Cirugía congénitos

Sci Rep. 2025 Jul 3;15(1):23690. doi: 10.1038/s41598-025-09461-6.

ABSTRACT

Due to advances in medical and surgical care, there are more adults than children living with congenital heart disease (CHD). Acute kidney injury (AKI) is a common complication following cardiac surgery in patients with CHD, with creatinine lacking sensitivity for early detection. Renal functional reserve (RFR), the kidney's capacity to increase filtration under stress, has emerged as a potential predictor of AKI. Our primary study objective was to evaluate whether preoperative RFR, using both creatinine clearance (CrCl) and cystatin C estimated glomerular filtration rate (eGFR) methods, predicts AKI following cardiopulmonary bypass in young adults with CHD. As a secondary objective, we compared RFR in CHD patients to that of healthy controls. This prospective cohort study included 30 young adults (ages 18-40) with acyanotic CHD and 8 healthy controls with normal baseline kidney function by serum creatinine. Preoperative RFR was measured using CrCl and cystatin C eGFR before and after a protein load. Postoperative AKI was diagnosed using the Kidney Disease Improving Global Outcomes criteria. Twelve (40%) CHD patients developed AKI, exhibiting significantly lower RFR when compared to those without AKI (median CrCl RFR: 9.6 vs. 35.0 mL/min/1.73m2; cystatin C eGFR RFR: 5.5 vs. 11.5 mL/min/1.73m2; P < 0.01). The ROC curve area for AKI prediction was 1.0 (CrCl RFR) and 0.88 (95% CI: 0.72-1.00, cystatin C eGFR RFR). CHD patients had lower RFR than controls (median CrCl: 25.5 vs. 56.4 mL/min/1.73m2, P < 0.01; median cystatin C eGFR: 9.0 vs. 13.5 mL/min/1.73m2, P = 0.03). In conclusion, preoperative RFR accurately predicts AKI in young adults with acyanotic CHD, providing a tool for the identification of high-risk patients and potentially improving perioperative care.

PMID:40604226 | DOI:10.1038/s41598-025-09461-6

J Heart Lung Transplant. 2025 Jun 30:S1053-2498(25)02054-6. doi: 10.1016/j.healun.2025.06.018. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to evaluate the clinical outcomes of mechanical circulatory support (MCS) using paracorporeal continuous flow (pCF) pumps in children.

METHODS: This multicenter retrospective study used the ACTION database (4/2018-7/2023). Children who were supported with a pCF pump were included. The primary outcome was survival to transplant, explant, or transition to a durable device. The secondary outcomes were adverse events. The outcomes were stratified between non-congenital heart disease (CHD) and CHD with single and biventricular physiology.

RESULTS: 367 patients (CHD, N=204, non-CHD, N=163) were supported with a median of 25 days of support (CHD: 33 vs non-CHD 19 days, P=0.04). CHD included single ventricle (n=135 [66.2%]) and biventricular physiology (n=69 [33.8%]). Non-CHD included dilated cardiomyopathy (n=130[79.8%]), transplant graft dysfunction (n=9 [5.5%]), and others (n=18[11%]). Patients with CHD were younger (0.55 vs. 2.0 years, P=<0.001) and smaller (BSA 0.35 vs. 0.52 m2, P=<0.001, weight 6.7 vs 11.1 kg, P=<0.001) than those without CHD. Overall positive outcome was 77.9% (n=286) [survival to transplant: 38.7 % (n=142), durable device: 22.9% (n=84)], recovery: 16.3% (n=60)]. Between CHD and non-CHD, CHD showed lower positive outcomes (73.0 vs. 82.2%, P=0.05) with higher mortality (24 vs 14.1 %, P=0.02). There were comparable positive outcomes between single and biventricular CHD (73.0%), with a lower recovery rate in single ventricles (8.9% vs 21.8%, P=0.01).

CONCLUSION: Mechanical circulatory support using a pCF pump in children was associated with a positive outcome in 78% of patients in a contemporary cohort. However, patients with CHD patients fared worse than patients without CHD.

