BACKGROUND:Asthma-related cardiopulmonary interactions may affect right ventricular (RV) performance even when children are clinically stable. Two-dimensional speckle-tracking echocardiography (2D-STE) may detect subclinical myocardial dysfunction beyond conventional indices. This study aims to investigate the effects of childhood asthma on RV function by using 2D-STE. METHODS:In this prospective case-control study, children aged 6-18 years with physician-diagnosed asthma (n = 70) and age-matched healthy controls (n = 30) underwent standard transthoracic echocardiography, tissue Doppler imaging (TDI), and 2D-STE. Primary outcomes were RV global longitudinal strain (RV GLS) and strain rate. Conventional RV systolic indices and RV diastolic indices were also assessed. Clinical characteristics and spirometry were recorded. RESULTS:RV systolic mechanics were largely preserved in the asthma group. RV GLS, RV strain rate, and tricuspid annular plane systolic excursion (TAPSE) did not differ significantly between asthmatic children and controls. In contrast, tricuspid annular E' velocity was significantly lower in the asthma group (p = 0.007), and tricuspid E/E' ratio was significantly higher (p < 0.001). Interventricular septal diastolic thickness was also significantly increased among children with asthma (p = 0.027). Within the asthma cohort, TAPSE showed positive correlations with age (r = 0.478, p < 0.001), BMI (r = 0.398, p = 0.001), asthma duration (r = 0.431, p < 0.001), and FEV1 (r = 0.301, p = 0.011), whereas RV strain parameters were not significantly associated with demographic or respiratory variables. CONCLUSIONS:In predominantly mild-to-moderate, clinically stable pediatric asthma, RV systolic deformation by 2D-STE appears preserved, while TDI-derived indices indicate early RV diastolic involvement. Focused assessment of RV diastolic function may help to identify subclinical cardiopulmonary effects in selected children with asthma.

Background/Objectives: Sudden unexpected death in epilepsy (SUDEP) is a major cause of mortality in pediatric epilepsy. Cardiac arrhythmias, possibly reflected by electrocardiographic (ECG) abnormalities, are thought to contribute significantly to SUDEP risk. This study aimed to evaluate ECG indices associated with an increased risk of both atrial and ventricular arrhythmias and sudden cardiac death in pediatric patients with generalized and focal seizures, excluding those with underlying channelopathies. Materials and Methods: Pediatric patients aged 0–18 years with generalized or focal epilepsy followed at our center between October 2024 and April 2025 were enrolled. Comprehensive cardiac evaluations, including echocardiography and 12-lead ECG, were conducted. Patients with channelopathies, structural heart defects, or significant congenital heart disease were excluded. ECG parameters—QT dispersion (QT Disp), corrected QT interval (QTc), QTc dispersion (QTc Disp), P-wave dispersion (P Disp), and T peak-T end interval (Tp-e)—were analyzed across epilepsy subgroups and compared to healthy controls. Effects of antiepileptic drug (AED) use and gender were also assessed. Results: A total of 151 participants were included (generalized: n = 51; focal: n = 50; controls: n = 50). QTc and Tp-e intervals were prolonged in both epilepsy groups compared to controls (p = 0.001 and p = 0.036, respectively), however, they fell within the conventional parameters. AED use was associated with further prolongation of QTc (p = 0.035) and Tp-e (p = 0.037), these metrics were similarly found to be within the established normative boundaries. Phenobarbital and lamotrigine users showed the longest QTc, albeit not statistically significant. Males with generalized seizures had longer maximum P-wave duration (P Max) than females (p = 0.009). A moderate correlation was found between Tp-e and QTc (r = 0.557, p = 0.001). Conclusions: Although there are findings in our study that may suggest a relationship between SUDEP and arrhythmia according to electrocardiographic markers associated with arrhythmia risk, larger and prospective studies with long-term follow-up are needed in the future.

