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Clinical Management of Pediatric Heart Diseases
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Clinical Management of Pediatric Heart Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 746

Special Issue Editor

Dr. Michele Lioncino

E-Mail Website
Guest Editor
Pediatric Cardiology and Cardiac Arrhythmias and Syncope Unit, Bambino Gesù Children’s Hospital, IRCSS, 00146 Rome, Italy
Interests: pediatric cardiology; cardiac arrhythmia; congenital heart diseases; cardiac death; atrial fibrillation; hypertrophic cardiomyopathy; cardiac amyloidosis; hypertrophic heart disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, advances in our understanding of pediatric cardiovascular diseases has shifted paradigms towards new patient subgroups and unmet needs.

With the changing epidemiology of CHD, chronicity has become the keyword in pediatric cardiology, making long-term management and quality of life essential components of patient care. For individuals with CHD, integrated care plans addressing the medical, functional, and psychosocial aspects of treatment are increasingly being recognized as critical. Despite progress, sudden cardiac death continues to represent a serious complication in CHD patients. However, there is a notable lack of pediatric-specific research in this area, with risk stratification models often extrapolated from studies in ACHD populations. These models may not fully account for differences in surgical techniques, anatomical variations, and risk phenotypes unique to pediatric patients.

In recent decades, our awareness of genetic and rare cardiovascular diseases has introduced the need for a tailored approach; nevertheless, the evolution of personalized medicine has not fully reached the world of pediatric cardiology. Historically, the heterogeneity of congenital heart disease—including variability in anatomical classifications, surgical interventions, and management strategies—has limited the development of high-quality evidence and long-term outcome studies. Addressing these challenges requires multidisciplinary research efforts and innovative approaches to diagnosis, treatment, and follow-up care.

This Special Issue will focus on advances and applications in imaging, surgery, interventional cardiology, sports cardiology, prognostic stratification, and follow-up studies addressing the clinical management of pediatric heart diseases. Original articles and reviews are welcome.

Dr. Michele Lioncino
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric heart diseases
  • children
  • pediatric cardiology
  • congenital heart disease
  • clinical management
  • congenital heart surgery
  • outcome

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Published Papers (1 paper)

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Research

11 pages, 227 KiB  
Article
Extracellular Matrix Tissue Patch for Aortic Arch Repair in Pediatric Cardiac Surgery: A Single-Center Experience
by Marcin Gładki, Anita Węclewska, Paweł R. Bednarek, Tomasz Urbanowicz, Anna Olasińska-Wiśniewska, Bartłomiej Kociński and Marek Jemielity
J. Clin. Med. 2025, 14(11), 3955; https://doi.org/10.3390/jcm14113955 - 3 Jun 2025
Viewed by 517
Abstract
Introduction: Among aortic diseases in children, congenital defects such as coarctation of the aorta (CoA), interrupted aortic arch (IAA), hypoplastic aortic arch (HAA), and hypoplastic left heart syndrome (HLHS) predominate. Tissue patches are applied in pediatric cardiovascular surgery for the repair of [...] Read more.
Introduction: Among aortic diseases in children, congenital defects such as coarctation of the aorta (CoA), interrupted aortic arch (IAA), hypoplastic aortic arch (HAA), and hypoplastic left heart syndrome (HLHS) predominate. Tissue patches are applied in pediatric cardiovascular surgery for the repair of congenital aortic defects as a filling material to replenish missing tissue or as a substitute material for the complete reconstruction of the vascular wall along the course of the vessel. This retrospective single-center study aimed to present the safety and feasibility of extracellular matrix (ECM) biological scaffolds in pediatric aortic surgery. Patients and methods: There were 26 patients (17 newborns and nine children), who underwent surgical procedures in the Department of Pediatric Cardiac Surgery (Poznań, Poland) between 2023 and 2024. The patients’ population was divided into two subgroups according to the hemodynamic nature of the primary diagnosis of the congenital heart defect and the performed pediatric cardiovascular surgery. The first group included 18 (72%) patients after aortic arch repair for interrupted aortic arch and/or hypoplastic aortic arch, while the second group included seven (28%) patients after aortopulmonary anastomosis. In the first group, patches were used to reconstruct the aortic arch by forming an artificial arch with three separate patches sewn together, primarily addressing the hypoplastic or interrupted segments. In the second group, patches were applied to augment the anastomosis site between the pulmonary trunk and the aortic arch, specifically at the connection points in procedures, such as the Damus–Kaye–Stansel or Norwood procedures. The analysis was based on data acquired from the national cardiac surgery registry. Results: The overall mortality in the presented group was 15%. All procedures were performed using median sternotomy with a cardiopulmonary bypass. The cardiopulmonary bypass (CPB) and aortic cross-clamp (AoX) median times were 144 (107–176) and 53 (33–79) min, respectively. There were two (8%) cases performed in deep hypothermic circulatory arrest (DHCA). The median postoperative stay in the intensive care unit (ICU) was 284 (208–542) h. The median mechanical ventilation time was 226 (103–344) h, including 31% requiring prolonged mechanical ventilation support. Postoperative acute kidney failure requiring hemodiafiltration (HDF) was noticed in 12% of cases. Follow-up data, collected via routine transthoracic echocardiography (TTE) and clinical assessments over a median of 418 (242.3–596.3) days, showed no evidence of patch-related complications such as restenosis, aneurysmal dilation, or calcification in surviving patients. One patient required reintervention on the same day due to a significantly narrow ascending aorta, unrelated to patch failure. No histological data from explanted patches were available, as no patches were removed during the study period. The median (Q1–Q3) hospitalization time was 21 (16–43) days. Conclusions: ProxiCor® biological patches derived from the extracellular matrix can be safely used in pediatric patients with congenital aortic arch disease. Long-term follow-up is necessary to confirm the durability and growth potential of these patches, particularly regarding their resistance to calcification and dilation. Full article
(This article belongs to the Special Issue Clinical Management of Pediatric Heart Diseases)
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