PMID:40602507 | DOI:10.1016/j.healun.2025.06.018

Sci Transl Med. 2025 Jul 2;17(805):eadt2426. doi: 10.1126/scitranslmed.adt2426. Epub 2025 Jul 2.

ABSTRACT

Ritscher-Schinzel syndrome (RSS) is a congenital malformation syndrome characterized by cerebellar, cardiac, and craniofacial malformations and phenotypes associated with liver, skeletal, and kidney dysfunction. The genetic cause of RSS remains to be fully defined, and limited information is available regarding the root cause of the multiple tissue phenotypes. Causative mutations in the Commander multiprotein assembly are an emerging feature of this syndrome. Commander organizes the sorting nexin-17 (SNX17)-dependent recycling of hundreds of integral membrane proteins through the endosomal network. Here, we identify previously unrecognized cohorts of patients with RSS that we genetically and clinically analyzed to identify causative genes in the copper metabolic murr1 domain-containing (COMMD) proteins COMMD4, COMMD9, and coiled-coil domain containing 93 (CCDC93) subunits of the Commander complex. Using interactome analysis, we determined that these mutations disrupted Commander assembly and, through cell surface proteomics, that this reduces tissue-specific presentation of cell surface integral membrane proteins essential for kidney, bone, and brain development. We established that these integral proteins contained ΦxNPxY/F or ΦxNxxY/F sorting motifs in their cytoplasmic-facing domains (where Φ is a hydrophobic residue and x is any residue) that are recognized by SNX17 to drive their Commander-dependent endosomal recycling. Last, through generation of mouse models of RSS, we show replication of RSS-associated clinical phenotypes including proteinuria, skeletal malformation, and neurological impairment. Our data establish RSS as a "recyclinopathy" that arises from a dysfunction in the Commander endosomal recycling pathway.

PMID:40601774 | DOI:10.1126/scitranslmed.adt2426

Future Sci OA. 2025 Dec;11(1):2527473. doi: 10.1080/20565623.2025.2527473. Epub 2025 Jul 2.

ABSTRACT

Congenital pulmonary airway malformation (CPAM) and pulmonary sequestration (PS) are among the most common congenital lung malformations and their association is extremely rare. In exceptional cases, patients with CPAM remain asymptomatic until adulthood. We report the case of a 30-year-old man who was hospitalized in our pneumology department for fever, cough and chest pain. Radiological and histological findings confirmed the coexistence of CPAM and PS. The patient underwent surgical resection and recovered well. This is one of the few reported cases in the literature that describe the uncommon association of CPAM and PS with an infrequent diagnosis in adulthood. Clinicians should consider congenital malformations in the differential diagnosis of recurrent respiratory infections, particularly when they affect the same pulmonary lobe.

PMID:40600506 | DOI:10.1080/20565623.2025.2527473

Echocardiography. 2025 Jul;42(7):e70237. doi: 10.1111/echo.70237.

ABSTRACT

We describe a case of congenitally corrected transposition of great arteries (ccTGA) with associated double aortic arch and membranous septal aneurysm. We describe the multimodality imaging features and clinical presentation due to these anomalies.

PMID:40600358 | DOI:10.1111/echo.70237

BMC Med Imaging. 2025 Jul 1;25(1):229. doi: 10.1186/s12880-025-01803-0.

ABSTRACT

BACKGROUND: Single ventricle (SV) Fontan patients are at risk for the development of pathological cervicothoracic lymphatic drainage pathways that are involved in the development of serious conditions such as plastic bronchitis or chylothorax. Visualization and categorization of cervicothoracic lymphatic drainage pathways might therefore help to stratify prognosis and to individualize therapy and follow-up for Fontan patients. This study aimed to show that the 3-dimensional (3D) modified Dixon (mDixon) steady state magnetic resonance (MR) angiography, commonly used to image cardiovascular anatomy, can visualize cervicothoracic lymphatic drainage pathways in high resolution in Fontan patients.

