Syncope belongs to the transient loss of consciousness(TLOC), characterized by a rapid onset, short duration, and spontaneous complete recovery. It is common in children and adolescents, accounting for 1% to 2% of eme...Syncope belongs to the transient loss of consciousness(TLOC), characterized by a rapid onset, short duration, and spontaneous complete recovery. It is common in children and adolescents, accounting for 1% to 2% of emergency department visits.Recurrent syncope can seriously affect children's physical and mental health, learning ability and quality of life and sometimes cardiac syncope even poses a risk of sudden death. The present guideline for the diagnosis and treatment of syncope in children and adolescents was developed for guiding a better clinical management of pediatric syncope. Based on the globally recent development and the evidence-based data in China, 2018 Chinese Pediatric Cardiology Society(CPCS) guideline for diagnosis and treatment of syncope in children and adolescents was jointly prepared by the Pediatric Cardiology Society, Chinese Pediatric Society, Chinese Medical Association(CMA)/Committee on Pediatric Syncope, Pediatricians Branch, Chinese Medical Doctor Association(CMDA)/Committee on Pediatric Cardiology, Chinese College of Cardiovascular Physicians, Chinese Medical Doctor Association(CMDA)/Pediatric Cardiology Society, Beijing Pediatric Society, Beijing Medical Association(BMA). The present guideline includes the underlying diseases of syncope in children and adolescents, the diagnostic procedures, methodology and clinical significance of standing test and headup tilt test, the clinical diagnosis vasovagal syncope, postural orthostatic tachycardia syndrome, orthostatic hypotension and orthostatic hypertension, and the treatment of syncope as well as follow-up.展开更多
Surgical repair of a variety of congenital heart diseases involves repair of the right ventricular outflow tract(RVOT)with valved or non-valved conduit to connect the right ventricle(RV)to the pulmonary artery(PA)or j...Surgical repair of a variety of congenital heart diseases involves repair of the right ventricular outflow tract(RVOT)with valved or non-valved conduit to connect the right ventricle(RV)to the pulmonary artery(PA)or just patch enlargement of the native RVOT.With time,this RV-PA conduit will degenerate with deterioration of function,either causing pulmonary stenosis or pulmonary regurgitation.This RVOT dysfunction may result in RV dilation,RV dysfunction,and eventual RV failure and arrhythmias.Multiple surgical pulmonary valve replacement(PVR)is often required throughout the patient’s lifetime.Patients are subjected to increased risks with each additional cardiac operation.Transcatheter PVR(TPVR)has been developed over the past two decades as a valuable non-surgical alternative to restore the RVOT and RV function,and hence reduce patients’lifetime risks related to surgery.This article will discuss the long-term results of TPVR which are demonstrated to be comparable to surgical results and the latest development of large pulmonary valves which will allow TPVR to be performed on native or larger RVOT.展开更多
文摘Syncope belongs to the transient loss of consciousness(TLOC), characterized by a rapid onset, short duration, and spontaneous complete recovery. It is common in children and adolescents, accounting for 1% to 2% of emergency department visits.Recurrent syncope can seriously affect children's physical and mental health, learning ability and quality of life and sometimes cardiac syncope even poses a risk of sudden death. The present guideline for the diagnosis and treatment of syncope in children and adolescents was developed for guiding a better clinical management of pediatric syncope. Based on the globally recent development and the evidence-based data in China, 2018 Chinese Pediatric Cardiology Society(CPCS) guideline for diagnosis and treatment of syncope in children and adolescents was jointly prepared by the Pediatric Cardiology Society, Chinese Pediatric Society, Chinese Medical Association(CMA)/Committee on Pediatric Syncope, Pediatricians Branch, Chinese Medical Doctor Association(CMDA)/Committee on Pediatric Cardiology, Chinese College of Cardiovascular Physicians, Chinese Medical Doctor Association(CMDA)/Pediatric Cardiology Society, Beijing Pediatric Society, Beijing Medical Association(BMA). The present guideline includes the underlying diseases of syncope in children and adolescents, the diagnostic procedures, methodology and clinical significance of standing test and headup tilt test, the clinical diagnosis vasovagal syncope, postural orthostatic tachycardia syndrome, orthostatic hypotension and orthostatic hypertension, and the treatment of syncope as well as follow-up.
文摘Surgical repair of a variety of congenital heart diseases involves repair of the right ventricular outflow tract(RVOT)with valved or non-valved conduit to connect the right ventricle(RV)to the pulmonary artery(PA)or just patch enlargement of the native RVOT.With time,this RV-PA conduit will degenerate with deterioration of function,either causing pulmonary stenosis or pulmonary regurgitation.This RVOT dysfunction may result in RV dilation,RV dysfunction,and eventual RV failure and arrhythmias.Multiple surgical pulmonary valve replacement(PVR)is often required throughout the patient’s lifetime.Patients are subjected to increased risks with each additional cardiac operation.Transcatheter PVR(TPVR)has been developed over the past two decades as a valuable non-surgical alternative to restore the RVOT and RV function,and hence reduce patients’lifetime risks related to surgery.This article will discuss the long-term results of TPVR which are demonstrated to be comparable to surgical results and the latest development of large pulmonary valves which will allow TPVR to be performed on native or larger RVOT.
