex immunomorphological study of the thymus in children of the first year of life (n = 129) with congenital heart diseases. Hystochemical and immunological methods were used to assess the influence of congenital heart disease-caused hypoxia on the functional status of thymus regarding provision of a child with T-lymphocytes. Results. It was established that the degree of severity of congenital heart disease correlated with the degree of suppression of T-lymphocyte pool formation. During the first year of life, proliferative activity of thymocytes (assessed by Ki-67 expression) in the thymus falls, being the reason of decrease in the number of CD3+ thymocytes. In conditions of marked hypoxia (blue type of defect) the process of T-lymphocyte differentiation is inhibited that causes preservation of less mature forms of thymocytes. As a result, hypoxia is the reason of proliferation suppression and thymocyte differentiation, influencing subpopulation composition of the cells. Thus, insufficient quantity of thymic migrants enters the peripheral blood that confirms low functional activity of thymus regarding provision of the organism with T-cellular resource. Conclusions. No doubt, it can be the cause of immunodeficient state and reduced formation of adaptive immunity in this category of children.

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What's New in Cardiology

Pediatrics in Review ◽

10.1542/pir.16.12.443 ◽

1995 ◽

Vol 16 (12) ◽

pp. 443-447

Author(s):

H. Scott Baldwin

Keyword(s):

Congenital Heart ◽

Heart Diseases ◽

Pediatric Population ◽

Medical Intervention ◽

First Year ◽

Recent Developments ◽

Contemporary Management ◽

Antiarrhythmic Medications ◽

And Function ◽

First Year Of Life

Congenital heart diseases occur with a frequency of 0.5 to 1 case per 1000 live births, accounting for more than 50% of reported birth defects. In addition, they are the leading cause of infant mortality in the first year of life. Significant progress in the diagnosis and treatment of most defects has been made in the past few years. In addition, new experimental evidence suggests that we soon may be able to identify the genes involved in disturbed cardiac anatomy and function. The following is a brief overview of some of the more recent developments that have made an important impact on the contemporary management of the child who has congenital heart disease. Transcatheter Ablation of Pediatric Tachyarrhythmias: A Cure Without Medication The prevalence of tachyarrhythmias within the general pediatric population is such that virtually every practitioner is faced with diagnostic and management considerations that involve patients from birth through adolescence. Fortunately, most tachyarrhythmias can be managed with relatively benign pharmacologic therapies. However, there is a subset of patients who do not respond to "simple" medical intervention, requiring multiple or more potent antiarrhythmic medications that may involve frequent or prolonged hospitalizations for monitoring and optimization of therapeutic regimens. These medications also may cause significant side effects and often result only in a decrease, not elimination, of the arrhythmia.

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Perioperative Management of Staged Palliation Surgery for Functional Univentricle Hearts: A Literature Review

10.22541/au.163827722.22328486/v1 ◽

2021 ◽

Author(s):

Moira Setiawan ◽

Suprayitno Wardoyo ◽

Dhama Shinta Susanti ◽

William Makdinata ◽

* Ardiansyah

Keyword(s):

Survival Rate ◽

Literature Review ◽

Congenital Heart ◽

Perioperative Management ◽

Heart Diseases ◽

Fontan Procedure ◽

Surgical Techniques ◽

Postoperative Management ◽

First Year ◽

Congenital Heart Diseases

Around 3-4 children born with congenital heart diseases have univentricular hearts, where the prognosis of univentricular hearts is poor in the past, with a survival rate of less than 50% during the first year and 10% during the first ten years of life. Based on a literature search, current advances in perioperative management of neonates with complex congenital heart diseases have increased their survival rate by 85%. To aid cardiothoracic surgeons worldwide, this comprehensive literature review will focus on the perioperative management of staged palliation surgery for functional univentricular hearts, considering current trends as well as how we do it in our centre. Our review article specifially discusses perioperative strategies regarding surgical considerations, current techniques, to deal with overshunting and undershunting during the first stage of palliation surgery. This article also gives an overview on when a patient is suitable to go through with the next stage of the procedure, which is the implementation of a bidirectional cavopulmonary shunt or the Hemi-Fontan procedure. Lastly, this article gives a comprehensive approach regarding perioperative strategies of the Fontan procedure, which include patient criteria, current surgical techniques, postoperative management, as well as the use of anticoagulants after the Fontan procedure.

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Dynamic electroneurostimulation in the prevention of broncho-pulmonary complications with children of the first year of life suffering from congenital heart diseases in the early post-operating period

Russian Journal of Physiotherapy Balneology and Rehabilitation ◽

10.17816/1681-3456-2019-18-1-4-8 ◽

2019 ◽

Vol 18 (1) ◽

pp. 4-8

Author(s):

Artavazd A. Pnjoyan ◽

Yuliya M. Borzunova ◽

Andrey A. Fedorov ◽

Elena V. Negodaeva

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Postoperative Period ◽

Congenital Heart ◽

Heart Diseases ◽

Pulmonary Complications ◽

Control Group ◽

First Year ◽

Hospitalization Period ◽

First Year Of Life

The purpose of the study is to substantiate the use of dynamic electronic neurostimulation as a means of preventing broncho-pulmonary complications with children of the first year of life with congenital heart disease in the early postoperative period. Material and methods. There have been observed 82 children operated on congenital heart disease at an average age of 7.6 2.0 months old. By simple randomization, the patients were divided into two groups. Children who received the dynamic electronic neurostimulation procedure from the first day against the background of basic drug therapy were in the 1st group (40 people). The 2nd group (42 people) included patients who were treated only with basic medication. Results. The result analysis of the study showed a statistically significant effect in the use of dynamic electronic neurostimulation compared to the control group. By evaluating the length of the patients stay in hospital after the operative treatment, significant differences have also been obtained. Thus, the patients in the control group stayed in the unit for an average of 14.6 0.3 days, while the patients in the group where dynamic electronic neurostimulation was used in combination with basic therapy had a hospitalization period of 13.4 0.4 days (p 0.05). The use of DENS allowed to reduce the frequency of complications associated with the bronchopulmonary system starting from 34 days of the postoperative period. Thus, in the control group, 5 (11%) children showed pneumonia, 13 (30%) showed atelectasis or dystelectasis, 23 (55%) showed tracheobronchitis, while in the main group 2 (5%), 6 (15%) and 11 (27.5%) children, respectively. Conclusion. The obtained results of the work show the expediency of including dynamic electronic neurostimulation in the complex of medical and rehabilitation measures in early post-operative period with infants suffering from congenital heart disease.

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