Heart Failure Reviews

, Volume 23, Issue 4, pp 555–562 | Cite as

Advances in heart failure therapy in pediatric patients with dilated cardiomyopathy

  • Stefan Rupp
  • Christian Jux


While in adults major advances in heart failure therapy in patients with dilated cardiomyopathy were documented in the last two decades, research on the mechanism and therapies of heart failure in children with left ventricular dilated cardiomyopathy has lagged behind. Despite the lack of sufficient randomized prospective studies, ACE inhibitors are first line and ß-receptor antagonists are second-line strategies in children. Following the adult guidelines, without having data concerning the pediatric population, mineral corticoids are also accepted in the treatment of pediatric heart failure, while diuretics should only be used to achieve a euvolemic status. In cases of complete left bundle bunch block or prolonged QRS duration, cardiac resynchronization is an option. If these instruments are exploited, and the child is still listed for heart transplantation as destination, evolving therapies like pulmonary artery banding in cases of preserved right ventricular function and cardiac cell therapy in cases of localized ventricular dysfunction might represent additional treatment options. This review summarizes the actual guidelines and provides an outlook for evolving therapies.


Heart failure Pediatrics Pulmonary artery banding Cardiac cell therapy Dilated cardiomyopathy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The treatment of patients has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior treatment.


  1. 1.
    Lipshultz SE, Sleeper LA, Towbin JA, Lowe AM, Orav EJ, Cox GF, Lurie PR, McCoy KL, McDonald MA, Messere JE, Colan SD (2003) The incidence of pediatric cardiomyopathy in two regions of the United States. N Engl J Med 348:1647–1655CrossRefPubMedGoogle Scholar
  2. 2.
    Nugent AW, Daubeney PE, Chondros P, Carlin JB, Cheung M, Wilkinson LC, Davis AM, Kahler SG, Chow CW, Wilkinson JL, Weintraub RG, National Australian Childhood Cardiomyopathy Study (2003) The epidemiology of childhood cardiomyopathy in Australia. N Engl J Med 348:1639–1646CrossRefPubMedGoogle Scholar
  3. 3.
    Arola A, Tuominen J, Ruuskanen O, Jokinen E (1998) Idiopathic dilated cardiomyopathy in children: prognostic indicators and outcome. Pediatrics 101:369–376CrossRefPubMedGoogle Scholar
  4. 4.
    Towbin JA, Lowe AM, Colan SD, Sleeper LA, Orav EJ, Clunie S, Messere J, Cox GF, Lurie PR, Hsu D, Canter C, Wilkinson JD, Lipshultz SE (2006) Incidence, causes, and outcomes of dilated cardiomyopathy in children. JAMA 296:1867–1876CrossRefPubMedGoogle Scholar
  5. 5.
    Alexander PM, Daubeney PE, Nugent AW et al (2013) Long-term outcomes of dilated cardiomyopathy diagnosed during childhood: results from a national population-based study of childhood cardiomyopathy. Circulation 128:2039–2046CrossRefPubMedGoogle Scholar
  6. 6.
    Rupp S, Apitz C, Tholen L (2015) Upgraded heart failure therapy leads to an improved outcome of dilated cardiomyopathy in infants and toddlers. Cardiol Young (7):1300–1305Google Scholar
  7. 7.
    Kirk R, Dipchand AI, Rosenthal DN, Addonizio L, Burch M, Chrisant M, Dubin A, Everitt M, Gajarski R, Mertens L, Miyamoto S, Morales D, Pahl E, Shaddy R, Towbin J, Weintraub R (2014) The International Society of Heart and Lung Transplantation Guidelines for the management of pediatric heart failure: executive summary. J Heart Lung Transplant 33:888–909CrossRefPubMedGoogle Scholar
  8. 8.
    Bristow MR (1997) Mechanism of action of beta-blocking agents in heart failure. Am J Cardiol 80:26L–40LCrossRefPubMedGoogle Scholar
  9. 9.
    Waagstein F, Bristow MR, Swedberg K et al (1993) Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Metoprolol in Dilated Cardiomyopathy (MDC) Trial Study Group. Lancet 342:1441–1446CrossRefPubMedGoogle Scholar
  10. 10.
    Packer M, Coats AJ, Fowler MB et al (2001) Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 344:1651–1658CrossRefPubMedGoogle Scholar
  11. 11.
    The SOLVD investigators (1991) Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 325:293–302CrossRefGoogle Scholar
  12. 12.
    Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J (1999) The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone evaluation study investigators. N Engl J Med 341:709–717CrossRefPubMedGoogle Scholar
  13. 13.
    Patel AR, Shaddy RE (2010) Role of beta-blocker therapy in pediatric heart failure. Pediatr Health 4:45–58CrossRefGoogle Scholar
  14. 14.
    Frenneaux M, Stewart RA, Newman CM, Hallidie-Smith KA (1989) Enalapril for severe heart failure in infancy. Arch Dis Child 64:219–223CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Lewis AB, Chabot M (1993) The effect of treatment with angiotensin-converting enzyme inhibitors on survival of pediatric patients with dilated cardiomyopathy. Pediatr Cardiol 14:9–12PubMedGoogle Scholar
  16. 16.
    Leversha AM, Wilson NJ, Clarkson PM, Calder AL, Ramage MC, Neutze JM (1994) Efficacy and dosage of enalapril in congenital and acquired heart disease. Arch Dis Child 70:35–39CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Mori Y, Nakazawa M, Tomimatsu H, Momma K (2000) Long-term effect of angiotensin-converting enzyme inhibitor in volume overloaded heart during growth: a controlled pilot study. J Am Coll Cardiol 36:270–275CrossRefPubMedGoogle Scholar
  18. 18.
    Stern H, Weil J, Genz T, Vogt W, Buhlmeyer K (1990) Captopril in children with dilated cardiomyopathy: acute and long-term effects in a prospective study of hemodynamic and hormonal effects. Pediatr Cardiol 11:22–28CrossRefPubMedGoogle Scholar
  19. 19.
    Kantor PF, Abraham JR, Dipchand AI, Benson LN, Redington AN (2010) The impact of changing medical therapy on transplantation-free survival in pediatric dilated cardiomyopathy. J Am Coll Cardiol 55:1377–1384CrossRefPubMedGoogle Scholar
  20. 20.
    Hsu DT, Zak V, Mahony L, Sleeper LA, Atz AM, Levine JC, Barker PC, Ravishankar C, McCrindle BW, Williams RV, Altmann K, Ghanayem NS, Margossian R, Chung WK, Border WL, Pearson GD, Stylianou MP, Mital S, for the Pediatric Heart Network Investigators (2010) Enalapril in infants with single ventricle: results of a multicenter randomized trial. Circulation 122:333–340CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Li JS, Colan SD, Sleeper LA, Newburger JW, Pemberton VL, Atz AM, Cohen MS, Golding F, Klein GL, Lacro RV, Radojewski E, Richmond ME, Minich LLA (2011) Lessons learned from a pediatric clinical trial: the pediatric heart network angiotensin-converting enzyme inhibition in mitral regurgitation study. Am Heart J 161:233–240CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Buchhorn R, Bartmus D, Siekmeyer W, Hulpke-Wette M, Schulz R, Bursch J (1998) Beta-blocker therapy of severe congestive heart failure in infants with left to right shunts. Am J Cardiol 81:1366–1368CrossRefPubMedGoogle Scholar
  23. 23.
    Buchhorn R, Hulpke-Wette M, Ruschewski W, Ross RD, Fielitz J, Pregla R, Hetzer R, Regitz-Zagrosek V (2003) Effects of therapeutic beta blockade on myocardial function and cardiac remodelling in congenital cardiac disease. Cardiol Young 13:36–43CrossRefPubMedGoogle Scholar
  24. 24.
    Buchhorn R, Hulpke-Wette M, Hilgers R, Bartmus D, Wessel A, Bursch J (2001) Propranolol treatment of congestive heart failure in infants with congenital heart disease: the CHF-PRO-INFANT trial. Congestive heart failure in infants treated with propanol. Int J Cardiol 79:167–173CrossRefPubMedGoogle Scholar
  25. 25.
    Shaddy RE, Olsen SL, Bristow MR, Taylor DO, Bullock EA, Tani LY, Renlund DG (1995) Efficacy and safety of metoprolol in the treatment of doxorubicin-induced cardiomyopathy in pediatric patients. Am Heart J 129:197–199CrossRefPubMedGoogle Scholar
  26. 26.
    Shaddy RE (1998) Beta-blocker therapy in young children with congestive heart failure under consideration for heart transplantation. Am Heart J 136:19–21CrossRefPubMedGoogle Scholar
  27. 27.
