Impact of Partnership Between Children's HeartLink and IQIC Database With a Pediatric Cardiology and Cardiovascular Surgery Center in Brazil.

Background: Aiming at fostering local development of cardiology and cardiovascular surgery centers in developing countries, the nonprofit organization Children's HeartLink (CHL) encourages centers to participate in the International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC). The definition of parameters and data to evaluate patient treatment provides an opportunity to improve quality of care, reducing morbidity and mortality. The objective of the study was to analyze the outcomes of the partnership between CHL and IQIC database with a single pediatric cardiology and cardiovascular surgery center for seven years providing continuous follow-up to guide actions aiming at morbidity and mortality reduction in patients with pediatric and congenital heart diseases.

Development and Evaluation of a Continuing Education Program for Nursing Technicians at a Pediatric Cardiac Intensive Care Unit in a Developing Country.

Background: The nursing profession faces continuous transformations demonstrating the importance of professional continuing education to extend knowledge following technological development without impairing quality of care. Nursing assistants and technicians account for nearly 80% of nursing professionals in Brazil and are responsible for uninterrupted patient care. Extensive knowledge improvement is needed to achieve excellence in nursing care.

Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of incomplete atrioventricular septal defect.

Introduction: Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect.

Objective: To determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect.

Methods: We assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010.

Evolution of weight and height of children with congenital heart disease undergoing surgical treatment.

Objective: To evaluate the height and weight development of children with congenital heart disease undergoing surgery with the goal of determining when they reach the threshold of normal development and whether there are differences between patients with developmental pattern below the level of normality preoperatively (z-score<-2 for the analyzed parameter) in comparison to the total group of cardiac patients.

Methods: We prospectively followed up 27 children undergoing operation into five time periods: preoperatively and at four subsequent outpatient appointments: 1st month, 3rd month, 6th month and 12th month after hospital discharge. The anthropometric parameters used were median z-score (MZ), weight (WAZ), height (HAZ), subscapular skinfold (SSFAZ), upper arm circumference (UAC) and triceps skinfold (TSFAZ).

Computed tomography in late evaluation of surgical treatment of pulmonary veins total anomalous connection.

Objective: To evaluate if the findings of multislice computed tomography (MSCT) are associated with clinical and laboratory tests routinely used in the late follow-up of children undergoing surgical treatment of total anomalous pulmonary venous connection (TAPVC).

Methods: From January 2002 to December 2007, 12 patients operated due to CATVP were evaluated with history, physical examination, chest X-ray, electrocardiogram, echocardiography and MSCT. Specific changes observed in each one of these tests were identified and compared with MSCT qualitative findings.

A trileaflet "mitral valve" with three papillary muscles: brand new echocardiographic finding.

Congenital mitral valve malformations are rare, but are well known and described entities. Mitral valve malformations involve mitral valve apparatuses (leaflets and annulus) and subvalvar apparatuses (chordae and papillary muscle). Case reports of accessory mitral leaflets were already described, but were usually an appendix of the normal valve.

Sinus node dysfunction in a patient with left atrial isomerism.

We report the case of an asymptomatic six-year-old child with left atrial isomerism and sinus venosus atrial septal defect. The physical examination revealed several periods of bradycardia. During a 24-hour electrocardiographic monitoring the patient presented a significant sinus node dysfunction with sinus pauses of up to 2.

Atrioventricular septal defect with intact septal structures presenting as left atrioventricular valvar insufficiency.

We describe the findings in a six-year-old girl who presented with signs of left atrioventricular valvar insufficiency. The echocardiogram showed a common atrioventricular junction, intact atrial and ventricular septal structures. At surgery, the left-sided atrioventricular valve was found to be tri-foliate, and corrected by valvoplasty.

Contrast echocardiography in the diagnosis of intrapulmonary vascular dilations in candidates for liver transplantation.

Objective: To determine the importance of contrast echocardiography in the diagnosis of intrapulmonary vascular dilations in patients with severe liver disease, who are candidates for liver transplantation.

Methods: The study comprised 76 patients with chronic liver disease and no evidence of intrinsic pulmonary disease, heart failure, or congenital heart disease with intracardiac communications, who underwent transthoracic echocardiography with second harmonic imaging. Thirty-two of them underwent consecutive transesophageal study.

Thrombosis of the abdominal aorta in a newborn: case report and review of literature.

The case of a newborn infant who presented thrombosis in the abdominal portion of the aorta, which resulted in the complete occlusion is reported. Diagnosis was made using Doppler echocardiography. The initial therapeutic approach was clinical support, but as the thrombi started to increase in size (secondary thrombosis) and evolved to the infrarenal terminal aorta, anticoagulation with heparin was indicated.