BACKGROUND:Duchenne muscular dystrophy (DMD) is an inherited neuromuscular disorder causing progressive degeneration of skeletal and cardiac muscles due to dystrophin deficiency. Cardiac involvement ranges from mild to severe, including heart failure, arrhythmias, conduction defects, and sudden cardiac death. OBJECTIVE:This study aimed to evaluate early markers of cardiac repolarization abnormalities in DMD patients by analyzing standard 12‑lead ECG parameters-QT interval, corrected QT (QTc), T peak to T end (Tp-e), Tp-e/QT, and Tp-e/QTc ratios-and microvolt T-wave alternans (MTWA) from 24-h Holter monitoring. METHODS:Seventy-four individuals participated: 39 DMD patients and 35 age- and sex-matched healthy controls. Data on demographics, ambulation status, ECG, and Holter recordings were collected and compared. All participants underwent standard 12‑lead electrocardiography and 24-h Holter electrocardiogram monitoring. ECG measurements were performed manually by a blinded operator using standardized techniques. Holter recordings were collected and compared (analyzable data obtained from 33 patients and 34 controls). The QTc interval was calculated using Bazett's formula. Correlation analyses and statistical comparisons between groups were performed using appropriate parametric and non-parametric tests. RESULTS:DMD patients exhibited significantly higher resting heart rates. The Tp-e interval was similar between groups, while the QT interval was significantly shorter in the patient group, the QTc interval showed no significant difference between groups. Tp-e/QT ratio was higher in the patient group; Tp-e/QTc ratios showed no difference. The QTc interval was significantly prolonged in the non-ambulatory DMD group. MTWA values did not differ significantly between groups. Due to the limited sample size and absence of established pediatric reference values, MTWA findings must be considered inconclusive. CONCLUSION:In conclusion, our study reveals subtle repolarization alterations in DMD patients, including elevated resting heart rate and a trend toward increased Tp-e/QT ratio. While these findings do not yet establish a definitive arrhythmic phenotype, they suggest the presence of early electrophysiological changes that may warrant longitudinal cardiac evaluation. Prospective follow-up studies are essential to determine the prognostic significance of these parameters and their relationship to clinical arrhythmic outcomes in the pediatric DMD population.

Kawasaki disease (KD) may present with manifestations beyond classical diagnostic criteria, but data on extracriteria manifestations as a multisystem phenotype remain limited. We aimed to assess the frequency and clinical significance of extracriteria manifestations in children with KD. In this retrospective single-center study, we reviewed 254 children with KD between January 2005 and December 2025. Extracriteria manifestations were defined as clinically documented organ-system involvement beyond the five principal diagnostic criteria of KD after exclusion of alternative diagnoses. Patients were compared according to extracriteria manifestations with respect to demographic, clinical, laboratory, echocardiographic, treatment, and coronary outcome variables. Extracriteria manifestations were identified in 77 patients (30.3

Abstract Background Transcatheter closure has become a widely accepted alternative to surgery for VSD, but long-term pediatric data are limited. This study evaluated procedural success, complications, and long-term outcomes with different occluders. Methods We retrospectively analyzed 118 children who underwent attempted transcatheter VSD closure between 2014 and 2024, with clinical, echocardiographic, and electrocardiographic follow-up. Results Closure was successful in 110 patients (93%). Failures were due to multifenestrated anatomy, embolization, residual shunt, atrioventricular (AV) block, tricuspid regurgitation, or insufficient aortic rim. Major complications occurred in six patients, including device embolization, progressive aortic regurgitation requiring surgery, persistent nodal rhythm requiring device removal, ventricular perforation, infective endocarditis, and subarachnoid hemorrhage. Minor complications included mild to moderate tricuspid regurgitation (n = 4) and mild aortic regurgitation (n = 5). Arrhythmic events comprised supraventricular tachycardia (n = 2, both resolved), nodal rhythm (n = 1, transient), right bundle branch block (n = 5, persistent in four), and left bundle branch block (n = 1, resolved). Residual shunt was present in 36.4% immediately, declining to 9.8% at follow-up. Larger VSD diameter (OR 1.75, 95% CI 1.14–2.69) and higher body weight (OR 1.07, 95% CI 1.00–1.15) were independent predictors. No late complete AV block, endocarditis, or embolization occurred. Patients treated with Konar-MF were younger and lighter, while Nit-Occlud was associated with higher residual shunt rates (85.7% vs. 33.0%, p = 0.010). Conclusion Transcatheter VSD closure in children demonstrated high success, acceptable complication rates, and favorable long-term outcomes. Results were influenced by device choice, defect size, and patient characteristics, highlighting the need for individualized strategies and continued surveillance.

