We present a case of a severely ill newborn with complex coarctation, multiorgan failure and massive oedema, who was treated with emergency stenting of the isthmus on the second day of life, which was followed by surgical stent removal and repair of the arch on the 29 day, after stabilization...

Paediatric hybrid cardiovascular procedures are becoming increasingly popular due to the wide spectrum of cardiovascular abnormalities and a large population of patients who could benefit from hybrid therapy. Contemporary hybrid procedures are introduced in the settings where routine cardiac surgery or cardiac interventions would not allow satisfactory results. Combining cardiac surgery and interventional cardiology techniques appears more beneficial and less invasive for the patient. To present results of hybrid procedures performed in the treatment of selected congenital heart disease in our centre in 2008-2013. We retrospectively analysed consecutive 80 patients referred for hybrid procedures. Overall, 73 patients survived, with 4 early and 3 late deaths. Hybrid procedures in children with congenital heart disease combine the experience of cardiac surgery and interventional cardiology. Hybrid treatment is an alternative option for selected borderline patients. Initial results of hybrid treatment encourage further development of these methods and strategies to provide optimal benefits for the patients.

Background: Extracorporeal circulation is associated with systemic inflammatory response syndrome. Therefore, the diagnosis of infection should be differentiated from a typical postoperative course. Aim: The aim of the study was to evaluate the kinetics of inflammatory biomarkers in children in the first days after cardiac surgery with extracorporeal circulation. Methods: Prospective data were collected from 51 consecutive children referred for surgical treatment in Department of Paediatric Cardiac Surgery, St. Adalbertus Hospital in Gdansk, between February and August 2015. Blood samples were collected on the first, second, and third postoperative days and sent to the institutional laboratory for routine investigations: white blood cell count, serum C-reactive protein (CRP) and procalcitonin concentrations. Results: The highest levels of procalcitonin were on the first postoperative day (median 3.53 ng/mL), although the peak values of CRP concentration and white blood cell count were on the second postoperative day (96 mg/L and 17.3 G/L). In the group of patients with foreign material implantation (Contegra (R) or Gore-Tex (R)), the higher values of procalcitonin concentration and white blood cell count were measured in the subsequent postoperative days. Conclusions: The kinetics of analysed inflammatory biomarkers on the first days after cardiac surgery for congenital heart disease in children have different characteristics. The knowledge about the kinetics of inflammatory biomarkers could be useful in determining the possibility of evolving infections in the early postoperative period.

Background and aim: Acute endocarditis (AE) is still rare disease in pediatric population, nevertheless the children suffering from AE usually need heart valves repair or replacement in emergency settings. Methods: We present a case of emergency mitral valve replacement with the use of Melody balloon expandable stented bioprosthesis in a 2-years-old patient with acute endocarditis, subsequent mitral (bicuspid) valve incompetence after aggressive infective destruction with the symptoms of critical multiorgan failure. Results: The patient with a history of rapid deterioration after 2-weeks-long septicemia in the course of acute endocarditis was operated urgently after initial antibiotic treatment because of huge vegetations into mitral valve orifice. Melody TVP 22 valve was expanded over 16 mm TyShak balloon and implanted into a mitral position (Melody-MVR) with good result. Conclusions: Based on actual knowledge concerning heart valves reconstructions and institutional experience we conclude that infected mitral valve in children should be primary repaired, nevertheless Melody valve could be reasonable considered as a mitral prosthesis in such conditions. Background and aim: Acute endocarditis (AE) is still rare disease in pediatric population, nevertheless the children suffering from AE usually need heart valves repair or replacement in emergency settings. Methods: We present a case of emergency mitral valve replacement with the use of Melody balloon expandable stented bioprosthesis in a 2-years-old patient with acute endocarditis, subsequent mitral (bicuspid) valve incompetence after aggressive infective destruction with the symptoms of critical multiorgan failure. Results: The patient with a history of rapid deterioration after 2-weeks-long septicemia in the course of acute endocarditis was operated urgently after initial antibiotic treatment because of huge vegetations into mitral valve orifice. Melody TVP 22 valve was expanded over 16 mm TyShak balloon and implanted into a mitral position (Melody-MVR) with good result. Conclusions: Based on actual knowledge concerning heart valves reconstructions and institutional experience we conclude that infected mitral valve in children should be primary repaired, nevertheless Melody valve could be reasonable considered as a mitral prosthesis in such conditions.

We present a case of a severely ill newborn with congenital atrioventricular heart block (CAVB) diagnosed prenatally. The initial drug therapy just after birth was ineffective, the heart rhythm remained 54 beats per minute, and control echocardiographies showed forthcoming decrease of the left...