Objective: This study aimed to evaluate the prevalence, types, and clinical significance of arrhythmias observed during acute rheumatic fever (ARF) episodes and their association with the severity of carditis in a single centre paediatric cohort. Material and Methods: A retrospective review of medical records from 118 patients diagnosed with ARF based on the revised Jones criteria was performed. Electrocardiograms (ECGs) recorded during the acute phase were analysed for arrhythmias, including atrioventricular (AV) blocks, supraventricular and ventricular arrhythmias, and conduction disturbances. Patients were stratified into mild-moderate and severe carditis groups. Statistical analyses were conducted using SPSS 26.0, with p-values<0.05 considered significant. Results: Among the 118 patients (mean age 10.5±1.7 years; 55% female), 51.6% exhibited first-degree AV block. The other arrhythmias included second-degree AV block (4.2%), complete AV block (0.8%), supraventricular tachycardia (0.8%), non-sustained ventricular tachycardia (0.8%), and junctional rhythm (1.7%). Supraventricular and ventricular extrasystoles were identified in 4.2% and 5.9% of the patients, respectively. Most arrhythmias occurred in the mild-to-moderate carditis group and resolved spontaneously or with minimal intervention. No arrhythmias were associated with mortality or long-term complications. Conclusion: Arrhythmias during ARF are relatively uncommon but may reflect myocardial inflammation. While typically benign and self-limiting, vigilant monitoring is essential for timely management. Further research is needed to elucidate the underlying mechanisms and optimise treatment strategies for arrhythmias in ARF.

Objective: This study aimed to evaluate the long-term clinical outcomes of pediatric patients with valvular aortic stenosis (VAS) treated at a single tertiary center, with a focus on the efficacy and safety of balloon aortic valvuloplasty (BAV). Materials and Methods: A total of 450 pediatric patients diagnosed with VAS between 2001 and 2023 were retrospectively reviewed. Clinical, echocardiographic, and angiographic data were analyzed. Among these, 130 patients who underwent BAV for moderate-to-severe or critical stenosis were evaluated in detail. Hemodynamic changes, procedural complications, development of aortic regurgitation (AR), and reintervention rates were recorded. Results: The cohort had a mean age of 120.6 +/- 55.8 months, and 74.5% were male. The mean follow-up duration was 5.2 years (range: 1-17 years). The bicuspid aortic valve was the most common morphology (75.5%). Among the 130 patients who underwent balloon aortic valvuloplasty (BAV), the age at angiography was <1 month in 27.6%, 1-12 months in 16.9%, 12-60 months in 16.1%, 60-120 months in 20.7%, and >120 months in 15.3% of cases. BAV resulted in a significant reduction in left ventricular pressure (from 171.6 to 135.2 mmHg) and systolic gradient (from 83.9 to 32.3 mmHg). AR developed in 84.6% of patients post BAV, but only 2.5% had severe regurgitation. Repeat BAV was required in 10.7% of patients, and 3.2% were referred for surgical intervention. Four neonates with critical of and pre-existing LV dysfunction died. Conclusion: BAV is an effective and minimally invasive intervention for pediatric VAS, offering substantial short- to mid-term relief from obstruction. However, the risks of AR and reintervention warrant careful patient selection and long-term follow-up.

Objectives: Syncope is a common cause of the transient loss of consciousness, with neurally mediated syncope (NMS) and particularly vasovagal syncope (VVS) being the most prevalent types among older children and adolescents. VVS is primarily caused by heightened parasympathetic activity triggered by emotional or postural stimuli, resulting in a temporary disruption of circulation. Although anamnesis and physical examination play key roles in diagnosing VVS, additional diagnostic methods are necessary in unclear cases. This study aims to evaluate the long-term outcomes of pediatric patients with syncope, focusing on clinical characteristics, diagnosis, and treatment approaches. Methods: A retrospective analysis was conducted on 455 pediatric patients aged 8–21 years who presented with syncope at our cardiology clinic between 2005 and 2023. Patients diagnosed with cardiac syncope, epilepsy, or postural orthostatic tachycardia syndrome (POTS) were excluded. The remaining 283 patients were categorized into two groups: those with confirmed VVS—based on a comprehensive evaluation, including medical history, physical examination, and electrocardiography—and those suspected of VVS who lack a confident diagnosis after an initial assessment requiring tilt table testing. Clinical features, diagnostic methods, and treatment outcomes were analyzed. Results: The study cohort had a mean age of 13.5 ± 1.6 years, with a female predominance of 69%. Among patients who underwent tilt table testing (TTT), 74.8% exhibited a positive response, with mixed-type syncope being the most prevalent (51%). Syncope recurrence was significantly higher in the TTT group (54%) compared to the clinically diagnosed group (15%) (p < 0.001). Relapse risk was strongly associated with the syncope subtype, particularly cardioinhibitory type 2B (OR: 2.3, 95% CI: 1.1–4, p < 0.01), and episode frequency (OR: 1.7, 95% CI: 1.3–2.5, p = 0.03). Beta-blocker therapy was selectively administered and demonstrated a reduced relapse risk in a univariate analysis. Conclusions: VVS is a significant health issue in pediatric patients and the therapeutic modalities available encompass various interventions, including modifications to lifestyle, adequate hydration, and pharmacological therapies. TTT was found to be an effective diagnostic tool for identifying high-risk patients and is recommended for appropriate cases in pediatric VVS diagnosis in accordance with the guidelines, with the objective of refining therapeutic methodologies and ultimately augmenting patient prognoses.

