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Some new coupled coincidence and coupled common fixed point theorems for ϕ − ψ−contraction mappings are established. We have also an application to some integral system to support the results. [ABSTRACT FROM AUTHOR]

Vitreous humour (VH) is a quite stable and well-protected biological fluid from post-mortem degradation and contamination, making it a usable specimen in forensic pathology. We aimed to analyse the biochemical markers in VH stored for one month at –20°C and to compare them with those of serum samples of the same deceased people. To the best of our knowledge this is the first time this has been reported in the literature. Serum levels of sodium, potassium and calcium, phosphorous and VH levels of calcium, creatinine, and urea were not statistically different between fresh and stored samples. There was no significant difference in VH urea and creatinine levels whereas serum levels were significantly decreased by the 15th and 30th days. In conclusion, urea and creatinine levels in VH showed adequate stability after one month of storage at –20°C, whereas large variations were seen in the stability of inorganic components such as Na, K, Mg, Cl, and P. Our results indicate the validity of using post-mortem VH samples for urea and creatinine but not for VH stored at –20°C for a limited time frame. The differences in sample handling before being stored at –20°C may introduce bias on some components of VH. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to present some existence results for coupled fixed point of a (φ,ψ) —contractive condition for mixed monotone operators in metric spaces endowed with a directed graph. Our results generalize the results obtained by Jain et al. in (International Journal of Analysis, Volume 2014, Article ID 586096, 9 pages). Moreover, we have an application to some integral system to support the results.

The object of our study was to compare the value of exercise stress testing with simultaneous dobutamine stress echocardiography and technetium-99m isonitrile singlephoton emission computed tomography for the diagnosis of coronary artery disease. Sixty-nine patients with either suspected or proven coronary artery disease underwent simultaneous dobutamine technetium-99m isonitrile singlephoton emission computed tomography and stress echocardiography, and treadmill exercise electrocardiography. Dobutamine echocardiography and technetium-99m isonitrile single-photon emission computed tomography revealed a higher overall sensitivity than exercise testing (94 vs 60% P<0·001), but dobutamine stress echocardiography showed a higher specificity than both technetium-99m isonitrile single-photon emission computed tomography and exercise testing (86 vs 64%, P<0·05, for both tests). In addition, the diagnostic accuracy of dobutamine stress echocardiography and technetium-99m isonitrile single- photon emission computed tomography was higher than that of exercise testing (91 vs 61%, P<0·001; 86 vs 61%, P<0·001, respectively).Dobutamine stress echocardiography and technetium-99m isonitrile single-photon emission computed tomography are superior to exercise testing in the diagnosis of coronary artery disease, and dobutamine stress echocardiography can act as an alternative to technetium-99m isonitrile single-photon emission computed tomography. [ABSTRACT FROM PUBLISHER]

Abstract Background Patent ductus arteriosus is a common congenital cardiac condition. Its importance is mostly underestimated and accepted as an “easy” heart disease. Physiological consequences of pulmonary overflow may cause severe mortality in premature neonates. Accurate timing of surgical intervention is essential to decrease the mortality in very low birth weight premature infants. On-site surgery in the intensive care units (ICUs) results excellent surgical quality without jeopardizing the safety of the patients. Methods We have summarized the clinical and operative data of 26 premature neonates (1000 gr). Results There was no surgical mortality in both groups. Co-existing problems were observed in both groups, which did not affect surgical mortality and morbidity. Conclusions Surgery in the ICU is a safe method for premature neonates with physiologically significant PDA. This technique should be the method of choice in experienced centers.

