Browsing by Author "Pinto, Fátima"
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- Fatal Superior Vena Cava Obstruction With High-Output Chylothorax in a Preterm Infant: A Complication of Central Venous CatheterizationPublication . Constante, Andreia D; Virella, Daniel; Lage, Maria J; Pinto, FátimaChylothorax in the perinatal period may have congenital or acquired aetiologies. In premature infants, invasive procedures with thrombosis risk are common practice. We present a case of a 29-week gestation neonate, diagnosed on the 27th postnatal day with vegetation on the tip of the central venous catheter (CVC) and right auricle thrombosis, along with superior vena cava (SVC) syndrome, leading to significant bilateral chylothorax. Despite antithrombotic therapy, extensive intramural SVC obstruction persisted. Surgical intervention was considered high risk in such a preterm infant. Lung function declined progressively, and the neonate died from cardiorespiratory failure at the age of 2 months and 26 days. A post-mortem examination revealed minimal SVC lumen obstruction, emphasizing the potential lethality of secondary complications, regardless of successful thrombolysis. This case highlights both the life-threatening risk of neonatal SVC thrombosis associated with CVC and the need to assess the causes of chylothorax for coexisting aetiologies.
- Prevalence, Management, and Outcomes of Atrial Fibrillation in Paediatric Patients: Insights from a Tertiary Cardiology Centre.Publication . Constante, Andreia Duarte; Suarez, Joana; Lourenço, Guilherme; Portugal, Guilherme; Silva Cunha, Pedro; Martins Oliveira, Mário; Trigo, Conceição; Pinto, Fátima; Laranjo, SérgioAtrial fibrillation (AF) is increasingly recognised in paediatric patients, presenting unique challenges in management due to its association with various underlying heart conditions. This study aimed to evaluate the prevalence, management strategies, and outcomes of AF in this population. : A retrospective analysis was conducted at a tertiary paediatric cardiology centre, including patients aged ≤18 years diagnosed with AF between January 2015 and December 2023. The study focused on demographic details, clinical presentations, treatments, and outcomes. Descriptive statistics were employed to assess treatment efficacy, recurrence rates, and complications. : The study included 36 paediatric patients (median age: 15 years, IQR: 13-17; 58% male). Of these, 52.8% had acquired heart disease, 16.7% had congenital heart anomalies, and 16.7% presented with lone AF. The initial management strategies involved electrical cardioversion in 53.3% of patients and pharmacological conversion with amiodarone in 46.7%. Rhythm control therapy was administered to over 80% of the cohort, and 63.9% were placed on oral anticoagulation, predominantly for rheumatic and congenital heart diseases. The overall success rate of rhythm control was 96.2%, with an AF recurrence rate of 3.8%. Ischemic stroke was the most common complication, occurring in three patients, all with underlying rheumatic heart disease. : AF in paediatric patients is predominantly associated with rheumatic and congenital heart diseases, though a significant proportion of patients present with lone AF. Despite effective rhythm control in most cases, neurological complications, particularly ischemic strokes in patients with underlying heart disease, remain a critical concern. These findings underscore the need for more comprehensive studies to better understand the aetiology, risk factors, and optimal management strategies for paediatric AF.