METHODS: 3D mDixon steady state MR angiography of 88 pediatric and young adult patients with a Fontan circulation were retrospectively analysed. The pattern of cervicothoracic lymphatic pathways and image quality according to diagnostic value were assessed. Furthermore, ventricular volumes, mass and ejection fraction from cine imaging were measured.

RESULTS: Image quality was assessed as very good or good in > 90% of the cases. Six patients had a lymphatic complication of which five (83.3%) had a higher cervicothoracic lymphatic pathway type (type 3 or 4).

CONCLUSIONS: 3D mDixon steady state MR angiography is an established method to assess cardiovascular anatomy and function in Fontan patients. The method also allows to visualize and evaluate the cervicothoracic lymphatic anatomy with high image quality. 3D mDixon steady state MR angiography is therefore particularly useful to comprehensively assess Fontan patients, a patient group prone not only to cardiac but also lymphatic failure.

PMID:40597770 | DOI:10.1186/s12880-025-01803-0

Minerva Pediatr (Torino). 2025 Jul 2. doi: 10.23736/S2724-5276.25.07753-5. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric tracheal surgery includes several complex and rare procedures. We report the surgical experience at our center.

METHODS: Our center has multidisciplinary team manages laryngotracheal malformations. We retrospectively analyzed all tracheal surgeries from January 2009 to September 2023, excluding endoscopic cases and tracheostomy insertion, revision, or closure not related to reconstructive tracheal surgery. We evaluated diagnosis, comorbidities, type of surgery, need for tracheostomy, complications, death, outcome in terms of decannulation and adequate caliber airway.

RESULTS: A total of 122 patients with a median age of 2.61 years (0-25.4 years) were operated for congenital (59.8%) or acquired (40.2%) tracheal pathology. The procedures performed were: cricothyroid resection (N.=18; 14.8%), laryngotracheal reconstruction with rib cartilage graft (N.=33; 27%), tracheal resection-anastomosis (N.=20; 16.4%), laryngotracheal cleft closure (N.=5; 4.1%), "slide tracheoplasty" (N.=15; 12.3%), posterior tracheopexy (N.=14; 11.5%); isolated tracheoesophageal fistula closure (N.=17; 13.9%). Depending on the type of operation, cardiac surgeons and otolaryngologists were involved. Preoperative tracheotomy was required in 54 patients and postoperative in 51 patients. We reported a mortality of 6.1%, or seven patients, four of whom died in the immediate postoperative period, but only one death was due to surgical causes. Other intraoperative complications were reported in two patients (1.6%) and postoperative complications in 34 patients (27.9%). Ninety-two patients (75.4%) were alive with adequate airway caliber and no need for tracheostomy.

CONCLUSIONS: There are many indications for tracheal surgery and a multidisciplinary approach has been essential. Tracheal surgery is complex and potentially associated with major complications, but outcomes are generally satisfactory.

PMID:40598991 | DOI:10.23736/S2724-5276.25.07753-5

Gen Thorac Cardiovasc Surg Cases. 2025 Jul 1;4(1):29. doi: 10.1186/s44215-025-00214-5.

ABSTRACT

A 21-year-old female patient had undergone two open heart surgeries in childhood, including Konno ventriculoplasty with mechanical aortic valve replacement. She underwent a redo mechanical aortic valve replacement and patch enlargement of stenotic ascending aorta using a triplex prosthetic graft. Unfortunately, 1 month after surgery, the patient was readmitted to the hospital with a diagnosis of midline chest wound infection. A culture sample from the wound revealed Serratia marcescens, however, subsequent all culture tests were negative. Since then, there has been a continued serous discharge from the caudal side of the midline skin incision scar and chest tube removal scar in the chest. Despite the implementation of four open chest treatments, the issue of perigraft seroma persisted, and a diagnosis was ultimately made. During her subsequent admission, negative pressure wound therapy was employed, followed by daily sterilization and film dressing post-discharge. It is understood that a gradual decrease in drainage and complete resolution of the seroma occurred 21 months after surgery, without the removal of the implanted triplex patch.