Background: Vitreous humor (VH) is relatively well-protected fluid from postmortem degredation and contamination. That is why it has high utility in forensic pathology and toxicology. Although there is no detailed studies focusing on the serum chemistry parameters. As a routine application, potassium analysis in the detection of postmortem interval and in some forensic laboratories serum chemistry parameters like glucose, creatinine, and keton bodies put into practice to illuminate the reason of hospital deaths. The purpose of the present study is to evaluate the time-course changes in serum chemistry parameters in VH. Methods: VH and blood samples were collected from a total of 35 autopsies (Female 11,32.4%, and Male 24,67.6%; Mean age:38.92±17.3), conducted at Ankara Branch of Council of Forensic Medicine morgue between December 2011 to May 2012. After centrifugation of samples, the supernatant of the fluid were analyzed for sodium, potassium, chloride, calcium, magnesium, urea, creatinine, glucose, phosphorus, albumin, cholesterol, and total protein by using an autoanalyzer Siemens Advia-2400 on the days 0,15 and 30 after the autopsies. Results: In VH samples, levels of sodium, glucose, magnesium, potassium, and chloride on the day 30 were found to be increased significantly when compared to the levels on the first day. The changes in calcium, creatinin, urea, albumin, cholesterol and protein levels by the time-course were not statistically significant. The correlation analyses between blood and VH samples showed a good relationship on sodium, potasium, chloride, calcium, and creatinin levels. Conclusion: The results clearly indicate that some chemistry parameters could be analysed to evaluate the postmortem interval or the manner of death, especially hospital deaths. This is a preliminary study and requires further studies to illuminate the effect of time-course in term of longer time periods. [ABSTRACT FROM AUTHOR]

Research on natural fibers as greener substitutes for synthetic ones has surged in response to the growing need for sustainable materials. An underutilized natural resource, Chamaerops humilis trunk (ChT), is the subject of this study's extraction and characterization process. The work examines these fibers' possible uses in biocomposites by examining their structural, physicochemical, and mechanical characteristics. Numerous characterization techniques were used to evaluate ChT fibers (ChTFs) thoroughly, including density measurement, diameter determination, analysis of the fibers' moisture content, X-ray diffraction, scanning electron microscopy, Fourier transform infrared spectroscopy, thermal analysis, water absorption tests, and tensile testing. Experimental results show that ChTFs possess an average density of 0.97 g/cm 3 , an average diameter of 562 ± 60 μm, a moisture regain ranging from 7.94 to 8.63 %, an average linear density of 9.338 Tex, heat resistance to 225 °C and a mean traction resistance of 45.08 ± 9.92 MPa. Such findings underscore the significance of comprehending the ChT's mechanical characteristics to enhance fiber-reinforced composites and explore their possible uses in the textile sector besides their promising reinforcements in biocomposites and as a source of biomass for renewable bioenergy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The aim of this study was to investigate the effect of the presence of the "cortex sign" (corticalization) in femoral diaphysis fractures determined by the dynamization of nails because of delayed union. The study included 12 patients with a closed transverse femoral fracture (AO 32a3) treated with dynamization (all the screws distal of the nail were removed) because of delayed healing and followed up for at least 2 years. These patients were evaluated for the presence of bone union, cortex-like sclerosis (corticalization) distal to the nail, and the distance of the corticalization from the joint during follow- up after dynamization. The nail lengths and diameters, and time of dynamization were evaluated. In cases that developed pseudarthrosis and were treated with nailing, the length and diameter of the new nails were evaluated. Corticalization and hypertrophic pseudarthrosis were present in 12 patients after dynamization. The old nail was removed and nail exchange was performed with a longer and larger diameter nail to pass the region formed in the cortex approximately 2-3 cm inferior to the old nail. Union was obtained in 3-4 months in all patients. When corticalization is seen during follow up after dynamization is performed because of non-union of a transverse femoral fracture, nail exchange should be performed without further delay. More rigid fixation should be applied with a longer and thicker nail crossing the area of corticalization.

