Lymphatic Disorder Management in Pediatric Patients With Congenital Heart Disease in European Pediatric Cardiology Centers : Current Status, Disparities, and Future Considerations
Safi, Sanam (University Hospital of Copenhagen, Rigshospitalet)
Hjortdal, Vibeke E. (University Hospital of Copenhagen, Rigshospitalet)
Gewillig, Marc (UZ Leuven)
Miller, Owen (Evelina Children's Hospital (Regne Unit))
Abumehdi, Mohammad Ryan (Royal Brompton Hospital (Londres))
Cantinotti, Massimiliano (National Research Institute (CNR))
Grotenhuis, Heynric (Wilhelmina Children's Hospital/UMCU)
Raimondi, Francesca (Meyer University Hospital, Florence University)
Garrido, Almudena Ortiz (Hospital Materno Infantil Málaga)
Roest, Arno (Willem-Alexander Children's Hospital, Leiden University Medical Center)
Sunnegårdh, Jan (The Queen Silvia Children's Hospital Sahlgrenska University Hospital)
Saleats, Thomas (UZ Leuven)
Brun, Henrik (Oslo University Hospital (Oslo, Noruega))
Pärna, Helen (Tallinn Children's Hospital)
Nolan, Oscar (University Hospitals Leicester)
Sabaté-Rotés, Anna (Hospital Universitari Vall d'Hebron)
Deri, Antigoni (Leeds University)
De Wolf, Daniel (Ghent University Hospital (UZ Gent))
Herberg, Ulrike (University of Aachen)
Liuba, Petru (Pediatric Heart Center, Skåne University Hospital Lund, Lund University)
Möller, Thomas (Oslo University Hospital (Oslo, Noruega))
Óskarsson, Gylfi (University of Iceland)
Rebonato, Micol (Ospedale Pediatrico Bambino Gesù (Roma, Itàlia))
Helbing, Willem A. (Erasmus MC-Sophia Children's Hospital)
Doros, Gabriela (Louis Turcanu Emergency Children Hospital)
Muntean, Iolanda (Institute for Cardiovascular Diseases and Transplantation, UMFST "George Emil Palade")
Ojala, Tiina (Children's Hospital, Helsinki University Hospital)
Lubaua, Inguna (Riga Stradins University)
Bhat, Misha (Pediatric Heart Center, Skåne University Hospital Lund, Lund University)
Wacker, Julie (Children University Hospital of Geneva)
Bonello, Beatrice (Great Ormond Street NHS Trust)
Ramcharan, Tristan (Birmingham Children's Hospital)
Greil, Gerald (UT Southwestern Medical Center (Dallas, Estats Units d'Amèrica))
Sendzikaite, Skaiste (Vilnius University)
Bonnet, Damien (Hôpital Necker Enfants Malades (París, França))
Marek, Jan (Great Ormond Street NHS Trust)
Voges, Inga (Universitätsklinikum Schleswig-Holstein)
McMahon, Colin J. (Maastricht University)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Lymphatic disorders such as protein-losing enteropathy, plastic bronchitis, and chylothorax are important complications of the Fontan circulation and ultimately result in an increased risk of early death. Several European centers are now performing lymphatic procedures. The aim of this study is to map the extent of these lymphatic disorders and treatments provided across European pediatric cardiology centers. A survey was circulated to 49 European pediatric cardiology centers consisting of 37 questions including a mix of binary, categorical, and continuous variables. Thirty-one centers (63%) participated in the study, performing a median of 250 (interquartile range, 178 - 313) cardiopulmonary bypass procedures per year. Chylothorax emerged as the most prevalent lymphatic disorder followed by protein-losing enteropathy and plastic bronchitis. The most common diagnostic investigation method was noncontrast magnetic resonance lymphangiography (52%). Eleven centers (35%) conducted lymphatic interventions with a median of 3 (interquartile range, 1 - 4) procedures per year and 12 (interquartile range, 5 - 15) interventions in total per center. This study confirms the rarity of and variation in treatment approaches for lymphatic disorders across Europe. With at least 11 centers offering lymphatic interventions, the adoption of these procedures is on the rise in Europe. To improve the quality of care and treatment outcomes for these complex patients, it is crucial to consider evidence-based lymphatic diagnostics, interventional lymphatic procedures, and the centralization of services in Europe.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Congenital heart disease ; Imaging modalities ; Lymphatic disorders ; Lymphatic interventions ; MRI ; Congenital Heart Disease ; Complications ; Treatment ; Imaging
Published in:	Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, Vol. 13 núm. 22 (november 2024) , ISSN 2047-9980

DOI: 10.1161/JAHA.124.036597
PMID: 39508150

11 p, 2.0 MB

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