Surgical Management of Ventricular Aneurysms in Pediatric Patients with Viral Myocarditis: A Comprehensive Review
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Abstract
Background: Viral myocarditis represents a significant cause of pediatric cardiac morbidity and is occasionally complicated by the formation of ventricular aneurysms (VAs). These rare lesions can lead to life-threatening complications, including arrhythmias, embolic events, and cardiac rupture, necessitating timely and effective management.
Objective: This article aims to review the surgical approaches employed in managing ventricular aneurysms in children with viral myocarditis, focusing on clinical presentations, diagnostic tools, surgical techniques, and outcomes.
Methods: A comprehensive review of existing literature was conducted, emphasizing pediatric cases of VA secondary to viral myocarditis. The analysis includes case reports, retrospective studies, and clinical guidelines outlining indications for surgical intervention and the technical considerations therein.
Results: Surgical resection of ventricular aneurysms in this population remains a challenging yet often life-saving procedure. Key findings highlight the importance of preoperative imaging modalities, intraoperative strategies to preserve ventricular function, and the role of postoperative care in optimizing outcomes.
Conclusions: While surgical management of VAs in pediatric viral myocarditis is rare, it provides a definitive treatment option with favorable outcomes in well-selected cases. Multidisciplinary collaboration and advancements in surgical techniques are critical in addressing this complex pathology.
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References
I. Grossi EA, Colvin SB, Galloway AC, et al. Repair of posterior left ventricular aneurysm in a six-year-old boy. Ann Thorac Surg 1991; 51: 484–487.
II. Yaku H, Ohira S, Yamazaki S, et al. Endocardial linear infarct exclusion technique for infarcted lateral wall interact. Cardiovasc Thorac Surg 2017; 24: 460–461.
III. Papagiannis J, Van Praagh R, Schwint O, et al. Congenital left ventricular aneurysm: Clinical, imaging, pathologic, and surgical findings in seven new cases. Am Heart J 2001; 141: 491–499.
IV. Ercan A, Senkaya I, Semizel E, et al. Left ventricular aneurysm in a 4-year-old boy. Tex Heart Inst J 2005; 32: 614–615.
V. Egunov OA, Krivoshchekov EV, Cetta F, et al. Surgical management of a giant congenital left ventricular aneurysm in a 2-month-old infant. J Card Surg 2021; 36: 2575–2577.
VI. Chowdhury UK, Seth S, Sheil A, et al. Successful aneurysmectomy of a congenital apical left ventricular aneurysm. Tex Heart Inst J 2009; 36: 331–333.
VII. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID‐19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239–1242.
VIII. Tagarro A, Epalza C, Santos M, Sanz‐Santaeufemia FJ, Otheo E, Moraleda C, Calvo C. Screening and severity of coronavirus disease 2019 (COVID‐19) in children in Madrid, Spain. JAMA Pediatr 2020: e201346.
IX. Belhadjer Z, Meot M, Bajolle F, Khraiche D, Legendre A, Abakka S, Auriau J, Grimaud M, Oualha M, Beghetti M, Wacker J. Acute heart failure in multisystem inflammatory syndrome in children (MIS‐C) in the context of global SARS‐CoV‐2 pandemic. Circulation 2020; 142: 429–436.
X. Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P, Ramnarayan P, Fraisse A, Miller O, Davies P, Kucera F, Brierley J, McDougall M, Carter M, Tremoulet A, Shimizu C, Herberg J, Burns JC, Lyall H, Levin M, for the PIMS‐TS Study Group and EUCLIDS and PERFORM Consortia . Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS‐CoV‐2. JAMA 2020; 324: 259–269.
XI. Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, Bonanomi E, D'Antiga L. An outbreak of severe Kawasaki‐like disease at the Italian epicentre of the SARS‐CoV‐2 epidemic: an observational cohort study. Lancet 2020; 395: 1771–1778.
XII. Ravelli A, Minoia F, Davi S, Horne A, Bovis F, Pistorio A, Arico M, Avcin T, Behrens EM, De Benedetti F, Filipovic L, Grom AA, Henter J‐I, Ilowite NT, Jordan MB, Khubchandani R, Kitoh T, Lehmberg K, Lovell DJ, Miettunen P, Nichols KE, Ozen S, Schmid JP, Ramanan AV, Russo R, Schneider R, Sterba G, Uziel Y, Wallace C, Wouters C, Wulffraat N, Demirkaya E, Brunner HI, Martini A, Ruperto N, Cron RQ, Paediatric Rheumatology International Trials Organisation , Childhood Arthritis and Rheumatology Research Alliance; Pediatric Rheumatology Collaborative Study Group , Histiocyte Society . 2016 classification criteria for macrophage activation syndrome complicating systemic juvenile idiopathic arthritis: a European League Against Rheumatism/American College of Rheumatology/PaediatricRheumatology International Trials Organisation Collaborative Initiative. Ann Rheum Dis 2016; 75: 481–489.