PMID:40598704 | PMC:PMC12220449 | DOI:10.1186/s44215-025-00214-5

BMC Nephrol. 2025 Jul 1;26(1):334. doi: 10.1186/s12882-025-04269-y.

ABSTRACT

BACKGROUND: Congenital anomalies of the kidney and urinary tract (CAKUT) represents an important global health challenge. However, the emerging analysis of the burden of CAKUT is limited and outdated. This study aimed to evaluate the global burden and temporal trends of CAKUT across 204 countries and territories from 1990 to 2021.

METHODS: Data on the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of CAKUT from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021. Temporal trends were analyzed using Joinpoint regression. The association between CAKUT burden and the socio-demographic index (SDI) was examined via Spearman correlation analysis. Decomposition analysis was used to estimate the effects of population growth, aging, and epidemiological changes on overall change of CAKUT burdens. The Bayesian age-period-cohort model was utilized to predict the CAKUT burden through 2036.

RESULTS: From 1990 to 2021, the global prevalence of CAKUT increased by 21.50%, reaching 6.34 million (95% uncertainty interval [UI]: 5.07, 7.90), with a modest rise of 3.96% in the age-standardized prevalence rate (ASPR). In contrast, the incidence, mortality, and DALYs of CAKUT declined, with the age-standardized incidence rate (ASIR) decreasing by 2.86%, the age-standardized mortality rate (ASMR) by 20.00%, and the age-standardized DALY rate (ASDR) by 18.46%. In 2021, Southern Sub-Saharan Africa exhibited the highest ASPR and ASIR, while Central Latin America recorded the highest ASMR, and Southern Latin America had the highest ASDR. Furthermore, ASPR, ASIR, ASMR, and ASDR were all negatively correlated with SDI. Decomposition analysis revealed that population growth drove the increase in CAKUT prevalence. Projections to 2036 suggest further increases in ASPR and ASIR, whereas ASMR and ASDR are expected to decline.

CONCLUSION: Despite reductions in ASIR, ASMR, and ASDR, the increasing ASPR underscores the persistent global burden of CAKUT. Targeted interventions are urgently needed, particularly in high-burden regions such as Southern Sub-Saharan Africa.

PMID:40597805 | PMC:PMC12219625 | DOI:10.1186/s12882-025-04269-y

Sci Rep. 2025 Jul 1;15(1):20935. doi: 10.1038/s41598-025-04838-z.

ABSTRACT

The Pediatric Quality of Life Inventory™ (PedsQL™) family impact module is a widely used tool for assessing the health-related quality of life (HRQoL) of caregivers of children with chronic illnesses; however, it has not been available in Swahili. This study aimed to translate, culturally adapt, and validate the Swahili version of the PedsQL family impact module (FIM) among caregivers of children with heart disease in Tanzania. As a secondary aim, the study explored differences in caregiver HRQoL between those whose children had undergone surgery and those who had not, using the newly translated tool. A cross-sectional survey was conducted among 204 primary caregivers at a national cardiac referral centre. Standardised translation and adaptation procedures were followed. Psychometric evaluation included internal consistency reliability, construct validity through known-groups comparisons, and effect size estimation. The Swahili version demonstrated excellent internal consistency (Cronbach's α = 0.99) and good construct validity. Socioeconomic status was the only consistent predictor of HRQoL in multivariable models. Caregivers in the operated group consistently reported higher HRQoL scores, highlighting the potential benefit of surgical intervention on family well-being. These findings strongly support the Swahili PedsQL FIM as a culturally appropriate and psychometrically sound tool. It offers promise for clinical care and future outcome evaluations in similar settings.

PMID:40594323 | PMC:PMC12216588 | DOI:10.1038/s41598-025-04838-z

Surg Case Rep. 2025;11(1):25-0230. doi: 10.70352/scrj.cr.25-0230. Epub 2025 Jun 25.