    Shaddy RE, Tani LY, Gidding SS, Pahl E, Orsmond GS, Gilbert EM, Lemes V (1999) Beta-blocker treatment of dilated cardiomyopathy with congestive heart failure in children: a multi-institutional experience. J Heart Lung Transplant 18:269–274CrossRefPubMedGoogle Scholar
  28. 28.
    Rusconi P, Gomez-Marin O, Rossique-Gonzalez M et al (2004) Carvedilol in children with cardiomyopathy: 3-year experience at a single institution. J Heart Lung Transplant 23:832–838CrossRefPubMedGoogle Scholar
  29. 29.
    Bruns LA, Chrisant MK, Lamour JM, Shaddy RE, Pahl E, Blume ED, Hallowell S, Addonizio LJ, Canter CE (2001) Carvedilol as therapy in pediatric heart failure: an initial multicenter experience. J Pediatr 138:505–511CrossRefPubMedGoogle Scholar
  30. 30.
    Laer S, Mir TS, Behn F et al (2002) Carvedilol therapy in pediatric patients with congestive heart failure: a study investigating clinical and pharmacokinetic parameters. Am Heart J 143:916–922CrossRefPubMedGoogle Scholar
  31. 31.
    Askari H, Semizel E, Bostan OM, Cil E (2009) Carvedilol therapy in pediatric patients with dilated cardiomyopathy. Turk J Pediatr 51:22–27PubMedGoogle Scholar
  32. 32.
    Bajcetic M, Kokic Nikolic A, Djukic M et al (2008) Effects of carvedilol on left ventricular function and oxidative stress in infants and children with idiopathic dilated cardiomyopathy: a 12-month, two-center, open-label study. Clin Ther 30:702–714CrossRefPubMedGoogle Scholar
  33. 33.
    Gachara N, Prabhakaran S, Srinivas S, Farzana F, Krishnan U, Efficacy SMJ (2001) Safety of carvedilol in infants with dilated cardiomyopathy: a preliminary report. Indian Heart J 53:74–78PubMedGoogle Scholar
  34. 34.
    Blume ED, Canter CE, Spicer R, Gauvreau K, Colan S, Jenkins KJ (2006) Prospective single-arm protocol of carvedilol in children with ventricular dysfunction. Pediatr Cardiol 27:336–342CrossRefPubMedGoogle Scholar
  35. 35.
    Azeka E, Franchini Ramires JA, Valler C, Alcides Bocchi E (2002) Delisting of infants and children from the heart transplantation waiting list after carvedilol treatment. J Am Coll Cardiol 40:2034–2038CrossRefPubMedGoogle Scholar
  36. 36.
    Shaddy RE, Boucek MM, Hsu DT, Boucek RJ, Canter CE, Mahony L, Ross RD, Pahl E, Blume ED, Dodd DA, Rosenthal DN, Burr J, LaSalle B, Holubkov R, Lukas MA, Tani LY, Pediatric Carvedilol Study Group F (2007) Carvedilol for children and adolescents with heart failure: a randomized controlled trial. JAMA 298:1171–1179CrossRefPubMedGoogle Scholar
  37. 37.
    Vaidyanathan B (2009) Is there a role for carvedilol in the management of pediatric heart failure? A meta analysis and e-mail survey of expert opinion. Ann Pediatr Cardiol 2:74–78CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Chesley A, Lundberg MS, Asai T, Xiao RP, Ohtani S, Lakatta EG, Crow MT (2000) The beta(2)-adrenergic receptor delivers an antiapoptotic signal to cardiac myocytes through G(i)-dependent coupling to phosphatidylinositol 3′-kinase. Circ Res 87:1172–1179CrossRefPubMedGoogle Scholar
  39. 39.
    Communal C, Singh K, Sawyer DB, Colucci WS (1999) Opposing effects of beta(1)- and beta(2)-adrenergic receptors on cardiac myocyte apoptosis : role of a pertussis toxin-sensitive G protein. Circulation 100:2210–2212CrossRefPubMedGoogle Scholar
  40. 40.
    Miyamoto SD, Stauffer BL, Nakano S, Sobus R, Nunley K, Nelson P, Sucharov CC (2014) Beta-adrenergic adaptation in paediatric idiopathic dilated cardiomyopathy. Eur Heart J 35:33–41CrossRefPubMedGoogle Scholar
  41. 41.
