Background. The use of new imaging techniques has contributed significantly to earlier diagnosis and treatment of cardiac tumors.Objectives. The aim of the study was to analyze data from children with cardiac tumors in terms of clinical presentation, the role of noninvasive diagnostic procedures and the long-term outcome.Material and methods. The data analyzed retrospectively concerned 30 children in whom cardiac tumors were diagnosed from January 1995 to July 2015. The cardiac evaluation included a review of the subjects' medical records and medical history, a physical examination, standard 12-lead electrocardiography, echocardiography and 24-h Holter ECG monitoring at the time of diagnosis and at 6-12 month intervals during the follow-up at the authors' outpatient clinic.Results. Most of the children did not need cardiac surgery; surgical tumor excision was necessary in 3 cases only. There was 1 death in the follow-up period. Rhabdomyoma was diagnosed in 22 cases, and in 16 of them tuberous sclerosis was confirmed during the follow-up period. In the remaining 8 cases, fibroma was the most likely diagnosis.Conclusions. The symptomatology of cardiac tumors in children can vary greatly, from the absence of any symptoms up to heart failure and respiratory distress indicating the need for surgical intervention. The diagnosis of cardiac tumors relies almost exclusively on noninvasive imaging techniques. The observations in this study confirm the fact that the most common cardiac tumor in children is rhabdomyoma, which may disappear spontaneously. Most patients with cardiac tumors do not require treatment.

The aim of this study was to determine the influence of lateral thoracotomy on the development of scoliosis in subjects undergoing repair of coarctation of the aorta (CoA) and patent ductus arteriosus (PDA). A group of 133 patients with CoA and PDA was evaluated. Forty-five patients with CoA and 38 with PDA underwent surgery using standard posterolateral thoracotomy (operative group), whereas 12 patients with CoA and 31 with PDA were treated using balloon dilatation and stent or coil implantation (nonoperative group). A spinal examination, together with the evaluation of chest and spinal roentgenograms, was conducted. Among the operated patients, 62% of those with CoA and 55% of those with PDA had clinical scoliosis. In the nonoperated patients, scoliosis was present in only 25% of those with CoA and 16% of those with PDA. Scoliosis ranged between 10 degrees and 42 degrees . In 89% of the operated patients with CoA and 76% of those with PDA the curve was thoracic; in 46% of the CoA group and 57% of the PDA group the curve was left-sided. All curves were right-sided in nonoperated subjects. Scoliosis in the operated group was higher in male than in female subjects (63% vs. 60% in CoA and 86% vs. 37% in PDA). The prevalence of scoliosis after standard posterolateral thoracotomy was significantly higher than after nonsurgical treatment methods in the CoA and PDA groups as well as in the general population. The rate of single thoracic and the rate of left-sided thoracic curves in patients after thoracotomy is higher than in nonoperated patients or in those with idiopathic scoliosis. The rate of scoliosis after thoracotomy is higher in male than female patients, especially after thoracotomy for PDA.

Bedside chest ultrasound examination is especially useful in children with high risk of PTE and in critical general condition. In newborns in severe general condition ultrasound examination of chest should be first imaging test for PTE. It is significant to set on a multicenter study to evaluate the diagnostic value of chest ultrasound in diagnosis of PTE in children.

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A 46-year-old male with a history of arterial hypertension and obesity was referred to our hospital due to symptoms of congestive heart failure (NYHA class III). Physical examination revealed a diastolic heart murmur. Transthoracic echocardiogram showed a fistula from the right aortic sinus to the right ventricle. Invasive angiography visualised a ruptured sinus of Valsalva aneurysm (SVA) (Fig. 1). The defect measured 6 mm in diameter at the aorta. The patient was qualified for transcatheter closure of the SVA. Occlusion of the SVA was performed using a 12 × 16 mm Nit-Occlud Lê VSD Occluder (Pfm Medical) under local anaesthesia. The procedure was conducted under transoesophageal echocardiography guidance. The device was delivered from the venous side after the formation of an arteriovenous loop (Fig. 2). The procedure and further hospitalisation was uneventful. The patient experienced gradual symptom reduction, and an echocardiography performed after three months did not reveal a residual shunt. SVAs constitute rare cardiac anomalies, which can be of congenital or acquired origin. Commonly they involve the right coronary sinus (70%) and the non-coronary sinus (29%). Congenital SVAs are caused by weakness at the junction between the aortic media and the aortic ring. Acquired aneurysms are caused by conditions affecting the aortic wall, such as endocarditis, trauma, or connective tissue disease. Unruptured SVAs usually remain asymptomatic. In most cases rupture occurs at the age of 20-40 years. Usually SVAs rupture into the right ventricle and the right atrium, or less frequently into the pulmonary artery, left ventricle, left atrium, or pericardial cavity. This most commonly manifests as exercise intolerance, dyspnoea, or chest pain. Surgery is considered the gold standard treatment for SVA. However, percutaneous closure appears to be a feasible alternative to surgical repair. The first transcatheter closure of SVA was reported in 1994. Since then, a significant number of such procedures have been performed using various devices, most commonly patent ductus arteriosus occluders or atrial septal defects occluders. We chose the Nit-Occlud Lê VSD Occluder, which was originally designed for ventricular septal defect (VSD) closure (Fig. 3). The implant is constructed of a single coil. The coil is made of nitinol, an alloy with shape memory characteristics, and in its relaxed state it adopts the form of a pair of cones nested one inside the other. This implant is distinguished by a gentle and refined structure, which minimises its interference with neighbouring tissues. This is substantiated by the lower rate of atrio-ventricular conduction disturbances after VSD closure with the Nit-Occlud Lê VSD Occluder in comparison with other devices (0% vs. 5-7%, respectively). We believe that the above-mentioned occluder should be considered for transcatheter SVA closure. Of note, to the best of our knowledge this is the first closure of an SVA with a Nit-Occlud Lê VSD device.