ABSTRACT

INTRODUCTION: Coagulation disorders can lead to massive perioperative bleeding regardless of the type of surgery. Their preoperative identification is essential (from a complete history of bleeding tendency) and steps should be taken to mitigate such complications at the time of surgery. Alpha2-plasmin inhibitor (α2-PI) deficiency is a rare congenital coagulation disorder resulting in activation of fibrinolysis and requiring specific treatment with antifibrinolytic agents. Lung transplantation has not been previously reported in a patient with α2-PI deficiency.

CASE PRESENTATION: A 46-year-old female affected by chronic obstructive pulmonary disease with congenital α2-PI deficiency was referred to our hospital for cadaveric lung transplantation. Due to a previous history of intramedullary hemorrhage, we conducted lung transplantation with prophylactic administration of fresh frozen plasma (FFP) and tranexamic acid during surgery. We used the point of care test (POC) rotational thromboelastometry (ROTEM) to diagnose intraoperative coagulopathy. The postoperative course was uneventful, and she was discharged from the hospital 42 days after lung transplantation. Six months have passed since transplant, and she is still attending outpatient clinics in good health and with no record of bleeding episodes.

CONCLUSIONS: Lung transplantation for a patient with α2-PI deficiency was safely performed with the use of planned FFP transfusion and tranexamic acid. A POC ROTEM testing approach to perioperative management was useful during lung transplantation.

PMID:40589561 | PMC:PMC12207097 | DOI:10.70352/scrj.cr.25-0230

Cleft Palate Craniofac J. 2025 Jul 1:10556656251355039. doi: 10.1177/10556656251355039. Online ahead of print.

ABSTRACT

BackgroundMicrotia is a congenital anomaly characterized by malformation of the external ear. The complex chronic conditions (CCC) classification system identifies children with long-standing health problems based on various body systems and disease types. This study utilized the Pediatric Health Information System (PHIS) database to investigate the relationship between microtia and CCCs to guide screening protocols and provide insight into patient-centered treatment.MethodsA retrospective review of PHIS was conducted between 2015 and 2023. Patients were identified with an initial encounter with an associated microtia diagnosis from all participating hospitals. Patient demographics, associated organ system flags, and CCCs were collected and analyzed. Descriptive statistics were performed and effect sizes were calculated to assess associations between variables and microtia complexity.ResultsA total of 20,313 patients with microtia were identified. Of these patients, 11 183 were male (55.1%), non-Hispanic White (n = 8089, 41.9%), or Hispanic (n = 6512, 33.8%). Nearly 40% of diagnoses were associated with at least 1 CCC (n = 8234), and a significant proportion (n = 5715) were noted to have 2 or more CCCs. Cardiovascular diagnoses were among the most common organ system affected (16.8%), followed by gastrointestinal conditions (15.4%).ConclusionThis study highlights a significant correlation between microtia and CCCs. With 40% of patients diagnosed with microtia also presenting with at least 1 CCC, this study underscores the importance of comprehensive medical assessment and care strategies while further supporting the increased correlation of cardiac conditions in this population. This necessitates a re-evaluation of first-line screening modalities for patients presenting with microtia.

PMID:40589417 | DOI:10.1177/10556656251355039

Kyobu Geka. 2025 Jun;78(6):444-447.

ABSTRACT

Pulmonary enteric adenocarcinoma is a rare subtype of adenocarcinoma that was introduced in the 2015 World Health Organization( WHO) Histological Classification and Lung Cancer Treatment Protocol (8th Edition). Distinguishing it from lung metastases of colorectal cancer poses a significant clinical challenge. We report three cases of pulmonary enteric adenocarcinoma with distinct computed tomography(CT) findings. Pulmonary enteric adenocarcinoma typically presents as a large mass, often characterized as substantial and lacking a significant ground glass shadow. However, in the first case, a partially filled nodular shadow was observed;in the second case, a well-difined cystic-like mass shadow was identified;and in the third case, a nodular shadow with an internal cavity was noted.

