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Abstract Background and aims To our knowledge, no previously reported clinical data of a coronary artery fistula forming a pseudoaneurysm and presenting as a anterior chest wall lump. We reported a rare case of Coronary pseudoaneurysm with a superficial mass and accompanying Brucella infection. The patient was successfully treated with surgery. Materials and methods The patient case data was extracted from hospital records. Results A 64-year-old male presented with a history of paroxysmal left-sided chest pain and painful anterior chest wall lump. Coronary computed tomography (CT) angiography revealed the RCA pseudoaneurysm that showed a peripherally calcified soft-tissue mass in the anterior mediastinum and communicated with the chest wall lump through intercostal spaces. The patient underwent the resection of chest lump and RCA pseudoaneurysm under cardiopulmonary bypass, along with a combined antimicrobial therapy. The patient was discharged successfully after the surgery. Discussion and conclusion We report this rare case and highlight the possible origin of the anterior mediastinal mass and anterior chest wall lump as a pseudoaneurysm formed by a coronary artery fistula.

Abstract Current guidelines give priority to surgical treatment of carotid artery stenosis (CAS) before coronary artery bypass grafting (CABG), especially in symptomatic patients. Carotid artery stenting is an alternative treatment for narrowing of the carotid arteries. This study sought to demonstrate the role of severe CAS in predicting stroke after CABG and assess the efficacy of carotid artery stenting in preventing postoperative stroke in a Chinese cohort. From 2015 to 2021, 1799 consecutive patients undergoing isolated CABG surgery were retrospectively recruited in a Chinese cohort. The predictive value of severe CAS in postoperative stroke and carotid stenting in preventing postoperative stroke was statistically analyzed. The incidence of postoperative stroke was 1.67%. The incidence of CAS with stenosis ≥ 50% and ≥ 70% was 19.2% and 6.9%. After propensity matching, the incidence of stroke was 8.0% in the severe CAS group and 0% in the non-severe CAS group. We successfully established an optimal predictive nomogram for predicting severe CAS in patients undergoing CABG. Carotid artery stenting was found ineffective in preventing postoperative stroke. The present study provides the incidence of CAS and postoperative stroke in a Chinese cohort, identifies severe CAS as an independent risk factor for postoperative stroke after CABG, constructs a nomogram predicting the incidence of severe CAS, and evaluates the effectiveness of carotid artery stenting in preventing postoperative stroke after CABG.

Background: The role of body mass index (BMI) in the treatment outcomes of lymphoma patients is controversial. While investigating the efficacy of ABVD-like regimen in Hodgkin lymphoma (HL) patients, we observed that obese patients had poor responses. To better understand this clinical phenomenon, we evaluated the effect of BMI on responses to ABVD-like chemotherapy in HL patients.Methods: This retrospective cohort study evaluated the clinical outcomes of all 67 patients with confirmed HL who were treated at the First Affiliated Hospital of Soochow University from November 2016 to March 2023 with an ABVD-like regimen as first-line chemotherapy. Baseline patient characteristics and clinical outcomes were compared across different BMI categories. The primary end-point was the overall response rate defined as the proportion of the HL patients who achieved complete response or partial response. The additional end-points included progression-free survival and overall survival.Results: The median age of the HL patients was 31 years old. Of the patients, 10.4% were obese, and 17.9% patients were overweight. Interim and end-term response evaluations revealed overall response rates of 98.5% and 83.6%, respectively. The proportion of patients with potential poor prognostic factors (IPS risk factors) did not differ significantly in the responders versus non-responders. However, non-responders had a higher average BMI when compared with responders (p = 0.002). Poor overall response rates in higher BMI patients indeed manifested with shorter progression free survival (p = 0.013). The minimum relative dose of the ABVD-like regimen in the overweight and obese groups was significantly lower than in the normal weight group (p < 0.001).Conclusion: Our analyses show that >80% of newly-diagnosed HL patients responded to the ABVD-like regimen. We find that being obese or overweight at the time of diagnosis correlated with a poorer overall response rate and that BMI was an independent risk factor in HL patients treated with the ABVD-like regimen. Lower doses of ABVD-like regimen contributed to the discrepant findings of responses in the high BMI groups. These findings indicate that newly-diagnosed, obese HL patients receiving an ABVD-like regimen require personalized treatment.

