Background/Objective: Ventricular septal defect (VSD) is the most common congenital heart anomaly, with the perimembranous subtype (pmVSD) being among the most prevalent forms. Surgical repair remains the gold standard for treatment; however, percutaneous closure has emerged as a promising alternative due to the availability of various occlusion devices. Each technique presents distinct advantages and limitations, particularly in terms of complications and long-term outcomes. We sought to evaluate the safety and mid-term outcomes of pmVSD closure employing the Nit-Occlud® Le VSD Coil within a single-centre, single-team setting. Methods: Of the 55 patients hospitalised for pmVSD closure, 45 children underwent the procedure with the Nit-Occlud® Le VSD device. Relevant clinical and defect-related data were collected during hospitalisation and throughout follow-up. Results: Among 45 patients, successful coil implantation was achieved in 41 cases (91.1%). Periprocedural complications occurred in 8 patients (17.8%), including haemolysis, transient atrioventricular block, aortic valve injury, transient ST-segment elevation and supraventricular tachycardia. Two of these complications (4.4%) were classified as severe. The occurrence of complications was significantly associated with the type of VSD shunt (p = 0.03). Conclusions: Transcatheter closure of pmVSD using the Nit-Occlud® Lê VSD Coil in young children is a feasible and safe option with careful patient selection. Patients with type C pmVSD appear to benefit the most. Nevertheless, potential complications, including haemolysis and aortic valve injury, require close monitoring.

BACKGROUND:Kawasaki disease (KD) is an acute inflammatory condition affecting blood vessels in children under 5 years old. Despite treatment advancements, KD remains a major cause of cardiovascular complications, particularly coronary artery aneurysms (CAAs). MATERIAL AND METHODS:This study analyzes 102 KD patients treated in Pomerania during 1997-2021. Clinical and laboratory data were collected. Eighty patients (78.4%) were monitored for a median of 7.1 years (IQR 2.5-12.5) to assess cardiovascular outcomes. RESULTS:The median annual number of cases was 3.0 cases (IQR 2.0-5.0), showing a gradual increase. Median age at onset was 1.8 years (IQR 1.1-3.3), with male-to-female ratio of 1.8:1. Delayed diagnosis occurred in 38.8% of cases. CAAs were detected in 46.3% of patients during the acute phase, with large CAAs in 32.4%. Long-term follow-up showed persistent coronary changes in 15% of patients. CONCLUSIONS:The high prevalence of coronary complications may be linked to delayed diagnosis. These findings emphasize the need for early detection and treatment to prevent complications. Further research is needed to refine KD management strategies across Central and Eastern Europe.

Background: The Amplatzer (TM) Trevisio (TM) Intravascular Delivery System (Trevisio DS; Abbott Laboratories, Chicago, IL, USA) facilitates the delivery of Amplatzer (TM) Occluders and features an ultraflexible tip, which improves assessment of occluder position before release.Aims: To assess the safety and efficacy of the Trevisio DS for transcatheter closure of patent foramen ovale and atrial septal defect.Methods: The Amplatzer (TM) Trevisio (TM) Intravascular Delivery System Post-Approval Study was a prospective, postmarket, single-arm, multicentre, observational study of the Trevisio DS. Enrolled patients were indicated for transcatheter closure of patent foramen ovale or atrial septal defect. In all procedures, the Trevisio DS was used to deliver Amplatzer (TM) Occluders. Technical success was defined as successful deployment and release of at least one occluder. Device- or procedure-related serious adverse events were tracked until discharge or day 7, whichever occurred earlier.Results: The study enrolled 144 patients with patent foramen ovale and 107 patients with atrial septal defect at 22 European sites; 53 patients with atrial septal defect (49.6%) were aged<18years. The rate of technical success was 98.4% (97.2% for atrial septal defect, 99.3% for patent foramen ovale). There was one serious adverse event (0.4%), an acute periprocedural device embolization that occurred after occluder release in a patient with atrial septal defect; the device was retrieved percutaneously. This was determined by the implanter to be unrelated to the performance of the Trevisio DS.Conclusions: The Trevisio DS exhibited a high rate of technical success and an excellent safety profile during transcatheter closure of patent foramen ovale and atrial septal defect.(c) 2023 Abbott Laboratories. Publie par Elsevier Masson SAS. Cet article est publie en Open Access sous licence CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Stroke remains one of the greatest health challenges worldwide, due to a high mortality rate and, despite great progress in its treatment, the significant disability that it causes. Studies conducted around the world show that the diagnosis of stroke in children is often significantly delayed. Paediatric ischaemic arterial stroke (PAIS) is not only a problem that varies greatly in frequency compared to the adult population, it is also completely different in terms of its risk factors, clinical course and outcome. The main reason for the lack of a rapid diagnosis of PAIS is a lack of access to neuroimaging under general anaesthesia. The insufficient knowledge regarding PAIS in society as a whole is also of great importance. Parents and carers of children should always bear in mind that paediatric age is not a factor that excludes a diagnosis of stroke. The aim of this article was to develop recommendations for the management of children with acute neurological symptoms suspected of ischaemic stroke and further treatment after confirmation of the ischaemic aetiology of the problem. These recommendations are based on current global recommendations for the management of children with stroke, but our goal was also to match them as closely as possible to the needs and technical diagnostic and therapeutic possibilities encountered in Poland. Due to the multifactorial problem of stroke in children, not only paediatric neurologists but also a neurologist, a paediatric cardiologist, a paediatric haematologist and a radiologist took part in the preparation of these recommendations.

