This study aimed to investigate the frequency of persistent left superior vena cava (PLSVC) and its impact on outcomes in children undergoing congenital heart surgery. The study was conducted retrospectively in cases diagnosed with congenital heart disease who were operated on under the age of 16 years between October 1st, 2021, and October 1st, 2024, at two major tertiary centers. The frequency of PLSVC and its possible impact on surgical outcomes were evaluated in these cases. The results were analyzed statistically. There were 4,000 cases during the study period, with 52% being male. The median weight was 5.2 kg (interquartile range 4.5 - 6 kg). PLSVC was detected in a total of 260 cases (6.5%). Of these cases, 92.3% (240/260) drained into the coronary sinus, while 7.7% (20/260) drained directly into the left atrium. In 251 (96.5%) of the patients with PLSVC, there was a right SVC, while nine (3.5%) did not have a right SVC. Of the 251 patients with double SVC, 105 (42%) had a normal innominate vein. PLSVC was primarily associated with heterotaxy syndrome, atrioventricular septal defect, and vascular ring defects. There is an increased frequency of PLSVC among certain congenital heart disease groups, and raising awareness during echocardiographic examination can facilitate the diagnosis of PLSVC. Preoperative diagnosis of PLSVC can help in managing complications more effectively.

Meningococcal infections range from asymptomatic carriage to fulminant sepsis with tissue necrosis. As the disease progresses rapidly, vaccination remains the most effective preventive strategy. Parental acceptance of vaccination is closely linked to awareness, knowledge, attitudes, and behaviors. This study explores these factors and offers targeted recommendations to enhance vaccine uptake. This cross-sectional, descriptive, and comparative study was conducted via a questionnaire administered to parents of pediatric patients seen or hospitalized at the University of Health Sciences Haydarpaşa Numune Training and Research Hospital. The survey assessed socio-demographic characteristics, awareness and knowledge of meningococcal infections and vaccines, and vaccination-related attitudes and behaviors. A total of 306 parents participated voluntarily. Of the 306 participating parents, 257 (84%) were mothers and 49 (16%) were fathers.Only 71 parents (23.3%) were aware of meningococcal infections and vaccines, and just 29 (9.5%) had their child vaccinated. Among those aware of the vaccine, the main reasons for non-vaccination were lack of recommendation from their family physician (57.1%), insufficient knowledge about side effects (54.8%), and exclusion from the national immunization program (52.4%). The low rate of vaccine acceptance among parents is primarily attributed to their limited awareness of meningococcal diseases and vaccines. Therefore, public health authorities - particularly the Ministry of Health - should implement organized vaccination awareness campaigns through media and social networks to enhance public knowledge and increase awareness levels.

We present an extremely rare case of anomalous single coronary artery from the pulmonary artery in a 2-month-old infant with severe heart failure. Due to the unique coronary anatomy, a modified venous arterial extracorporeal membrane oxygenation technique was employed to maintain coronary perfusion and prevent coronary steal. Following surgical reimplantation, the patient showed significant recovery and remains stable at 2-year follow-up.

Fontan-associated lymphatic failure may result in severe complications such as plastic bronchitis. We report a 6-year-old Fontan patient with refractory plastic bronchitis despite catheter-based interventions. Surgical thoracic duct decompression via innominate vein rerouting to the right atrium resulted in marked symptomatic improvement and resolution of bronchial cast expectoration, highlighting its role in refractory Fontan-related lymphatic disease.

Background: Tetralogy of Fallot with absent pulmonary valve syndrome (TOF-APVS) is a rare variant of tetralogy of Fallot marked by aneurysmal pulmonary artery dilatation and variable tracheobronchial compression. The identification of clinical indicators that predict perioperative risk in this patient population remains challenging. We aimed to review the surgical outcomes and reintervention requirements of patients with TOF-APVS over a 15-year single-center experience, with particular focus on two indicators of disease severity: preoperative mechanical ventilation (MV) and computed tomography (CT)-detected airway compression. Methods: We retrospectively reviewed 27 patients with TOF-APVS who underwent surgical repair at a single center between January 2010 and January 2025. Airway compression was assessed by CT in 20 patients. The primary outcome was the need for any reintervention during follow-up. Secondary outcomes comprised early and overall mortality and postoperative duration of intubation, ICU stay, and hospital stay. Subgroup comparisons were performed using the Fisher exact test and the Mann–Whitney U test. Results: The median age at surgery was 8 months (IQR, 4.5–16). Preoperative MV was required in 5 patients (18.5%), and CT revealed airway compression in 13 of 20 patients (65.0%). Early postoperative mortality was 7.4%, and overall mortality during follow-up was 18.5%. At least one reintervention was required in 9 patients (33.3%). Preoperative MV was significantly associated with early mortality (40.0% vs. 0%; p = 0.028) and with prolonged ICU stay (median 15 vs. 4 days; p = 0.008). CT-detected airway compression was not significantly associated with either mortality or reintervention. Conclusions: In this 15-year single-center experience with 27 patients, preoperative mechanical ventilation was associated with markedly higher early postoperative mortality and prolonged ICU stay, and may thus serve as a practical clinical indicator of disease severity in TOF-APVS. CT-detected airway compression was a frequent and often severe finding, but its association with early mortality and reintervention could not be statistically confirmed, likely reflecting the selective use of CT and small subgroup size. These findings support the integration of preoperative ventilation status into perioperative risk assessment and highlight the need for larger, preferably multicenter, studies with standardized airway assessment to clarify the prognostic role of anatomical airway compression.

Background/Objectives: Left atrial appendage isomerism (LAAI) is associated with substantial variation in venous connections and intracardiac anatomy. A subgroup of LAAI patients has L-loop ventricular topology together with a particular great artery relationship—a combination that corresponds historically to Van Praagh’s {A,L,I} segmental notation—but this subgroup has not been separately characterized. We aimed to describe the anatomical spectrum, rhythm and conduction abnormalities, biventricular repair eligibility, and surgical pathways in this subgroup. Methods: This single-center retrospective study included 15 patients with LAAI, L-loop ventricular topology, and a specific great artery relationship (aorta left-sided, pulmonary artery right-sided)—a combination corresponding historically to Van Praagh’s {A,L,I} notation—evaluated between January 2010 and December 2025. Diagnosis was confirmed independently by echocardiography and cardiac computed tomography in all patients. Anatomical suitability for biventricular repair was determined by multidisciplinary consensus. Results: Median age at presentation was 3.0 months, and median follow-up was 31.0 months. An interrupted inferior vena cava was present in all patients. The great artery relationship was aorta left-posterior/pulmonary artery right-anterior in 12 patients, aorta left-anterior/pulmonary artery right-posterior in 2, and side-by-side in 1. Ventriculoarterial connection was concordant in 8 patients, double-outlet right ventricle in 6, and double-outlet left ventricle in 1. A common atrioventricular valve was present in 7 patients. Right ventricular outflow tract obstruction was present in 7 patients. Arrhythmia was documented in 6 patients, and 2 required permanent pacemaker implantation. Ten patients (66.7%) were considered anatomically eligible for biventricular repair; repair had been completed in 4, 2 had received interim palliation, and 4 remained awaiting surgery. The remaining 4 patients followed a single-ventricle pathway. One death was confirmed, and 2 patients were lost to follow-up. Conclusions: Within LAAI, the coexistence of L-loop ventricular topology and a specific great artery relationship was associated with ventriculoarterial concordance in most patients, which may support biventricular repair. Anatomical eligibility for repair, however, did not always translate into completed repair. Larger, multicenter studies are needed to confirm these findings.