Objective: We describe the presentation, treatment and outcome of children with multisystem inflammatory syndrome with COVID-19 (MIS-C) in Mumbai metropolitan area in India. Methods: This is an observational study conducted at four tertiary hospitals in Mumbai. Parameters including demographics, symptomatology, laboratory markers, medications and outcome were obtained from patient hospital records and analyzed in patients treated for MIS-C (as per WHO criteria) from 1 May, 2020 to 15 July, 2020. Results: 23 patients (11 males) with median (range) age of 7.2 (0.8-14) years were included. COVID-19 RT-PCR or antibody was positive in 39.1% and 30.4%, respectively; 34.8% had a positive contact. 65% patients presented in shock; these children Conclusion: Initial data on MIS-C from India is presented. Further studies and longer surveillance of patients with MIS-C are required to improve our diagnostic, treatment and surveillance criteria.

Vascular occlusion is the major complication of percutaneous cardiac catheterization in children. This is a prospective study to evaluate post catheterization vascular complications in 120 consecutive children with the help of vascular ultrasound and Doppler imaging. Ultrasound imaging of both iliac and femoral veins and arteries was done one hour prior and 24 hours after cardiac catheterization. Patients with prior thrombus or occlusion of femoral/iliac vein or artery due to previous cardiac catheterization were excluded from the study. Age of the patients ranged from 22 days to 12 years with a mean of 56 months and weight ranged from 3 to 57 kg with a mean of 14.3 kg. Procedure time was less than 60 minutes in 74 patients (61.66%) and more than 60 minutes in 46 patients (38.33%). 4F sized arterial sheath was used in 108 patients. 5F or bigger sized arterial sheath was used in remaining 12 patients. Incidence of arterial occlusion was higher in patients weighing less than 10 kg (16%) as compared with patients weighing more than 10 kg (5.5%) {P = 0.031}. Arterial thrombosis was more in infants (16%) as compared with older children (7%) {P = 0.203} Prolonged procedure time or use of larger sized sheath did not have higher incidence of arterial occlusion. Venous thrombosis was found in 2 patients (1.66%) who had 5F venous sheath. One patient had arterio venous fistula. Our study shows vascular ultrasound imaging can provide anatomical details of femoral and iliac vessels and is a easier and accurate method of assessing post-catheterization vascular complications in children.

In a retrospective analysis of echocardiograms, the incidence of retroaortic innominate vein was found to be 0.55% amongst children with congenital heart disease. It was most commonly associated with tetralogy of Fallot and right aortic arch.

Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD.

Introduction:Incidence of junctional ectopic tachycardia (JET) after repair of tetralogy of Fallot (TOF) is 5.6–14%. Dexmeditomidine is a α-2 adrenoceptor agonist modulates the release of catecholamine, resulting in bradycardia and hypotension. These effects are being explored as a therapeutic option for the prevention of perioperative tachyarrhythmia. We undertook this study to examine possible preventive effects of dexmedetomidine on postoperative JET and its impact on the duration of ventilation time and length of Intensive Care Unit stay.Methods:After obtaining approval from the hospitals ethics committee and written informed consent from parents, this quasi-randomized trial was initiated. Of 94 patients, 47 patients received dexmedetomidine (dexmedetomidine group) and 47 patients did not receive the drug (control group).Results:Dexmedetomidine group had more number of complex variants like TOF with an absent pulmonary valve or pulmonary atresia (P = 0.041). Hematocrit on cardiopulmonary bypass (CPB), heart rate while coming off from CPB and inotrope score was significantly low in the dexmedetomidine group compared to control group. The incidence of JET was significantly low in dexmedetomidine group (P = 0.040) compared to control group.Conclusions:Dexmedetomidine may have a potential benefit of preventing perioperative JET.