Cardiac effects of hemodialysis in children with chronic kidney disease

Purpose: The aim of the study was to evaluate cardiac functions before and after hemodialysis in children with chronical renal failure. Materials and Methods: The study comprised 24 children undergoing hemodialysis more then six months. Conventional and tissue Doppler echocardiography was performed, NT-proBNP levels were measured before and after hemodialysis. Echocardiographic results were compared regard to hydration status which measured with body composition monitor and hypotension event during dialysis. Results: Myocardial performance indices which gained with tissue Doppler echo were high in 22 patient. Mitral E/A ratio significantly decreased after hemodialysis. NT-proBNP levels were high but no difference was determined after dialysis. Nine patient experienced hypotension but nonsignificant difference was detected regarding echocardiographic findings and NT-proBNP levels. Conclusion: Diastolic dysfunction is frequent in chronical renal failure. Tissue Doppler echocardiography and myocardial performance index supply a more proper evaluation of global and regional cardiac function in chronical renal failure due to less hydration affectability. NT-proBNP should be monitored for cardiac dysfunction in chronical renal failure. Body composition monitor should be used in children for setting the ultrafiltration volume

Transjugular Approach to Device Closure of Atrial Septal Defect in a Child with Heterotaxia and Interrupted Inferior Vena Cava

In heterotaxia syndrome with left atrial isomerism, the distinguishing feature is interrupted inferior vena cava with azygos continuation. We report using a transjugular approach to device closure of an atrial septal defect in an 8-year-old boy with heterotaxia syndrome. We found that device closure of the child's atrial septal defect through a jugular venous approach was safe when an inferior vena cava approach was not possible. To our knowledge, ours is the first report of the use of internal jugular vein access to close an atrial septal defect in a child

Diagnostic and management difficulties in congenitally long QT syndrome: a single centre experience

Purpose: Long QT Syndrome (LQTS) is characterized by prolonged ventricular repolarization and tendency to malignant tachyarrhythmia. We reported 16 patient diagnosed congenitally LQTS as a tertiary centre's 12 years experience. Material and Methods: Patients whom diagnosed as congenitally LQTS in Cukurova University Divison of Pediatric Cardiology between years 2001 to 2013 were included the study. Results: Sixteen patients (6 female, 12 male) were diagnosed as congenitally LQTS. Mean age of patients was 10 years (2.6-20 years), mean follow up period was 35 months (11-120 months). Mean corrected QT interval was measured 520 ms (470-590 ms). At the diagnosis nine of sixteen patients (56%) had syncope, convulsion or cardiac arrest history, and three of them were misdiagnosed as epilepsy and were treated with antiepileptic drugs as well. Conclusion: We want to underline the importance of electrocardiography monitoring at all family members and some patients who misdiagnosed as recurrent seizures