Here, we report an unusual case of left atrial myxoma presented with morphology of cavernous hemangioma supplied by the right coronary artery. Surgical resection of the left atrium myxoma was performed, and the patient experienced an uneventful recovery during hospitalization.

Abstract Background Calcific aortic valve stenosis (CAVS) represents a serious health threat to elderly patients. Post-stenotic aortic dilation, a common feature in CAVS patients, might progress into aneurysm and even dissection, potential consequences of CAVS, and predicts a poor prognosis. This study sought to investigate the association of lymphocyte-to-monocyte ratio (LMR), an inflammatory biomarker, with severe post-stenotic aortic dilation in a case–control study in Chinese population. Materials and methods 208 consecutive patients with CAVS were recruited retrospectively in a case–control study in Chinese population, from July 1, 2015 to June 31, 2018. LMR was statistically analyzed using the ROC curve and binary logistic regression analyses for its prognostic value in severe post-stenotic aortic dilation. Results LMR was significantly reduced in patients with severe post-stenotic aortic dilation (2.72 vs. 3.53, p = 0.002

Keypoint detection and description play a pivotal role in various robotics and autonomous applications, including Visual Odometry (VO), visual navigation, and Simultaneous Localization And Mapping (SLAM). While a myriad of keypoint detectors and descriptors have been extensively studied in conventional camera images, the effectiveness of these techniques in the context of LiDAR-generated images, i.e., reflectivity and ranges images, has not been assessed. These images have gained attention due to their resilience in adverse conditions, such as rain or fog. Additionally, they contain significant textural information that supplements the geometric information provided by LiDAR point clouds in the point cloud registration phase, especially when reliant solely on LiDAR sensors. This addresses the challenge of drift encountered in LiDAR Odometry (LO) within geometrically identical scenarios or where not all the raw point cloud is informative and may even be misleading. This paper aims to analyze the applicability of conventional image keypoint extractors and descriptors on LiDAR-generated images via a comprehensive quantitative investigation. Moreover, we propose a novel approach to enhance the robustness and reliability of LO. After extracting keypoints, we proceed to downsample the point cloud, subsequently integrating it into the point cloud registration phase for the purpose of odometry estimation. Our experiment demonstrates that the proposed approach has comparable accuracy but reduced computational overhead, higher odometry publishing rate, and even superior performance in scenarios prone to drift by using the raw point cloud. This, in turn, lays a foundation for subsequent investigations into the integration of LiDAR-generated images with LO.

The summer hypoxia off the Changjiang Estuary is one of the largest coastal hypoxic systems in the world and has displayed spatial heterogeneity in recent years. Based on observation data in the summer of 2014, hypoxia was identified both in the bottom and mid-layers. Except for the typical bottom hypoxia in the submarine canyon, the subsurface oxygen minima (SOM) were captured in the mid-layer of 10~15 m, with lower dissolved oxygen in the mid-layer than at the bottom (30–50 m). This SOM phenomenon was located in the lower boundary of the pycnocline and above the Taiwan warm current (TWC) and Kuroshio subsurface water (KSSW). Due to the southern expansion of Changjiang diluted water (CDW), a high phytoplankton biomass (the maximum chlorophyll a of 25 μg L−1, pH of 8.6, and DO of 11 mg L−1) band occupied the surface area along 123°E. By analyzing the 24-h continuous observation and high-resolution profile data, we revealed that the subsurface oxygen minima were predominantly controlled by remineralization and bottom-flushing effects. Fast local consumption occurred near the pycnocline layer, while the lateral transport of oxygen-rich ambient water replenished the bottom oxygen deficit from south to north. We summarize and contextualize three hot spots of hypoxia into a conceptual diagram and emphasize the influences of advection, mixing, and respiration on their location and severity. Overall, compared with the discussion about the low DO background of TWC/KSSW, this research highlights the flushing effects of TWC/KSSW that will reshape the hypoxia structure and alleviate the hypoxia severity in the south hypoxia area off the Changjiang Estuary.

