Left ventricular and mitral valve function long after repair of left anomalous coronary artery from the pulmonary artery: recovery years after severe ischemia.

Background: The study evaluates the long-term results of surgery for anomalous left coronary artery from the pulmonary artery (ALCAPA) with special attention on the left ventricular (LV) function and mitral regurgitation.

Methods: Twenty-one children underwent surgery for ALCAPA over 23 years (1987-2010). All patients underwent establishment of a two-coronary system, by direct reimplantation (n = 13) or by intrapulmonary tunnel technique (n = 8), with concomitant mitral valve repair in one.

Thromboembolic complications in children with nephrotic syndrome in Bulgaria (1974-1996).

Over a period of 22 years, 447 children with nephrotic syndrome (NS) have been retrospectively studied for clinically apparent thromboembolic complications (TEC). The incidence of TEC is 2% (9/447); 16 clinically apparent TEC were registered in 9 children. The incidence of TEC was 1.

Budd-Chiari syndrome and inferior vena cava thrombosis in a nephrotic child.

We observed Budd-Chiari syndrome in a boy aged 2 years 6 months with nephrotic syndrome due to hepatic vein and inferior vena cava thrombosis, confirmed by Doppler imaging. Normal values of the routine hemostatic parameters proved that they are of little predictive value for the thrombotic state. Immediate heparin infusion was initiated.

[Subphrenic abscess and suppurative pericarditis as complications in children with perforated appendicitis].

The combination of subphrenic abscess with purulent pericarditis is a rare postoperative complication of perforated appendicitis in children, with severe clinical course, difficult to diagnose and high case fatality rate. A 7-year-old child with this complication, successfully diagnosed and treated is reported. The importance of complex therapy--surgical and intensive and collaboration between pediatric surgeons, anesthesiologists, cardiac surgeons and cardiologists for the favourable outcome is emphasized.

Heart murmurs in low birth weight infants.

This study is based on 315 infants in different prematurity stages who were patients in the Special Care Unit for Preterm Infants at the First City Hospital, Sofia. Heart murmurs were observed in 98 infants. The clinical observations and investigations can be grouped as follows: 1) murmurs due to late closing or reopening of ductus arteriosus; 2) murmurs in patients with anemia; 3) murmurs in patient with anemia; and 4) accidental murmurs.