Background: Despite extensive knowledge about the quality of life of people suffering from rare diseases, data on patients with Marfan syndrome (MFS) are scarce and inconsistent. Hence, the problem of assessing the quality of life (QOL) and its relationship with the assessment of which ailments are the most burdensome for these patients is still open. Aim: Comparison of the quality of life of patients with MFS and determination as to which of the reported complaints in patients with MFS are related to the QOL of patients. Methods: The study included 35 patients with MFS and 35 healthy controls, matched for gender and age. In the study, the questionnaire of quality of life assessment SF-36 was used to assess the level of health-related quality of life, as well as an interview of the most severe symptoms reported by patients with MFS. Results: The level of the physical dimension of the QOL (p < 0.001) and limiting of roles due to physical health (p = 0.002), as well as the level of general index of the QOL (p < 0.001), were statistically significantly lower in MFS patients when compared to controls. People from both studied groups do not vary in the scope of pain, vitality, social functioning, limiting the roles due to emotional problems, and state of mind but also in the mental dimension of the health-related quality of life (HRQL). Additionally, there has been a correlation between HRQL and the subjective assessment of the effects of orthopedic, ophthalmic, and cardiological problems in life, as well as lower exercise tolerance in the evaluation of people with MFS and QOL in most areas. Conclusions: Patients with MFS present a reduced QOL in the areas of physical functioning, limiting roles due to physical health, general feeling of general health, the physical dimension of the HRQL, and the general index of the QOL; in these areas, they require careful evaluation, as well as medical and psychosocial assistance.

Background: Human heart’s growth and development are followed by gradual changes on the electrocardiogram. The study was conducted to analyse changes in the resting electrocardiogram of 10-year-olds in relation to their somatic growth. Methods: 120 students (62 male) aged 10.8 (+/-0.49) years were examined. The study consisted of a resting electrocardiogram and anthropometric measurements repeated in 3-year interval. Statistical analysis of changes in electrocardiographic parameters (PR, QRS, QTc, QRS axis, wave amplitudes) and corresponding changes in height, weight and BMI was conducted. Results: Through time, a substantial elongation of PR (p < 0.001), ORS (p < 0.001) and QT (p < 0.001) lengths was observed while the QRS axis and corrected QT time remained stable (p=0.320 and 0.857 respectively). In girls PR elongation correlated with an increase in BMI (r=0.33). Right axis deviation corresponded with height gain in boys (r=0.45). R and S amplitudes in limb leads did not change significantly except for lead I. There was a considerable decline in R and S wave voltages in precordial leads in adolescent girls that corresponded with weight and BMI increase. In boys the increase in BMI was related to greater R waves in left precordial leads. Conclusion: Adolescent growth has an influence on some electrocardiographic variables. There are significant differences between boys’ and girls’ electrocardiograms regarding QRS amplitudes.

Restrictive cardiomyopathy (RCM) has a poor prognosis and limited treatment options apart from heart transplantation (HTx). We report on the first-in-human interventional atrial flow regulator (AFR) implantations in 3 children with RCM, leading to marked clinical and hemodynamic improvement. We propose the AFR as bridge to HTx or destination therapy in RCM. (Level of Difficulty: Advanced.)

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Wałdoch A, Sabiniewicz R, Meyer-Szary J. Interventional treatment using a 3D model of a right pulmonary artery to left atrial fistula in an infant. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2022;18(2):170-172. doi:10.5114/aic.2022.118535. APA Wałdoch, A., Sabiniewicz, R., & Meyer-Szary, J. (2022). Interventional treatment using a 3D model of a right pulmonary artery to left atrial fistula in an infant. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 18(2), 170-172. https://doi.org/10.5114/aic.2022.118535 Chicago Wałdoch, Anna, Robert Sabiniewicz, and Jarosław Meyer-Szary. 2022. "Interventional treatment using a 3D model of a right pulmonary artery to left atrial fistula in an infant". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 18 (2): 170-172. doi:10.5114/aic.2022.118535. Harvard Wałdoch, A., Sabiniewicz, R., and Meyer-Szary, J. (2022). Interventional treatment using a 3D model of a right pulmonary artery to left atrial fistula in an infant. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 18(2), pp.170-172. https://doi.org/10.5114/aic.2022.118535 MLA Wałdoch, Anna et al. "Interventional treatment using a 3D model of a right pulmonary artery to left atrial fistula in an infant." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 18, no. 2, 2022, pp. 170-172. doi:10.5114/aic.2022.118535. Vancouver Wałdoch A, Sabiniewicz R, Meyer-Szary J. Interventional treatment using a 3D model of a right pulmonary artery to left atrial fistula in an infant. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2022;18(2):170-172. doi:10.5114/aic.2022.118535.