Post-COVID-19 domestic travel, a valuable component of tourism recovery, has been initiated. However, verified and detailed knowledge regarding epidemic-induced travel behaviour changes from an emic perspective is lacking. Focusing on actual behaviour based on a field investigation of Chinese domestic travellers, this study provides detailed knowledge of the travel constraint-negotiation interaction process between travellers and the epidemic. The findings suggest that the effects of COVID-19 involve various constraints including intrapersonal, interpersonal and structural factors at both the context and system levels. Both cognitive and behavioural strategies are synergistically used in an interlinking manner and depend not only on individual preference and self-efficacy but also, more importantly, on the temporality and socioculture of COVID-19 created by anti-epidemic practices.

BackgroundBoth catheter left atrial appendage occlusion combined with ablation (COA) and thoracoscopic surgical left atrial appendage clipping combined with ablation (TCA) have shown favorable outcomes in management of patients with atrial fibrillation (AFib). However, studies comparing the endpoints of both techniques are still lacking. Herein, a meta-analysis of safety and efficacy outcomes of COA versus TCA was performed in patients with AFib.MethodsPubmed, Embase, Cochrane, and Web of Science databases were searched for retrieving potential publications. The primary outcome was the incidence of stroke during follow-up period of at least 12 months. Secondary outcomes were acute success rate of complete left atrial appendage (LAA) closure by COA or TCA, postprocedural mortality and complications, and all-cause mortality during follow-up period of at least 12 months.Results19 studies of COA containing 1,504 patients and 6 studies of TCA with 454 patients were eligible for analysis. No significant difference in stroke and all-cause mortality was found in patients undergoing COA versus TCA after at least a 12-month follow-up (stroke: p = 0.504; all-cause mortality: p = 0.611). COA group had a higher acute success rate compared with TCA group (p = 0.001). COA placed the patients at a higher risk of hemorrhage during the postprocedural period compared with TCA (p = 0.023). A similar risk of other postprocedural complications (stroke/transient ischemic attack and pericardial effusion) and mortality was found in the COA group in comparison with TCA group (p>0.05).ConclusionThis meta-analysis showed that COA and TCA did not differ in stroke prevention and all-cause mortality in patients with AFib after a follow-up of at least 12 months. Postprocedural complications and mortality were almost comparable between the two groups. In the near future, high-quality randomized controlled trials exploring the optimal surgical strategies for AFib and endpoints of different procedures are warranted.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022325497].

Abstract Background Bone marrow mesenchymal stem cell (BM-MSC) has been shown to treat pulmonary arterial hypertension (PAH). However, excessive reactive oxygen species (ROS) increases the apoptosis of BM-MSCs, leading to poor survival and engraft efficiency. Thus, improving the ability of BM-MSCs to scavenge ROS may considerably enhance the effectiveness of transplantation therapy. Mammalian Ste20-like kinase 1 (Mst1) is a pro-apoptotic molecule which increases ROS production. The aim of this study is to uncover the underlying mechanisms the effect of Mst1 inhibition on the tolerance of BM-MSCs under H2O2 condition. Methods Mst1 expression in BM-MSCs was inhibited via transfection with adenoviruses expressing a short hairpin (sh) RNA directed against Mst1 (Ad-sh-Mst1) and exposure to H2O2. Cell viability was detected by Cell Counting Kit 8 (CCK-8) assay, and cell apoptosis was analyzed by Annexin V-FITC/PI, Caspase 3 Activity Assay kits, and pro caspase 3 expression. ROS level was evaluated by the ROS probe DCFH-DA, mitochondrial membrane potential (ΔΨm) assay, SOD1/2, CAT, and GPx expression. Autophagy was assessed using transmission electron microscopy, stubRFP-sensGFP-LC3 lentivirus, and autophagy-related protein expression. The autophagy/Keap1/Nrf2 signal in H2O2-treated BM-MSC/sh-Mst1 was also measured. Results Mst1 inhibition reduced ROS production; increased antioxidant enzyme SOD1/2, CAT, and GPx expression; maintained ΔΨm; and alleviated cell apoptosis in H2O2-treated BM-MSCs. In addition, this phenomenon was closely correlated with the autophagy/Keap1/Nrf2 signal pathway. Moreover, the antioxidant pathway Keap1/Nrf2 was also blocked when autophagy was inhibited by the autophagy inhibitor 3-MA. However, Keap1 or Nrf2 knockout via siRNA had no effect on autophagy activation or suppression. Conclusion Mst1 inhibition mediated the cytoprotective action of mBM-MSCs against H2O2-induced oxidative stress injury. The underlying mechanisms involve autophagy activation and the Keap1/Nrf2 signal pathway. Graphical abstract