Femoral vascular access is the most commonly used route for pediatric cardiac interventions; however, its technical difficulty increases the risk of access-related complications. Ultrasound (USG) guidance has the potential to improve procedural safety and efficiency. Primary outcomes were puncture attempts and vascular complications; secondary outcomes included crossover rates and risk factors for complications. This prospective, single-center study included 66 patients undergoing 90 femoral vascular accesses for diagnostic or therapeutic cardiovascular interventions. Patients were assigned to the USG or manual-guided groups in an alternating order. The pediatric cardiologist performed manual vascular access procedures, while the interventional radiologist performed USG-guided procedures. A total of 40 procedures were performed under USG guidance, and 50 under manual access. The mean number of puncture attempts was significantly lower in the USG group (1.50 ± 0.93) than in the manual group (2.38 ± 1.90; p = 0.009). In the subgroup analysis, the difference reached statistical significance for venous interventions (p = 0.04) but not for arterial interventions (p = 0.088). Overall complication rate was 7.5% in the USG group versus 22% in the manual group (p = 0.08). The major complication rate was 3.3%, and all of them occurred in the manual group. Most crossover cases were successfully rescued with USG guidance, predominantly in infants under one year of age. USG-guided femoral access in children significantly reduces the number of puncture attempts. This technique has the potential to reduce access-related complications, especially in infants. [Med-Science 2025; 14(4.000): 1194-2000]

Background:This study aims to evaluate the mid-term outcomes of transcatheter ventricular septal defect closure with the Konar-MF™ device and to investigate the impact of an optimized device selection strategy using a retrograde approach. Methods:Between January 2019 and November 2023, a total of 58 patients (32 males, 26 females; median age: 4.5 years; range, 8 months to 16 years) who underwent transcatheter closure of ventricular septal defects using the Konar-MF™ device were retrospectively analyzed. Patient demographics, procedural details, and follow-up data were recorded. Results:Procedural success was achieved in 95% of cases, with a median procedure time of 60 min and fluoroscopy time of 12.6 min. Retrograde implantation was used in 79% of patients, significantly reducing procedural time and minimizing complications associated with an arteriovenous loop. Our refined strategy of selecting smaller devices when anatomically feasible played a crucial role in reducing interference with surrounding cardiac structures, substantially contributing to the absence of complete atrioventricular block in our cohort. Major complications included device embolization, moderate aortic regurgitation due to device dislocation, and right ventricular perforation (each in 1.8% of patients). The median follow-up was 34.5 months. Residual shunt rates were initially 42% on postoperative Day 1, reducing to 1.8% by the end of the follow-up period. Conclusion:The Konar-MF™ occluder demonstrated high procedural success and acceptable complication rates for perimembranous ventricular septal defect closure. The use of a retrograde approach and a refined device selection strategy were key factors in achieving favorable outcomes, minimizing complications such as atrioventricular block and valve interference. The device offers significant advantages, making it a suitable alternative to surgical ventricular septal defect closure.