Objective: Atrial Septal Defect (ASD), one of the most common congenital heart diseases, is usually asymptomatic in childhood, but is associated with long-term consequences such as arrhythmia, stroke, heart failure and pulmonary hypertension. In our study, we aimed to present our experiences in our center and provide information about the arrhythmias we encountered after transcatheter ASD closure, possible risk factors and their course. Methods: In ourstudy,the filesof patients who underwenttranscatheterASD closure in our clinic between 2010 and 2020 were retrospectively scanned. It is a cross-sectional descriptive study. A total of 216 patients were included in our study (131 girls 60.6%, 85 boys 39.4%).. Since our study aimed to detect arrhythmias that developed after ASD closure, even though the follow-up period was long the data especially in the first 6 months after the procedure were evaluated. These evaluated data are: ECG findings, complaints expressed by the patients, if any, and 24-hour rhythm Holter results deemed necessary accordingly. Results: 216 patients (131 girls 60.6%, 85 boys 39.4%) whose data could be accessed in their files were included in our study. The mean age of the patients was 79 +/- 48.5 months (min 30 months, max:17 years ). The average ASD size of the patients was 14.27 +/- 3.85 mm (min: 9 mm, max:26 mm) and the mean device size was 16.8 +/- 3.7 mm (min: 10mm, max: 28 mm). All the patients were at sinus rhythm prior to procedure. Arrhythmia was detected in 13 of the 216 patients included in the study after the closure procedure. The arrhythmia rate after closure was 6%. Of the 13 patients with arrhythmia, supraventricular premature beat (SVE) was detected in 6, ventricular premature beat (VES) in 2, supraventricular tachycardia (SVT) in 2 patients, 1st degree AV block in 1 patient, 2nddegree AV block in 1 patient and 3rd degree AV block in 1 patient. Conclusions: Arrhythmias that develop after transcatheter treatment are not common and are usually temporary. The best option is to evaluate each patient individually and decide on closure at the most appropriate age possible.

Background/Objectives: Secundum-type atrial septal defect (ASD) is one of the most common congenital heart defects, with an incidence of 5.64 per 10,000 live births worldwide. In our study, long-term follow-up results of children who underwent percutaneous ASD closure and patients who underwent surgical treatment were evaluated using right ventricular strain echocardiography and electrocardiography. Methods: 30 patients who underwent transcatheter ASD closure and 30 patients provided with surgical ASD closure were prospectively compared with 50 healthy children with similar demographic characteristics. ECG and transthoracic echocardiography were performed for all patients. The evaluated echocardiography variables are Tricuspid annular plane systolic excursion (TAPSE), 2D right ventricle (RV) and right atrium (RA) dimensions, right ventricular segmental longitudinal strain, and global longitudinal strain. ECG evaluation was performed especially in terms of QRS duration and its correlation with strain echo measurements. Results: The surgical treatment group has statistically significant ASD size compared to patients who underwent transcatheter closure (20 ± 3.6 and 14.87 ± 3.7 mm, p < 0.001). Patients who had surgical treatment have increased RA and RV diameters, and a statistically significant decrease was observed in right ventricular free-wall longitudinal strain and right ventricular four-chamber longitudinal strain compared to patients in transcatheter and the control group (p < 0.001). QRS durations were similarly normal in electrocardiography in the transcatheter and the control groups, and the QRS duration was observed as statistically significantly increased in the patients in the surgical treatment group (p < 0.001). Conclusions: Strain values of the patients who underwent surgical closure were lower, and the QRS values on the ECG were longer, compared to the transcatheter group, which is an indicator that a large ASD diameter has a negative effect on long-term right ventricular function. With this in mind, we argue that early surgical closure is an appropriate treatment option for children whose ASD is large for their age and who are not suitable candidates for transcatheter treatment.