BackgroundThis study examined the role of blood urea nitrogen-to-albumin ratio (BAR) in predicting long-term mortality in patients undergoing coronary artery bypass grafting (CABG).MethodsIn this retrospective cohort study, patients undergoing CABG were enrolled from the Medical Information Mart for Intensive Care III (MIMIC III) database. Patients were divided into the three groups according to the optimal cutoff values of BAR determined by X-tile software. The survival curve was constructed by the Kaplan–Meier method and multivariate Cox regression analysis was performed to explore the independent prognostic factors of 1- and 4-year mortality after CABG. The receiver operating characteristic (ROC) curves and the areas under the ROC curves (AUCs) were calculated to estimate the accuracy of BAR in predicting the outcomes. Subgroup analyses were also carried out.ResultsA total of 1,462 patients at 4-year follow-up were included, of which 933, 293, and 236 patients were categorized into the group 1 (≤ 6.45 mg/g), group 2 (>6.45 and ≤ 10.23 mg/g), and group 3 (>10.23 mg/g), respectively. Non-survivors showed an increased level of BAR at both 1- (p < 0.001) and 4-year (p < 0.001) follow-up compared with the survivors. The patients with a higher BAR had a higher risk of 1- and 4-year mortality following CABG (33.05 vs. 14.33 vs. 5.14%, p < 0.001 and 52.97 vs. 30.72 vs. 13.08%, p < 0.001, respectively). Cox proportional hazards regression model suggested a higher BAR as an independent risk factor of 1-year mortality (HR 3.904; 95% CI 2.559–5.956; P < 0.001) and 4-year mortality (HR 2.895; 95% CI 2.138–3.921; P < 0.001) after adjusting for confounders. Besides, the receiver operating characteristic (ROC) curves showed the better predictive ability of BAR compared to other grading scores at both 1- (0.7383, 95% CI: 0.6966–0.7800) and 4-year mortality (0.7189, 95% CI: 0.6872–0.7506). Subgroup analysis demonstrated no heterogeneous results of BAR in 4-year mortality in particular groups of patient.ConclusionThis report provided evidence of an independent association between 1- and 4-year mortality after CABG and BAR. A higher BAR was associated with a higher risk of long-term mortality and could serve as a prognostic predictor in patients following CABG.

Abstract Background The acute kidney injury (AKI) remains a frequent complication following open thoracic aortic surgery (OTAS) and worsens the postoperative prognosis. It remains unclear that whether the predictors of AKI following OTAS are different in the patients with or without acute aortic syndrome (AAS). Methods Preoperative and intraoperative variables were compared between the patients with or without AKI, and were further analyzed for identifying the potential predictors of postoperative AKI. Subgroup analysis was conducted in the patients with or without AAS, respectively. Results AKI after OTAS occurred in 57.6% of the overall cohort, 70.1% of the patients with AAS and 46.7% of the patients without AAS. In the multivariate analysis, history of hypertension (OR 1.011, 95% CI: [1.001–1.022], p = 0.04), preoperative platelet (OR 0.995, 95% CI: [0.991–0.999], p = 0.006) and operation time (OR 1.572, 95% CI: [1.355–1.823], p

Abstract The seasonal variations of blood lipids have recently gained increasing interest in this field of lipid metabolism. Elucidating the seasonal patterns of blood lipids is particularly helpful for the prevention and treatment of cardiovascular and cerebrovascular diseases. However, the previous results remain controversial and the underlying mechanisms are still unclear. This mini-review is focused on summarizing the literature relevant to the seasonal variability of blood lipid parameters, as well as on discussing its significance in clinical diagnoses and management decisions.

