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PurposeEvaluate Piccolo and ADOII devices for transcatheter patent ductus arteriosus (PDA) closure. Piccolo has smaller retention discs reducing risk of flow disturbance but residual leak and embolization risk may increase.MethodsRetrospective review of all patients undergoing PDA closure with an Amplatzer device between January 2008 and April 2022 in our institution. Data from the procedure and 6 months follow-up were collected.Results762 patients, median age 2.6 years (range 0–46.7) years and median weight 13 kg (range 3.5–92) were referred for PDA closure. Overall, 758 (99.5%) had successful implantation: 296 (38.8%) with ADOII, 418 (54.8%) with Piccolo, and 44 (5.8%) with AVPII. The ADOII patients were smaller than the Piccolo patients (15.8 vs. 20.5 kg, p

Kingella spp. have emerged as an important cause of invasive pediatric diseases. Data on Kingella infective endocarditis (KIE) in children are scarce. We compared the clinical features of pediatric KIE cases with those of Streptococcus species IE (StIE) and Staphylococcus aureus IE (SaIE). A total of 60 patients were included in the study. Throughout the study period, a rise in incidence of KIE was noted. KIE patients were significantly younger than those with StIE and SaIE, were predominately boys, and had higher temperature at admission, history of oral aphthae before IE diagnosis, and higher lymphocyte count (p

Abstract Background Accessory pathways (APs) are a common reason for supraventricular tachycardia in small children. Trans‐septal puncture (TSP) approach is commonly used for the ablation of left‐sided APs, however it may be challenging in small children. The aim of this study was to assess the efficacy and safety of trans‐septal approach radiofrequency (RF) ablation of left‐sided APs in children weighing up to 30 kg. Methods Of the 658 children who underwent catheter ablation of APs since 06/2002, 86 children had left‐sided AP and weighed less than 30 kg. TSP approach guided with TEE and fluoroscopy was used for left atrium access. Results The mean age, height, and body weight were 7.6 ± 1.9 years, 122.4 ± 9.3 cm and 24.0 ± 4.2 kg, respectively. Forty‐three children (50%) were male, 46 of 86 (53%) had manifest AP, 17 of 86 (20%) weighed less than 20 kg and in 24 of 86 children (28%) a three‐dimensional system (3DS) was used to reduce fluoroscopy time. The acute success rate was 98.8% (85/86), with a recurrence rate of 2.4% (2/85) in a mean follow‐up of 66.2 ± 42.7 (9.1‐184.2) months. The mean procedure time and fluoroscopy time were significantly lower for the 3DS group compared to the standard fluoroscopy group 131 ± 41 (55‐262) and 2.4 ± 1.5 (1‐6) minutes vs 164 ± 51 (62‐249) and 27 ± 13 (8‐77) minutes, P

Background: The effect of pulmonary vasodilator therapy in non-pulsatile pulmonary circulation in single ventricle palliation (Fontan operation) is controversial. We evaluated the effect of chronic pulmonary vasodilator therapy on the hemodynamic findings during balloon occlusion of fenestration in Fontan patients who were identified as high risk for fenestration closure on a previous catheterization. Methods and results: Of 44 consecutive patients who underwent a fenestrated Fontan operation and attempted fenestration closure at catheterization, 8 were found to be unsuitable due to a decrease in cardiac index by more than 35%, or a significant increase in central venous pressure. All 8 patients were treated with pulmonary vasodilator therapy for at least 6 months prior to an additional attempt at closure. All repeated catheterizations for fenestration closure were successful. Comparison of hemodynamic parameters during balloon occlusion, prior to and under therapy, demonstrated a significantly smaller decrease in cardiac index [36% (15%) vs. 10% (5%), p = 0.008], a tendency to significant increase in pulmonary flow [3.2(1.2)vs. 2.5(1.2) Lit/min/m2, p = 0.1) while the PVRi was significantly lower too [2.6(0.2)vs. 1.45(0.45) Wui, p = 0.008]. Conclusion: Chronic oral pulmonary vasodilator therapy in fenestrated Fontan patients with a Fontan unsuitable for fenestration closure demonstrated significant hemodynamic benefit during catheterization and afforded subsequent fenestration closure.