Incomplete Kawasaki disease: a pediatric diagnostic conflict - Reply

WOS: 000256807300017

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

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

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

Ductus arteriosus aneursym causing hoarseness which is the best treatment option; surgery or endovascular?

WOS: 000392631500025PubMed ID: 27665349

An ignored cause of chronic kidney disease in children: type 2 cardiorenal syndrome

Cardiorenal syndrome is a disorder of the heart and kidneys in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. It is well known that the main cause of mortality among patients with end-stage renal disease is due to cardiovascular events and a common complication in patients in acute heart failure is a decrease in renal function. However, when there are no signs and/or symptoms of chronic cardiovascular disease, cardiovascular causes in the etiology of chronic kidney disease is not the first differential considered. We present an 11 year-old girl patient, diagnosed with type 2-chronic cardiorenal syndrome who had previously been followed in another center with the diagnosis of chronic kidney disease for six months and referred to our hospital for kidney biopsy. We present this case to increase awareness of pediatrician and nephrologist about this syndrome. [Cukurova Med J 2016; 41(2.000): 393-395

Delivering stents in congenital heart disease using the double-wire technique: Technical considerations

OBJECTIVES: To evaluate the use of a double-wire technique to deliver stents. BACKGROUND: Placement of a stent in lesions close to bifurcations or without an anatomic obstruction can be problematic. PATIENTS AND METHODS: Stents were implanted in 12 patients between August 2010 and August 2012. Indications were complex anatomic obstruction in nine, external compression of pulmonary veins in two, and exclusion of an aortic aneurysm in one patient. RESULTS: Median age and body weight of the group were 11.6 years (range: 1.6-34.8) and 36 kg (range: 10-78), respectively. All stents were delivered safely and the patency of all side vessels was maintained; the distal end of the stent was flared to a median ratio of 1.4 (range: 1.2-1.8). The clinical objective was met in all patients: in lesions with stenosis, diameter increased from 5.9 mm (range: 1-13) to 9.9 mm (range: 8-17) [P < 0.01; 95% confidence interval (CI): 2.0-7.2]; oxygen saturations improved in the 2 patients after relief of the external pulmonary venous compression and in another an aortic aneurysm was excluded. One patient developed a hemothorax and one required blood transfusion for bleeding from the valve of the sheath. CONCLUSIONS: The double-wire stenting technique is effective to accurately deliver and anchor stents into lesions close to side branches and bifurcations. Side branch patency is maintained; the clinical objective (gradient relief, aneurysm exclusion, relief of external compression) can safely be reached. Technique and balloon selection should be based on the underlying anatomical substrate. © 2013 Wiley Periodicals, Inc.status: publishe