Background: The post-operative acute kidney injury (AKI) represents a common complication in the Acute Debakey Type I Aortic Dissection (ADTIAD) and predicts a poorer prognosis. The clinical evidence is scarce supporting the predictive value of the pre-operative lymphocyte-to-monocyte ratio (LMR) in post-operative AKI in ADTIAD.Methods: In this retrospective cohort study, 190 consecutive patients with ADTIAD enrolled for surgical treatment between January 1, 2013, and December 31, 2018. The diagnosis of AKI followed the Kidney Disease: Improving Global Outcomes guidelines (KDIGO). Pre-operative LMR and other possible risk factors were analyzed for their prognostic value in the post-operative AKI in ADTIAD.Results: The subjects were assigned to the low-LMR and high-LMR groups according to the median value of pre-operative LMR. For post-operative AKI, the incidence and the severity in the low-LMR group were statistically different from that of the high-LMR group. Besides, the lower LMR was statistically associated with the more extended ICU stay and intubation time and higher incidences of ischemic stroke and in-hospital mortality. Additionally, in the multivariable analysis, the pre-operative LMR was an independent predictor for post-operative AKI in ADTIAD. A predictive model for post-operative AKI in ADTIAD was established incorporating LMR.Conclusions: LMR is an independent prognostic indicator incorporated into the predictive model with other risk factors to predict the post-operative AKI in ADTIAD.

This study explores the psychological factors affecting small tourism firm (STF) owners’ decision making about reopening businesses in the midst of COVID-19 based on protection motivation theory and the theory of planned behaviour. The data were collected from a sample of 300 STFs in the Ancient City of Pingyao when the lockdown policy was lifted in China. A symmetric approach, i.e., partial least squares structural equation modelling (PLS–SEM), and an asymmetric model, i.e., a fuzzy set/qualitative comparative analysis (fsQCA), were used to analyse the net effect of the psychological determinants and correlations between the variables leading to high and low behavioural intentions to reopen businesses. The results indicate that social norms and perceived business uncertainty were the critical factors influencing the intention to reopen. The pathway (low perceived risk of infection, low perceived business uncertainty, high reward, high response efficacy, high self-efficacy, high attitude, and high subjective norm) was only one configuration for a high intention to reopen. The study results are discussed based on dual-process theory, and practical implications are offered to guide STF recovery amid COVID-19.

Abstract Background Constrictive Pericarditis(CP) can be viewed as a constellation of syndromes resulting from compression of the heart, etiologies, course and types are well discussed in other reports. However, localized CP as a cause of right heart failure is rare, and presentation with interposed fluid under-pressure is extremely odd. Case report A case of C.X. Z, male aged 39 years old, who presented to our department with sudden onset of symptoms of subacute right heart failure due localized CP. In January, 2018 C.X.Z presented to the county hospital with complaints of 10-day history of transient mild bilateral pedal edema. He was managed on diuretic therapy and symptoms resolved completely. 10 months later, he suddenly presented to the local facility with symptoms of subacute right heart failure. 7 days after on-set of symptoms, his condition shifted from NYHA I to III-IV. Although wake-up chest radiography appeared normal, standard medical therapy yielded no positives results. He was referred to our hospital, upon which after echocardiography and computed tomography investigations, aforementioned diagnosis was made. We performed off-pump partial pericardiectomy with no complications. After operation, he received analgesics and diuretics for pain and edema(ascites) respectively. He was discharged 7-days after operation on analgesics only, with no symptoms of right heart failure. Conclusion Localized constrictive pericarditis as a cause of subacute right heart failure (RHF) has never been reported elsewhere, and presentation with interposed fluid is extremely odd. Progressive symptoms of Acute RHF in the absence of typical radiologic clue ‘egg-shell’ should heighten suspicion index of CP.