PMID:40589021

Neoreviews. 2025 Jul 1;26(7):e477-e489. doi: 10.1542/neo.26-7-034.

ABSTRACT

Double outlet right ventricle (DORV) is a complex congenital heart disease with a wide spectrum of anatomical variations and clinical presentations. In this conotruncal anomaly, greater than 50% of the semilunar valve diameter of both the aorta and pulmonary artery arises from the morphologic right ventricle. Additionally, patients with DORV have a ventricular septal defect that allows blood to egress from the left ventricle and may obstruct either the pulmonary or systemic circulations. Physiological characteristics differ among patients based on the orientation of the great arteries, the presence of additional intracardiac shunts, and cardiac abnormalities. A thorough understanding of an individual's clinical features based on their DORV phenotype is essential for clinicians caring for these vulnerable patients. Knowledge of the expected postnatal hemodynamic derangements as transitional physiology evolves allows for tailored therapeutic approaches at the bedside. In this review, we will discuss the main DORV subtypes, delineate the physiology of each subtype, and provide clinical considerations and medical management strategies to guide the care for patients with this complex cardiac lesion.

PMID:40588272 | DOI:10.1542/neo.26-7-034

J Neurosurg Case Lessons. 2025 Jun 30;9(26):CASE25253. doi: 10.3171/CASE25253. Print 2025 Jun 30.

ABSTRACT

BACKGROUND: Neurenteric cysts are rare congenital lesions of the CNS, typically found in the cervical or thoracic spine and presenting in early life. Only 5% of spinal neurenteric cysts are intramedullary. The authors report the case of an intradural intramedullary neurenteric cyst in a 68-year-old woman.

OBSERVATIONS: The patient presented with 4 months of progressive left extremity numbness, weakness, and imbalance consistent with cervical myelopathy. MRI revealed a 1-cm cystic lesion in the intradural intramedullary cervical spine. Multilevel posterior cervical laminectomy for cyst resection was performed with gross-total resection. Histopathological analysis revealed squamous, columnar, and pseudostratified epithelium positive for epithelial membrane antigen and cytokeratin and negative for glial fibrillary acidic protein and S100 protein, consistent with a neurenteric cyst. Her symptoms and examination significantly improved after surgery.

LESSONS: Neurenteric cysts comprise 1% of spinal lesions, and 5% are intradural intramedullary. Symptoms progress gradually but may fluctuate with cyst size changes. MRI is the preferred imaging, with histopathological analysis required for diagnosis. Operative intervention for gross-total resection is the recommended management. This case emphasizes that neurenteric cysts should be considered in older adults with cervical myelopathy and a cystic intramedullary mass and demonstrates the benefit of complete surgical removal. https://thejns.org/doi/10.3171/CASE25253.

PMID:40587885 | PMC:PMC12210062 | DOI:10.3171/CASE25253

Am J Case Rep. 2025 Jun 30;26:e947068. doi: 10.12659/AJCR.947068.

ABSTRACT

BACKGROUND Renal ectopia (RE) is a congenital malformation in which one or both kidneys fail to reach their normal anatomical position. Most cases are asymptomatic, but they can occasionally lead to complications. This case report presents the incidental finding of a pelvic ectopic kidney during a pre-transcatheter aortic valve replacement (TAVR) evaluation, showing the importance of recognizing anatomical variations in surgical planning for vascular access. CASE REPORT A 68-year-old man undergoing evaluation for severe symptomatic aortic stenosis was incidentally found to have a left pelvic kidney on computed tomography (CT) angiography. The CT scan revealed a dual arterial supply, with one artery entering the kidney medially and an accessory artery wrapping laterally around the kidney, which may have contributed to the failure of its ascent during embryological development. He had no urinary symptoms, and renal function was normal, so no further intervention was required. The identification of this vascular anomaly emphasizes the need for proper preoperative imaging to avoid complications. CONCLUSIONS Recognizing anatomical variations like renal ectopia can help optimize complex vascular procedure planning and prevent complications. Additionally, this case highlights the association between multiple renal arteries and renal ectopia, suggesting further research is needed to understand these correlations.

