Background/Objectives: Myocarditis is a major cause of morbidity and mortality in children and can lead to long-term heart failure, dilated cardiomyopathy, the need for heart transplantation, or death. New systemic inflammatory indices that combine lymphocyte, neutrophil, and platelet counts have been recently used as strong prognostic markers of some inflammatory diseases and adverse outcomes of neoplasms. This study aimed to investigate the use of new systemic indices as early predictive markers for adverse outcomes in patients with pediatric myocarditis. Methods: This study retrospectively examined patients between the ages of >1 month and <18 years who were monitored in our clinic with a diagnosis of myocarditis between 1 January 2022 and 31 December 2024. The cases were divided into two groups: fulminant myocarditis (requiring the use of inotropes or extracorporeal membrane oxygenation due to hemodynamic disturbance) and non-fulminant myocarditis. The systemic inflammatory index values of these groups (calculated in the first 6 h) were compared, and the results were statistically analyzed. Results: The study included 122 pediatric myocarditis cases treated during the study period (80 boys; median age: 11 (IQR: 8–14) years). Twenty-six of these patients (21.3%) developed fulminant myocarditis. The median systemic immune-inflammation index (SII) value in the group with fulminant myocarditis was 1300 (IQR: 1000–1600), while this value was 500 (IQR: 350–650) for the non-fulminant group (p < 0.05). The median systemic inflammatory response index (SIRI) values were 2.9 (IQR: 2.5–3.2) in the fulminant myocarditis group and 1.5 (IQR: 1.2–1.8) in the non-fulminant group (p < 0.05). The cut-off values for fulminant myocarditis were found to be 1050 for the SII, with an AUC value of 0.76 (95% confidence interval: 0.80–0.96; p < 0.001), and 1.9 for the SIRI, with an AUC value of 0.64. Conclusions: The SII and SIRI may independently predict adverse myocarditis prognoses in children. These new biomarkers are easy to calculate using routine blood parameters.

Background: Tetralogy of Fallot (TOF) is a complex congenital heart condition characterized by four major anatomical abnormalities. Accurate preoperative imaging is critical for optimal surgical outcomes, with transthoracic echocardiography (TTE), computed tomography angiography (CTA), and conventional catheter angiography (CCA) being the primary diagnostic tools. This study aimed to compare the diagnostic utility of TTE, CTA, and CCA in preoperative evaluations of TOF patients, focusing on anatomical parameters, imaging accuracy, and patient outcomes. Methods: A retrospective, single-center analysis included TOF patients under one year of age who underwent complete repair between January 2021 and December 2024. Preoperative imaging with TTE, CTA, and CCA was analyzed for parameters including pulmonary artery diameters, Nakata index, McGoon ratio, and Z-scores. Radiation exposure, procedure duration, contrast volume, and complications were documented. Statistical analyses were performed to assess the comparative accuracy and safety of these modalities. Results: All patients underwent TTE (n = 127), while CTA was performed in 86 patients and CCA in 41 patients. Among 127 patients, 62% were male, with a mean age of 5.81 ± 2.15 months. On TTE, CTA and CCA provided statistically similar measurements of the pulmonary annulus, main pulmonary artery, and branch diameters, with no significant differences in the Nakata index and McGoon ratio. CTA had a shorter procedure duration (3.1 ± 0.58 min) and lower radiation dose (1.19 ± 0.22 mSv) compared to CCA (20.73 ± 11.12 min; 5.48 ± 1.62 mSv). CTA successfully identified major aortopulmonary collateral arteries (MAPCAs) in 10% of patients and detected additional pulmonary pathologies, such as subsegmental atelectasis in 12%. Access site complications were observed in 10% of CCA cases but were absent in CTA evaluations. Conclusions: CTA emerges as a highly effective and non-invasive alternative to CCA for preoperative assessment of TOF, offering comparable anatomical accuracy with significantly reduced procedural risks, radiation exposure, and contrast volume. Combining TTE and CTA provides comprehensive diagnostic coverage, minimizing the need for invasive procedures and enhancing surgical planning. These findings underscore the evolving role of CTA in the management of congenital heart disease, contributing to improved patient safety and outcomes.

Background: Cardiac catheterization may be required in the management of congenital heart diseases. The use of risk scoring or grading systems in these procedures can assist in planning the intervention and predicting potential complications. This study aimed to evaluate the use of risk scores in grading cardiac catheterization procedures in pediatric patients and to investigate their predictive value for serious adverse events (SAEs). Material and Methods: A total of 700 pediatric patients (350 male; median age 1 year [IQR 6 months–2 years]) who underwent cardiac catheterization in our catheterization laboratory between 1 January 2023 and 1 January 2025 were retrospectively analyzed. Demographic and clinical data of the patients, including procedure duration, anesthesia management, Catheterization Risk in Pediatrics Score (CRISP), and serious adverse events related to the procedure, were recorded. The results were analyzed statistically. Results: In total, 50% of the patients were male (n = 350), and 58% (n = 406) had single-ventricle physiology. Interventional procedures were performed in 72% of the cases. The median CRISP score was 8 (IQR 6–10). SAEs occurred in 7.7% of the patients (n = 54), most of which were arrhythmia-related. The incidence of SAEs was analyzed according to CRISP score categories. The rates of SAEs in patients with CRISP Categories 1 through 5 were 2.9%, 4.3%, 11%, 17.3%, and 41%, respectively. As the CRISP score and category increased, the incidence of SAEs also increased [area under the curve of 0.84 (95% confidence interval, 0.76–0.92; p < 0.05)]. Conclusions: CRISP may serve as an effective benchmarking and risk classification tool in pediatric cardiac catheterization procedures and can predict SAE occurrence. Therefore, it may have a positive impact on patient care by assisting in the planning of pre- and post-catheterization care.

Background: Brain abscess is a rare but life-threatening complication in patients with cyanotic congenital heart disease (CHD), especially in those without prior corrective surgery.Methods: We report the case of a 36-year-old woman with unoperated cyanotic CHD who presented with neurological deficits. Diagnostic evaluation included cranial magnetic resonance imaging (MRI).Results: Imaging revealed a brain abscess. Contributing factors included chronic hypoxia, polycythaemia, and right-to-left shunting facilitating systemic circulation of infectious agents. The patient was treated with intravenous antibiotics and surgical drainage.Conclusions: This case highlights the elevated risk of brain abscess in uncorrected cyanotic CHD and underlines the importance of early recognition and timely management to avoid fatal outcomes.

Pseudoaneurysms develop as a result of disruption of the arterial wall due to trauma or iatrogenic reasons such as catheterization, and it is important due to the high risk of bleeding and rupture. Until recently, the main treatment of pseudoaneurysms was surgical repair. However, in recent years, minimally invasive methods such as ultrasound-guided compression and percutaneous thrombin injection have been used more frequently. In this article, the clinical course and findings of three different cases who developed pseudoaneurysm as a result of stenting the ductus arteriosus via the axillary artery were discussed.