Background: Chronic hypoxemia in cyanotic congenital heart disease triggers well-recognized hematological adaptation; however, whether hypoxemia also drives systemic inflammatory activation remains uncertain. This study aimed to evaluate hematological parameters and inflammatory indices in cyanotic and acyanotic congenital heart disease (CHD) to better characterize the relationship between hypoxemia and systemic inflammatory status. Methods: In this single-center retrospective study, 260 children with congenital heart disease were classified as cyanotic (n = 158) or acyanotic (n = 102). Preoperative clinical data and laboratory parameters were analyzed, including oxygen saturation, hemoglobin, hematocrit, leukocyte indices, C-reactive protein (CRP), and procalcitonin (PCT). Inflammatory indices derived from complete blood counts were calculated, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune–inflammation index (SII). Results: Oxygen saturation was significantly lower in cyanotic patients than in acyanotic patients (75 ± 9% vs. 95 ± 4%, p < 0.001). Consistent with hypoxemia-driven hematological adaptation, hemoglobin and hematocrit levels were significantly higher in the cyanotic group (16.1 ± 2.9 g/dL vs. 13.1 ± 2.0 g/dL and 50.8 ± 9.7% vs. 39.7 ± 5.5%, respectively; p < 0.001). In contrast, inflammatory indices (NLR, PLR, and SII) were similar between cyanotic and acyanotic patients, and no significant associations were observed between oxygen saturation and these inflammatory indices. Conclusions: While cyanotic congenital heart disease demonstrates marked hematological adaptation secondary to chronic hypoxemia, systemic inflammatory indices appear similar in cyanotic and acyanotic patients. These findings suggest a relative dissociation between hypoxemia-driven hematological responses and the evaluated systemic inflammatory indices, indicating that inflammatory burden in congenital heart disease may not be solely explained by cyanosis and may reflect additional underlying mechanisms not captured by these markers.

Aims: Circumcision is a surgical procedure performed on nearly all males in our society. This study aimed to evaluate mothers’ knowledge and attitudes regarding circumcision and to raise awareness of common misconceptions that may lead to adverse outcomes. Methods: This retrospective, cross-sectional study was conducted between February 17 and April 17, 2014, among mothers whose children had previously undergone circumcision and who presented to the pediatric outpatient clinic for any reason. A total of 540 mothers were included. A structured questionnaire assessing socioeconomic status, educational background, and knowledge about circumcision was administered. Results: The study included 540 mothers. The mean age at circumcision was 3.7±2.6 years. Circumcision was performed during the neonatal period in 13.8% (n=75), at 1-2 years in 24.9% (n=135), at 3-6 years in 44.3% (n=240), and after 6 years in 17% (n=92) of cases. Mothers with lower socioeconomic and educational levels had significantly less knowledge regarding circumcision. Conclusion: The majority of circumcisions were performed between the ages of 3 and 6, a developmentally vulnerable period. The findings suggest that families were generally unaware of the potential psychological effects and medical risks associated with circumcision at this age. Mothers with low income and education levels should be included in educational programs to improve awareness about the benefits and possible complications of circumcision.

Aim: To evaluate the safety and efficacy of two-stage arterial switch operation using bidirectional Glenn anastomosis combined with pulmonary artery banding in late-diagnosed dextro-transposition of the great arteries with intact ventricular septum. Method: This single-centre retrospective study included 24 children with late-diagnosed dextro-transposition of the great arteries with intact ventricular septum treated between 2020 and 2025, all with left ventricular mass index <35 g/m ² and banana-shaped geometry. Demographics, interventions, imaging, postoperative course, and follow-up data were collected. Haemodynamics, left ventricular retraining, complications, and survival were evaluated. Results: The cohort included 9 boys (37.5%) and 15 girls (62.5%), with a median age at first-stage surgery of 5 months (4–9.75). Patent ductus arteriosus was more common in patients without prior interventions (61.54% vs. 0%, p = 0.002). Additional surgical interventions performed concurrently with the first-stage BDG + pulmonary artery banding differed by prior-intervention status ( p = 0.016). One mortality (4.17%) occurred due to sepsis in the no-prior group. Twenty-three patients proceeded to second-stage arterial switch (median interval 15 months, median age 22 months). In the prior-intervention group, post-second-stage ICU stay (median 5 vs. 4 days, p = 0.007) and inotrope use (median 4 vs. 3 days, p = 0.027) were longer. Two patients (8.7%) required ECMO (both prior group, resolved). At follow-up (1–4 years), all survivors were NYHA class I, with mild neo-aortic insufficiency in 52.17% and mild neo-pulmonary insufficiency in 13.04%. Conclusion: Bidirectional Glenn anastomosis combined with pulmonary artery banding is a safe and effective strategy for gradual left ventricular retraining in late-diagnosed dextro-transposition of the great arteries with intact ventricular septum. It reduces perioperative morbidity and provides good survival and functional outcomes, which is valuable in resource-limited settings.

