Imaging of pediatric congenital heart disease.

The evaluation of a patient with a heart murmur and congenital heart disease is diagnostically very challenging. Multiple advanced techniques aid in the diagnosis of simple and complex malformations. Interventional procedures and surgical corrections have allowed most patients to enjoy a good and productive lifestyle.

The use of inferior vena cava filters in pediatric patients for pulmonary embolus prophylaxis.

Purpose: To report our experience with inferior vena cava (IVC) filters in pediatric patients.

Methods: Over a 19-month period, eight low-profile percutaneously introducible IVC filters were placed in four male and four female patients aged 6-16 years (mean 11 years). Indications were contraindication to heparin in six patients, anticoagulation failure in one, and idiopathic infrarenal IVC thrombosis in one.

Arteriovenous fistula after biopsy of renal transplant kidney: diagnosis and treatment.

An 11-year-old renal transplant recipient was noted to have a bruit over her transplant graft 26 months post transplant and 17 months following percutaneous renal biopsy during an episode of rejection. Diagnosis of an arteriovenous (AV) fistula was made by ultrasound examination with Doppler flow and was confirmed with arteriography. The AV fistula was occluded by transcatheter embolotherapy with placement of a steel coil into the fistula from the renal vein approach.

Preoperative embolization of the spleen in children with hypersplenism.

Splenomegaly associated with myelodysplastic disorders in children may be massive and can result in pancytopenia, abdominal discomfort, and respiratory distress. When these symptoms cannot be relieved by nonsurgical means, splenectomy may be indicated. Under such conditions, surgical splenectomy carries increased risks, as the thrombocytopenia is difficult to correct secondary to splenic sequestration.