BACKGROUND:The objective is to compare the frequency and clinical characteristics of pediatric Postural Orthostatic Tachycardia syndrome (POTS) diagnoses before and during the Coronavirus Disease 2019 (COVID-19) pandemic and assess potential contributing factors. METHODS:This retrospective study analyzed 117 pediatric patients diagnosed with POTS between January 2018 and December 2023 at a single tertiary center. Patients were divided into pre-pandemic (n = 46) and pandemic (n = 71) groups. Clinical, laboratory, and psychosocial data were collected and compared. Logistic regression was used to identify independent predictors of pandemic-period diagnoses. RESULTS:A significant increase in POTS diagnoses was observed during the pandemic (10.5% vs. 6.1%, P= .01). Pandemic-period patients reported lower physical activity (72%) and higher screen time (85%), with increased symptoms of anxiety (34% vs. 18%, P= .04) and palpitations (P= .03). Vitamin B12 levels were higher in the pandemic group (P= .043), while hemoglobin levels and heart rate variability remained similar across groups. CONCLUSION:The COVID-19 pandemic was associated with a marked rise in pediatric POTS diagnoses, likely driven by lifestyle alterations and psychosocial stress rather than nutritional deficiencies. These findings underscore the importance of early recognition, physical reconditioning, and psychological support in managing POTS, particularly during global health crises.

Objective: This study investigates electrocardiographic (ECG) findings in pediatric patients diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) during the coronavirus disease-2019 pandemic, offering valuable insights into the diagnostic process. Method: Demographic, clinical, and laboratory data of 71 MIS-C cases and 27 Kawasaki disease cases between January 2019 and December 2021 were retrospectively collected from hospital records, following ethics committee approval. MIS-C diagnosis adhered to World Health Organization criteria, and Kawasaki disease diagnosis followed American Heart Association guidelines. Results: Seventy one MIS-C cases and 27 Kawasaki disease cases were included. MIS-C patients exhibited a significantly shorter duration of fever, higher C-reactive protein levels, and elevated serum cardiac troponin T troponin values compared to Kawasaki disease cases. Transthoracic echocardiographic evaluation revealed specific cardiac abnormalities in MIS-C patients, including mitral regurgitation and aortic regurgitation. ST segment changes, T-wave negativity, and QRS changes were observed significantly in MIS-C patients. Conclusion: Results provide crucial information about the ECG profile of MIS-C cases. Particularly, indicators such as ST segment changes and T-wave negativity play a critical role in distinguishing MIS-C from other similar conditions and understanding its cardiac effects. These data offer valuable clinical markers that can be utilized in the diagnosis and treatment of MIS-C.

BACKGROUND:Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), is an established treatment for heart failure (HF) with reduced left ventricular ejection fraction. It has not been rigorously compared with angiotensin-converting enzyme inhibitors in children. PANORAMA-HF (Prospective Trial to Assess the Angiotensin Receptor Blocker Neprilysin Inhibitor LCZ696 Versus Angiotensin-Converting Enzyme Inhibitor for the Medical Treatment of Pediatric HF) is a randomized, double-blind trial that evaluated the pharmacokinetics and pharmacodynamics (PK/PD), safety, and efficacy of sacubitril/valsartan versus enalapril in children 1 month to <18 years of age with HF attributable to systemic left ventricular systolic dysfunction (LVSD). METHODS:Children with HF attributable to LVSD were randomized to sacubitril/valsartan versus enalapril to assess the efficacy and safety of sacubitril/valsartan at 52 weeks of follow-up. The primary end point of the study was to determine whether sacubitril/valsartan was superior to enalapril for the treatment of pediatric patients with HF attributable to systemic LVSD, assessed using a primary global rank end point consisting of ranking patients from worst to best on the basis of clinical events such as death, listing for urgent heart transplant, mechanical life support requirement, worsening HF, New York Heart Association (NYHA)/Ross class, Patient Global Impression of Severity (PGIS), and Pediatric Quality of Life Inventory physical functioning domain. The change from baseline to 52 weeks in NT-proBNP (N-terminal pro-B-type natriuretic peptide) was an exploratory end point. RESULTS:A total of 375 children (mean age, 8.1 +/- 5.6 years; 52% female) were randomized to sacubitril/valsartan (N=187) or enalapril (N=188). At week 52, no significant difference was observed between the 2 treatment arms in the global rank end point (Mann-Whitney probability, 0.52 [95% CI, 0.47-0.58]; Mann-Whitney odds, 0.91 [95% CI, 0.72-1.14]; P=0.42). At week 52, clinically meaningful reductions were observed in both treatment arms in NYHA/Ross, PGIS, Patient Global Impression of Change, and NT-proBNP, without significant differences between groups. Adverse events were similar between treatment arms (incidence: sacubitril/valsartan, 88.8%; enalapril, 87.8%), and the safety profile of sacubitril/valsartan was acceptable in children. CONCLUSIONS:In this study, sacubitril/valsartan did not show superiority over enalapril in the treatment of children with HF attributable to systemic LVSD using the prespecified global rank end point. However, both treatment arms showed clinically meaningful improvements over 52 weeks.