Objective: Non-sustained ventricular tachycardia (NSVT) is an important arrhythmic finding in pediatric patients, with varying clinical implications based on the presence of structural heart disease. This study aimed to evaluate the clinical characteristics, follow-up, and management of children diagnosed with NSVT detected on 24-hour Holter monitoring. Methods: A retrospective analysis was conducted on 22 pediatric patients (9 males, 13 females) aged 2.5-17 years, who were diagnosed with NSVT between 2015 and 2023. Patients with sustained VT, channelopathies, or electrolyte-related prolonged QTc were excluded. Echocardiography, electrocardiography, and Holter monitoring were performed for all patients. Statistical analyses were conducted using SPSS 26.0, with significance set at p<0.05. Results: Monomorphic NSVT was observed in 14 patients (64%), while polymorphic NSVT was found in 8 patients (36%). The mean VT rate was 161.2 +/- 18.7 bpm, with polymorphic VT demonstrating a significantly higher rate (175.3 +/- 4.4 bpm) than monomorphic VT (153.3 +/- 4.6 bpm) (p=0.003). The prematurity index was significantly lower in polymorphic VT (0.75 +/- 0.03) than in monomorphic VT (1.1 +/- 0.03) (p<0.001). Additionally, QTc was longer in polymorphic VT (463.5 +/- 5.1 ms vs. 425.4 +/- 6.5 ms, p=0.004). Structural heart disease was present in 50% of cases, with polymorphic VT being predominantly associated with cardiomyopathies (dilated, hypertrophic, and non-compaction). Only three patients (14%) were symptomatic, and all symptomatic patients had structural heart disease. All patients with underlying cardiac abnormalities were treated with beta-blockers, primarily propranolol, while those with normal echocardiography were followed without medication. No adverse effects, syncope, or mortality were observed during follow-up. Conclusion: NSVT in pediatric patients should be carefully evaluated, particularly in the presence of structural heart disease. While monomorphic NSVT in structurally normal hearts appears benign, polymorphic NSVT is strongly associated with cardiomyopathies, necessitating medical therapy and close monitoring. Individualized management based on echocardiographic findings and arrhythmic characteristics is essential for optimizing patient outcomes.

The most common cause of death in patients with Duchenne muscular dystrophy (DMD) is cardiomyopathy. Our aim was to investigate the relationship between the Tpeak-Tend (Tp-e) interval and the premature ventricular contraction (PVC) burden and therefore early arrhythmic risk and cardiac involvement in DMD patients. Twenty-five patients with DMD followed by pediatric cardiology were included in the study. Those with a frequency of <1% PVC in the 24 h Holter were assigned to Group 1 (n = 15), and those with >1% were assigned to Group 2 (n = 10). Comparisons were made with healthy controls (n = 27). Left ventricular ejection fraction (LVEF) was lowest in Group 2 and highest in the control group (p < 0.001). LV end-diastolic diameter was greater in Group 2 than in Group 1 and the control group (p = 0.005). Pro-BNP and troponin levels were higher in Group 1 and Group 2 than in the control group (p = 0.001 and p < 0.001, respectively). Tp-e interval was longer in Group 2 compared to Group 1 and the control group (p < 0.001). The LVEF (OR 0.879, 95% CI 0.812-0.953; p = 0.002) and Tp-e interval (OR 1.181, 95% CI 1.047-1.332; p = 0.007) were independent predictors of PVC/24 h frequency of >1%. A Tp-e interval > 71.65 ms predicts PVC > 1%, with a sensitivity of 80% and a specificity of 90% (AUC = 0.842, 95% CI (0.663-1.000), p = 0.001). Determination of Tp-e prolongation from ECG data may help in the determination of cardiac involvement and early diagnosis of arrhythmic risk in DMD.

End-stage renal disease (ESRD) is a devastating disease associated with cardiovascular morbidity. The prevalence of pericardial syndromes associated with ESRD is increasing because the survival of chronic renal failure (CRF) patients is prolonged. Pericardial involvement in ESRD is seen commonly as acute uremic or dialysis pericarditis and infrequently as chronic constrictive pericarditis (CCP). Here, we report on a 17-year-old male patient who started hemodialysis after kidney graft loss and did not comply with the treatment, and presented with recurrent chest pain, dyspnea, and hypotension. Sequential hemodialysis treatment was given to the patient, who had recurrent pericardial effusion. Despite frequent hemodialysis treatment, the patient’s response to treatment was not adequate. After diagnosis with CCP, total pericardiectomy was performed for definitive treatment. A literature review revealed end-stage kidney disease appears to be a relatively rare cause of CCP. Only a few other cases have been reported so far, mostly in adulthood. This case highlights that CRF patients presenting with symptoms of right heart failure should be investigated for constrictive pericarditis with clinical evaluations and examinations.

