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Background The mortality risks of children undergoing various cardiac surgeries for congenital heart disease (CHD) in India are not well defined. We conducted a systematic review and meta-analysis to estimate the inhospital mortality of various common CHD surgeries reported in India and compared it to representative data from established Western databases. Methods and Results We searched four bibliographic databases for studies published in India over the last 25 years. In total, 135 studies met the inclusion criteria and included 30,587 patients aged from 1 day to 65 years. The pooled mortality rate of 43 Indian studies reporting multiple CHD surgical outcomes is 5.63% (95% confidence interval [CI]: 4.26–7.16; I2 = 93.9%), whereas the Western data showed a pooled mortality rate of 2.65% (P value for comparison

Partial cavopulmonary shunt is an established procedure for patients with abnormal right ventricular (RV) physiology. Late failure of the Glenn shunt is usually due to further progression of the primary disease process. However, there may be surprises, as in our patient. We report an 8-year-old child who was diagnosed with tricuspid valve (TV) dysplasia with borderline RV hypoplasia. He underwent TV repair with a right cavopulmonary shunt. He presented with features of heart failure after 6 years of the surgery. An echocardiographic evaluation suggested a restrictive filling pattern of the RV with preserved size and function. Computed tomography and cardiac magnetic resonance imaging revealed a normal pericardial thickness with no evidence of myocardial involvement. Despite the contradicting clinical and imaging features, endomyocardial biopsy confirmed a diagnosis of desmin cardiomyopathy. Restrictive cardiomyopathy may remain an elusive diagnosis despite extensive imaging. In our case, the altered loading conditions due to a cavopulmonary shunt further masked pathophysiological hemodynamic changes.

Arterial desaturation following surgical repair of tetralogy of Fallot (TOF) is rare. In most instances, it results from residual right ventricular outflow tract obstruction, causing right-to-left shunt across residual interatrial or interventricular communication. In this report, we present an unusual scenario of arterial desaturation due to a recanalized left cardinal vein in a child with repaired TOF. We also discuss stepwise evaluation that led to successful identification and occlusion of the abnormal venous channel by percutaneous device closure.

Tuberculous (TB) involvement of the vascular system has been reported in the preantibiotic era. We, hereby, report a case involving a teenage boy who presented to us with left upper limb pain followed by gradually progressive motor and sensory deficit over 1 month with preceding history of tuberculosis. Examination revealed a palpable, noncompressible, nonpulsatile swelling superior to the lateral third of the clavicle. Imaging through ultrasonography, computed tomography, and magnetic resonance imaging confirmed the presence of a pseudoaneurysm with compression of the underlying nerves. The child underwent surgical thrombectomy with pseudoaneurysm repair and arteriorrhaphy along with antitubercular medications with complete recovery at 6 months. The tissue staining, nucleic acid amplification tests, and histopathology confirmed TB etiology. Tuberculosis continues to remain a major health concern, especially in the developing world. High index of suspicion is necessary to diagnose such manifestations to avoid catastrophic sequelae.

Mass on the aortic valve is extremely rare in children, and the differential diagnosis includes vegetation, thrombus, and primary cardiac tumors. A rise in infective endocarditis in infants is seen due to increasing survival of children with congenital heart diseases and sick newborn infants with prolonged hospitalization. We report a 4-month-old infant born prematurely with early-onset sepsis requiring prolonged antibiotic treatment and valvular aortic stenosis presenting with sudden hemodynamic compromise due to aortic vegetation extending into the ascending aorta eroding through its posterior wall. The report details management of our case and a brief description of available alternative treatment strategies.