An asymptomatic 11 year child with ruptured sinus of Valsalva

Ruptured sinus of Valsalva (RSOV) is a rare lesion in a paediatric age group. A right sinus of Valsalva aneurysm usually ruptures into the right ventricle, while aneurysms of non-coronary sinus do so into the right atrium. RSOV usually presents in the third decade of life with congestive heart failure and is more common among Asians with male predominance. It may present as acute cardiogenic shock and sudden death or may remain completely asymptomatic with incidental detection by a murmur. Surgery is indicated as early as possible, once the diagnosis is made as without surgery, most cases will eventually succumb to uncontrollable congestive heart failure. This article reports an 11 year old child with the diagnosis of ruptured sinus of Valsalva.peer-reviewe

RCC prolapse causing Aortic regurgitation in a restrictive VSD

The incidence of aortic right coronary cusp (RCC) prolapse in outlet ventricular septal defect (VSD) is reported at 5%- 16%. Detection of RCC prolapse is critical in patients with outlet VSD because this complication may cause permanent aortic regurgitation. Aortic regurgitation occurs due to a poorly supported RCC combined with the venturi effect due to the VSD jet resulting in cusp prolapse. This is an indication for VSD closure even if VSD is small and restrictive.peer-reviewe

Right Ventricular Outflow Tract Stenting

RVOT stenting has gained popularity over the last decade. Conventional treatment of choice in children with cyanotic heart defect with decreased pulmonary blood flow has always been the systemic to pulmonary arterial shunt, but lately, many centres are opting for RVOT stenting as the first choice of palliation. It is associated with fewer post-procedural complications and helps in a more physiological growth of pulmonary arteries, which can significantly impact the definitive repair at later date. Normally, RVOT stenting is performed in the early newborn period but it is not unusual to be done at a later age because of varied reasons. Two-point fixation of the stent ensures its safety against embolization but sparing the valve and covering the infundibular area only protect the child from future trans annular patches, though removing the stent can sometimes be challenging at a later stage. RVOT stenting has now become a safer alternative in centres with early stage of cardiac programmes

Profile and risk factors for congenital heart defects: A study in a tertiary care hospital

Introduction: Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. It is thus important to determine their prevalence and spectrum and identify risk factors associated with the development of heart defects. Materials and Methods: A case-control study was carried out in the Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from February 2014 to August 2015. All patients referred with complaints or clinical examination suggestive of CHDs were further evaluated with echocardiography. On Echocardiography, patients having CHDs were included as cases and those having a normal echocardiographic study were included as controls. Healthy controls were also included. 400 cases and 400 controls were thus identified; preterms having patent ductus arteriosus and patent foramen ovale and those with acquired heart defects were excluded. Risk factors among cases and controls were further studied. Results: Acyanotic heart defects were 290 (72.50%) of the total heart defects, whereas the contribution of cyanotic heart defects was 110 (27.50%). Out of all CHDs, ventricular septal defect was the most common lesion with contribution of 152 (38%) cases, whereas among the cyanotic heart defects, Tetralogy of Fallot was the most common lesion (18% of total cases). Out of the total 400 cases, 261 were males (65.25%). On univariate analysis, paternal age (odds ratio, OR, 2.01), bad obstetric history (OR, 2.65), antenatal febrile illness (OR, 4.12), and advanced maternal age (OR, 3.28) were found to increase the risk of CHD whereas intake of multivitamin (OR, 3.02) was found to be protective. The risk factors were further analyzed with multivariate logistic regression analysis and all the above factors were found to be significantly associated. Conclusion: We noted that the profile of CHD in our population was similar to the published literature although many were missed during infancy and detected later in life. Several antenatal factors were found to be associated with the incidence of congenital heart disease emphasizing the need to prioritize antenatal care and counseling to pregnant mothers along with good maternal nutrition and folic acid supplementation