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Left subclavian artery originating from the left pulmonary artery is a rare aortic arch anomaly. Herein, we, for the first time in Turkey, present a case of left subclavian artery originating from the left pulmonary artery via ductus arteriosus in DiGeorge syndrome and causing subclavian steal syndrome.

WOS: 000387109800019 PubMed ID: 27184808 Introduction Definitive therapy of idiopathic right ventricular arrhythmias (VA) remains a challenge in interventional electrophysiology. The aim of this study was to evaluate the utility of EnSite Velocity system in the catheter ablation of RV tachycardia in children. Methods Thirty-five children with idiopathic right VA underwent catheter ablation procedure using the EnSite Velocity system guidance. Results The mean patient age was 12.0 +/- 3.7 years and the mean patient weight was 43.6 +/- 18.7 kg. The origin of right VA was divided into right ventricular outflow tract (RVOT) (30 patients) and other right ventricular localizations (five patients). The mean procedure and fluoroscopy times were 175 +/- 67 min and 2.35 +/- 1.89 min, respectively. No fluoroscopy was used in 19 patients. Acute success was achieved in 29 patients (83 %). The focus of VA was epicardial in three failed procedures. Cryocatheter (6-mm or 8-mm tip) was used in six patients, radiofrequency ablation (RFA) (4-mm or 8-mm tip) in 26 patients, and 4-mm tip irrigated RFA in three patients. During a mean follow-up of 15.9 +/- 7.1 months, ventricular tachycardia recurred in six patients (20 %). There were three complications (transient atrioventricular block developed in one patient during parahissian cryoablation and two patients developed transient complete right bundle branch block). Conclusions Catheter ablation of idiopathic right VA in children can be performed safely and effectively with limited fluoroscopy using the EnSite Velocity system.

WOS: 000460612600008 PubMed ID: 31180383 OBJECTIVE: A 12-lead electrocardiography is a critical component for the screening of long QT syndrome; however, besides, an electrocardiograph, trained personnel are also necessary which limits the screening capability of conventional electrocardiographs. The development of smartphone electrocardiography technologies provides a potential alternative platform for electrocardiography screening for selective purposes such as arrhythmias and QT interval abnormalities. The aim of this pilot study was to assess the reliability of a smartphone-based electrocardiography device in the measurement of QT and corrected QT intervals in children. METHODS: In all participants, 10-s smartphone electrocardiography tracing from AliveCor device and a standard 12-lead electrocardiograph were obtained simultaneously. Two pediatric electrophysiologists performed the measurements of QT and corrected QT intervals in a blinded manner with Bazett's formula. The results were compared statistically. RESULTS: A total of 285 children (mean age 9.8 +/- 4.9 years) who presented to our clinic were included in the study. The mean QT intervals obtained from 12-lead electrocardiographs and AliveCor devices were 343 +/- 40 ms and 340 +/- 41 ms, respectively. The mean corrected QT intervals obtained from 12-lead electrocardiographs and AliveCor devices were 419 +/- 28 ms and 415 +/- 33 ms, respectively. There was high correlation between the QT intervals of 12-lead electrocardiographs and AliveCor recordings (Pearson's correlation coefficient: 0.83 [p

WOS: 000426870600005 PubMed ID: 29318633 BackgroundAtrioventricular nodal reentrant tachycardia (AVNRT) is a common tachyarrhythmia substrate inchildren, which is successfully treated by catheter ablation using radiofrequency or cryothermal energy. In recent years, cryoablation (Cryo) using electroanatomical system guidance is more commonly preferred for use in children in order to decrease the risk of an atrioventricular block. However, there are concerns regarding the long-term efficacy of Cryo in treating AVNRT. We aimed to evaluate the feasibility, safety, and long-term efficacy of Cryo for AVNRT in children. Methods and resultsA total of 275 consecutive children above 4 years of age diagnosed with AVNRT were included in our study. The EnSite system (St. Jude Medical, Inc., St. Paul, MN, USA) was used to reduce or eliminate fluoroscopy. The study included 275 patients (148 females, age: 11.9 3.6 years) undergoing catheter ablation forAVNRT from July 2012 to September 2016. Acute success was obtained in all (100%) patients with a mean procedure time of 140 +/- 44 minutes. Fluoroscopy was used in only 12 (4.4%) patients. During a follow-up time of 25.6 +/- 13.5 months (median: 23 months),AVNRT recurred in 12 of 279 (4.4%) of the patients. Age, sex, number of Cryo lesions, and catheter tip size (6-mm vs 8-mm) were not predictive for recurrence. In nine patients, a repeat ablation was successfully performed with cryoenergy. ConclusionsCryo for AVNRT is a safe and effective procedure with excellent long-term outcomes. The use of electroanatomical systems during ablation significantly decreases exposure to fluoroscopy without compromising success.

