It is technically feasible to undertake transcatheter coil closure of PDA in carefully selected symptomatic pre-term infants, and it is a safe alternative to surgical ligation.

No abstract

Plastic bronchitis, a rare but serious clinical condition, commonly seen after Fontan surgeries in children, may be a manifestation of suboptimal adaptation to the cavopulmonary circulation with unfavorable hemodynamics. They are ominous with poor prognosis. Sometimes, infection or airway reactivity may provoke cast bronchitis as a two-step insult on a vulnerable vascular bed. In such instances, aggressive management leads to longer survival. This report of cast bronchitis discusses its current understanding.

closure was often mentally reconstructed based on multiple 2-dimensional echocardiographic images (1). Three-dimensional imaging was an improvement but needed elaborate post-processing, used nonuniform protocols that sometimes needed deep sedation, and respiratory motion often caused multiple stitch artifacts in full-volume acquisitions. We show an easier real-time method using a uniform subxiphoid live 3-dimensional echocardiographic acquisition (60 o ϫ 20 o sector width) that is steered to cover the entire interventricular septum and generates good reproducible images in most patients under 10 to 12 years of age. This protocol does not involve major post-processing, and images are available online for interpretation during the time of acquisition. The relation of the defect to various right ventricular septal landmarks such as tricuspid, aortic, and pulmonary annuli; proximity of the defect to the anterior, posterior, and apical margins of the interventricular septum; and other landmarks such as septal band are shown on the volume-rendered enface image. This iPIX shows a series of different image sets depicting various types of ventricular septal defects, all of which were acquired using this protocol (Figs. 1 to 6).

In coarctation with patent ductus arteriosus associated with good sized aortic isthmus, closure of duct with duct occluder device and balloon aortoplasty would correct the lesions. If there is isthmic hypoplasia, device closure of the duct and stenting of the coarctation is needed. Covered stent is a reasonable alternative only in presence of non dilated descending aorta.