Introduction: With the development of transcatheter interventional techniques and the introduction of next-generation duct occluder devices, transcatheter closure has become the first treatment option for patent ductus arteriosus (PDA) in pediatric patients. In this study, we compared the effectiveness and safety of different devices for transcatheter PDA closure in pediatric patients, focusing on long-term outcomes., Methods: A total of 235 patients aged 0-18 years who underwent transcatheter PDA closure at a tertiary care center between January 2005 and February 2020 were included. The medical records of the cases were retrospectively evaluated., Results: The median age of the patients was 2.3 years (range: 3.5 months to 17 years), with a mean weight of 12.8 kg (range: 5.7-43.2 kg). The mean PDA diameter at its narrowest point was 2.9 mm (range: 2.2-5.1 mm). Ductal anatomy was as follows: Type A in 98 (41.7%) patients, Type E in 36 (15.6%) patients, Type C in 32 (13.5%) patients, Type F in 27 (11.4%) patients, Type D in 23 (9.7%) patients, and Type B in 19 (8.1%) patients. Arterial access was used in 138 (57.1%) patients, venous + arterial access in 58 (24.6%) patients, and venous access only in 39 (16.5%) patients. Closure was performed with Amplatzer Duct Occluder (ADO; AGA Medical Corp., Golden Valley, MN, USA) II in 151 (64.2%) cases, ADO I in 43 (18.2%) cases, and coils in 41 (17.4%) cases. The mean fluoroscopy time and mean procedural time were 10.3 ± 4.2 minutes and 41 ± 7.2 minutes, respectively. The mean radiation dose was 1364 ± 497 cGy/min. The early closure rate after the procedure was 92%, while residual shunting on the first day post-procedure was observed in 1.8% of cases, decreasing to 0.1% at the one-month follow-up. The overall procedural success rate for all cases was 96.0%. The mean follow-up duration was 9.7 years (range: 2.9-13.8 years)., Conclusion: For percutaneous PDA closure, ADO I devices are preferred for larger defects, whereas ADO II devices are prioritized for small- to medium-sized defects instead of coils., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Yıldız et al.)

Background: Despite reports of reduced physical fitness in children with congenital heart disease (CHD), no specific performance evaluations for activities of daily living have been conducted., Objectives: The aim was to compare the activities of daily living, quality of life, posture, physical fitness and physical activity levels of children with CHD with healthy controls (HC)., Methods: The study included 30 children aged 6-14 diagnosed with moderate or severe CHD and 30 age-sex-matched HC. The sociodemographic and clinical data of the participants were recorded. All participants went through several tests, namely the TGlittre-P test for activities of daily living, the 6-minute walk test (6MWT) for functional capacity, the Fitnessgram test battery for physical fitness, the hand dynamometer for measuring grip strength, the pedometer for measuring physical activity, and both the child and parents reported the Pediatric Quality of Life Inventory (PedsQL) for evaluating the quality of life, in addition to posture analyses. Values of p < 0.05 were considered statistically significant., Results: Individuals with CHD had a longer TGlittre-P test completion time and a shorter 6MWT distance than HC (TGlittre-P: CHD 3.45 [3.24-4.02]min vs. HC 3.10 [2.57-3.23]min, 6MWT: CHD 514.00 [412.50-566.00]m vs. HC 591.50 [533.00-631.00]m). For the CHD group, sit-ups, push-ups, trunk lift, and sit-and-reach test scores within the Fitnessgram battery, grip strength, posture, and quality of life scores were lower than those for the HC group. Physical activity levels were similar in the groups., Conclusions: The performance of activities of daily living, functional capacity, physical fitness, posture, and quality of life of children with moderate and severe CHD were affected compared to healthy peers.

In this study, we aimed to show the results of exchange nail and decortication in patients whose subtrochanteric femur fractures were treated with intramedullary nails and subsequently developed fracture nonunion and nail breakage com- plications. This study consisted of patients presenting with subtrochanteric femur fractures between January 2013 and April 2019 who underwent surgery and later experienced nail breakage due to hypertrophic nonunion. There were a total of 10 patients aged 26-62 years (Avg 40,30, SD: 9,989). Nine patients were smokers, and 1 patient had diabetes and hypertension. Three patients were admitted to the trauma center due to a car accident and 7 patients were admitted because of a fall. The infection parameters of all patients were normal. All patients had pathological movement complications and pain at the fracture site. Preoperatively, medulla diameter was measured with standard radiography in all patients. The diameters of the old nails applied to the patients ranged from 10 to 12 mm, and the diameters of the newly applied nails ranged from 14 to 16 mm. The fracture lines of all patients were opened to remove the broken nails, and decortication was performed. No additional autograft or allograft was applied to any patient. Union was achieved in all patients. We conclude that the use of larger diameter nails in conjunction with decortication will prevent nail breakage, improve healing and provide early union in patients with subtrochanteric femur fractures with hypertrophic pseudoarthrosis.

