scholarly journals Ten-Year Experience in the Treatment of Coarctation of the Aorta through Endovascular Stenting in Patients of Different Age Groups

2021 ◽  
pp. 71-84
Author(s):  
Bogdan V. Cherpak ◽  
Igor O. Ditkivskyy ◽  
Nataliia S. Yashchuk ◽  
Yuliia V. Yermolovych ◽  
Oleksandr S. Golovenko ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Pregnant Women ◽  
Heart Defects ◽  
Age Groups ◽  
Coarctation Of The Aorta ◽  
Endovascular Stenting ◽  
Refractory Hypertension ◽  
Aneurysm Formation ◽  
Stent Type ◽  
Morphological Variants

The aim. To analyze the 10-year experience in aortic coarctation endovascular stenting in patients of different age groups. Materials and methods. Examination and endovascular treatment of 194 patients aged 3 days to 60 years with coarctation of the aorta (CoA) with different anatomical and morphological variants was performed. According to the age criterion, the examined patients were divided into 4 study groups. The first group consisted of 84 patients (43.3%) over 25 years of age, group 2 included 33 patients (17.0%) aged 19 to 25 years, group 3 included 71 patients (36.6%) aged 5 to 18 years, and group 4 included 6 patients (3.1%) under 1 year of age. Results and discussion. We presented the clinical features of different anatomical and morphological variants of CoA. Endovascular treatment of CoA with stenting is considered the best method for adolescents and adults, due to the lower risk of aneurysm formation compared to balloon angioplasty. We were able to successfully reduce the invasive pressure gradient in patients of different ages and to establish the dependence of complication rate on the stent type used. The most common complications were aneurysm formation (2.1%) and stent migration (2.1%). Complications occurred more often in cases of uncovered stents compared to stent grafts (5.3% and 2.1%, respectively, p <0.05). No cases of hospital mortality were recorded in patients older than 5 years. Seven endovascular procedures were performed in 5 patients aged 3 days to 11 months (mean age 3.5 ± 1.6 months) with combined heart defects. Complications were documented in 1 child (20.0%). Endovascular intervention in pregnant women is indicated in refractory hypertension. We performed endovascular CoA stenting in 4 pregnant women at 15–23 weeks of gestation (average, 19.8 ± 3.1 weeks), and in 6 women with well-controlled hypertension stenting was performed within 48 hours to 5 years after delivery. In all the presented cases, successful revascularization was achieved. During follow-up (from 2 months to 10 years), all 10 women are alive, did not develop recoarctation or complications. Conclusions. The results of the analysis of CoA endovascular treatment showed that the chosen method and technique of intervention is appropriate and safe for patients of all ages, including pregnant women. Based on the results obtained, we have developed an algorithm for the management of patients who, according to clinical examination and echocardiography, were diagnosed with CoA during pregnancy.

Impact of Novel Coronavirus (COVID-19) on Pregnant Women: A Review

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saima Habeeb ◽  
Manju Chugani
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Respiratory Infections ◽  
Age Groups ◽  
Well Being ◽  
Fetal Outcome ◽  
Global Public Health ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
The Impact

: The novel coronavirus infection (COVID‐19) is a global public health emergency.Since its outbreak in Wuhan, China in December 2019, the infection has spread at an alarming rate across the globe and humans have been locked down to their countries, cities and homes. As of now, the virus has affected over 20million people globally and has inflicted over 7 lac deaths. Nevertheless, the recovery rate is improving with each passing day and over 14 million people have recuperated so far. The statistics indicate that nobody is immune to the disease as the virus continues to spread among all age groups; newborns to the elders, and all compartmentsincluding pregnant women. However, pregnant women may be more susceptible to this infection as they are, in general, highly vulnerable to respiratory infections. There is no evidence for vertical transmission of the COVID-19 virus among pregnant women, but an increased prevalence of preterm deliveries. Besides this, the COVID-19 may alter immune response at the maternal-fetal interface and affect the well-being of mothers as well as infants. Unfortunately, there is limited evidence available in the open literature regarding coronavirus infection during pregnancy and it now appears that certain pregnant women have infected during the present 2019-nCoV pandemic. In this short communication, we study the impact of the COVID-19 infection on vertical transmission and fetal outcome among pregnant women.

scholarly journals Proximity to risk-appropriate perinatal hospitals for pregnant women with congenital heart defects in New York state

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lauren E. Schlichting ◽  
Tabassum Insaf ◽  
George Lui ◽  
Ali Zaidi ◽  
Alissa Van Zutphen
Keyword(s):  
New York ◽  
Pregnant Women ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
New York State ◽  
York State

scholarly journals Is it time to administer acellular pertussis vaccine to childbearing age/pregnant women in all areas using whole-cell pertussis vaccination schedule?