Background/Aims: Previous studies have examined the associations between the single nucleotide polymorphism in the Paraoxonase 1 (PON1) gene and development of calcific aortic valve stenosis (CAVS). The association between functional SNP in 3’UTR of PON1 and the risk of CAVS, however, is unclear. In this study, we investigated the role of SNP in the regulation of PON1 expression via miR-616, as well as the association of SNP with the risk of CAVS. Methods: Two hundred and sixteen patients with CAVS and 243 CAVS-free participants were recruited in this study.They all obtained transthoracic echocardiogram and the ejection fraction (EF) and aortic valve area were recorded and analyzed. The PON1 expression were measured by western blot, Quantitative Real-Time Polymerase Chain Reaction were used to examine the transcriptional activity of miR-616 and PON1. Differences between CVAS patients and controls in terms of genotype frequency distribution and the estimates of Hardy-Weinberg equilibrium were evaluated using chi-square tests. Logistic regression modeling was used to determine the association between the independent effect of rs3735590 SNP and the interaction between genotype, PON1 activity, and other covariates on lipids and CAVS risk. All statistical analyses were performed using SPSS, version 17.0.1 for Windows (SPSS Inc., Chicago, IL). A p value of < 0 .05 was considered significant for all analyses. Results: This study confirmed that PON1 is a validated target gene of miR-616 in liver cells. The relative quantification representing the expression of PON1 mRNA and the serum level of PON1 protein was decreased in the TT genotype. Moreover, the expression of PON1 had a negative regulatory relationship with the expression of miR-616(r=-0.3959, P

Abstract Background Cardiac myxoma, a common benign primary tumor of the heart can be categorized into syndromic (Carney Complex) and non-syndromic(isolated). Carney Complex associated myxomas can be found in any region and system (cardiac, cutaneous, osseous, genitalia), and may manifest at a tender age. On the contrary, non-syndromic cardiac myxomas are usually confined to the chambers, and symptoms often present from 5th decade of life. Aortic valve myxoma is a very unusual occurrence, and presentation in a teen is extremely rare. Case report We share a case of aortic valve myxoma, uncovered using echocardiography in a 16-year-old male, admitted with complaints of exertional chest pain, dyspnoea and systolic murmur. Patient underwent uneventful surgery for tumor excision, and discharged 6-days post operation. Conclusion Given the high risk of developing cardiogenic stroke, infective endocarditis, degenerative effects on aortic valve leaflets and possible sudden death, like many other centers, we advocate for immediate liquidation of aortic myxoma regardless of age and symptoms.

Abstract Background Aortic dissection (AD) represents a clinically uncommon aortic pathology which predicts a dismal prognosis if not promptly treated. In acute Debakey type I AD (ADIAD), aortic lesion extends from aortic root to even distal abdominal aorta among which aortic arch and its three main branches still remain a great surgical challenge for repair and reconstruction. Several decades have witnessed the painstaking efforts of cardiovascular surgeons across the globe for optimizing the surgical procedures, from total or hemi-arch replacement, “elephant trunk” technique to branched stent graft. However, operative mortality and morbidity still remain to be reduced and surgical strategy is to be advanced and simplified, particularly the repair and reconstruction of aortic arch and supra-aortic vessels. Methods In this paper, we reviewed the relevant literature concerning recent advances in surgical intervention of aortic arch and summarized our opinions in the application of branched stent graft in ADIAD. Results The operative strategy for acute Debakey type I aortic dissection still remain to be advanced and simplified, especially the repair and reconstruction of aortic arch and supra-aortic vessels. For selection of branched stent grafts, the anatomic features and pathological changes of diseased arch are the crucial factors for clinical decision making. Conclusions Branched stent graft is potentially an effective alternative for the treatment of type I AD with diseased aortic arch and supra-aortic vessels. The selection of branched stent grafts still remains to be further discussed in large-scale studies in the future.

Maghemite (γ-Fe2O3) nanopowders were synthesized under aeration (oxidizing) conditions by aqueous synthesis in this study. The microstructures of the prepared powders were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), and BET-BJH. The XRD analysis and the chemical experiments showed that well-crystallized γ-Fe2O3 nanoparticles were successfully obtained with a mean particle size of approximately 17 nm. The prepared γ-Fe2O3 was spherical with a BET surface area of 14.357 m2/g and a total pore volume of 0.050 cm3/g. Varying the reaction conditions, such as pH, temperature, and reaction time, we obtained crystallized γ-Fe2O3 powders with different crystallization extent and different particle sizes. When the pH of the reaction suspension was increased, the reaction time was prolonged, and the reaction temperature was increased, the γ-Fe2O3 powders underwent superior crystallization and had larger particle sizes. All the obtained γ-Fe2O3 powders had significant photocatalytic activities under both UV and visible light irradiation for Orange I degradation, and the powders with better crystallization and larger particle size had relatively lower activities for Orange I photocatalytic degradation. The one-step aqueous synthesis method presented in this paper may provide an advantageous pathway to synthesize large quantities of this important iron oxide.