BACKGROUND:The aim of this study is to evaluate the role of leukotriene B4, an inflammatory mediator, in the development of pulmonary hypertension in paediatric patients with CHD with left-right shunt. METHODS:The study included forty patients with CHD with left-right shunts. Based on haemodynamic data obtained from cardiac diagnostic catheterisation, 25 patients who met the criteria for pulmonary arterial hypertension were included in the patient group. The control group comprised 15 patients who did not meet the criteria. The standard cardiac haemodynamic study was conducted. Leukotriene B4 levels were assessed in blood samples taken from both pulmonary arteries and peripheral veins. RESULTS:The median age of patients with pulmonary arterial hypertension was 10 months (range: 3-168), while the median age of the control group was 50 months (range: 3-194). In the pulmonary hypertension group, the median pulmonary artery systolic/diastolic/mean pressures were 38/18/24 mmHg, compared to 26/10/18 mmHg in the control group. Leukotriene B4 levels in pulmonary artery blood samples were significantly higher in the pulmonary arterial hypertension group compared to the controls (p < 0.05). Peripheral leukotriene B4 levels were also elevated in the pulmonary arterial hypertension group in comparison to the control group, though the difference was not statistically significant. CONCLUSION:The discovery of elevated leukotriene B4 levels in pulmonary artery samples from paediatric patients with pulmonary arterial hypertension secondary to CHD with left-to-right shunt suggests that local inflammation may have a pathological role in the development of pulmonary arterial hypertension.

Objective: Transcatheter closure of patent ductus arteriosus (PDA) has taken its place as the first choice in the treatment of PDA thanks to the development of new devices and techniques. In this study, we present our cases with PDA closed with Amplatzer duct occluder I (ADO I), Amplatzer duct occluder II (ADO II) and discuss the efficacy and safety of transcatheter PDA closure with these devices in children. Method: Between January 2010 and January 2023, a total of 373 patients underwent PDA closures using ADO I (n=40), and ADO II (n=333) devices in the Pediatric Cardiology Clinic of our hospital and PDA closure was successfully performed in 370 patients. These cases were analysed retrospectively. Results: The mean age of our patients was 3 (0.2-17) years. The mean narrowest diameter of the PDA was 2.48 +/- 0.80 mm. Median procedure and fluoroscopy times were 55, and 11 minutes, respectively. The procedure was successful in 99.1% of the cases. PDA was successfully treated in 387 patients using ADO I (n=39), ADO II (n=331) devices. Minimal residual shunt was detected as a minor complication only in 7 patients in the acute phase. In 4 of these 7 patients, residual shunt disappeared completely in the follow-up period, but it persisted in 3 patients. Major complications in our study were device embolisation in 2 patients who underwent ADO I and infective endocarditis that developed in 1 patient 2 weeks after the procedure. In our patient with device embolisation, the device was tried to be removed with the help of a snare, but it failed, so it was surgically removed and the PDA was closed surgically. In our case with infective endocarditis, the device was surgically removed and the PDA was surgically closed. In one patient, the mean pulmonary artery pressure measured during the procedure was found to be high with 29 mmHg, but the procedure was continued because the pulmonary vasoreactivity test was positive. In the procedure performed with ADO I device, the PDA was closed by opening the first disc without releasing the device, but the procedure was not continued because the patient developed desaturation. Conclusion: Transcatheter PDA closure can now be successfully performed in many centres. In this study, we evaluated the cases of PDA closure performed with ADO I and ADO II devices, in the last 13 years. As a result of our study, in accordance with the literature data, we have shown that transcatheter PDA closure using ADO I, ADO II devices is an effective and safe method with low complication rates in children.