2021 ◽  
Vol 9 ◽  
pp. 251513552110158
Author(s):  
Abdoulreza Esteghamati ◽  
Shirin Sayyahfar ◽  
Yousef Alimohamadi ◽  
Sarvenaz Salahi ◽  
Mahmood Faramarzi
Keyword(s):  
Pregnant Women ◽  
Age Groups ◽  
Vaccination Schedule ◽  
Immunoglobulin M ◽  
Enzyme Linked Immunosorbent Assay ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Whole Cell ◽  
Childbearing Age Women ◽  
The Mean

Background: Whole-cell pertussis (wP) vaccine administration is still advocated for children under 7 years of age in Iran. However, there is no recommendation for the administration of a dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine to childbearing age/pregnant women in the Iranian vaccination program and it has increased the risk of infection through waning immunity during women’s childbearing age life. The study aimed to assess the levels of anti- Bordetella pertussis antibodies in childbearing age women of different ages in Iran. Methods: A cross-sectional study was conducted on a total number of 360 childbearing age women divided into six age groups, with 5-year intervals from 15 to 45 years old, in 2018–2019. Then, the levels of immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) antibodies against B. pertussis were evaluated using enzyme-linked immunosorbent assay (ELISA). The IBM SPSS Statistics software (version 16.0) (SPSS Inc., Chicago, IL, USA) was used for data analysis. Results: The mean age of the participants was 30.01 ± 8.35 years (range 14–45 years). All the cases were IgM negative, but two IgA-positive individuals (in the age groups of 14–19 and 30–34 years) were reported. Overall, 239 (66.4%) cases were IgG positive. The mean age of IgG-positive cases was 30.37 ± 8.37 years. The IgG-positive cases were mostly in the age groups of 30–34 and 35–39 years [43 (71.1%)]. The odds of IgG positivity were 1.97. The highest odds of IgG positivity were seen in 30–34 and 35–39 years groups (2.52) and the lowest odds were seen in the 20–24 and 25–29 years groups (1.60). Using the Jonckheere–Terpstra test, the increasing trend of IgG changes in different age groups was not statistically significant (Tπ=5.78, p = 0.09). Conclusion: The infants of women of childbearing age might be prone to pertussis in countries using the wP vaccination schedule. It is suggested to administer a dose of Tdap to women before or during pregnancy to increase the immunity of their infants against this disease during early infancy.

Arachnodactyly Heart

PEDIATRICS ◽  
1959 ◽  
Vol 24 (4) ◽  
pp. 522-522
Author(s):  
S. G.
Keyword(s):  
Myocardial Hypertrophy ◽  
Coarctation Of The Aorta ◽  
Hereditary Disease ◽  
Pathologic Finding ◽  
Cardiovascular Pathology ◽  
Cardiac Malformations ◽  
Septal Defects ◽  
Aneurysm Formation ◽  
Cardiac Decompensation ◽  
Myocardial Pathology

Cardiovascular lesions are known to be frequently associated with arachnodactyly. The most common pathologic finding is cystic medionecrosis, particularly affecting the aorta, which often gives rise to aneurysm formation. Congenital cardiac malformations have also been described in patients with arachnodactyly; the more common lesions encountered are coarctation of the aorta and septal defects. From his experience at the Gronigen Clinic, Netherlands, the author reports another, but less frequently observed, finding of myocardial hypertrophy and fibrosis, in the absence of other cardiovascular pathology; this lesion leads eventually to cardiac decompensation and demise. The term "arachnodactyly heart" is proposed to designate the primary myocardial pathology in this hereditary disease.

