Efficiency, sensitivity and specificity of automated auscultation diagnosis device for detection and discrimination of cardiac murmurs in children

Intelligent electronic stethoscopes and computer-aided auscultation systems have highlighted a new era in cardiac auscultation in children. Several collaborative multidisciplinary researches in this field are performed by physicians and computer specialists. Recently, a novel medical software device, Automated Auscultation Diagnosis Device [AADD], has been reported with intelligent diagnosing ability to differentiate cardiac murmur from breath sounds in children with normal and abnormal hearts due to congenital heart disease. The aim of this study is to determine efficiency, sensitivity and specificity of the diagnoses made by this AADD in children with and without cardiac disease. We performed a cross-sectional study to determine efficiency, sensitivity and specificity of diagnoses made by AADD. Our patient population was two groups of children with and without cardiac disease [563 patients and 50 normal]. SPSS version 16 was used to calculate sensitivity, specificity and efficiency and descriptive analysis. Using cardiac sound recording in four conventional cardiac areas of auscultation [including aortic, pulmonary, tricuspid and mitral], AADD proved to have a >/= 90% sensitivity, specificity and efficiency for making the correct diagnosis in children with heart disease and 100% diagnostic accuracy in children with normal hearts either with or without innocent murmurs. Considering the high sensitivity, specificity and efficiency of AADD for making the correct diagnosis, application of this software is recommended for family physicians to enhance proper and timely patients' referral to pediatric cardiologists in order to provide better diagnostic facilities for pediatric patients who live in deprived and underserved rural areas with lack access to pediatric cardiologists

Transcatheter atrial septal defect closure using occlutech figulla device: a two-center experience

Despite several reports regarding the use of the Occlutech Figulla[R] Flex septal occluder [OFFSO] in adults, there are few reports on its use in children. We sought to study the result of the transcatheter closure of atrial septal defect [ASD] using the OFFSO in children

novel method for quantification of left ventricular noncompaction using two-dimensional echocardiography in children

Although there are several echocardiographic criteria, there is not yet a general consensus about the diagnosis of left ventricular noncompaction. The current criteria are mostly based on the areas with maximal noncompaction in the heart The echocardiographer may miss this maximal point leading to a misdiagnosis. Accordingly, we suggested a new method to measure the percentage of myocardial noncompaction using two-dimensional echocardiography. In this study, the new method was examined on 4 noncompaction and 26 dilated cardiomyopathies, and 25 normal subjects. The percentage of noncompaction was measured at 3 levels [apical, papillary muscle and mitral valve] and averaged. The mean percentages of myocardial noncompaction were 3.59 +/- 2.27, 8.86 +/- 5.52 and 34.7 +/- 26.1 in the control, dilated cardiomyopathy and noncompaction groups, respectively. A value of 17% or greater could distinguish left ventricular noncompaction from dilated cardiomyopathy with 92% specificity and 100% sensitivity and from normal subjects with 100% specificity and sensitivity. This percentage had a statistically significant association with noncompacted to compacted myocardial thickness ratio [P<0.001]. This method showed good correlations with the existing echocardiographic and magnetic resonance criteria. However, it is not dependent on finding the area of maximal involvement Being comparable to magnetic resonance imaging in accuracy, it is easier to perform and more available

Complications of aortic stenting in patients below 20 years old: immediate and intermediate follow-up

Optimal timing and mode of treatment for patients with coarctation of the aorta [COA] remain controversial, particularly in children. Surgery, balloon dilatation, and stent implantation have all proven effective in the treatment of moderate or severe obstruction. The aim of this study was to investigate the complications of COA stenting angioplasty in pediatric patients. This retrospective, descriptive study was conducted on patients less than 20 years of age who underwent aortic stenting angioplasty because of congenital COA in the pediatric catheterization laboratory of Rajaie cardiovascular, medical and research Center, Tehran between 2005 and 2010. A total of 26 patients [18 [65.4%] males and 9 [34.6%] females] with congenital COA who had undergone aortic stenting angioplasty were recruited. Nineteen [73.1%] of these patients had native COA and 7 [26.9%] had recurrent COA. Most of the early complications were minor and temporary; only one patient developed early major complications. During the follow-up, whereas none of the native group patients developed late complications, in the re-COA group 28.57% of the patients had re-stenosis and 14.28% had chronic systemic hypertension, requiring drug therapy. Our investigation into post-stenting complications in patients with native COA and re-COA showed that endovascular stenting could be an effective and safe method, even in young patients with native COA