Objective: This study aims to evaluate right atrial functions in children with pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) by deformation indices assessed by two dimensionalspeckle tracking echocardiography.Method: A total of 40 patients, including 15 patients with World Health Organization Functional class II-III CHD-PAH and 25 age-matched healthy controls were enrolled in the study.Deformation indices were measured by electrocardiogram-gated right atrial longitudinal strain recordings.Results: Peak atrial strain/reservoir phase (24.19±15.81%vs. 40.62±12.35%)(p=0.01),conduit phase (15±00.13.6% vs. 26.4±10.7%)(p=0.006) and pump phase (10.06±9.07%vs. 14.21±5.05%) (p=0.07) were comparatively evaluated in the patient and control groups, respectively.Regional peak atrial strain measurements performed for basal anterolateral (p=0.06),mid anterolateral (p=0.12),apical anterolateral (p=0.61),apical inferoseptal (p=0.28) and mid inferoseptal (p=0.001),basal inferoseptal (p=0.02)segments were also compared between the patient and control groups. Conclusion:Right atrial deformation indices were significantly impaired in patients with CHD-PAH.Deterioration in the right atrial reservoir and conduit functions are associated with right ventricular diastolic dysfunction.Both global and regional changes can be observed in the measurement of right atrial strain secondary to the existing heart defects and operative conditions of the patients.

Konjenital kalp hastalıkları çocukların ve ailelerin hayatlarını etkileyen en yaygın kronik çocukluk çağı hastalıklarından birisidir. Çocukların hayat kalitesinin değerlendirilmesi 1980’lerde kullanılmaya başlanmış olup son zamanlarda tedavi seçeneklerinin karşılaştırılmasında ve etkinliklerinin değerlendirilmesinde ve klinik uygulamada yaygın olarak kullanılmaktadır. Çalışmamızda Dr. Behçet Uz Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk Kardiyoloji Biriminde konjenital kalp hastalığı tanılı ve girişim uygulanmış olan 8-16 yaşları arasındaki 52 hastaya yaş grubuna özgü ve sağlıkla ilgili yaşam kalitesi ölçeği olan Konjenital Kalp Hastalıkları Yaşam Kalitesi (ConQol) anketi uygulanmıştır. 8-11 yaş grubu 27 hasta ve 26 sağlıklı kontrolden oluşuyordu. 12-16 yaş grubunda 25 hasta ve 26 sağlıklı kontrol vardı. 8–11 yaş grubunda koşuşturabilme, spor ve egzersiz yapılmasına izin verilmesi ve arkadaşlara ayak uydurabilme sorularında kontrol grubuna göre anlamlı bir fark olduğu saptanmıştır. 12–16 yaş grubunda spor ve egzersiz yapılmasına izin verilmesi, arkadaşlara ayak uydurabilme ve kulübe gitme veya okul dışında aktivitelere katılma sorularında kontrol grubuna göre anlamlı bir fark olduğu saptanmıştır. Konjenital kalp hastalıklı çocuklarda yaşam kalitesi özellikle fiziksel aktivite kısıtlanmasından etkilenmektedir.

Objective: Atrial septal defect (ASD) accounts for 6-10% of all congenital heart disorders.Secundum ASD closure can be performed surgically or percutaneously.We aimed to identify the various arrhythmias that occur before, during, and after the procedure and evaluate their management. Methods:The study included a total of 427 patients aged 0-18 years who underwent transcatheter or surgical closure of isolated secundum ASD between January 2008 and January 2020.Postoperative electrocardiogram (ECG) traces, intraoperative arrhythmias, and treatments were recorded for both groups.Echocardiography and ECG were evaluated at postoperative 1 week, 1, 3, and 6 months, and annually thereafter.Results: After transcatheter closure, follow-up basal ECG showed incomplete right bundle branch block pattern in 21 patients and sinus rhythm in 229 patients.After surgical closure, incomplete right bundle branch block pattern was detected in 23 patients, complete right bundle branch block in 3 patients, and complete AV-block (Atrioventricular Block) pattern in 1 patient.The other 150 patients showed sinus rhythm.At least one postoperative follow-up Holter ECG record could be obtained for 104 patients in the transcatheter group and 96 patients in the surgical group.Of 104 patients who underwent transcatheter closure, 97 (93.3%) had normal Holter ECG findings and 7 (6.7%) had arrhythmia.Of the 96 patients who underwent surgical closure, 85 (88.5%) had normal Holter ECG traces and 11 (11.5%) had arrhythmia.There was no statistically significant difference in the frequency of arrhythmia (P = 0.164). Conclusion:The higher frequency of arrhythmia in adult studies compared to the pediatric age group once again demonstrates the importance of early diagnosis and treatment of ASD in childhood.The similar incidence of arrhythmia in both groups supports the safety and effectiveness of both closure methods in eligible patients.

