Search

Trans-aortic septal myectomy is the gold standard for septal reduction therapy. This technique has low peri-procedural mortality and excellent long-term survival. Moreover, it relieves the heart failure symptoms and improves the quality of life. Secondary chordal cutting along with septal myectomy has shown to improve the outcome but can potentially cause deterioration of left ventricular function. In patients with relatively thin inter-ventricular septum, abnormalities of mitral valve apparatus may be the main reason for systolic anterior motion and left ventricular outflow tract obstruction. These patients may require additional procedures on the mitral valve to shift the coaptation plane away from outflow tract. Mitral valve replacement should be performed only in patients with intrinsic mitral valve abnormalities that are not suitable for repair and its routine use along with limited septal myectomy should be discouraged. Minimal access surgery although attractive in concept requires more robust data before universal application. [ABSTRACT FROM AUTHOR]

Left Ventricular Non Compaction (LVNC) is considered a unique cardiomyopathy according to the American Heart Association guidelines. The genetic ethology of LVNC in children is not completely understood although upto 41% of LVNC are thought to be genetic. We report a family with LVNC due to a novel mutation in the MYH 7 gene. [ABSTRACT FROM AUTHOR]

Background: The aetiology of congenital heart disease (CHD) is multifactorial. Environmental risk factors have emerged as an important modifiable determinant of several congenital cardiac conditions. Previous studies have shown a strong relationship between CHD and air pollution. Much less is known about the influence of ambient temperature on CHD. The primary objective of this meta-analysis was to examine the association between exposure to extreme heat events (EHE) during pregnancy and CHD in the offspring., Methods: comprehensive literature search was conducted using electronic databases such as Scopus and PubMed, along with a review of secondary references. This process yielded eight studies that met the inclusion criteria: four from the USA, two from China, one from Israel and one from Canada. The risk of bias was assessed using the Newcastle Ottawa scale. Mixed-effect regression was used to pool the estimates of individual studies. Heterogeneity was measured by I 2 . Results were visualised by a forest plot, a Baujat plot and an albatross plot. Subgroup analyses were performed for climate zones, exposure definitions and the study region. As a sensitivity analysis, a leave-one-out meta-analysis was performed to assess the robustness of the estimates., Results: Exposure to EHE during pregnancy increased the risk for CHD in the offspring (OR=1.12, 95% CI 1.04 to 1.34). Studies from the USA observed the smallest effect (OR=1.01, 95% CI 0.91 to 1.13), studies in the continental climate zone observed a slightly larger effect (OR=1.07, 95% CI 0.97 to 1.19), and studies from the temperate climate zone observed the largest effect (OR=1.35, 95% CI 1.23 to 1.48). Subgroup analysis was conducted with respect to exposure, effect definition and region. The residual heterogeneity measures were 88% (exposure), 61% (effect definition) and 38% (Region)., Conclusion: The association between prenatal EHE exposure and future risk of CHD has important implications for pregnant mothers, infant health and health policy. Future studies should explore the additional burden of CHD contributed by current trends in global ambient temperature in other parts of the world., Prospero Registration Number: CRD42023455934., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)