    Kozlik-Feldmann R, Kramer HH, Wicht H, Feldmann R, Netz H, Reinhardt D (1993) Distribution of myocardial beta-adrenoceptor subtypes and coupling to the adenylate cyclase in children with congenital heart disease and implications for treatment. J Clin Pharmacol 33:588–595CrossRefPubMedGoogle Scholar
  42. 42.
    Stauffer BL, Russell G, Nunley K, Miyamoto SD, Sucharov CC (2013) miRNA expression in pediatric failing human heart. J Mol Cell Cardiol 57:43–46CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP, Estes NA 3rd, Foster E, Greenberg H, Higgins SL, Pfeffer MA, Solomon SD, Wilber D, Zareba W, MADIT-CRT Trial Investigators (2009) Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 361:1329–1338CrossRefPubMedGoogle Scholar
  44. 44.
    Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Loh E, Kocovic DZ, Packer M, Clavell AL, Hayes DL, Ellestad M, Trupp RJ, Underwood J, Pickering F, Truex C, McAtee P, Messenger J, MIRACLE Study Group. Multicenter InSync Randomized Clinical Evaluation (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346:1845–1853CrossRefPubMedGoogle Scholar
  45. 45.
    Motonaga KS, Dubin AM (2014) Cardiac resynchronization therapy for pediatric patients with heart failure and congenital heart disease: a reappraisal of results. Circulation 129:1879–1891CrossRefPubMedGoogle Scholar
  46. 46.
    Dubin AM, Janousek J, Rhee E, Strieper MJ, Cecchin F, Law IH, Shannon KM, Temple J, Rosenthal E, Zimmerman FJ, Davis A, Karpawich PP, al Ahmad A, Vetter VL, Kertesz NJ, Shah M, Snyder C, Stephenson E, Emmel M, Sanatani S, Kanter R, Batra A, Collins KK (2005) Resynchronization therapy in pediatric and congenital heart disease patients: an international multicenter study. J Am Coll Cardiol 46:2277–2283CrossRefPubMedGoogle Scholar
  47. 47.
    Janousek J, Gebauer RA, Abdul-Khaliq H, Turner M, Kornyei L, Grollmuss O, Rosenthal E, Villain E, Fruh A, Paul T, Blom NA, Happonen JM, Bauersfeld U, Jacobsen JR, van den Heuvel F, Delhaas T, Papagiannis J, Trigo C, for the Working Group for Cardiac Dysrhythmias and Electrophysiology of the Association for European Paediatric Cardiology (2009) Cardiac resynchronisation therapy in paediatric and congenital heart disease: differential effects in various anatomical and functional substrates. Heart 95:1165–1171CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Friedberg MK, Roche SL, Balasingam M, Stephenson E, Slorach C, Fackoury C, Kantor PF (2008) Evaluation of mechanical dyssynchrony in children with idiopathic dilated cardiomyopathy and associated clinical outcomes. Am J Cardiol 101:1191–1195CrossRefPubMedGoogle Scholar
  49. 49.
    Albert HM, Fowler RL, Craighead CC, Glass BA, Atik M (1961) Pulmonary artery banding. A treatment for infants with intractable cardiac failure due to interventricular septal defects. Circulation 23:16–20CrossRefPubMedGoogle Scholar
  50. 50.
    Boutin C, Jonas RA, Sanders SP, Wernovsky G, Mone SM, Colan SD (1994) Rapid two-stage arterial switch operation. Acquisition of left ventricular mass after pulmonary artery banding in infants with transposition of the great arteries. Circulation 90:1304–1309CrossRefPubMedGoogle Scholar
  51. 51.
    Winlaw DS, McGuirk SP, Balmer C, Langley SM, Griselli M, Stümper O, de Giovanni JV, Wright JG, Thorne S, Barron DJ, Brawn WJ (2005) Intention-to-treat analysis of pulmonary artery banding in conditions with a morphological right ventricle in the systemic circulation with a view to anatomic biventricular repair. Circulation 111:405–411CrossRefPubMedGoogle Scholar
  52. 52.
    Cools B, Brown SC, Louw J, Heying R, Meyns B, Gewillig M (2012) Pulmonary artery banding as “open end” palliation of systemic right ventricles: an interim analysis. Eur J Cardio-Thorac Surg 41:913–918CrossRefGoogle Scholar
  53. 53.
    Roncon-Albuquerque R Jr, Vasconcelos M, Lourenco AP et al (2006) Acute changes of biventricular gene expression in volume and right ventricular pressure overload. Life Sci 78:2633–2642CrossRefPubMedGoogle Scholar
  54. 54.