WOS: 000405798800018 PubMed ID: 28612086 Due to its safety profile, cryoablation (Cryo) for atrioventricular nodal reentrant tachycardia (AVNRT) is more commonly preferred over radiofrequency (RF) ablation in children in recent years. Recent studies demonstrated high long-term success rates comparable to radiofrequency ablation. The aim of this prospective study was to compare the efficacy and safety of an 8-mm-tip versus 6-mm-tip Cryo catheter in the treatment of AVNRT in children. A total of 125 consecutive patients over 10 years of age with AVNRT were included. EnSite system (St. JudeMedical, St Paul, MN, USA) was used to reduce or eliminate fluoroscopy. The acute procedural success was 100% in both groups. The prodecure duration for the 8-mm-tip group was shorter (151.6 +/- 63.2 vs. 126.6 +/- 36.7 min, p < 0.01, respectively). Fluoroscopy was used in only 7 patients. The mean follow-up duration was 14.6 +/- 8.4 months (median 13.5 months, min. 3 months and max. 27 months). The recurrence rate for AVNRT was also comparable between the two groups (6-mm tip: 9.6 vs. 8-mm tip: 8%). Cryo of AVNRT is a safe and effective procedure with comparable acute and mid-term follow-up success rates using 6-mm and 8-mm-tip catheters in children. In addition, procedure duration is shorter with an 8-mm-tip Cryo catheter.

WOS: 000385271000023 Currently, arterial switch operation appears as a standard surgical management for patients under three weeks of age with transposition of the great arteries with an intact ventricular septum, while, beyond three weeks of age, there is no such standard approach and surgical procedures may vary among the health care centers. Low cardiac output and left ventricle failure may also develop after three weeks due to the progressive involution of left ventricle after arterial switch operation. Therefore, the Senning or Mustard procedure, or two-stage repair arterial switch operation are optional surgical management modalities in this patient population. However, due to the potential complications of these procedures in the short-and long-term, there has been an increased interest in performing primary arterial switch operation with extracorporeal membrane oxygenator support in patients older than three weeks of age. This report presents two cases in whom primary arterial switch operation with extracorporeal membrane oxygenator support was performed at the age of 110 days and 60 days, respectively. Primary arterial switch operation with extracorporeal membrane oxygenator support appears to be a more effective option in the short-term than alternative surgical management modalities. Günümüzde ventriküler septumu intakt, üç haftadan küçük basit büyük arter transpoziyonu olan hastalarda standart cerrahi tedavi primer arteriyel switch ameliyatı iken, üç haftadan büyüklerde bu tür bir standart yaklaşım yoktur ve cerrahi işlemler merkezler arasında değişiklik gösterebilmektedir. Üç haftadan sonra sol ventrikülün ilerleyici involüsyonu nedeniyle, arteriyel switch ameliyatı sonrası düşük kalp debisi ve sol ventrikül yetmezliği de gelişebilir. Bu nedenle, Senning veya Mustard işlemi veya iki aşamalı arteriyel switch ameliyatı, bu hasta popülasyonunda alternatif cerrahi tedavi yöntemleridir. Bununla birlikte, bu işlemlerin kısa ve uzun dönemde muhtemel komplikasyonları nedeniyle, üç haftadan büyük olan hastalarda ekstrakorporeal membran oksijenatörü desteği altında primer arteriyel switch ameliyatına karşı ilgi giderek artmaktadır. Bu yazıda, ekstrakorporeal membran oksijenatörü desteği altında primer arteriyel switch ameliyatı yapılan 110 günlük ve 60 günlük iki olgu sunuldu. Kısa dönemde ekstrakorporeal membran oksijenatörü desteği ile yapılan arteriyel switch ameliyatının, diğer seçeneklere kıyasla, daha etkili bir seçenek olabileceği düşünülmektedir.

WOS: 000421983000008 PubMed ID: 26363748 Anomalous origin of the circumflex coronary artery from the pulmonary artery is a rare congenital coronary anomaly. While it generally follows an asymptomatic course, if undiagnosed it may lead to severe clinical outcomes, including sudden death. The condition can be masked by associated defects, so when it is clinically suspected, diagnosis must be confirmed by conventional and/or magnetic resonance angiography, even if echocardiography clearly shows coronary roots. This report describes a patient who underwent neonatal surgery for aortic coarctation and was diagnosed with coronary artery anomaly at 15 months old.