Neo Reviews

NeoReviews current issue

  • Acyanotic Congenital Heart Disease: Left-to-Right Shunt Lesions
    Acyanotic congenital heart diseases or left-to-right shunting lesions are the most common form of congenital heart disease. Although most resolve spontaneously, many will remain hemodynamically significant, particularly in the premature infant. Understanding the difference in pathophysiology, diagnosis, and management between the term and preterm infant is imperative to minimize the risk of secondary organ dysfunction and ensure proper growth and development.

  • Right and Left Ventricular Outflow Tract Obstructive Lesions
    Obstructive cardiac lesions are a common type of congenital heart disease ranging in severity from asymptomatic, mild valvular stenosis to valvar atresia with congestive heart failure and cyanosis. Understanding the pathophysiology and initial management of right and left ventricular outflow tract obstruction is imperative to minimize morbidity and mortality in term and preterm infants.

  • Diagnosis and Management of Patent Ductus Arteriosus
    Preterm infants are at increased risk for patent ductus arteriosus (PDA). Prolonged exposure to PDA may be deleterious and has been associated with neonatal morbidity and mortality. Although the molecular mechanisms underlying regulation of postnatal ductus arteriosus closure are not fully understood, clinical experience and research trials have informed recent changes in PDA management strategies and refocused treatment strategies on smaller subsets of infants who require intervention. This review examines current diagnostic and management approaches to PDA in preterm neonates.

  • Myocardial Disorders in the Neonate
    Myocardial disorders in the neonate could be a significant cause of morbidity and mortality. The neonatal myocardium is immature and undergoes several changes after birth. These include changes in the size of the myocardium, cellular transport of calcium, and utilization for fatty acid and glucose metabolism. Neonatal myocardium relies heavily on the heart rate to improve cardiac output. Myocardial disorders in the neonate can be classified as primary and secondary. Primary myocardial disorders have an inherent abnormality in the cardiac muscle and can be further subclassified based on the morphology and presentation. These include hypertrophic cardiomyopathy, dilated cardiomyopathy, and restrictive cardiomyopathy. Secondary myocardial disorders are usually caused by a systemic disorder that affects the cardiac muscle and function. These include inborn errors of metabolism, neuromuscular disorders, and mitochondrial disorders. The diagnosis and management of cardiomyopathy is very specific to the type of cardiomyopathy or underlying disorders. A team approach, including neonatology, genetics and metabolism, and cardiology and cardiac transplantation, is essential in managing these cases.