Short and long term outcomes of repaired complete atrioventricular septal defects: risk factor analysis

To study rates of survival and incidence of reoperation of complete atrioventricular septal defects [CAVSD] repair in Kuwait and to determine the risk factors affecting surgical outcome. Retrospective study. Chest Diseases Hospital, Kuwait. One hundred and forty consecutive patients during the 16-year period between January 1992 and December 2007. Surgical correction for CAVSD. Short and long-term surgical outcomes of repaired CAVSD; demographic, cardiac and surgical risk factors that influence the postoperative mortality and morbidity. Median age and weight at primary repair were 4.4 months and 5 kg respectively. Down syndrome was diagnosed in 78.6% of the patients. The operative mortality was 12.9% [95% CI 7.5, 18.3]. Significant postoperative complications, relative hypoplasia of left atrioventricular valve [LAVV] and / or left ventricle were shown to be independent risk factors of operative mortality in multivariate Cox's model [p < 0.01]. Actuarial estimate of survival at six months and 15.5 years following definitive repair after discharge was 99.1% and 98%, respectively. Freedom from reoperation at 16.5 years after definitive operation was 93.5% [95% CI 89.4,97.6]; most reoperations were related to LAVV regurgitation. In the multivariate model with LAVV dysplasia [2/8 = 25%] and hypoplasia [2/7 = 28.6%], patients with such valve abnormalities had less freedom from reoperation [p < 0.001]. Left heart obstructive lesion was shown to be an independent risk factor for CAVSD surgical outcomes. Detailed evaluation for such lesions should be performed peri-operatively to reduce the impact on operative mortality and LAVV reoperation

Effcacy of carvedilol in the treatment of doxorubicin- induced cardiomyopathy in a pediatric patient

We report a pediatric case with doxorubicin-induced cardiomyopathy that failed to respond to conventional heart failure medication but improved significantly when placed on carvedilol over a period of one year

Dissecting aneurysm of the carotid artery after a minor neck trauma in a child: a case report

A case of dissecting aneurysm in a 5-year-old girl without a pre-existing predisposing factor is presented. Her clinical presentation in spite of being typical, did not progress to severe deficit. The diagnosis was achieved by 2D and 3D-TOF MRI studies after the indirect indications of the CT studies after the accident. This case study emphasizes the possible presentation s in children. This diagnosis in the pediatric age-group is difficult and is probably the reason for the very few cases reported

Delleman syndrome: a known case with an unusual finding

A new case of Delleman syndrome [oculocerebro-cutaneous syndrome] with predominant and typical cutaneous involvement is association with coarctation of the aorta is reported