Amaç: Kawasaki hastalığı çocuklarda düşmeyen ateş ile giden bir vaskülittir. Ateşin yanında konjonktivit, döküntü, dudaklarda ve oral mukozada eritem, ekstremitelerde ödem, kızarıklık, soyulma ve servikal lenfadenopati görülür. Vaskülit sıklıkla koroner arterleri etkilemektedir. Koroner arter tutulumu prognozu belirleyen en önemli faktördür. Bu çalışmada Kawasaki hastalığı tanısı almış olan vakaların klinik, laboratuvar ve ekokardiyografik bulguları ile prognozlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 2004-2019 yılları arasında hastanemize başvurup Kawasaki hastalığı tanısı alan yaşları 6-91 ay arasında değişen 66 hastanın klinik, laboratuvar özellikleri, tedavi ve izlem sonuçları geriye dönük olarak değerlendirildi. Bulgular: Hastaların %38’i kız, %62’si erkekti. Tanı anındaki ortalama yaş 32±21 aydı. Hastaların %52,3’ü 1-5 yaş aralığındaydı. Hastaların %40,9’u inkomplet Kawasaki, %59,1’i ise komplet Kawasaki kriterlerine uymakta idi. İnkomplet vakaların bir yaş altında daha sık olduğu gözlendi. Ateşten sonra en sık görülen klinik bulgu dudak ve oral mukoza değişikliğiydi. Koroner tutulumu olan hastalarda koroner tutulumu olmayan hastalara göre tanı yaşı, hemoglobin (Hb), sodyum, albümin düşük; eritrosit sedimentasyon hızı (ESH), C-reaktif protein (CRP), başvuru sırasındaki lökosit (WBC), kontrolde bakılan trombosit (PLT), lipoproteinler, total kolesterol, alanin aminotransferaz (ALT), aspartat aminotransferaz (AST), intravenöz immünglobulin (IVIG) öncesi ve sonrası pro beyin natriüretik peptit (proBNP) değerleri yüksek saptandı. Hastaların %54,6’sında başvurduğunda koroner arterlerde dilatasyon ve bir hastada anevrizma mevcuttu. Başvurusunda koroner anormalliği olan 43 vakanın %79’unun normalleştiği, yedisinde koroner arterde dilatasyonun devam ettiği, ikisinde ise koroner arter anevrizması geliştiği saptandı. Hastaların hepsine IVIG ve asetil salisilik asit verilmişti. Sekiz hastaya ikinci doz IVIG verildi. IVIG tedavisine dirençli iki olguya steroid uygulandı. Ölüm gözlenmedi. Sonuç: Kawasaki hastalığının erken tanınarak akut dönemde tedavi edilmesiyle ciddi ve yaşam boyu sürecek komplikasyonları engellemek mümkündür. Kawasaki hastalığının prognostik bir bulgu ve belirteci olmaması nedeniyle yeni belirteçlerin keşfi önemli bir araştırma alanıdır.

Objective: The aim of this study is to evaluate complications of cardiac catheterization (CC) procedures in a pediatric cardiology center. Methods: The clinical records of 781 cardiac catheterizations were reviewed to identify procedure-associated complications. Catheterizations were grouped as diagnostic or interventional procedures. A complication was classified as a major or a minor. Results: Patient ages ranged from 1 day to 28.8 years (median 3.3 years). Interventional catheterizations represented 58.5% of total procedures. Patent ductus arteriosus (PDA), atrial septal defect (ASD), and aortic coarctation were the most common diagnoses in our cohort. PDA occlusion, ASD closure, pulmonary valvuloplasty, angioplasty/stenting for aortic coarctation, and aortic valve dilation were the most commonly performed interventional catheterizations. Complications were detected in 17.5% of all procedures. Major complications were 2.3% for all procedures. Decreased/absent pulses were the most common complication in all categories (8.1%). The mortality rate of cardiac catheterization procedures was 0.5%. Relative to diagnostic procedures, interventional catheterizations were associated with a greater risk of complications. Conclusion: Our study’s success and complication rates were similar to other studies. Complications of CC depend on the severity of the underlying congenital heart disease and the type of procedure.