    Correia Pinto J, Henriques-Coelho T, Roncon-Albuquerque R Jr, Leite-Moreira AF (2006) Differential right and left ventricular diastolic tolerance to acute afterload and NCX gene expression in Wistar rats. Physiol Res/ Academia Scientiarum Bohemoslovaca 55:513–526Google Scholar
  55. 55.
    Schranz D, Rupp S, Muller M et al (2013) Pulmonary artery banding in infants and young children with left ventricular dilated cardiomyopathy: a novel therapeutic strategy before heart transplantation. J Heart Lung Transplant 32:475–481CrossRefPubMedGoogle Scholar
  56. 56.
    Bailey LL (2013) Back to the future! Bold new indication for pulmonary artery banding. J Heart Lung Transplant 32:482–483CrossRefPubMedGoogle Scholar
  57. 57.
    Latus H, Hachmann P, Gummel K, Recla S, Voges I, Mueller M, Bauer J, Yerebakan C, Akintuerk H, Apitz C, Schranz D (2016) Biventricular response to pulmonary artery banding in children with dilated cardiomyopathy. J Heart Lung Transplant 35:934–938CrossRefPubMedGoogle Scholar
  58. 58.
    Strauer BE, Brehm M, Zeus T, Köstering M, Hernandez A, Sorg RV, Kögler G, Wernet P (2002) Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans. Circulation 106:1913–1918CrossRefPubMedGoogle Scholar
  59. 59.
    Wollert KC, Meyer GP, Lotz J, Ringes Lichtenberg S, Lippolt P, Breidenbach C, Fichtner S, Korte T, Hornig B, Messinger D, Arseniev L, Hertenstein B, Ganser A, Drexler H (2004) Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial. Lancet 364:141–148CrossRefPubMedGoogle Scholar
  60. 60.
    Schachinger V, Erbs S, Elsasser A et al (2006) Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction. N Engl J Med 355:1210–1221CrossRefPubMedGoogle Scholar
  61. 61.
    Assmus B, Honold J, Schachinger V et al (2006) Transcoronary transplantation of progenitor cells after myocardial infarction. N Engl J Med 355:1222–1232CrossRefPubMedGoogle Scholar
  62. 62.
    Abdel-Latif A, Bolli R, Tleyjeh IM, Montori VM, Perin EC, Hornung CA, Zuba-Surma EK, al-Mallah M, Dawn B (2007) Adult bone marrow-derived cells for cardiac repair: a systematic review and meta-analysis. Arch Intern Med 167:989–997CrossRefPubMedGoogle Scholar
  63. 63.
    Lipinski MJ, Biondi-Zoccai GG, Abbate A, Khianey R, Sheiban I, Bartunek J, Vanderheyden M, Kim HS, Kang HJ, Strauer BE, Vetrovec GW (2007) Impact of intracoronary cell therapy on left ventricular function in the setting of acute myocardial infarction: a collaborative systematic review and meta-analysis of controlled clinical trials. J Am Coll Cardiol 50:1761–1767CrossRefPubMedGoogle Scholar
  64. 64.
    Rupp S, Bauer J, Tonn T, Schächinger V, Dimmeler S, Zeiher AM, Schranz D (2009) Intracoronary administration of autologous bone marrow-derived progenitor cells in a critically ill two-yr-old child with dilated cardiomyopathy. Pediatr Transplant 13:620–623CrossRefPubMedGoogle Scholar
  65. 65.
    Olgunturk R, Kula S, Sucak GT, Ozdogan ME, Erer D, Saygili A (2010) Peripheric stem cell transplantation in children with dilated cardiomyopathy: preliminary report of first two cases. Pediatr Transplant 14:257–260CrossRefPubMedGoogle Scholar
  66. 66.
    Rupp S, Zeiher AM, Dimmeler S (2010) A regenerative strategy for heart failure in hypoplastic left heart syndrome: intracoronary administration of autologous bone marrow-derived progenitor cells. J Heart Lung Transplant 29(5):574–577Google Scholar
  67. 67.
    Limsuwan A, Pienvichit P, Limpijankit T, Khowsathit P, Hongeng S, Pornkul R, Siripornpitak S, Boonbaichaiyapruk S (2010) Transcoronary bone marrow-derived progenitor cells in a child with myocardial infarction: first pediatric experience. Clin Cardiol 33:E7–12Google Scholar
  68. 68.