Medical management of coral reef aorta through optimised diuretic use and angiotensin receptor blockade

2021 ◽  
Vol 14 (6) ◽  
pp. e242724
Author(s):  
Nicodemus Edrick Oey ◽  
Haresh Tulsidas ◽  
Krithikaa Nadarajan
Keyword(s):  
Coral Reef ◽  
Medical Management ◽  
Rare Condition ◽  
Definitive Treatment ◽  
Receptor Blockade ◽  
Angiotensin Receptor ◽  
Endovascular Stenting ◽  
Refractory Hypertension ◽  
First Case ◽  
Angiotensin Receptor Blockade

Coral reef aorta (CRA) is a rare condition with potentially devastating complications. It is characterised by atherosclerotic calcification and stenosis of the visceral part of the aorta, usually occurring at the juxtarenal or suprarenal locations, and causing refractory hypertension and renal dysfunction. Surgical intervention, which is the recommended definitive treatment, is associated with significant morbidity and mortality. Endovascular stenting has been reported to be an alternative management option. To the best of our knowledge, this is the first case report to describe medical management of a patient with CRA with diuretics and angiotensin receptor blockade without surgical treatment.

Fetomaternal Outcome of Pregnancy with COVID-19: An Observational Study in Tertiary Care Hospitals of Pakistan

2021 ◽  
Vol 15 (6) ◽  
pp. 1903-1906
Author(s):  
Nabila Khan ◽  
Zahra Wasim ◽  
Aesha Sadaf Rizwan ◽  
Afshan Ahmad ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Negative Impact ◽  
Heart Defects ◽  
Tertiary Care ◽  
World Health ◽  
Observational Research ◽  
Military Hospital ◽  
Corona Virus ◽  
Study Results ◽  
The World

Background: The new corona virus first appeared in Wuhan, China in December 2019 and has since spread around the world to other countries. The World Health Organization believes that this new CoV-19 epidemic is a public health emergency of international concern (PHEIC) on January 30, 2020Worldwide.The mortality rate of this viral infection ranges from 2% in Pakistan to 14.4% in Italy. Lympopenia, elevated transminase, proteinuria, increased LDH, and C-reactive protein levels are all common laboratory findings in the early stages of the disease. Covid patients have experienced a variety of complications, including extreme pneumonia, ARDS, heart defects, sepsis and septic shock, and respiratory tract super infection. Methodology: This retrospective observational research study was carried out at the Gynecology Unit of MardanMedical Complex, Mardan and Combined Military Hospital, Risalpur for 06 months duration from April 2020 to September 2020. In a pre-constructed data collection form, biochemical and radiological parameters of medical history, test results, symptoms, pregnancy, and neonatal outcomes were noted. Patients treated in an outpatient setting were not included in the study. Results: There were 121 patients in total, with mean age of 27 having standard deviation ± 5, having range 19-40 years. 48.3% pregnant women reported their first pregnancy(primigravida). 51.3% of SARS-Cov-2 were in their 3rd trimester while 34.7% were in their 35-40 weeks of gestational age. Common complications are gestational hypertension (PIH) (16 cases), hypothyroidism (14 cases) and gestational diabetes (GDM) 9 cases. More than half (53%) of patients are asymptomatic. Common symptoms are cough (22%) and fever (11%). The incidence of multiple organ failure was 2% as shown in table 01. Lymphopenia was common (84%). A CT scan of 24 patients showed bilateral invasion. Conclusion: COVID-19 has a negative impact on the foetus, according to our results. Although pregnant women do not seem to be more vulnerable to COVID-19 complications than non-pregnant adults, previous research has suggested that pregnant women could be at higher risk for negative pregnancy outcomes such as preterm birth, foetal pain and respiration, symptoms, and LBW in a newborn baby. Keywords: Corona virus, COVID-19, Pregnancy, Outcome.

scholarly journals Smoking during pregnancy in Finland – Trends in the MATEX cohort

2018 ◽  
Vol 47 (8) ◽  
pp. 890-898 ◽  
Author(s):  
Isabell K. Rumrich ◽  
Kirsi Vähäkangas ◽  
Matti Viluksela ◽  
Mika Gissler ◽  
Heljä-Marja Surcel ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Young Women ◽  
Trigger Point ◽  
Age Groups ◽  
Smoking Behaviour ◽  
Smoking Rate ◽  
Female Population ◽  
Smoking During Pregnancy ◽  
Spatial Trends ◽  
Eastern Finland

