Caution in the use of sedation and endomyocardial biopsy for the management of pediatric acute heart failure caused by endocardial fibroelastosis

doi:10.12998/wjcc.v11.i22.5412

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Aug 6, 2023 (publication date) through Mar 7, 2026

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World Journal of Clinical Cases

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Letter to the Editor

World J Clin Cases. Aug 6, 2023; 11(22): 5412-5415
Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5412

Caution in the use of sedation and endomyocardial biopsy for the management of pediatric acute heart failure caused by endocardial fibroelastosis

Xiao-Xuan Xin, Yo-Yeng Se

Xiao-Xuan Xin, School of Hulunbuir Clinical Medicine, Inner Mongolia Minzu University, Hulunbuir 021000, Inner Mongolia Autonomous Region, China

Yo-Yeng Se, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China

Yo-Yeng Se, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong 999077, China

Author contributions: Se YY compiled literature and data; Xin XX drafted the paper and created Figure 1; Se YY reviewed and revised the final version of the paper.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Yo-Yeng Se, MSc, Researcher, Faculty of Medicine, The Chinese University of Hong Kong, Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Room 94020, 7/F, Shatin, N.T., Hong Kong 999077, China. yoyengcityu@yeah.net

Received: April 30, 2023
Peer-review started: April 30, 2023
First decision: June 19, 2023
Revised: July 4, 2023
Accepted: July 17, 2023
Article in press: July 17, 2023
Published online: August 6, 2023
Processing time: 95 Days and 5.3 Hours

Abstract

Endocardial fibroelastosis (EFE) is commonly considered to be an inflammatory reactive lesion of hyperplasia and deposition of tissue fibers and collagen in the endocardium and/or subendocardium, which is strongly associated with endocardial sclerosis, ventricular remodeling and acute and chronic heart failure, and is one of the important causes for pediatric heart transplantation. Early diagnosis and treatment are the key factors in determining the prognosis of the children. In this paper, we would like to highlight the potential unintended consequences of the use of sedation and biopsy for pediatric acute heart failure caused by EFE and the comprehensive considerations prior to clinical diagnosis.

Keywords: Endocardial fibroelastosis; Sedation in children; Endomyocardial biopsy; Comprehensive clinical diagnosis

Core Tip: The high-risk medical operation for the clinical diagnosis of pediatric acute heart failure due to endocardial fibroelastosis remains debatable, and the medical management of sedation and biopsy requires a comprehensive assessment of the indications and contraindications in children.