Background: This study aimed to evaluate the Turkish validity and reliability of the 8-12-and 13-18-years child and parent forms of the Pediatric Quality of Life Inventory (PedSQL) 3.0 Cardiac Module.Methods: This methodological study was conducted in children (8-18 years old) with cardiac disease and their parents. The PedsQL 4.0 were also used to collect data for the parallel form method. Pearson correlation coeffi-cients between the scale and its sub-dimensions were evaluated for construct validity. For construct validity, mean scores of children with cardiac disease and healthy children and their parents were compared. Cronbach's alpha coefficient was calculated to evaluate the internal consistency of the items.Results: In this study, 136 children aged 8-12 years and 135 adolescents aged 13-18 years with cardiac diagnosis and their parents participated. The Cronbach alpha coefficients were found to be above 0.80 for all sub-dimensions and the total scale. Correlations between PedsQL 3.0 Cardiac module and PedsQL 4.0 scores were moderate to highly significant. A significant difference was found between the mean scores of the children with cardiac disease and healthy child and parent forms (p < .001).Conclusion: PedsQL 3.0 Cardiac Module's 8-12-and 13-18-year child and parent forms are valid and reliable for the Turkish language.Application to practice: It is important to evaluate the PedsQL cardiac module, which is a very comprehensive scale, with accurate measurements to increase the general health level and life satisfaction of these patient groups. (c) 2023 Elsevier Inc. All rights reserved.

Objectives:This study aimed to evaluate the diagnostic tests and treatments applied in patients with multisystem inflammatory syndrome in children (MIS-C) and to determine the effect of the disease on health costs. Patients and methods:This retrospective cohort study included 59 MIS-C patients (40 males, 19 females; mean age: 7.7±4.2 years; range, 4 months to 16.5 years) who were admitted and treated between April 1, 2020, and November 1, 2021. Demographic and clinical features with hospital costs and length of stay were retrospectively reviewed from the medical files and computerized system of the hospital. Direct medical care costs of items were calculated with the hospital perspective using a combination of microcosting technique (resource-based accounting method) and hospital list data. Cases were classified as mild, moderate, or severe, and the patients were divided into two groups: the mild group and the moderate-severe group. Classification was determined by the vasoactive inotropic score (VIS), degree of respiratory support, and evidence of organ damage. Results:The mean age of the cases in the mild group was 6.5±3.7 years, and the mean age of the cases in the moderate-severe group was 9.2±4.3 years. Of 59 patients, 19 (32.2%) were followed up in the pediatric intensive care unit. The median duration of hospitalization in the hospital was 8 (interquartile range: 7-12) days. The total cost of the patients hospitalized with the diagnosis of MIS-C during the study period was 849,242.93$, and the mean cost per patient was 14,393.94±9,631.92$. In the distribution of the total cost of hospitalization according to expenses, the highest rate was pharmacy and blood products (51.99%) and IVIG costs (43.99%). While the mean total cost per person was 13,682.87±8,799.63$ in mild cases, it was 16,433.82±9,440.02$ in moderate-severe cases, and no statistically significant relationship was found between the two groups (p>0.05). There was no difference in the mean cost per patient between the cases with and without heart, lung, kidney, or neurologic involvement and advanced respiratory support (p>0.05). There was a strong positive correlation between the total costs and age (r=0.883, n=59, p<0.0001), with increased amount of costs with increased age. Conclusion:In the study, no statistically significant correlation was found between the total cost of per person in the mild group and the moderate-severe group (p>0.05). This finding may be due to the wide use of IVIG in MIS-C treatment, in addition to low transfer rates to pediatric intensive care units due to high-flow nasal cannula usage.

