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Background: Intracardiac thrombosis (ICT) is a rare complication after the cardiopulmonary surgery for interrupted aortic arch (IAA) or total anomalous pulmonary venous connection (TAPVC) without previous records. There are still no general guidelines regarding as the mechanism or management of postoperative ICT in neonates and younger infants. Case presentation: We reported the conservative and surgical therapies in two neonates with intra-ventricular and intra-atrial thrombosis after the anatomical repair for IAA and TAPVC, respectively. There were no risk factors for ICT in both patients, except for the use of blood product and prothrombin complex concentrate. The surgery was indicated after TAPVC correction due to the worsening respiratory status and rapidly decreased mixed venous saturation. Anticoagulation combined with antiplatelet therapies was adopted in another patient. These two were both finally recovered, and three-month, six-month, and one-year follow-up echocardiography revealed no abnormality. Conclusions: ICT is uncommon in pediatric population after the surgery for congenital heart disease. Single ventricle palliation, heart transplantation, longer central line use, post-extracorporeal membrane oxygenation, and massive blood product use are major risk factors for postcardiotomy thrombosis. The causes of postoperative ICT are multifactorial, and the immaturity of thrombolytic and fibrinolytic system in neonates may serve as a prothrombotic factor. However, no consensus reached regarding as the therapies for postoperative ICT, and the large-scale prospective cohort study or randomized clinical trial is needed. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine the independent associations of each individual physical performance measure (i.e., grip strength, walking speed, repeated chair stands, and balance test) with subdomains of cognitive function and to determine predictors for each subdomain of cognitive function. A secondary data analysis was performed using a nationally representative middle-aged and older sample of hypertensive population. The findings showed that after adding all four physical performance measures, stronger grip strength was significantly associated with better visuospatial abilities, episodic memory, orientation/attention, and overall cognitive function. In addition, faster walking speed and faster repeated chair stands were strongly associated with better episodic memory and overall cognitive function, respectively. Because grip strength was significantly associated with several subdomains of cognitive functioning, it seems conceivable that increasing physical activity would improve both grip strength and cognitive function in patients with hypertension. [ABSTRACT FROM AUTHOR]

Unlike an usual mesh-like appearance, the Chiari network of this infant was more like a membrane, which might contribute to the obstruction and right-to-left shunt in the atrium ( I Panel E i ). Transthoracic echocardiography (TTE) revealed a suspicious Chiari network leading to supravalvular obstruction of the tricuspid valve ( I Panel A i and I B i ), an atrial septum defect (ASD) with right-to-left shunt ( I Panel C i ) and a ductus arteriosus. Graph A 26-day-old full-term male infant was transferred to our centre due to uncorrectable severe cyanosis after birth. [Extracted from the article]

Background: The extent of acute aortic dissection (AAD) was correlated with inflammation positively. On the other side, inflammation was negatively correlated with mean platelet volume (MPV), which can reflect platelet (PLT) activation. The aim of this study was to clarify the relationship between the extent of dissection and PLT activation.Methods: Between February 2010 and October 2013, 147 patients with acute aortic dissection (AAD) were divided into Group 1 (Stanford A, n = 59) and Group 2 (Stanford B, n = 88). Platelet count, MPV and platelet size distribution width (PDW) were measured to assess PLT activation. Additionally, the severity of inflammation was assessed via serum C-reactive protein (CRP), white blood cell (WBC) count and the neutrophil percent (Neut%). Computerized tomography (CT) was employed to analyze the extent of AAD. Volume tear index (VTI) was calculated as the false lumen (FL) volume divided by body surface area (BSA).Results: PLT count was significantly lower in group 1 than in group 2 (137.24 ± 31.04 × 10(9)/L vs 171.43 ± 27.57 × 10(9)/L, P < 0.001). The MPV/PLT ratio and PDW were significantly higher in the group 1 respectively(0.08 ± 0.02 vs 0.06 ± 0.02, P < 0.001; 22.65 ± 1.87 fl vs 20.69 ± 1.97 fl, P < 0.001). The CRP was significantly higher in group 1 than in group 2 (36.40 ± 8.89 mg/L vs 28.97 ± 8.48 mg/L, P < 0.001). VTI was significantly higher in group 1 than in group 2 (250.12 ± 27.82 vs 198.79 ± 24.52, P < 0.001). There was a significant negative correlation between VTI and PLT count (r = -0.673, P < 0.001), CRP and PLT count (r = -0.640, P < 0.001), respectively. There was a significant positive correlation between VTI and CRP (r = 0.670, P < 0.001), VTI and PDW (r = 0.601, P < 0.001), respectively.Conclusions: PLT activation and inflammation in AAD appear to be closely correlated with the extent of dissection, which possibly induced by the tear of aortic wall. Elimination of the false lumen is the goal of traditional surgery. Suppression of the PLT activation might be future targets of therapy in the prevention of systemic inflammation in AAD patients. [ABSTRACT FROM AUTHOR]

A doubly committed subarterial ventricular septal defect (VSD) used to be a contraindication for device closure. Perventricular device closure has been widely applied in China in the past years, but not in a doubly committed subarterial VSD. Chinese surgeons are now beginning to try this procedure also in a doubly committed subarterial VSD in selected patients. The technique of closure of the perimembranous defect has been described previously in this journal, but we hereby present some additional information on this procedure performed in a doubly committed subarterial VSD., (© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)