    Rivas J, Menendez JJ, Arrieta R et al (2011) Usefulness of intracoronary therapy with progenitor cells in patients with dilated cardiomyopathy: bridge or alternative to heart transplantation? An Pediatr 74:218–225CrossRefGoogle Scholar
  69. 69.
    Zeinaloo A, Zanjani KS, Khosroshahi AG (2011) Further follow up of the cardiomyopathic patient treated by intracoronary administration of autologous mesenchymal stem cells. Pediatr Transplant 15:442CrossRefPubMedGoogle Scholar
  70. 70.
    Ishigami S, Ohtsuki S, Tarui S, Ousaka D, Eitoku T, Kondo M, Okuyama M, Kobayashi J, Baba K, Arai S, Kawabata T, Yoshizumi K, Tateishi A, Kuroko Y, Iwasaki T, Sato S, Kasahara S, Sano S, Oh H (2015) Intracoronary autologous cardiac progenitor cell transfer in patients with hypoplastic left heart syndrome: the TICAP prospective phase 1 controlled trial. Circ Res 116:653–664CrossRefPubMedGoogle Scholar
  71. 71.
    Fisher SA, Doree C, Mathur A, Taggart DP, Martin-Rendon E (2016) Stem cell therapy for chronic ischaemic heart disease and congestive heart failure. Cochrane Database Syst Rev 12:CD007888PubMedGoogle Scholar
  72. 72.
    Ishigami S, Ohtsuki S, Eitoku T, Ousaka D, Kondo M, Kurita Y, Hirai K, Fukushima Y, Baba K, Goto T, Horio N, Kobayashi J, Kuroko Y, Kotani Y, Arai S, Iwasaki T, Sato S, Kasahara S, Sano S, Oh H (2017) Intracoronary cardiac progenitor cells in single ventricle physiology: the PERSEUS (cardiac progenitor cell infusion to treat Univentricular heart disease) randomized phase 2 trial. Circ Res 120:1162–1173CrossRefPubMedGoogle Scholar
  73. 73.
    Pincott ES, Ridout D, Brocklesby M, McEwan A, Muthurangu V, Burch MA (2017) Randomized study of autologous bone marrow-derived stem cells in pediatric cardiomyopathy. J Heart Lung Transplant 36:837–844CrossRefPubMedGoogle Scholar
  74. 74.
    Rupp S, Schranz D (2015) Cardiac regeneration in children. Pediatr Cardiol 36:713–718CrossRefPubMedGoogle Scholar
  75. 75.
    Caspi J, Pettitt TW, Sperrazza C, Mulder T, Stopa A (2007) Reimplantation of anomalous left coronary artery from the pulmonary artery without mitral valve repair. Ann Thorac Surg 84:619–23; discussion 623CrossRefPubMedGoogle Scholar
  76. 76.
    Dodge-Khatami A, Mavroudis C, Backer CL (2002) Anomalous origin of the left coronary artery from the pulmonary artery: collective review of surgical therapy. Ann Thorac Surg 74:946–955CrossRefPubMedGoogle Scholar
  77. 77.
    Shiraishi S, Uemura H, Kagisaki K, Hagino I, Kobayashi J, Takahashi M, Yagihara T (2011) Long-term results of total cavopulmonary connection with low ejection fraction. Gen Thorac Cardiovasc Surg 59:686–692CrossRefPubMedGoogle Scholar
  78. 78.
    Ono M, Boethig D, Goerler H, Lange M, Westhoff-Bleck M, Breymann T (2006) Clinical outcome of patients 20 years after Fontan operation—effect of fenestration on late morbidity. Eur J Cardio-Thorac Surg 30:923–929CrossRefGoogle Scholar
  79. 79.
    Ono M, Boethig D, Goerler H, Lange M, Westhoff-Bleck M, Breymann T (2007) Somatic development long after the Fontan operation: factors influencing catch-up growth. J Thorac Cardiovasc Surg 134:1199–1206CrossRefPubMedGoogle Scholar
  80. 80.
    Rupp S, Apitz C, Tholen L, Latus H, Ostermayer SH, Schmidt D, Bauer J, Schranz D (2015) Upgraded heart failure therapy leads to an improved outcome of dilated cardiomyopathy in infants and toddlers. Cardiol Young 25:1300–1305CrossRefPubMedGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pediatric Heart CenterUniversity of Giessen and MarburgGiessenGermany

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