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Background: To normally grow and develop, children with congenital heart diseases (CHD) in the hypermetabolic state need 50% more energy than healthy ones. Objectives: This study aimed to investigate the prevalence of malnutrition and its association with other factors among the nonsyndromic acyanotic patients with CHD undergoing palliative or corrective surgery. Methods: A retrospective study of medical records of 812 children with acyanotic congenital heart disease undergoing palliative or corrective surgery was performed from March 2011 to March 2017. Collected data consisted of the age at the time of the surgery, gender, weight at the time of the surgery, height at the time of the surgery, birth weight, length of ICU stay, and 1-year mortality. The WAZ, WLZ, LAZ, and BMI Z-scores were calculated based on World Health Organization (WHO) standards. We classified the Z-scores into 4 groups, including normal (Z-scores >-1), mild (-2 to >-1), moderate (-3 to >-2), and severe (<-3) malnutrition groups. Results: Total amount of 812 patients, 375 (46.2%) were female and 437 (53.8%) male, participated in this study. The average age, weight, and height at the time of the surgery were 23.52 + 29.38 months, 9.086 + 6.71 kilograms, and 76.93 + 23.37 centimeters, respectively. Moreover, 68.7% and 66.4% of the patients suffered from mild to severe forms of malnutrition based on WAZ and WLZ, respectively (P value < 0.0001, 0.025). There was no significant difference between males and females in WAZ, WLZ, LAZ and, BMIZ (P value: 0.154, 0.265, 0.965, and 0.667, respectively). Generally, in acyanotic defects, we found that more severe malnutrition causes an increment in length of ICU stay (P value = 0.001) and lesser birth weight has a significant relationship with the severity of growth failure in infancy or childhood (P value < 0.0001). Conclusions: In our study, the high prevalence of the malnutrition and related complications during and after surgical repair shows the importance of nutritional support and interventions in patients with CHD.

Objectives: This study compared the success rate of atrial septal defect device closure in children with and without balloon sizing during the procedure. Methods: This four-year, combined retrospective and prospective study was performed at a single center. All participants underwent transcatheter closure under transthoracic echocardiography and the success rate was analyzed considering the effect of balloon sizing. Results: Eighty-eight patients with a mean age of 6.48 ± 3.32 years were enrolled. Balloon sizing was performedor in 39 (44%) patients. It didn’t change the success rate compared to 49 (56%) patients without balloon sizing. Likewise, age and sex had no effect on thesuccess rate. However; the failure rate was higher in patients with larger defects. Conclusions: The study demonstrated that balloon sizing did not influence the success rate of atrial septal defect device closure, and a precise measurement by echocardiography can be as successful as balloon sizing.

Background: Kawasaki disease (KD) is often complicated by coronary artery lesion (CAL), including dilatation or aneurysms. Intravenous immunoglobulin (IVIG) is used with aspirin to prevent CAL in KD.Objective: Given that the primary treatment for other vasculitis is the use of corticosteroids, this study has been performed to evaluate the effect of intravenous methylprednisolone pulse (IVMP) therapy in preventing CAL in KD.Method: A randomized, single-blind clinical trial was conducted on 40 KD patients aged six months to five years. Patients were randomized into two groups according to the main treatment plan in addition to aspirin: case group (IVMP for three consecutive days and then oral prednisolone for three days) and control group (intravenous immunoglobulin 2 g/kg). Echocardiography was performed for all children at least three times, during the acute phase, two weeks, and two months later.Results: Data analysis at the end of the study was done on 40 patients (20 patients in each group). There were no significant differences in age and sex distribution, mean fever, and acute phase duration, as well as baseline echocardiography in the two groups. The frequency of CAL was 20% in the case group and 45% in the control group, after two weeks (p<0.05), but there was no significant difference between two groups in types of coronary artery lesion after two weeks and the frequency and severity of CAL after two months.Conclusion: IVMP as initial line therapy effectively control systemic and vascular inflammation and decrease coronary artery damage in KD.

Pulmonary artery‐focused agitated saline contrast echocardiography unveils tricky cases of ALCAPA by the entry of microbubbles into the left coronary artery (LCA) during systole and retrograde flow from LCA into the main pulmonary artery during diastole. Associated pulmonary hypertension, if present, augments the former flow and supplemental oxygen increases the latter.

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Introduction: The people worldwide have been affected by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection since its appearance in December, 2019. Kawasaki disease-like hyperinflammatory shock associated with SARS-CoV-2 infection in previously healthy children has been reported in the literature, which is now referred to as a multisystem inflammatory syndrome in children (MIS-C). Some aspects of MIS-C are similar to those of Kawasaki disease, toxic shock syndrome, secondary hemophagocytic syndrome, and macrophage activation syndrome. Case Presentation: This study reported an 11-year-old boy with MIS-C presented with periorbital and peripheral edema, abdominal pain, elevated liver enzymes, severe right pleural effusion, moderate ascites, and severe failure of right and left ventricles. Conclusions: Due to the increasing number of reported cases of critically ill patients afflicted with MIS-C and its life-threatening complications, it was recommended that further studies should be carried out in order to provide screening tests for myocardial dysfunction. Adopting a multidisciplinary approach was found inevitable.

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