Browsing by Author "Stajevic, Mila (8392548400)"

[No abstract available]

There are no more than 20 antenatally diagnosed aorto-left ventricular tunnel cases reported in the literature. In most of them the diagnosis was made indirectly and only after multiple fetal scans based on findings such as thick and dilated left ventricle and grossly dilated ascending aorta. We present a patient in whom a direct tunnel visualization and aorto-left ventricular tunnel diagnosis was made at the 30th gestation week after a single fetal scan using the recently introduced “cockade sign”. Clinical implications of antenatal diagnosis on postnatal treatment and outcome are also discussed. © 2017, Turkish Journal of Pediatrics. All rights reserved.

Mediastinal teratomas are uncommon, fast-growing thoracic tumours, which are usually diagnosed in childhood or adolescence. Neonatal forms are the rarest and often present with life-threatening respiratory distress syndrome. In our case, respiratory failure in a neonate was aggravated by severe cardiogenic shock due to aortic and systemic venous compression, extreme heart displacement and rotation, necessitating an emergency operation on the first day of life. © The Author(s) 2020.

Postoperative aneurysms of the right ventricle after correction of Tetralogy of Fallot are usually the consequence of a long standing pulmonary regurgitation or distal pulmonary obstruction. They occur more frequently in patients where a transannular incision has been initially applied. The aneurysm formation is usually slow with progressive dilatation of the anterior free wall of the right ventricle. We report a very early and unusual postoperative polytetrafluorethylene (PTFE) patch aneurysm accidentally discovered in the sixth postoperative week during the prolonged hospital stay due to a postoperative cerebral stroke. The dilatation of the right ventricular outflow tract could not be completely outlined by ultrasound, and Multiple Detector Computed Tomography scan (MDCT) gave an excellent insight to the anatomy of the aneurysm and provided the cardiac surgeon with necessary information. The patch had not been previously resterilized or damaged in any way. The explanted patch was not infected. PTFE aneurysms have been observed and studied for decades and were mostly related to PTFE grafts in vascular surgery. Creep or "cold flow" theories have been proposed to explain gradual stretching of the material, one of them including wall tensions dependent on the pressure and radius parameters. © 2014 Stajevic M, et al.

Background: The vertical vein (VV) ligation during the total anomalous pulmonary venous return (TAPVR) correction is still controversial. Our study aimed to define the potential risk factors for VV persistence and their percutaneous occlusion. Methods: The retrospective cohort study included 40 patients (26 males) with TAPVR treated at the tertiary referral center from 2005 to 2024. Results: The average days of age at diagnosis was two (IQR 1–8). Complex congenital heart disease with TAPVR was diagnosed in eight patients. A supracardiac type of TAPVR was found in 47% of them. The patients underwent the operation on their eighth day of life (IQR 5–57). The follow-up period was 32 months (IQR 8–99). The early postoperative mortality rate was 17.5%, significantly frequent in the patients’ group with combined CHD (p = 0.002). Four were reoperated on—three due to a postoperative obstruction between the pulmonary venous confluence and the left atrium (LA), while in one patient, a redirection of the VCI was performed. Four patients, aged 12.3 on average (IQR 8.9–14.7), underwent vertical vein embolization. All patients achieved complete occlusion with AVP2. The LA diameter Z score was lower than −4, an increased risk for VV persistence of almost 19 times (OR 18.6, 95% CI 1.6–216.0). Conclusions: We found that an LA diameter Z score of lower than −4 was a major risk factor for VV persistence. Percutaneous VV embolization is a safe and effective procedure in adolescents. © 2024 by the authors.

Background: The vertical vein (VV) ligation during the total anomalous pulmonary venous return (TAPVR) correction is still controversial. Our study aimed to define the potential risk factors for VV persistence and their percutaneous occlusion. Methods: The retrospective cohort study included 40 patients (26 males) with TAPVR treated at the tertiary referral center from 2005 to 2024. Results: The average days of age at diagnosis was two (IQR 1–8). Complex congenital heart disease with TAPVR was diagnosed in eight patients. A supracardiac type of TAPVR was found in 47% of them. The patients underwent the operation on their eighth day of life (IQR 5–57). The follow-up period was 32 months (IQR 8–99). The early postoperative mortality rate was 17.5%, significantly frequent in the patients’ group with combined CHD (p = 0.002). Four were reoperated on—three due to a postoperative obstruction between the pulmonary venous confluence and the left atrium (LA), while in one patient, a redirection of the VCI was performed. Four patients, aged 12.3 on average (IQR 8.9–14.7), underwent vertical vein embolization. All patients achieved complete occlusion with AVP2. The LA diameter Z score was lower than −4, an increased risk for VV persistence of almost 19 times (OR 18.6, 95% CI 1.6–216.0). Conclusions: We found that an LA diameter Z score of lower than −4 was a major risk factor for VV persistence. Percutaneous VV embolization is a safe and effective procedure in adolescents. © 2024 by the authors.

Objective: The predisposing factors for pericarditis recurrence in the pediatric population have not yet been established. This study aimed to define the risk factors for the unfavorable prognosis of pediatric acute pericarditis. Methods: This was a retrospective study that included all patients with acute pericarditis treated from 2011 to 2019 at a tertiary referent pediatric center. Results: The study included 72 children. Recurrence was observed in 22.2% patients. Independent risk factors for recurrence were: erythrocyte sedimentation rate ≥ 50 mm/h (p = 0.003, OR 186.3), absence of myocarditis (p = 0.05, OR 15.2), C-reactive protein ≥ 125 mg/L (p = 0.04, OR 1.5), and non-idiopathic etiology pericarditis (p = 0.003, OR 1.3). Corticosteroid treatment in acute pericarditis was associated with a higher recurrence rate than treatment with non-steroid anti-inflammatory therapy (p = 0.04). Furthermore, patients treated with colchicine in the primary recurrence had lower recurrence rate and median number of repeated infections than those treated without colchicine (p = 0.04; p = 0.007, respectively). Conclusion: Independent risk factors for recurrence are absence of myocarditis, non-idiopathic etiology pericarditis, C-reactive protein ≥ 125 mg/L, and erythrocyte sedimentation rate ≥ 50 mm/h. Acute pericarditis should be treated with non-steroid anti-inflammatory therapy. A combination of colchicine and non-steroid anti-inflammatory drugs could be recommended as the treatment of choice in recurrent pericarditis. © 2020 Sociedade Brasileira de Pediatria