Bone healing deficiencies are challenging for orthopedic practice. The use of stem cells with scaffolds to treat bone tissue losses currently is popular for promoting regeneration of tissue. Programmable cells of monocytic origin (PCMO) may differentiate into three germ layers and may be a promising alternative treatment due to their stem cell-like properties. Parathyroid hormone (PTH) participates in bone metabolism. Intermittent administration of PTH promotes osteogenic activity of mesenchymal stem cdells (MSC). We investigated the osteogenic effects of continuous and intermittent administration of PTH on PCMO. Mononuclear cells were harvested from the peripheral blood of healthy donors. Isolated cells were cultured for six days in a de-differentiation medium. Indirect immunocytochemistry using anti-CD14, anti-CD45 and anti-CD90 primary antibodies, as well as electron microscopy were used to detect PCMO. PCMO then were cultured in an osteogenic differentiation medium supplemented with continuous or intermittent 50 ng/ml PTH. The PTH-free control group (CG), intermittent PTH treated group (IPG) and continuous PTH treated group (CPG) were cultured and assessed for their differentiation into osteogenic lineage cells by indirect immunocytochemistry using anti-collagen I, anti-osteonectin and anti-osteocalcin primary antibodies. Osteoblast-like cells obtained by continuous or intermittent PTH administration exhibited increased levels of collagen I, osteonectin and osteocalcin immunoreactivity. We found that continuous and intermittent PTH administration to PCMO enhanced their differentiation to osteogenic lineage cells and increased osteoblastic activity.

Background: This study aimed to document early left ventricular (LV) dysfunction in chronic kidney disease (CKD) using methods such as tissue Doppler imaging and the myocardial performance index (MPI)., Methods: A total of 40 patients diagnosed with CKD (mean age, 10.1 ± 4.1 years) and 40 sex- and age-matched healthy controls (mean age, 9.6 ± 4.3 years) were examined. In the patient group, 20 patients had early stage (Stage 2-3) CKD and 20 patients had late-stage (stage 4-5) CKD, and 18 patients had hypertension., Results: The pulmonary artery systolic pressure (PAPs) and LV mass index (LVMI) were significantly higher in the patient group (P < 0.05). The LV septal and lateral margins of the mitral annulus E'/A' ratio, E/E' ratio and MPI results were significantly different between the groups (P < 0.05). The MPI scores were higher in late-stage CKD than in early stage CKD (P < 0.05). The E'/A' ratio was lower and the MPI was higher in the hypertensive CKD group compared with the normotensive CKD group (P < 0.05). The E/E' ratio was correlated positively with the LVMI, and the PAPs, and negatively with glomerular filtration rate, S' value, E'/A' ratio. The MPI was correlated positively with blood pressure, LVMI, PAPs, and the S value, and negatively with the E'/A' ratio., Conclusions: The E'/A' ratio, the E/E' ratio, and the isovolumetric relaxation time measured by tissue Doppler imaging is highly accurate and easily applicable for detecting diastolic LV function, and the MPI is suitable for detecting both systolic and diastolic LV dysfunction. Their routine use may be useful in evaluating LV functions in children with CKD., (© 2021 Japan Pediatric Society.)

Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue tumor of the heart. In the literature, cardiac IMT is often described as an endocardial-based cavitary mass originating from the right side of the heart in infants and adolescents. In this article, we present a 5-year-old boy with a rare cardiac IMT who had no complaints and was diagnosed with murmur during his routine examination. Transthoracic echocardiography showed a homogeneous polypoid mass originating from the pulmonary valve, extending into the main pulmonary artery during systole and causing obstruction of the pulmonary artery and right ventricular outflow tract. Surgical resection of the tumor was performed successfully. There was no tumor recurrence in the control echocardiography at the postoperative first month., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Background/aim: Two-dimensional speckle-tracking echocardiography (2D-STE) is a novel method that allows the assessment of regional myocardial function. The aim of our study was to use 2D-STE to assess left ventricular deformation in patients with coarctation of the aorta (CoA)., Methods: In this prospective study, patients with CoA (n = 42) and healthy controls (n = 39) were recruited. Children with CoA who visited the outpatient clinic between 2013 and 2014 were included. The data were compared with those obtained from the sex- and age-matched controls., Results: The mean age of the patients was 5.8 ± 4.5 years. Global longitudinal strain based on all three apical views and total global strain values did not appear to be different between the patient and the control groups (P = .59, P = .51, P = .15, P = .38). Hypertension was detected in 14 (33.3%) patients with CoA. There were significant differences between the global longitudinal strain values of the normotensive CoA subgroup and the hypertensive CoA subgroup (P < .05)., Conclusions: In our study, we found that 2D-STE total strain analysis of patients with CoA was not different from comparative healthy controls. However, we determined that 2D-STE parameters were lower in the hypertensive CoA subgroup compared to the normotensive CoA subgroup., (© 2021 Wiley Periodicals LLC.)