Aims: In Finland, smoking rates in the general population are decreasing due to increased awareness of the adverse effects and tightened tobacco legislation. However, previous studies have shown that smoking in pregnant Finnish women remained as high as in the general Finnish female population at around 15% in 2010. Our aim was to describe temporal and spatial trends in smoking behaviour, and determinants of changes in smoking behaviour between first and second pregnancy. Methods: Self-reported smoking from the Finnish Medical Birth Register covered the years 1991–2015 ( N=1,435,009). The association of maternal age and socioeconomic status with smoking rate was analysed. Spatial trends were assessed at municipality level. Results: The overall smoking rate during early pregnancy remained fairly stable at around 15% from 1991 to 2015, but increased in teenage and young women below 25 years of age. The mean smoking rate (36%) was higher in these age groups than in older pregnant women (11%). Through the study period the smoking rate remained higher in blue collar workers compared with higher socioeconomic groups. Between the first and second child, on average only 4% of women started to smoke and 41% quitted. Smoking rates developed less favourably in Eastern Finland. Conclusions: The observed increase in smoking rate during pregnancy in teenage and young women is concerning. Pregnancy is a trigger point for smoking cessation in a big fraction of pregnant women. More studies are needed to explain the opposite trends of smoking rates in Northern and Western Finland compared with Eastern Finland.

scholarly journals Genetic testing for coarctation of aorta

2018 ◽  
Vol 2 (s1) ◽  
pp. 64-66
Author(s):  
Yeltay Rakhmanov ◽  
Paolo Enrico Maltese ◽  
Alessandra Zulian ◽  
Tommaso Beccari ◽  
Munis Dundar ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Neonatal Period ◽  
Heart Defects ◽  
Coarctation Of The Aorta ◽  
Coarctation Of Aorta ◽  
Descending Thoracic Aorta ◽  
Routine Examination ◽  
Live Births ◽  
Gene Test ◽  
Medial Thickening

Abstract Coarctation of the aorta (CoA) is an inherited narrowing of the proximal descending thoracic aorta. Histological features include localized medial thickening and infolding with superimposed neointimal tissue. CoA is diagnosed by detection of a murmur or hypertension during routine examination. Typical clinical features are delayed or absent femoral pulses and difference in blood pressure between the arm and legs. These symptoms may appear in the first weeks of life or after the neonatal period. CoA accounts for 4-6% of all congenital heart defects and has a reported prevalence of about 4 per 10,000 live births. It is more common in males than females (59% vs 41%). This Utility Gene Test was developed on the basis of an analysis of the literature and existing diagnostic protocols. It is useful for confirming diagnosis, as well as for differential diagnosis, couple risk assessment and access to clinical trials.

scholarly journals Efficacy and safety of balloon valvuloplasty as a treatment of choice for pulmonary stenosis in children and adolescents

2014 ◽  
Vol 142 (9-10) ◽  
pp. 542-546
Author(s):  
Vojislav Parezanovic ◽  
Milan Djukic ◽  
Sanja Dzelebdzic ◽  
Tamara Ilisic ◽  
Igor Stefanovic ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Pulmonary Valve ◽  
Heart Defects ◽  
Pulmonary Stenosis ◽  
Age Groups ◽  
Balloon Valvuloplasty ◽  
Pulmonary Artery Stenosis ◽  
Pulmonary Valve Insufficiency ◽  
Valve Insufficiency

Introduction. Pulmonary artery stenosis (PS) is a congenital heart defect which occurs in 10% of all congenital heart defects. Pulmonary balloon valvuloplasty (BVP) has been the treatment of choice of PS over the last 30 years. Objective. The purpose of this study was to evaluate the efficacy of this method based on middle-term hospital follow-up, and safety of BVP based on our experience. Methods. The study included 88 patients diagnosed with PS. The patients were divided into three groups based on the severity of the disease. Also, they were divided into two age groups in order to analyze the frequency of complications. Hemodynamic measurements and echocardiography results were recorded before, 24-36 hours after BVP and at the end of follow-up. Results. The studied group involved patients of average age 3.75?4.3 years (20 days to 17 years). Immediately after BVP a significant decrease of pressure gradient across the pulmonary valve (PV) was recorded in all patients; this result was similar in all 3 groups of patients regardless of the severity of stenosis (p<0.001). Complications of BVP occurred most commonly in children up to 12 months of age (ventricular tachycardia 4.5% and supraventricular tachycardia 6.8%). Pulmonary valve insufficiency after dilatation occurred in 6.6% of cases, and was most common in children aged up to 12 months. In 87 (98.9%) patients BVP was a definitive solution, and a significant residual stenosis was not recorded during follow-up. Conclusion. BVP is a safe and effective procedure in the treatment of isolated PS in children, regardless of the severity of stenosis but also regardless of patients? age.

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