PMID:40587412 | DOI:10.12659/AJCR.947068

Ann Afr Med. 2025 Jun 30. doi: 10.4103/aam.aam_244_24. Online ahead of print.

ABSTRACT

The thoracic duct is susceptible to damage from a variety of surgical operations, including esophagectomy, lung resection, and mediastinal or aortic surgery, because of its anatomical placement. Lymphatic leaks are known as chylothorax, which is a common complication of coronary artery bypass grafting. However, In congenital cardiac surgeries, the incidence of chylothorax ranges from 2.5% to 4.7%, while in esophageal procedures, it is 0.4%-4%. There have been a few reports of a chylous lymphatic leak following coronary bypass surgery. In this case report, we would like to present the anesthetic management of a chyle leak that developed a couple of days following triple coronary arterial bypass surgery, which was successfully managed with suprainguinal fascia iliaca compartment block for the embolization of the lymphatic duct.

PMID:40587160 | DOI:10.4103/aam.aam_244_24

Multimed Man Cardiothorac Surg. 2025 Jun 30;2025. doi: 10.1510/mmcts.2025.060.

ABSTRACT

Coronary artery aneurysms are exceedingly rare and are most often discovered incidentally. Rupture of such aneurysms is even more uncommon. In this case report, we describe an 82-year-old patient who presented with sudden-onset chest pain and was diagnosed with a fissurating aneurysm of the right coronary artery. The aneurysm was associated with a congenital abnormality of the coronary venous sinus return. The patient underwent emergency surgery. Given her advanced age, the surgical strategy focused solely on addressing the imminent risk of rupture. A 10-mm Gore-Tex graft was implanted because direct suture repair or vein grafting was deemed unsuitable. The patient recovered well postoperatively and was given dual antiplatelet therapy. At nine months of follow-up, she remains asymptomatic, with no recurrence of chest pain.

PMID:40586769 | DOI:10.1510/mmcts.2025.060

Oxf Med Case Reports. 2025 Jun 27;2025(6):omaf074. doi: 10.1093/omcr/omaf074. eCollection 2025 Jun.

ABSTRACT

Cystic hygroma is a rare congenital anomaly typically observed in newborns, with cases in adults being exceptionally rare. In adults, these lesions often remain asymptomatic and present unique challenges owing to the absence of established treatment protocols. This report describes a 23-year-old male with a large pulmonary cystic hygroma manifesting as progressive chest discomfort, breathing difficulties, and systemic symptoms. Diagnostic imaging revealed an extensive cystic structure within the mediastinal-pulmonary region, which was managed surgically via cystotomy. Histopathological analysis confirmed the diagnosis, and the patient experienced a complete recovery with no recurrence during follow-up. This case highlights the need for standardized guidelines in the management of pulmonary cystic hygromas and emphasizes the importance of including cystic hygroma in the differential diagnosis of pulmonary masses in adults. Further studies are essential to optimize therapeutic approaches and enhance outcomes for adult patients with this rare condition.

PMID:40585459 | PMC:PMC12202292 | DOI:10.1093/omcr/omaf074

Phys Med Rehabil Clin N Am. 2025 Aug;36(3):647-662. doi: 10.1016/j.pmr.2025.03.008. Epub 2025 May 24.

ABSTRACT

Hospitalized pediatric heart transplant (PHT) recipients face unique and multifaceted challenges that impact their functional outcomes, including motor skills, activities of daily living, feeding, and communication. Perioperative complications, lengthy hospitalizations, physical deconditioning, and comorbidities associated with complex congenital heart disease are important considerations as they can have a profound impact on their functional abilities and progress of individuals toward achieving independence. This article explores the role of rehabilitation providers in addressing these functional challenges through performance-based outcome measures and aims to support the development of tailored rehabilitation programs to achieve improved quality of life and long-term independence for PHT recipients.

PMID:40581444 | DOI:10.1016/j.pmr.2025.03.008