Late-onset aortic regurgitation after device closure of atrial septal defect.

A 10-year-old girl underwent successful device closure of a 15-mm atrial septal defect with a short and thick retroaortic rim using a 16-mm atrial septal occluder from the conventional approach under transesophageal echocardiographic guidance. There were no periprocedural complications. The aortic valve was noted to be trileaflet and competent.

Resolution of high aortic valve systolic gradient suggesting significant stenosis following closure of patent ductus arteriosus.

A 3-month-old baby girl presenting with heart failure was found to have a large persistent ductus arteriosus as well as a bicuspid aortic valve with severe aortic stenosis. She underwent surgical ductal closure following which there was complete resolution of aortic valve gradients without requiring any aortic valve intervention. This case highlights the importance of understanding hemodynamics in efficacious management of congenital heart disease.

Confidence intervals and prediction intervals for two-parameter negative binomial distributions.

Problems of finding confidence intervals (CIs) and prediction intervals (PIs) for two-parameter negative binomial distributions are considered. Simple CIs for the mean of a two-parameter negative binomial distribution based on some large sample methods are proposed and compared with the likelihood CIs. Proposed CIs are not only simple to compute, but also better than the likelihood CIs for moderate sample sizes.