Background : Ventricular septal defects (VSD) are the second commonest congenital heart defects after bicuspid aortic valve. When left unrepaired, they can undergo spontaneous closure or elicit a spectrum of complications including pneumonia (PNA) or pulmonary hypertension (PH) with subsequent anaemia. In this retrospective study, we aim to establish and compare the prevalence of anaemia in patients with solitary acyanotic VSD in comorbid with PNA or PH. Methods: A total of 75 case files of patients with solitary acyanotic VSD, who underwent surgical closure or device occlusion had haemoglobin level analysed prior to the procedure. The cohort included patients with (history of) PNA and PH, and asymptomatic. The cohort included 27 females and 48 males with mean age and weight of 8.3±5.72 (3-24) months and 5.9±3.9 (2.7-17.8) kilograms, respectively. Depending on associated complication and age, the cohort was divided: PNA (A), PH (B) and Control (C); and (I) young children (≥3-6≤) and (II) older children (>6-≤24) months. We used 95 and 105 grams per litre as haemoglobin lower threshold level for (I) and (II), respectively. Results : According to data analysis 27 patients (36%) in total had anaemia. Of the anaemia cohort 16 (59.3%) had PNA, 9 (33.3%) PH and 2 (7.4%) were asymptomatic. Of the cohort, 42 were young children, with anaemia prevalence of 19/42 (45.2%), while 24.2% of the older children had anaemia. Intergroup ANOVA independent sample t-test was significant (pTukey HSD test for haemoglobin: A/B (p>0.05), A/C (p Conclusion : Paediatric patients with acyanotic VSD in comorbid with PNA or PH are 8 and 4 times more susceptible to develop anaemia compared to asymptomatic counterparts. Susceptibility is even higher among young children (3-6months). However, a prospective study is needed to validate our findings.

Background : Ventricular septal defects (VSD) are the second commonest congenital heart defects after bicuspid aortic valve. When left unrepaired, they can undergo spontaneous closure or elicit a spectrum of complications including pneumonia (PNA) or pulmonary hypertension (PH) with subsequent anaemia. In this retrospective study, we aim to establish and compare the prevalence of anaemia in patients with solitary acyanotic VSD in comorbid with PNA or PH. Methods: A total of 75 case files of patients with solitary acyanotic VSD, who underwent surgical closure or device occlusion had haemoglobin level analysed prior to the procedure. The cohort included patients with (history of) PNA and PH, and asymptomatic. The cohort included 27 females and 48 males with mean age and weight of 8.3±5.72 (3-24) months and 5.9±3.9 (2.7-17.8) kilograms, respectively. Depending on associated complication and age, the cohort was divided: PNA (A), PH (B) and Control (C); and (I) young children (≥3-6≤) and (II) older children (>6-≤24) months. We used 95 and 105 grams per litre as haemoglobin lower threshold level for (I) and (II), respectively. Results : According to data analysis 27 patients (36%) in total had anaemia. Of the anaemia cohort 16 (59.3%) had PNA, 9 (33.3%) PH and 2 (7.4%) were asymptomatic. Of the cohort, 42 were young children, with anaemia prevalence of 19/42 (45.2%), while 24.2% of the older children had anaemia. Intergroup ANOVA independent sample t-test was significant (pTukey HSD test for haemoglobin: A/B (p>0.05), A/C (p Conclusion : Paediatric patients with acyanotic VSD in comorbid with PNA or PH are 8 and 4 times more susceptible to develop anaemia compared to asymptomatic counterparts. Susceptibility is even higher among young children (3-6months). However, a prospective study is needed to validate our findings.