Background: The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings. Methods: In a cohort study, 626 healthy children (52% male) aged 10.8 ± 0.5 years attending primary school in a single town underwent a 12-lead electrocardiogram coupled with measurements of height, weight and blood pressure. Indices of respiratory sinus arrhythmia (pvRSA, RMSSD, RMSSDc) were derived from semi-automatic measurements of RR intervals. Height, weight, BMI, blood pressure as well as waist and hip circumferences were compared between subjects with rhythmic heart rate and respiratory sinus arrhythmia, and correlations between indices of sinus arrhythmia and anthropometry were investigated. Results: Respiratory sinus arrhythmia was recognized in 43% of the participants. Subjects with sinus arrhythmia had lower heart rate (p < 0.001), weight (p = 0.009), BMI (p = 0.005) and systolic (p = 0.018) and diastolic (p = 0.004) blood pressure. There were important inverse correlations of heart rate and indices of sinus arrhythmia (r = −0.52 for pvRSA and r = −0.58 for RMSSD), but not the anthropometry. Conclusion: Lower prevalence of respiratory sinus arrhythmia among children with overweight and obesity is a result of higher resting heart rate observed in this population.

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. Cardiac magnetic resonance characteristics of acute myocarditis occurring after mRNA-based COVID-19 vaccines immunization Jaroslaw Meyer-Szary , Magdalena Bazgier , Paulina Lubocka , Karolina Dorniak , Robert Sabiniewicz

Marfan Syndrome (MFS) is a systemic disorder caused by mutations in fibrillin-1. The most common cause of mortality in MFS is dissection and rupture of the aorta. Due to a highly variable and age-dependent clinical spectrum, the diagnosis of MFS still remains sophisticated. The aim of the study was to determine if there exist phenotypic features that can play the role of “red flags” in cases of MFS suspicion. The study population included 306 patients (199 children and 107 adults) who were referred to the Department of Pediatric Cardiology due to suspicion of MFS. All patients underwent complete clinical evaluation in order to confirm the diagnosis of MFS according to the modified Ghent criteria. MFS was diagnosed in 109 patients and marfanoid habitus in 168 patients. The study excluded 29 patients with other hereditary thoracic aneurysm syndromes. Comparative analysis between patients with Marfan syndrome and marfanoid habitus was performed. Symptoms with high prevalence and high positive likelihood ratio were identified (pectus carinatum, reduced elbow extension, hindfoot deformity, gothic palate, downslanting palpebral fissures, lens subluxation, myopia ≥ 3 dioptres remarkably high stature). The differentiation between patients with MFS and marfanoid body habitus is not possible by only assessing external body features; however, “red flags” could be helpful in the screening phase.

As a result of the COVID-19 pandemic, telemedicine has become an important branch of healthcare worldwide. Apart from their undeniable advantages, the virtual visits lack physical examination, which can lead to important diagnostic mistakes. We hereby present a case of a pediatric patient whose weight gain, initially attributed to a sedentary lifestyle was, in fact, due to sub-acute right heart failure in the context of a ruptured sinus of Valsalva aneurysm. The condition was not diagnosed until the patient presented at the emergency. The boy was successfully treated with two percutaneous interventions and returned to his previous stature.

Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.

Background: In patients following complete repair of the tetralogy of Fallot, the duration of the QRS complex is associated with the size and mechanical function of the right ventricle, which are contemporarily assessed by cardiac magnetic resonance (CMR). Methods: 38 patients aged 18.0–54.9 years (median age 24.9 years) who had undergone complete repair of the tetralogy of Fallot were examined using CMR and concomitant 24 h ambulatory electrocardiography monitoring. We used statistical analysis to investigate the correlations between electrocardiographic parameters (heart rate, HR; PQ interval, PQ; QRS duration, QRS; and corrected QT interval, QTc) and CMR results (right ventricular ejection fraction, RVEF; right ventricular end-diastolic volume index, RVEDVI; and right ventricular end-systolic volume index, RVESVI) for patients after early and late repair. Results: The ECG-based parameters were not correlated with time since repair. There were significant correlations between QRS duration and RVEF (r = −0.61), RVEDVI (r = 0.56), and RVESVI (r = 0.54) for early operated patients but not for late-operated patients. No other substantial correlations were reported. Conclusion: Despite its role in screening for arrhythmias, electrocardiography has a limited role as a predictor of morphology and function of the right ventricle in patients after repair of the tetralogy of Fallot.