Interventricular septal hematoma following cone repair for Ebstein's anomaly.

Unlabelled: Interventricular septal hematoma (IVSH) is a rare complication following pediatric heart surgery involving interventricular septum (IVS). We present the case of an adult who developed IVSH after cone repair for Ebstein's anomaly and the management challenges involved.

Supplementary Information: The online version contains supplementary material available at 10.

Clinical profile of restrictive cardiomyopathy in children at a South Indian tertiary care cardiac center: A retrospective three decade experience.

Background: Research on pediatric restrictive cardiomyopathy (RCM), especially from the developing world, is limited. The study aimed to describe the clinical features and outcomes of childhood RCM and the predictors of outcome.

Methods: The study included all children with RCM who were < 18 years old.

Pulmonary Arterial Hypertension After Repair of Classical Tetralogy of Fallot.

Tetralogy of Fallot (TOF), the most common cyanotic congenital heart disease, is classically associated with decreased pulmonary blood flow. Classical TOF is characterized by antegrade pulmonary blood flow and right ventricular outflow tract obstruction at varying levels. In the modern era, most children with TOF undergo definitive intracardiac repair during infancy, and pulmonary artery hypertension (PAH) is virtually unheard of in postoperative TOF in the absence of major aortopulmonary collaterals.

The efficacy and safety of dapagliflozin in pediatric heart failure.

Background: SGLT2 inhibitors (SGLT2i) have consolidated their position as first-line therapeutic agents in adult heart failure. However, there is minimal data on pediatric population. We conducted an observational study to evaluate efficacy and safety of Dapagliflozin in pediatric heart failure.

Digoxin in rheumatic heart disease: Rationale and design of a multicenter, placebo-controlled double-blind randomized controlled trial (Dig-RHD trial).

Background: Rheumatic heart disease (RHD), is a public health problem in low and middle-income countries. It causes high morbidity and mortality due to heart failure (HF), but there are no randomized trials of HF-treatments in these patients. Digoxin is an inexpensive drug that is widely used in RHD despite a lack of data on its effect on clinical outcomes.

Beyond arrhythmias in the ECG: Is there any correlation between QT interval and stroke subtype and severity?

Background: The QT interval in ECG is susceptible to autonomic fluctuations, a known occurrence in acute ischemic stroke (AIS). Previous research has highlighted QT interval changes between ischemic and haemorrhagic strokes. However, there is scarce literature on the differential effect of AIS subtypes on QT interval.

Late-onset aortic regurgitation after device closure of atrial septal defect.

A 10-year-old girl underwent successful device closure of a 15-mm atrial septal defect with a short and thick retroaortic rim using a 16-mm atrial septal occluder from the conventional approach under transesophageal echocardiographic guidance. There were no periprocedural complications. The aortic valve was noted to be trileaflet and competent.

Imaging and endovascular management of haemoptysis in congenital heart disease.

Haemoptysis, a rare but serious complication that can arise in patients with congenital heart disease, necessitates prompt diagnosis and specialized care. The radiologist plays a critical role in this scenario, including identifying the source of haemoptysis, devising treatment plans, and delivering endovascular interventions. This article highlights the importance of imaging techniques, especially computed tomography, in identifying the cause of haemoptysis and the therapeutic value of endovascular interventions.

Resolution of high aortic valve systolic gradient suggesting significant stenosis following closure of patent ductus arteriosus.

A 3-month-old baby girl presenting with heart failure was found to have a large persistent ductus arteriosus as well as a bicuspid aortic valve with severe aortic stenosis. She underwent surgical ductal closure following which there was complete resolution of aortic valve gradients without requiring any aortic valve intervention. This case highlights the importance of understanding hemodynamics in efficacious management of congenital heart disease.

Long-term outcome of permanent epicardial pacemaker implantation in neonates: Experience from an Indian center.

Introduction: Permanent pacemaker implantation (PPI) in neonates is challenging with respect to indications, device selection, implantation technique, and long-term outcomes. Complex anatomy, the need for long-term pacing with high rates, and a problematic postoperative period are the major problems.

Methods: We prospectively followed up 22 newborns who underwent PPI below 28 days of life at our institute.

Left ventricular apical aneurysm in Takayasu arteritis and chronic active Epstein-Barr virus infection.

Background: Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology characterized by a large vessel vasculitis involving the aorta and its branches. Myocardial involvement is extremely unusual in TA and is mostly in the form of myocarditis, ventricular hypertrophy, and ventricular dysfunction secondary to coronary ischemia. Submitral aneurysms have been reported in TA and has been attributed to the chronic inflammatory process in TA.

Markedly dilated right atrium in an infant: what is the diagnosis?

An 18-month-old boy presented with recurrent episodes of irritability and documented fast heart rate suggestive of supraventricular tachycardia. Cardiovascular examination revealed significant cardiomegaly, normal heart sounds and no murmurs. The differential diagnosis of marked right atrial dilatation and management principles of idiopathic dilatation of the right atrium are described.

Early and Long-Term Clinical Outcomes of Ductal Stenting Versus Surgical Aortopulmonary Shunt Among Young Infants with Duct-Dependent Pulmonary Circulation.

Surgical aortopulmonary shunting (SAPS) and ductal stenting (DS) are the main palliations in infants with cyanotic congenital heart diseases (CHD). We aimed to study the safety and efficacy of DS and to compare it with SAPS as a palliative procedure in infants with CHD and duct-dependent pulmonary circulation. Retrospective institutional clinical data review of consecutive infants aged < 3 months who underwent DS or SAPS over 5 years.

All that flows across the ventricular septum are not ventricular septal defects.

Coronary cameral fistula is a rare congenital anomaly and clinical presentation depends on the location of the defect, degree of shunting, and associated complications. We present a case of coronary cameral fistula where segmental analysis by echocardiogram helped us to avoid misdiagnosis as a ventricular septal defect.

Acute ST-elevation myocardial infarction with Guillain-Barre syndrome in Fontan circulation.

Total cavopulmonary connection, commonly referred to as the Fontan procedure, is the established destination therapy for univentricular hearts. While the procedure permits a longer survival of these patients, this circulation involves several compromises from normal human circulation and poses several challenges with increasing age after surgery. We present an instance of acute ST-elevation myocardial infarction with Guillain-Barre syndrome in an adult after Fontan palliation and discuss the challenges in management.