Long QT syndrome (LQTS) is a serious condition that can cause sudden cardiac death. Subsequently, a heterozygous mutation of KCNH2 was identified. This has led to the hypothesis that the use of maternal tacrolimus may cause LQTS or have an effect that may facilitate the early occurrence of congenital LQTS.

Objective: Kawasaki disease is a vasculitis associated with acute fever in children. Conjunctivitis, rash, erythema of the lips and oral mucosa, edema of the extremities, redness, peeling and cervical lymphadenopathy are seen along with fever. Vasculitis frequently affects the coronary arteries. Coronary artery involvement is the most important predictor of prognosis. In this study, we aimed to evaluate the clinical, laboratory and echocardiographic findings and prognosis of patients diagnosed with Kawasaki disease. Materials and Methods: The clinical, laboratory characteristics, treatment and follow-up results of 66 patients aged between 6 months and 91 months admitted to our hospital between 2004-2019 and diagnosed as Kawasaki disease were evaluated retrospectively. Results: 38% of the patients were female and 62% were male. The I/F ratio was 1.64. The mean age at diagnosis was 32 +/- 21 months. 38.5% of these patients were at the age of 1 year or less, and 52.3% were between 1 and 5 years of age. 27 patients (40.9%) were diagnosed as incomplete Kawasaki, and 39 patients (59.1%) were complete Kawasaki. Incomplete cases were more frequent under the age of 1 year (p=0.002). The most common clinical finding after fever was lip and oral mucosal changes (84.8%). 72.7% of the patients had anemia. There was a statistically significant difference between thrombocyte and leukocyte values at admission and control (p<0.001). The age at diagnosis, Hb, sodium, albumin was lower in patients with coronary involvement than in patients without coronary involvement; ESR, CRP, leukocyte at admission, thrombocyte in second week, HDL, LDL, VLDL, total cholesterol, ALT, AST, proBNP levels before and after IVIG were found to be high. In 54.6% of the patients, there was dilatation of the coronary arteries, and aneurysm in one patient. On admission, 79% of 43 cases with coronary abnormality had normalized, 7 had dilatation of the coronary artery, and 2 had coronary artery aneurysm. All patients were given IVIG and acetyl salicylic acid. Eight patients received a second dose of IVIG. Steroid was administered to 2 patients who were resistant to IVIG treatment. Primary additional therapies were applied to 3 cases with infarction of coronary arteries, and giant and middle aneurysm. No deaths were observed. Conclusion: Early diagnosis and treatment of Kawasaki disease can prevent serious and lifelong complications. Since Kawasaki disease has not a prognostic finding and a marker, the discovery of new markers is an important research area.

Objective: Atrial septal defect is a congenital heart disease usually diagnosed in childhood. This study aimed to evaluate the mid-term follow-up results of patients who underwent transcatheter closure of atrial septal defect by comparing the devices and methods used in the procedure and investigating the complications of this procedure in children. Materials and Methods: This study evaluated 232 patient files retrospectively. Of the 232 patients, 24 were excluded from the study due to missing files or data. Also, patients with multi-fenestrated atrial septal defect and aneurismatic septal tissue were excluded from the study. The following data were evaluated: follow-up time, patient complaints, symptoms, transthoracic echocardiography, and transesophageal echocardiography findings (if performed), the size of the defect as measured by balloon-sizing, the size of the device used in the procedure, and major and minor complications. Results: The study included 208 children who were diagnosed with atrial septal defect. The mean age of the patients was 88.0 ± 56.5 months. Of the patients, 170 (81.7%) had no complaints. The success rate of the procedure was found to be 95.7%. While device embolization was the most common major complication, arrhythmia was the most common minor complication. The complication rate was statistically different according to the device type used in the procedure. Conclusion: Transcatheter closure of atrial septal defect is a safe method for atrial septal defect closure in pediatric patients. The study found that defect diameters measured by different methods were not correlated with each other. The procedure complication rates differed according to device type.

