RESUMEN
Multiple congenital heart disease in the small preterm newborn such as severe narrowing of aortic valve and patent ductus arteriosus (PDA) is a therapeutic challenge. We report successful transcatheter antegrade balloon dilatation of the aortic valve and device closure of the PDA in a 1700-gram preterm newborn. Meticulous planning and team work aids in such transcatheter intervention.
RESUMEN
A multisystem inflammatory syndrome in children (MIS-C) was identified as an entity temporally associated with the present COVID-19 pandemic. This inflammatory syndrome affects various organ systems including the gastrointestinal and hepatobiliary systems. The following study was undertaken to primarily detect the fraction of children who had pancreatitis as major organ involvement during the development of MIS-C. The secondary objective was to evaluate their clinical and investigational profile as well as the outcome of management. METHODS: A retrospective chart analysis of all children admitted in a tertiary pediatric center from April to December 2020, diagnosed as COVID-19 associated MIS-C, was done. Those presenting with acute pancreatitis were detected and detailed clinical features, investigations, treatments, as well as outcomes, were recorded. RESULTS: A total of 17 children were diagnosed as MIS-C associated with SARS-CoV-2 in the above-mentioned period. Among them, 9 (53%) children had pancreatitis right from the start of the illness; 5 (56%) children with pancreatitis presented with shock. A very high CRP and cardiac involvement were observed in all. A severe reduction of myocardial contractility was associated with poor outcomes. Necrotic pancreatitis was not noted in any of them. A mortality of 22% was documented in this group and a 3-month outcome among those who survived displayed complete resolution of all cardiac as well as pancreatic abnormalities. CONCLUSION: Acute pancreatitis can be an essential cause of abdominal symptoms in COVID-19-related MIS-C. Pancreatitis may be considered to be one of the parameters in the diagnostic criteria of MIS-C.
RESUMEN
Perimembranous ventricular septal defect (pmVSD) is a common congenital heart disease that is sometimes associated with indirect left ventricle (LV) to right atrium (RA) shunt (indirect Gerbode defect). This defect has a rare chance of spontaneous closure and therefore was usually closed surgically in the past, but more recently transcatheter closure has been reported by a few authors. In our study, we have described a series of 14 children (age ranging from 1.2 to 12 years and weight ranging from 7.2 to 25.5 kg) with the above-mentioned defect which were closed by various interventional devices. The procedures were successful in complete elimination of pmVSD and immediate reduction of indirect LV-RA shunts with negligible residual tricuspid regurgitation on follow-up. In our midterm experience, the judicious use of double-disc devices is efficacious for occluding pmVSD associated with indirect Gerbode defect.