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Keywords: Atrial Septal Defect; Vascular Closure Devices; Echocardiography Introduction Atrial septal defect (ASD) is one of the most common congenital anomalies which accounts for 10%-15% of all congenital heart diseases (CHDs) and uncorrected remnants of ASD account for up to 30% of adult heart anomalies.1 Most of ASD-affected children are asymptomatic while in untreated cases, it may turn to ventricular tachyarrhythmia, right ventricular (RV) dysfunction, and pulmonary hypertension (PHTN).2 Percutaneous closure of ASD has been raised by in 1974 for the first time. Performance of this procedure before the age of 25 years accompanies acceptable RV morphology, exercise physiology, and positive effects on remodeling function and dimension;3 thus, it poses normal life expectancy.4 Percutaneous approaches of ASD closure have been considerably promoted through the years and assessment of post procedure outcomes plays an important role in detecting short- and long-term quality and efficacy of ASD closure;1-5 however, information in this regard is poorly explained.6 Echocardiographic methods have been notably developed in recent decades and provided high quality of assessing RV and left ventricular (LV) function. Results Four cases were excluded from the study as they refused to participate in follow-up visits. [...]study analysis was performed on 22 remained cases. Following the ASD closure, volume load on both ventricles changes, and this unloading of RV is the absolute benefit of ASD closure that can improve its function and prevent long-term further complications.16 In our study, this improvement was seen especially in the middle septal segment of RV (the part which was more under the loading pressure due to specific RV geometry).

Background: Face masks have become an important tool for preventing the spread of respiratory diseases. However, we hypothesized that face masks with reduced nasal airflow may alter pulmonary artery systolic pressure (PASP).Purpose: This study aimed to evaluate the effect of face masks on PASP in children and adolescents.Methods: This case-control study was conducted between March 2021 and April 2022 at the Pediatric Cardiovascular Research Center in Isfahan, Iran. Using a convenience sampling method, a total of 120 children and adolescents, boys and girls aged 3–18 years, were allocated into 2 groups of 60 each (case group with congenital heart disease (CHD), control group of healthy subjects). For each patient in the case and control groups, echocardiography (ECHO), heart rate (HR), and blood oxygen saturation (SpO2) were performed and measured twice—once with a surgical mask and once without a surgical mask—by a pediatric cardiologist at 10-min intervals.Results: A total of 110 participants were analyzed. The mean patient age was 9.58±3.40 years versus 10.20±4.15 years in the case (n=50) and control (n=60) groups, respectively. Approximately 76.0% (n=38) of the participants in the case group versus 60.0% of those in the control group were male. In the case and control groups, there was a statistically significant reduction in the mean changes in tricuspid regurgitation (P=0.001), pulmonary regurgitation (P=0.002), and PASP (P=0.001) after face mask removal. Although this study showed a reduction in pulmonary arterial pressure after face mask removal in patients with CHD and healthy subjects, no significant changes in HR (P=0.535) or SpO2 (P=0.741) were observed in either group.Conclusion: Wearing a face mask increased PASP in healthy children and adolescents with CHD; however, the SPO2 and HR remained unchanged. Therefore, mask removal during ECHO is recommended.

Background: Recurrences are common in neurally mediated syncope. The aim of this study is the evaluation of the effectiveness of nonpharmacologic treatments alone in preventing of syncope relapse. Methods: 70 patients (age 5-20 years) with neurally mediated syncope were enrolled. Thirty patients received pharmacologic therapies along with nonpharmacological methods, and 40 patients received just nonpharmacological treatments then followed them for 36 months. The incidences of different outcomes were analyzed with descriptive statistics using percentages. Results: The recurrence rate of syncope was significantly higher in pharmacological group than in nonpharmacological group in each period of the follow-up (P < 0.001). Conclusions: Nonpharmacologic treatment is very effective in the prevention of syncope relapses and can be a substitute for pharmacologic drugs in the initiation of treatment and if done correctly.

There is growing evidence of left ventricular decompensation following the closure of the patent ductus arteriosus, which most often happens early in the post-surgical time and improves on its own a few months after. Here, we aim to present nine cases whose left ventricular ejection fraction deteriorated early or late after the procedure. There were nine patients diagnosed with patent ductus arteriosus by echocardiography. The patients presented with a murmur, easy fatigability, exercise intolerance, and poor weight gain. The age varied from 5 months to 41 years old. Patients developed left ventricular ejection fraction deterioration, starting from the day after the operation to 3 years after the closure. Pre-closure left ventricular ejection fraction ranged from 60% to 75% and post-closure from 33% to 59%. The range for shortening fraction (SF) was from 30% to 42% and 16% to 31%, respectively. The patent ductus arteriosus was moderate to large in all patients. One patient was finally diagnosed with dilated cardiomyopathy. Patients with patent ductus arteriosus show left ventricular ejection fraction deterioration up to years after closure, whether percutaneous or operative. Large patent ductus arteriosus is associated with more complications and reduced post-surgery cardiac function due to the amount of the shunt before closure.