Background: Atrial septal defect (ASD) is a congenital heart disease which is usually diagnosed in childhood. However the large part of studies in literature include adults. In this study, we aimed to evaluate the follow-up results of patients who had transcatheter closure of ASD to understand the factors effected success and complications of this procedure in children. Methods: 232 patient files were evaluated retrospectively. 24 of the patients excluded from the study as the files of these patients could not be found in archive or the data needed to be evaluated was missing. Demographical data, family history, accompanying syndromes, complaints of patients, symptoms, echocardiographical (ECO) findings, transesophageal echocardiogram (TEE) findings if performed, the size of defect in balloon-sizing, the size of device used in procedure, major and minor complications evaluated. Results: In our study, 208 children [39.9% (n = 83) male, 60.1% (n = 125) female] included who were diagnosed with ASD. The mean age of the patients are 88,06 ± 56,52 months (3 days to 220 months). When the family history is examined; heart disease was not found in 87.0% (n = 181) of the patients whereas 13.0% (n = 27) of the patients had family history of heart disease. 81.7% of the patients (n = 170) had no complaint and 18.3% (n = 38) had complaints. There was a statistically significant correlation between diameter and length of defect measured with ECO, TEE and by balloon-sizing. Success rates of procedure found to be 95.7%. While the major complication of the procedure was device embolization; arrythmia was the most common minor complication. None of our patients died due to device embolization. The procedure complication rate is not statistically different according to the device type. (p = 0.075; p> 0.05) Conclusion: In our study, we found that device diameters measured by different methods correlated with each other. The procedure complication rates do not differ according to the device type. When the transcatheter ASD closure process is performed with an experienced and qualified team; mortality and morbidity rates compatible with developed countries can be achieved.

Atrial septal defect (ASD) is known to be the most widespread type of congenital heart disease in adulthood (1). Ostium secundum type is the most common form of ASD (60%-70%). Percutaneous closure of ASD is known as an alternative treatment to surgery. Percutaneous transcatheter closure of ASD provides many benefits compared with surgery, such as decreased surgical morbidity, no scarring, and shortened hospital stay. Nowadays, transcatheter treatment is the first choice in secundum ASD treatment. Various devices have been developed for this purpose, and the Amplatzer septal occluder is the most commonly used. However, this closure method is associated with rare complications observed in the early and late stages. The frequency of device embolization in experienced centers during ASD closure is less than 1%. Embolization usually occurs in the early postoperative period and in the right heart cavities. In the acute period, if embolization into the right ventricular outflow tract or pulmonary artery branches occurs, a snare catheter may be used for the attempted recovery. Late dislocation and embolization of the ASD occluder device are rarely reported in the literature. In this case report, we report silent and late embolization of the ASD occluder device into the main pulmonary artery.

Cardiomyopathy is a serious complication of Human Immunodeficiency virus (HIV) infection. Direct effects of HIV, cardiac autoimmunity, opportunistic infections (OIs), nutritional deficiencies (selenium) and severe immunesuppression have been implemented for HIV related cardiomyopathy (HIVAC) ; Elevated anti-alpha myosin antibodies in HIV infection cause cardiac autoimmunity, selenium deficiency leads to cardiomyopathy, myosite invasion and cytokine release cause myocarditis whereas zidovudine triggers reversible and dose dependent myocyte toxicity.

Introduction: Familial hypercholesterolemia (FH) is characterized by severe hypercholesterolemia that can result in coronary artery disease occurring at an early age. If patients are not cured with lipid-lowering drugs and diets, lipid apheresis may be an effective treatment option in these cases. Here, we evaluate the efficacy, selectivity and safety of the DALI apheresis technique. Materials and Methods: Seven pediatric patients (2 girls; 5 boys) with ages between 7 and 14 years (mean age: 6.5±2.1 years) with HFH were included in this study. We restrospectively evaluated clinical and laboratory findings. We used the DALI system for lipid apheresis concomitant with medical treatment and diet for hyperlipidemia. Results: The cohort's mean T.cholesterol level prior to apheresis was 700.57±136.36 mg/dl,the mean LDL-C value was 526.86±131.56 mg and the mean HDL-C level was 36.57±4.58 mg/dl.The mean cholesterol levels after apheresis were consecutively 317.57±93.70 /257.29±90.38 / 33.36±4.78 mg/dl.We noted a 51.1% reduction in LDL-C level and an 8.7% reduction in HDL-C level in our apheresis sessions.The reduction in LDL-C was statistically significant (p<0.05). During 1025 apheresis therapy, the most frequent mild and moderate adverse events were deviceaccess problems and hypotension (in all patients);severe adverse events were mainly due to cardiac problems(myocardial infarct and arrhythmia) and hypotension. Conclusion: Lipid apheresis is an inevitable alternative treatment for HFH. Despite all of its application problems, DALI system is an effective therapy for decreasing atherogenic lipids from circulation.