Patients with BA have subclinical right ventricular diastolic dysfunction even in the early stages. The severity of the functional impairment is parallel with the severity of the disease. Tissue Doppler echocardiography has a greater predictive value than conventional imaging, and is useful for evaluating ventricular function in patients with BA.

BackgroundT1 mapping based on cardiovascular magnetic resonance (CMR) is a novel approach using the magnetic relaxation T1 time as a quantitative marker for myocardial tissue composition. Various T1 mapping sequences are being used, with different strengths and weaknesses. Data comparing different sequences head to head however are sparse.MethodsWe compared three T1 mapping sequences, ShMOLLI, MOLLI and SASHA in phantoms and in a mid-ventricular slice of 40 healthy individuals (mean age 59 ± 7 years, 45 % male) with low (68 %) or moderate cardiovascular risk. We calculated global and segmental T1 in vivo through exponential curve fitting and subsequent parametric mapping. We also analyzed image quality and inter-observer reproducibility.ResultsThere was no association of T1 with cardiovascular risk groups. T1 however differed significantly depending on the sequence, with SASHA providing consistently higher mean values than ShMOLLI and MOLLI (1487 ± 36 ms vs. 1174 ± 37 ms and 1199 ± 28 ms, respectively; p < 0.001). This difference between sequences was much smaller in phantom measurements. In patients, segmental values were lower in the anterior wall for all sequences. Image quality, in general good for the steady-state-free-precession readouts in all sequences, was lower for SASHA parametric maps. On multivariate regression analysis, a longer T1 measured by MOLLI was correlated with lower ejection fraction and female gender. Inter-observer variability as assessed by intra-class correlation coefficients was excellent for all sequences (ShMOLLI: 0.995; MOLLI: 0.991; SASHA: 0.961; all p < 0.001).ConclusionIn a cross-sectional population with low to moderate cardiovascular risk, we observed a variation in T1 mapping results between inversion-recovery vs. saturation-recovery sequences in vivo, which were less evident in phantom images, despite a small interobserver variability. Thus, physiological factors, most likely related to B1 inhomogeneities, and tissue-specific properties, like magnetization transfer, that impact T1 values in vivo, render phantom validation insufficient, and have to be further investigated for a better understanding of the clinical utility of different T1 mapping approaches.Trial registration“Canadian Alliance For Healthy Hearts and Minds” – ClinicalTrials.gov NCT02220582; registered August 18, 2014.

ÖZETAmaç: Yetişkin ve çocuklarda Cheatham-Platinum stent implantasyonu ile tedavi edilen nativ ve rekürren aort koarktasyonu olgularının erken ve kısa dönem sonuçlarını sunmayı amaçladık. Yöntemler: Ağustos 2007-Kasım 2009 tarihleri arasında 45 hastaya 47 stent yerleştirildi. Koarktasyon tanısı alıp müdahale endikasyonu olan adölesan ve yetişkin hastalarda ilk tercih olarak, 5 yaş üzerindeki çocuklarda ise subatretik veya kör koarktasyon varlığı, önceki tedaviye bağlı anevrizma gelişimi, eşlik eden patent duktus arteriyozus veya yeniden daralma durumlarında stent implantasyonu tercih edildi. Stent implantas- ABSTRACTObjective: To present our institutional experience of endovascular Cheatham-Platinum stent implantation in children and adults with native and recurrent aortic coarctation. Methods: Between August 2007 and November 2009, 45 patients had aortic coarctation treated with 47 stents implantation. We preferred primarily stent implantation in adult patient with coarctation, in children more than five years-old it is preferred in cases of aneurysm, subatretic or blind coarctation and coarctation with patent ductus arteriosus or in restenosis. Files of stent-implanted patients were retrospectively analyzed in terms of patients' demographic features, echocardiographic and angiographic findings both before and after procedure. Patients grouped as Group 1: native coarctation and Group 2: recoarctation developed after either surgery or balloon angioplasty. Findings of the cases' were compared using paired and unpaired Student's t, Mann-Whitney U and Chi-square tests. Results: Sixteen covered and 31 bare totally 47 balloon expandable stents were implanted in 45 patients. The mean follow up duration was 12.1±7.1, median 11 months (2-29 months). There was no procedure related death. In two patients two stents were implanted in tandem. While the coarctation of the aorta was native in 26 patients (functionally interrupted aortic arch in one), recoarctation was detected in 7 patients after surgery, in 8 patients after balloon angioplasty, in 4 patients both after surgery and balloon angioplasty. One patient had functionally interrupted aortic arch perforated with guide wire and then covered stent implanted. The mean age 12.2±5.9 years (5-33 years) and mean body mass index was 21±3.7 kg/m 2 (14.8-31 kg/m 2 ). Considering all cases, a statistically significant decrease in both the invasive and echocardiographic gradients (p<0.001 for both) and statistically significant increase in lesion diameter (p<0.001) were detected. The decrease in invasive and echocardiographic gradients and increase in lesion diameter is statistically significant in each group also (p<0.001, <0.001 and <0.001 for both groups, respectively). Before the procedure, the invasive gradient was significantly higher and the lesion diameter was significantly lower in group I than in group II (p=0.002 and p=0.005, respectively). Also the percentage of decrease in gradient and increase in diameter was statistically higher in group 1 than in group 2 (p=0.04 a...

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These data support the hypothesis that parvovirus B19 infection may be associated with the onset of juvenile rheumatoid arthritis in a proportion of patients.

(0.7-19.7). None of the patients developed major complications. After the average follow-up period of 6.5 months (3-18), all patients were symptom-free without medication. Conclusions: RFA and TCA can be performed successfully in neonates and infants with incessant medically refractory SVT. (Cardiol J 2013; 20, 3: 241-246)

Due to its safety profile, cryoablation is used increasingly in pediatric patients, especially for septal arrhythmia substrates. Recent advances in electroanatomical-mapping technologies have resulted in a decrease or complete elimination of fluoroscopy exposure during catheter ablation procedures. The aim of this study was to assess the efficacy and safety of cryoablation of anteroseptal accessory pathways (APs) using electroanatomical-mapping system guidance with limited fluoroscopy exposure. A total of 24 patients underwent cryoablation of anteroseptal APs between July 2010 and April 2012. Cryomapping was performed with a 6 mm-tip catheter at -30 °C before the lesions were delivered. An 8 mm-tip catheter was used in one patient. The EnSite system (St. Jude Medical, St Paul, MN) was used in all procedures. The mean age was 11.9 ± 4.3 years. Acute success rate was 95.8 % (23 of 24). The mean procedure and cryoablation durations were 168 ± 58 min and 1,463 ± 525 s, respectively. Limited fluoroscopy was used only in 7 patients, and the mean fluoroscopy time was 1.7 ± 1.8 min (range 0.1-4 min) in these patients. Recurrence was noted in 2 patients (8.7 %) who underwent a second successful cryoablation procedure. The patient who underwent a failed attempt during the first procedure was successfully treated with a repeat procedure. The resultant long-term success rate was 100 % at a mean follow-up period of 14.2 ± 7.7 months. There were no complications except for transient atrioventricular block in one patient. Cryoablation of anteroseptal APs can be performed effectively and safely in children using a limited fluoroscopic approach with the help of electroanatomical-mapping systems.

Minimally invasive epicardial ICD coil implantation in children with low DFT values is possible. The anterior implantation approach appears superior to the posterior approach.