Critical congenital heart disease (CCHD) is one of the leading causes of neonatal and infant mortality. We aimed to elucidate the epidemiology, spectrum, and outcome of neonatal CCHD in Türkiye. This was a multicenter epidemiological study of neonates with CCHD conducted from October 2021 to November 2022 at national tertiary health centers. Data from 488 neonatal CCHD patients from nine centers were entered into the Trials-Network online registry system during the study period. Transposition of great arteria was the most common neonatal CHD, accounting for 19.5

The prevalence of intracardiac thrombus (ICT) is gradually increasing, though it is rare among children. Data related to the occurrence of ICT among children are limited, and treatment recommendations have been made utilizing adult guidelines. The primary objective of this study is to determine associated factors, management, and outcomes of intracardiac thrombosis in children. Between January 2013 and January 2020, patients diagnosed with ICT at the Pediatric Hematology-Oncology and Pediatric Cardiology departments in our hospital were included in the study. Demographic characteristics, clinical and laboratory findings, treatment protocols, and outcomes were analyzed retrospectively. The median age at diagnosis was 10.5 months (2 days to 14.5 years), and the median follow-up period was 6.5 months (1 month to 3.1 years). The most common primary diagnoses of the patients, in order of frequency, were heart disease (n: 8), metabolic disease (n: 3), prematurity and RDS (n: 3), burns (n: 2), pneumonia (n: 2), and asphyxia (n: 2). CVC was present in 19/23 of the patients. The reasons for CVC insertion were the need for plasmapheresis in one patient with a diagnosis of HUS and the need for well tolerated vascular access because of long-term hospitalization in others. LMWH was administered to all patients as first-line therapy. Complete response was achieved in 19 (79%) of 24 patients and 4 patients (16.6%) were unresponsive to medical treatment. It was found out that the thrombus location, type, sepsis, and hemoculture positivity, as well as the presence of CVC, had no impact on treatment response (chi-square P = 0.16, 0.12, 0.3, 0.49, 0.56). Moreover, no correlation was determined between thrombus size and treatment response (Mann Whitney U test P = 0.47). The mortality rate was determined to be 12.5% (3/24). Spontaneous occurrence of ICT is rare in childhood, without any underlying primary disease or associated factor. The presence of CVC, sepsis, and heart disease are factors associated with ICT. The success rate is increased with medical treatment. There was no significant difference in treatment response between the newborn and 1 month to 18-year-old patient group. It has been demonstrated that thrombus size, type, localization; sepsis, and hemoculture positivity had no impact on the treatment response.

Objectives:There is no clear information in the literature about causes of reactivation of multisystem inflammatory syndrome in children (MIS-C) or indications for readmissions for MIS-C after discharge; as a result, the conditions that may develop after infection in children with MIS-C were discussed, and the reasons for hospitalization were screened. Patients and methods:This single-center retrospective study was conducted with 95 patients (65 males, 30 females; mean age: 92.8±55.5 months; range, 5 to 17 months) between November 11, 2020, and December 30, 2021. Children who were rehospitalized in the study center after their discharge with the diagnosis of MIS-C were included in the study, and the indications for readmissions were evaluated. Results:During the study period, six (6.3%) patients (4 males, 2 females; median age: 114.5 months [interquartile range: 122 months]) had to be rehospitalized. Four of these patients had an underlying disease, while the other two were previously healthy children. Fever was the most common reason for readmissions in half of the patients, while the remaining patients were readmitted with the indications of myocarditis, pneumonia, and posttraumatic pain syndrome. Conclusion:Although no evidence for the reactivation of MIS-C was detected in patients in the literature, it should also be emphasized that close follow-up of these patients is a must, considering possible cardiac complications.