Background and Aim: Chronic kidney disease may lead to left ventricular dysfunction. Early detection of cardiovascular disease in children with chronic kidney disease is essential to prevent cardiovascular morbidity and mortality in early adulthood. This study aimed to document the dysfunction using methods such as two-dimensional speckle-tracking echocardiography in the early stage., Methods: A total of 34 patients diagnosed with chronic kidney disease (mean age ± standard deviation, 10.5 ± 4.1 years) and 37 sex- and age-matched (mean age 9.8 ± 4.2 years) healthy controls were studied. The results of the two groups were compared along with those of the published studies., Results: The echocardiography measurements had no significant difference in the end-diastolic and end-systolic diameter values of left ventricular, ejection fraction, shortening fraction, mitral E value, mitral A value, and E/A ratio between the groups. Pulmonary artery systolic and diastolic pressure and left ventricular mass index were significantly higher in the patient group (p < 0.01). The longitudinal global strain values in the apical four-chamber, three-chamber, and two-chamber views and the total global strain values were significantly lower in the patients (p < 0.01). The circumferential global strain values in the apical, mid, basal, and total global strain were lower in the patient group, but this difference was statistically significant in the apical global and total global strain values (p < 0.05)., Conclusions: Speckle-tracking echocardiography might help identify subclinical left ventricular dysfunction in patients with chronic kidney disease with unremarkable conventional echocardiography.

Background: Cystic fibrosis may lead to left ventricular (LV) dysfunction. This dysfunction can be documented by methods such as tissue Doppler echocardiographic (TDI) imaging and two-dimensional speckle tracking echocardiography (STE) in early stage., Study Design: This was prospective cohort study., Methods: A total of 34 patients diagnosed with cystic fibrosis (mean age and SD 9.9 ± 4.9 years) and 37 healthy control subjects with a comparable gender and age distribution (mean age 9.8 ± 4.3) were studied. The results for the two groups were compared along with the results of published reports., Results: No significant relationship was found between the groups in terms of systolic and diastolic measurements of the interventricular septum and posterior left ventricular wall, and ejection fraction (P > .05). Myocardial performance indexes of left ventricular free wall and interventricular septum increased in the patient group compared with the controls (P < .05). As measured by STE, seven segments in the LV myocardial longitudinal strain and three segments in the LV myocardial circumferential strain showed significant reductions in patients with cystic fibrosis compared with controls (P < .05). The longitudinal global, circumferential global, and total global strain values had no significant difference between the groups (P > .05). Longitudinal strain rates and circumferential strain rates were both lower in five segments in the patient group (P < .05)., Conclusions: Tissue Doppler echocardiographic imaging and STE may help identifying subclinical LV dysfunction in cystic fibrosis patients with unremarkable conventional echocardiography. They may be considered for the routine follow-up of cystic fibrosis patients., (© 2020 Wiley Periodicals LLC.)

