Aims Following the peak of the UK COVID-19 epidemic, a new multisystem inflammatory condition with significant cardiovascular effects emerged in young people. We utilized multimodality imaging to provide a detailed sequential description of the cardiac involvement. Methods and Results Twenty consecutive patients (mean age 10.6 ± 3.8 years) presenting to our institution underwent serial echocardiographic evaluation on admission (median day 5 of illness), the day coinciding with worst cardiac function (median day 7), and the day of discharge (median day 15). We performed cardiac computed tomography (CT) to assess coronary anatomy (median day 15) and cardiac magnetic resonance imaging (CMR) to assess dysfunction (median day 20). On admission, almost all patients displayed abnormal strain and tissue Doppler indices. Three-dimensional (3D) echocardiographic ejection fraction (EF) was <55% in half of the patients. Valvular regurgitation (75%) and small pericardial effusions (10%) were detected. Serial echocardiography demonstrated that the mean 3D EF deteriorated (54.7 ± 8.3% vs. 46.4 ± 8.6%, P = 0.017) before improving at discharge (P = 0.008). Left main coronary artery (LMCA) dimensions were significantly larger at discharge than at admission (Z score –0.11 ± 0.87 vs. 0.78 ± 1.23, P = 0.007). CT showed uniform coronary artery dilatation commonly affecting the LMCA (9/12). CMR detected abnormal strain in all patients with global dysfunction (EF <55%) in 35%, myocardial oedema in 50%, and subendocardial infarct in 5% (1/20) patients. Conclusions Pancarditis with cardiac dysfunction is common and associated with myocardial oedema. Patients require close monitoring due to coronary artery dilatation and the risk of thrombotic myocardial infarction.

Tuberous sclerosis complex has been associated though infrequently, with abnormalities in the endocrine tissues. Alterations in thyroid function, in patients with tuberous sclerosis have been reported rarely. We report a patient with tuberous sclerosis complex who presented with hypothyroidism and precocious puberty.

Background A 9‐year‐old boy with Berlin Heart biventricular assist device for diagnosis of dilated cardiomyopathy developed progressive reduction in left ventricular assist device(VAD) emptying and evidence of low cardiac output despite alterations to the device settings. Computed tomography revealed that the Dacron graft attaching the systemic cannula to the ascending aorta was stenosed. Method & Result A minimally invasive approach with novel circuit modification was used to achieve antegrade stenting of the stenosed graft. Conclusion This proposed technique provides a large port for minimally invasive access via an adapted VAD circuit allowing stent insertion to the aortic graft with an excellent outcome.

correlation coefficient was 0.75 and R 2 was 0.55(p<0.05). The mean of differences between both methods was 0.75±1.6g/dl. Bland-Altman plot shows that 65% had a difference < 1g/dl in comparison with laboratory hemoglobin. Conclusions SpHb offers moderately acceptable accuracy in pediatric cardiac postoperative patients, maybe influenced by the low weight and PI of our patients. It has the advantages of providing continuous measurements, noninvasively, which may facilitate hemoglobin monitoring in the intensive care unit.

PurposeOccasionally, single ventricle (SV) patients survive into adulthood without Fontan palliation; with the theoretical advantage of potentially lower inferior caval vein pressures. We studied liver and renal function in an adult cohort of SV patients who had not undergone Fontan completion (F-) and a group who had Fontan completion (F+) in adult life.MethodsRetrospective case note analysis between 1990–2017.ResultsThere were 12 SV patients in the F- group [9 (75%) male, age 41 years (18–52), 8 (67%) had previous surgery, aortopulmonary shunt: 3, Glenn: 5]. Outcomes: 2 deaths (at 42 and 24 years), 1 assessed for transplant, 2 for TCPC completion, 7 balanced circulations. At last review, saturations were 78% (69–85), Hb 192 g/L (159–252), creatinine 88 μmol/L (59–129), eGFR 65 (59– >90), albumin 46 g/L (35–50), bilirubin 20 μmol/L (12–46) and platelets 220 (105–333). Abdominal USS was available in 5: normal liver (2), mild-moderate fibrosis (2), cirrhosis (1).There were 8 SV patients in the F+ group, [3 (37%) male, age 46 years (23–55), age at Fontan completion 28 years (16–46)]. Follow-up was 13 years (2–24).Outcomes1 transplant, 4 failing Fontan physiology, 3 well. At last review, saturations were 95% (75–96), Hb 163 g/L (108–171), creatinine 76 μmol/L (66–148), eGFR 72 (36– >90), albumin 47 g/L (30–52), bilirubin 13 μmol/L (10–39) and platelets 216 (137–429). Abdominal USS was available in 5: normal liver (2), mild-moderate fibrosis (2), severe fibrosis (1).ConclusionIn both groups, synthetic liver function was preserved and a minority showed advanced fibrosis/cirrhosis on USS. Renal function was impaired, more prominently in the non-Fontan group, likely reflecting the effect of chronic hypoxia. Strategies to delay or avoid Fontan completion may not preserve liver function.