Children with CHD are at risk of neurodevelopmental impairment. Modifiable risk factors associated with hospitalisation that could impact neurodevelopment include being left alone for long periods of time with minimal interaction or opportunity to engage in developmentally appropriate play. Volunteers are an underutilised resource to help the medical team and families support neurodevelopment in cardiac care. Our Cardiac Inpatient Neurodevelopmental Care Optimization or CINCO team aimed to develop a volunteer programme specific to paediatric cardiac inpatient units.

CINCO volunteers were recruited from the hospital volunteer pool and, in 2022, partnered with the University of Colorado to recruit health profession-interested students from under-represented backgrounds. All underwent hospital volunteer orientation and CINCO-specific training with cardiac child life, including education and shadowing. Volunteers completed an activity log and provided qualitative feedback.

Between September 2021 and October 2024, 43 volunteers were onboarded and worked a total of 754 shifts. There were 2310 patient interactions, with an average of 3 patients seen per shift. Volunteers held patients 1231 times, played with patients 1230 times, and read to patients 780 times.

A dedicated cardiac volunteer programme is a feasible, low-cost, and low-risk way to enhance neurodevelopmental care for inpatient children with CHD. When parents or caregivers are not present, volunteers participate as therapy extenders and may offset the care burden for nurses. Furthermore, allowing parents breaks may support their mental health, and increasing neurodevelopmental stimulation through volunteer interactions may mitigate disadvantageous aspects of a hospitalisation for neurodevelopment.

Right ventricular outflow tract stenting is a palliative treatment option in symptomatic infants with tetralogy of Fallot or with pulmonary atresia with ventricular septal defect. Predominantly bare metal stents are used for this procedure. The authors sought to assess the efficacy and safety of using the covered coronary stent grafts for the right ventricular outflow tract stenting.

Between November 2017 and July 2021, the covered coronary stent graft was used to widen the right ventricular outflow tract in 20 symptomatic patients (pulmonary atresia with ventricular septal defect n = 5, tetralogy of Fallot n = 15).

All stent grafts were implanted successfully. The median time of palliation was 156 (43–1578) days. Eleven patients required stent redilation. Fifteen patients required additional stent implantation to relieve a proximal obstruction in the right ventricular outflow tract. There were three complications observed: right ventricular outflow tract perforation (n = 1), stent embolisation (n = 1), and main pulmonary aneurysm (n = 1). Oxygen saturation improved immediately after the procedure. During the follow-up time, all stents were patent, and we observed a significant increase in the diameters of the pulmonary arteries. Sixteen patients had corrective surgery performed with complete and easy removal of the implanted stents.

Stenting of the right ventricular outflow tract with stent grafts was safe and effective and provided a durable method of palliation. Utilisation of the covered coronary stent graft facilitated surgical removal of the implanted stent during the surgical correction.

Advancements in healthcare have significantly improved the prospect of patients with CHD, with over 97% now surviving adulthood. This growing population requires lifelong care and support to manage their condition. Digital health innovations, such as the “Ask Me Anything” (AMA) tool, aim to empower patients and improve collaboration with clinicians.

In this pilot study, 70 patients were invited to participate, and 58 completed the questionnaire (response rate: 82.9%). Patients completed a digital question prompt list (QPL) prior to their consultations to select key topics from a predefined list of questions. Permission from the institution was obtained before conducting the pilot study.

Patients frequently selected questions related to prognosis, ageing, emotional well-being, lifestyle, and potential future interventions. The tool allowed for more personalised consultations and promoted active patient participation.

The AMA tool demonstrates feasibility in engaging ACHD patients and supporting shared decision-making. Further research is needed to optimise system integration and evaluate long-term outcomes.

Although global knowledge on paediatric cardiomyopathies has advanced, prospective cohort studies from Brazil, particularly those integrating clinical and genetic data, remain limited.

To describe the clinical and genetic characteristics of paediatric cardiomyopathy patients and identify mortality predictors in a metropolitan region of Brazil.

Prospective observational study of paediatric patients with cardiomyopathies. Clinical data, genetic findings, and survival were analysed using Kaplan–Meier curves.

A total of 45 cases, male predominance (55.6%), and mean age at diagnosis of 6.5 years. Dilated and hypertrophic cardiomyopathy were the most common (33.3%). The main reason for diagnosis was the investigation of cardiovascular symptoms (60.9%). Genetic investigation occurred in 66.6%, a positivity rate of 60%. Multi-organ/system involvement was significantly associated with a positive genetic result (77.7%, p = 0.017). Mortality was 11.1%; survival was significantly lower in the following conditions: ejection fraction < 30% (p < 0.0001), functional class III/IV (p < 0.0001), heart failure (p = 0.0091), use of three or more cardiovascular medications (p < 0.001), N-Terminal Pro-B-Type natriuretic peptide >1000pg/mL (p = 0.004), and heart transplant indication (p < 0.001).

