Images in Paediatric Cardiology

BACKGROUND: Congenital cardiovascular malformations are the most common category of birth defects and responsible for mortality in the first twelve months of life. Critical congenital heart disease (CCHD) will be present in approximately one quarter of these children, which requires catheter or surgery intervention in the first year of life. AIM: To determine the accuracy of pulse oximetry for detecting clinically unrecognized CCHD in the newborns. METHODS: Pulse oximetry was performed on clinically normal newborns within first 4 hours of life...

BACKGROUND: Cardiac rhabdomyomas represent the most common primary cardiac tumour in children and are strongly associated with tuberous sclerosis complex. RESULTS: We reported a newborn for whom three-dimensional echocardiogram, with multiplane mode, real-time imaging, full volume and i-slice view, allowed detailed visualisation of multiple highly echogenic and well-circumscribed cardiac rhabdomyoma. CONCLUSIONS: Three-dimensional imaging allowed a better definition of the tumour characteristics and provided a better delineation of the spatial relationship of the mass with a tomographic perspective...

Double aortic arch (DAA) is a common vascular ring. It may occur in isolation or coexist with various types of congenital heart disease. The anomaly usually presents in early infancy. This reports a 23yr old male presenting with dysphagia, who was found to have a double aortic arch and tetralogy of Fallot. Both lesions were successfully corrected surgically.

We report a case of scimitar syndrome with pulmonary sequestration, persistent primitive hepatic venous plexus and stenosis of the inferior vena cava in a child presenting with failure to thrive. Such associations are rare but may have implications when planning interventions for patients with complex congenital heart disease.

Crisscross heart (CCH) is a rare cardiac malformation characterized by crossing of the inflow streams of the two ventricles due to an apparent twisting of the heart about its long axis. The developmental mechanisms and causes of CCH are remaining unknown. Neonates mainly presents with cyanosis and a systolic murmur. We herein present a case of CCH with concordant atrioventriculo connections with double outlet right ventricle (DORV) which was diagnosed by echocardiography.

No abstract text is available yet for this article.

The prenatal sonographic diagnosis of congenitally corrected transposition of the great arteries (ccTGA), a rare form of congenital heart disease is very difficult. A24-year-old woman was referred to our center at 28 weeks' gestationbecause of suspected fetal cardiac anomalies. We report a case of ccTGA with supraventricular tachycardia, ventricular septal defect, pulmonary valve stenosis, tricuspid valvar displacement and moderate tricuspid regurgitation during her pregnancy. The combined presence of SVT and ccTGA are occasionally present in the literature...

BACKGROUND: Three dimensional (3D) rotational angiography is a technique used increasingly for imaging in congenital heart disease. RESULTS: We describe the use of this technique for imaging of double aortic arch vascular ring and discuss the advantages of this modality. CONCLUSIONS: 3D rotational angiography is an excellent tool for imaging of various vascular anomalies. It provides high quality accurate images through a quick and safe procedure...

Lead thrombosis is a recognized complication of permanent transvenous pacemaker (PM) implantation. We present the interesting case of an adolescent with a dual-chamber PM presenting with fatigue and hypoxemia. Due to limitations of various imaging modalities, the diagnosis was difficult. She was eventually diagnosed with intracardiac PM lead thrombi obstructing tricuspid valve inflow. The pediatric literature on PM lead thrombosis is also briefly reviewed.

The occurrence of spontaneous subarachnoid haemorrhage (SAH) in association with coarctation of thoracic aorta and absence of intracranial aneurysm is a rare association. In spontaneous SAH, the predominant cause is intracranial aneurysmal rupture. This report describes a case of a 40 year-old male who presented with SAH and was incidentally diagnosed to have coarctation of aorta (CoA) with intraspinal collaterals on further work up. This case demonstrates the importance of detailed evaluation of patients with spontaneous SAH on whom common aetiologies have been ruled out...

The mortality and morbidity of children with pulmonary atresia with intact ventricular septum (PA/IVS) is closely related with right ventricle hypoplasia and its consequent hemodynamics. Prenatal intervention for fetuses with PA/IVS has the potential to improve growth of the RV and the prospect of a biventricular outcome after birth. Successful valvulotomy of the pulmonary valve (PV) was performed in a fetus with PA/IVS at 28 weeks. Following the procedure there was an improvement in fetal hemodynamics. In utero perforation and dilation of the PV in midgestation fetuses with PA/IVS is technically feasible...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Cor triatriatum sinister is a rare congenital cardiac malformation characterized by a membrane in the left atrium which separates the left atrium into the proximal and distal chambers. Association of cor triatriatum is extremely rare with situs inversus totalis. Here we report a rare case of cor triatriatum sinister with situs inversus totalis in a 5 month old female infant.

Biventricular noncompaction is a recently recognized rare form of cardiomyopathy. It is characterized by altered structure of myocardial wall as a result of intrauterine arrest of compaction of the myocardial fibers in absence of coexisting congenital lesion. Left ventricle is the most affected site for noncompaction, but right ventricular involvement has been reported in a few cases. Diagnosis is made with 2-dimensional echocardiography or cardiac magnetic resonance imaging. While major clinical manifestations are heart failure, arrhythmias and embolic events,pulmonary artery hypertension (PAH) has not been well elaborated in the literature...

It is accepted practice to close large patent arterial ducts (PDA) with Amplatzer duct occluder devices, with extremely low rates of residual PDA. We report a child who required device closure of PDA with two Amplatzer PDA devices on two separate occasions, despite the first device deployment being a standard placement of an appropriately sized Amplatzer device in the usual position.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

This pictorial assay illustrates the methodology of evaluating the atrial septal defects by three dimensional transesophageal echocardiography with the help of representative images. The article starts by discussing the technical details of how to acquire and crop the dataset to reconstruct the transesophageal three dimensional echocardiographic images of the inter atrial septum. Next, the anatomical details of the normal inter atrial septum are illustrated, followed by representative examples of all the possible defects of inter atrial septum...