Background: Patent ductus arteriosus (PDA) is a common disease in premature neonates, which could occur in up to 50% of the neonates weighting <1000 g. PDA might induce hemodynamic and respiratory disorders and increase mortality and morbidity. This study aimed to compare the effectiveness of oral ibuprofen and a low dose of intravenous acetaminophen in the management of PDA. Materials and Methods: This randomized double-blind clinical trial was conducted on the preterm neonates with an equal gestational age of <34 weeks and weight of >1000 g with symptomatic PDA, who were admitted in Shahid Beheshti and Al-Zahra Hospitals Affiliated to Isfahan University of Medical Sciences, Iran. In total, 40 preterm neonates were examined, 20 of whom received 15 mg/kg/6 h of intravenous acetaminophen for 2 days and 20 infants received 10 mg/kg of intravenous ibuprofen on the 1st day and 5 mg/kg for the next 2 days, and the results include vital signs and echocardiography findings were compared. Results: In the acetaminophen and ibuprofen groups, 16 (80%) and 17 neonates (85%) responded (PDA closure rate) to the treatment, respectively (P = 0.68). Furthermore, acetaminophen and ibuprofen have a similar effect on vital signs. Both drugs did not change in blood pressure, but they reduced the respiratory rate and heart rate after treatment. Conclusion: Low-dose acetaminophen compared to ibuprofen has an equal effectiveness in the closure of PDA.

Congenital malformations are defined as \"any defect in the structure of a person that exists from birth\". Among them, congenital heart malformations have the highest prevalence in the world. This study focuses on the development of a predictive model for congenital heart disease in Isfahan using support vector machine (SVM) and particle swarm intelligence. It consists of four parts: data collection, preprocessing, identify target features, and technique. The proposed technique is a combination of the SVM method and particle swarm optimization (PSO). The data set includes 1389 patients and 399 features. The best performance in terms of accuracy, with 81.57%, is related to the PSO-SVM technique and the worst performance, with 78.62%, is related to the random forest technique. Congenital extra cardiac anomalies are considered as the most important factor with averages of 0.655. Congenital extra cardiac anomalies are considered as the most important factor. Detecting more important feature affecting congenital heart disease allows physicians to treat the variable risk factors associated with congenital heart disease progression. The use of a machine learning approach provides the ability to predict the presence of congenital heart disease with high accuracy and sensitivity.

Kawasaki disease (KD) is a febrile vasculitis and is considered a leading cause of acquired coronary artery disease in children. A clinically critical complication is the coronary artery aneurysm, which may progress and lead to coronary stenosis or even obstruction. Herein, we describe a 14.5-year-old boy with a history of KD at 6 months old, who developed multiple aneurysms along all the coronary branches. During the follow-up at the age of 14 years, the left coronary artery aneurysms regressed, while the aneurysm of the right coronary artery persisted and was complicated by obstruction at its proximal part, according to computed tomography angiography. However, the patient at the last follow-up was asymptomatic and well. The serious nature of KD coronary complications warrants follow-up visits. Since echocardiography alone may fail to reveal stenosis or obstruction, other adjunct follow-up imaging modalities such as conventional, computed tomography, and magnetic resonance angiography should be performed in patients with coronary aneurysms.

Coarctation of aorta (CoA) is a congenital heart disease that can lead to heart failure during infancy and neonatal period. Several treatments have been proposed for this disease, including surgery and balloon angioplasty. The experiences of using stents in small infants or neonatal patients are very low. In this article, we report a 3 months old age infant who after balloon angioplasty, his CoA symptoms had return and stenting of CoA was performed for him.

Wolff-Parkinson-White (WPW) is a rare congenital arrhythmia that could result in peripartum cardiomyopathy. This condition could be managed by medical treatments or ablation treatments. In this report, we presented a 14-year-old pregnant girl with initial signs of syncope and palpitation, who was later diagnosed with WPW-induced peripartum cardiomyopathy. The baby was successfully delivered at 32 weeks gestational age, and the patient received a beta-blocker as the main treatment strategy. We recommend that a proper cardiology and gynecology care is critical in providing the best prognosis.