These findings provide novel data in Brazil, highlight a high rate of positive genetic test, particularly among patients with systemic involvement and identify key clinical predictors of mortality to guide risk stratification and care.

Central venous catheter use is not standardised in paediatric cardiology, yet it is associated with additional morbidity. We aimed to characterise variation in central venous catheter use and complications across paediatric acute care cardiology units.

This retrospective, multi-centre, and registry-based study examined all unique acute care cardiology encounters from February 2019 through September 2021 in the Paediatric Acute Care Cardiology Collaborative registry. Descriptive and comparative statistics were assessed for differences based on central venous catheter use. Multivariate logistic regression identified factors associated with increased line duration and use frequency.

About 35,379 encounters from 24 institutions were assessed. About one in five encounters had at least one central venous catheter (n = 7,524, 21.3%). Neonates and post-operative cardiothoracic surgery patients were more likely to have central venous catheters than not (28.9% of neonates with, versus 11.4% without; 58.4% of post-operative patients with, versus 35.7% without; p < 0.001). Most patients after STAT 4 procedures retained central venous access for over half of the acute care cardiology stay. Institutions with overall “low” central venous catheter utilisation rates (<20%) also used central venous access most often on STAT 4 patients (p < 0.0001). Complication rates for venous thrombus and central line-associated bloodstream infection were low (1.9% and 0.2%).

There is variable utilisation of central venous catheters across participating acute care cardiology units, though overall they are common vascular access modalities. Acute care cardiology units use central venous catheters more often in neonates, those after cardiac surgery, and in their higher-risk patients (i.e. after STAT 4 procedures).

Coarctation of the aorta accounts for approximately 6–8% of CHDs, typically manifesting as narrowing of the proximal thoracic aorta. Clinical and haemodynamic effects vary depending on the severity and associated anomalies. We aimed to compare the outcomes of surgical versus percutaneous interventions in patients with coarctation of the aorta and to identify factors influencing the choice of treatment strategy.

We retrospectively analysed the medical records of 120 patients diagnosed and treated for coarctation of the aorta at Ankara University Faculty of Medicine, Department of Pediatric Cardiology over a 12-year period. Patients were grouped by age (0–4 months and >4 months). Clinical and echocardiographic data were reviewed. Treatment selection was based on American Heart Association 2011 guidelines, considering age, weight, and anatomy. Surgical repair was preferred in infants <4 months; balloon angioplasty or stent implantation was used in older patients. Procedural success and complications were assessed.

A total of 62% were male, the median age at diagnosis was 1.1 months, and 67% were diagnosed before 4 months of age. The most common symptom was a cardiac murmur (62.5%). Initially, balloon angioplasty was performed in 50%, surgical repair in 45%, and stent implantation in 5%. The acute success rate was 98.3%. Complications occurred in 13.3%, including thrombosis (7.5%) and aneurysm (2.5%). Recoarctation developed in 43% and was significantly higher after balloon angioplasty compared to surgery (55% vs. 29.6%, p = 0.004), and in patients <4 months (52.2% vs. 25.5%, p = 0.014). Management strategies typically included surgical repair in infants <4 months, balloon angioplasty in older children, and stenting in those ≥25 kg, while treatment was ultimately individualised.

Recoarctation was the most frequent complication, especially among infants under four months and after balloon angioplasty. Surgical repair was associated with a lower risk of recoarctation in early infancy. Percutaneous stent implantation for coarctation is an effective and safe procedure, but it is limited by the patient’s weight. Individualised treatment based on age, anatomy, and clinical status is essential to optimise outcomes.

Radiofrequency catheter ablation of ventricular arrhythmias, originating from the left ventricular summit, is challenging due to epicardial localisation of the substrate, surrounded by coronary arteries. This paper highlights the successful elimination of LVOT summit ventricular arrhythmia which was ablated from the aortic cusp and aortic mitral continuity in two paediatric patients.

Ventricular tachycardia arising from the basal region of the left ventricular summit was identified in two male patients aged 9 and 13 years. Electroanatomic mapping of ventricular arrhythmia revealed the earliest ventricular signal within the left coronary artery which was successfully ablated from the left coronary cusp. The second patient with exactly similar ECG of ventricular arrhythmia was treated by delivering energy to the aorta-mitral continuity beneath the aortic valve. No recurrences were observed during the follow-up period of 20 months.

Ventricular tachycardia arising from the basal region of the left ventricular summit is very rarely observed in paediatric patients. Utilising radiofrequency catheter ablation in proximity to the source can effectively and safely eliminate tachycardia.