Oxytocin has been shown to stimulate social approach behaviors, although effects may depend on contextual and individual difference factors. Here, we examined intranasal oxytocin effects on interpersonal distance using an immersive Virtual Reality paradigm, taking into account early caregiving experiences and interpersonal context as potential moderators. Participants were 180 women who received 24 IU oxytocin or a placebo and had reported how often their mother used love withdrawal as a disciplinary strategy, involving withholding love and affection after a failure or misbehavior. We used a virtual stop-distance paradigm, instructing participants to approach a virtual person or to stop an approaching virtual person at a preferred distance (passive approach). In order to examine the role of interpersonal context in shaping oxytocin effects, facial expressions and bodily gestures of the virtual person were manipulated. The person showed a dynamical expression of sadness, happiness, anger, fear, disgust, or no emotional expression in six different emotion conditions. We found that oxytocin reduced interpersonal distance across the different emotion conditions, but only in individuals with lower levels of love withdrawal. In addition, oxytocin reduced anxiety levels during passive approach, in particular in the disgust condition, but only in individuals with lower levels of maternal disciplinary love withdrawal. Individuals with more love withdrawal experienced more anxiety while being approached by a virtual person displaying disgust or fear, but benefitted less from anxiety-reducing oxytocin effects. These results are consistent with previous research showing a dysregulated oxytocinergic system after childhood adversity and indicate that oxytocin may be less effective for individuals who are most in need of an intervention because of a problematic family background., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background and Aims: Anthracyclines are one of the most preferred agents in practical pediatric oncology despite their dose-dependent cardiotoxic effects. The aim of this study was to investigate whether or not acetyl-L-carnitine (ALCAR) has protective effects on doxorubicin (DOX)-induced cardiotoxicity., Methods: Wistar rats were divided into four groups; control, DOX, ALCAR and ALCAR+DOX. Rats in the first group were given saline on study days, whereas those in the second group were given a single dose of DOX on the 5 th day and saline on the other days. Rats in the third group were given ALCAR and those in the fourth group were given ALCAR on study days but also given only a single dose of DOX on the fifth day of the study. Ejection fractions (EF) were measured by echocardiography before and after drug administration. Heart tissues were evaluated by light and electron microscopy. Apoptotic cells were determined with TUNEL and caspase-3 staining., Results: DOX significantly decreased the EF values, whereas ALCAR did not. Cardiac functions were higher in the ALCAR+DOX group when compared to the DOX group. DOX administration caused a cardiac injury not only functionally, but also structurally, whereas ALCAR prevented it., Conclusions: ALCAR has a capacity of preventing DOX-induced cardiac injury at both functional and structural levels., (Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to search for evidence suggesting treatment for childhood subclinical hypothyroidism (SH) by evaluating left ventricular (LV) functions of children with SH by using M-mode and tissue Doppler echocardiography (TDE)., Methods: Children with SH and euthyroid healthy children (control group) were enrolled in the study. At baseline and 6 months after euthyroidism was achieved, M-mode and TDE were performed and LV functions were evaluated. Pretreatment parameters of the SH group were compared with those of controls and post-treatment parameters., Results: 31 children with SH and 32 euthyroid healthy children were enrolled in the study. The groups had similar age, gender, puberty and body mass index. Interventricular septum thickness and LV mass index, which are the parameters for LV morphology, were slightly increased in the SH group than in the controls (p<0.05). In TDE, children with SH had significant changes in LV diastolic (lower E'm, higher E/E'm ratio and longer isovolumic relaxation time) and systolic functions (lower isovolumic contraction time) compared with controls (p<0.05). Six months after euthyroidism was achieved, TDE showed a significant improvement of some of the diastolic and systolic parameters (p<0.05)., Conclusions: The results of this study showed that SH is associated with subclinical alterations in LV function, and LT4 replacement may improve LV systolic and diastolic parameters. However, since SH is usually a self-limiting process, these improvements in LV functions may simply be associated with the natural course of the disease and/or physiological linear growth of the children., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Objective: We have utilized subclavian flap angioplasty (SFA) frequently in infants with coarctation particularly in patients with arch hypoplasia which is quite frequent. We have followed these patients with serial echocardiography and have analyzed our results in this study to determine recoartation rates, recurrent hypertension and left arm development., Methods: Thirty eight infants less than 3 months age (22 boys and 16 girls, mean age was 28±22.6 days) operated at Dokuz Eylul University Hospital between August 2007 - December 2013. Twelve (32%) patients with pulmonary banding due to accompanying VSD or AVSD were included to the study, those infants with complex pathologies such as transposition of great arteries or single ventricle, while the patients less than 1000 gram in weight were excluded., Results: The mean follow-up time was 21 months (1-76 months). Twelve (32%) patients had aortic arch hypoplasia proximal to the left subclavian artery. Operative mortality was found 7.7% for isolated coarctation, 16% for coarctation repair with pulmonary banding. In 5 patients, a residual gradient was detected and re intervention was required in 7.8% patients with balloon angioplasty., Conclusion: Subclavian flap angioplasty is a safe repair technique in small infants and neonates. High gradients and intervention more likely depends on the anatomy of the aortic arch rather than the subclavian flap angioplasty technique.