Kabuki syndrome (KS) is a rare genetic disorder characterized by multisystemic involvement, craniofacial dysmorphism, and congenital heart defects. We present a 2.5-year-old boy with genetically confirmed KS who was admitted with a giant ascending aortic aneurysm and critical aortic coarctation. The patient underwent successful surgical repair with resection of the aneurysm and conduit placement between the mid-descending aorta and the region above the coronary ostia. In addition, the presence of significant aortic pathology in a sibling highlights the need for family screening in KS. This case emphasizes the broad spectrum of cardiovascular involvement in KS and the importance of early diagnosis and multidisciplinary management.

Background: This study evaluated the diagnostic efficacy of transthoracic echocardiography (TTE) and 128-slice multislice computed tomography (MSCT) angiography in congenital heart disease (CHD). Methods: Between January 2018 and August 2022, 50 patients diagnosed with CHD underwent both TTE and ECG-gated 128-MSCT. The imaging findings were compared with intraoperative observations, categorizing pathologies into cardiac, heart–great vessel, and great vessel malformations. Results: The median age of the patients was 0.45 months, and the median weight was 5 kg. Echocardiography showed a sensitivity of 89.8% and specificity of 99.12%, with an overall accuracy of 98%. MSCT had a sensitivity of 87.9%, specificity of 98.95%, and accuracy of 97.62%. There was no significant difference in diagnostic accuracy between the two modalities (χ² = 31.796, p = 0.215), with substantial agreement (kappa = 0.901). For surgically confirmed cardiac malformations (n = 69), echocardiography had a 100% sensitivity, whereas MSCT had an 88.41% sensitivity (χ² = 20.633, p = 0.039), with high concordance (kappa = 0.931). For heart–great vessel connection anomalies (n = 27), both modalities had an 81.48% sensitivity (χ² = 14.115, p = 0.481), with substantial agreement (kappa = 0.887). For great vessel malformations (n = 61), the echocardiography and MSCT sensitivities were 81.97% and 88.52%, respectively, with no significant difference in performance (χ² = 30.303, p = 0.063), indicating substantial concordance (kappa = 0.863). Conclusions: Both TTE and MSCT are highly accurate for CHD diagnosis, each with unique advantages. Their complementary use, especially where one modality is limited, enables a more comprehensive assessment, supporting clinical decision-making and surgical planning.

Background: Palpitations are common in adolescents and often occur without structural heart disease. Although anxiety and autonomic dysregulation have been implicated, the role of micronutrient status remains unclear. This study aimed to investigate the association between palpitations, micronutrient levels, and anxiety in adolescents and to evaluate the independent associations between selected micronutrients and palpitations using multivariable regression models. Methods: This case–control study included 52 adolescents with palpitations and 52 frequency-matched healthy controls. Structural heart disease was excluded by electrocardiography, echocardiography, and 24-h Holter monitoring. Results: Adolescents with palpitations had significantly lower serum magnesium, selenium, and ferritin levels and higher anxiety scores than controls, despite most values remaining within reference ranges. In age- and sex-adjusted analyses, lower magnesium and selenium levels were independently associated with palpitations. Conclusions: Subclinical differences in micronutrient status, particularly magnesium and selenium, together with increased anxiety, may contribute to non-structural palpitations in adolescents. These findings support a more integrative evaluation that includes micronutrient and psychological assessment alongside standard cardiac investigations.