The purpose of the study was to prove to efficacy of Milrinone in the management of open heart surgery in children with congenital heart malformations, the link between Milrinone efficacy and the prevention of low cardiac output syndrome and Milrinone side effects. We conducted a retrospective study on a group of 24 patients, admitted to the Tg Mures Emergency Institute for Cardiovascular Diseases and Transplant, between August 2016 and February 2017. Milrinone was administered to children that underwent open heart surgery for different congenital heart malformations, using doses between 0.25 and 0.75 mcg per kg bodyweight, in continuous intravenous drip, before de-clamping of the Aorta, the procedures being conducted in extracorporeal circulation. We recorded demographic data, biological parameters of renal function, myocardial function and hemodynamic parameters, before and after surgery. The administration of Milrinone determined a reduction of incidence of low cardiac output syndrome, registering only 4 deaths, the survival rate being 83.33%, 13 cases presenting complications. Postoperatively we registered a significant improvement of the mean heart rate. Milrinone proved efficient in the re-establishment of hemodynamic parameters in patients with this type of clinical manifestations. Using Milrinone in children that undergo open heart surgery determines a decrease in incidence of low cardiac output syndrome, its� presence in the pharma market being necessary.

Acute pancreatitis is a very mortal disease, mortality that increases even more in patients with cardiac transplantation. Medical-surgical management of acute pancreatitis in transplanted patients can make the difference between life and death. The aim of this paper was to highlight the severity of this pathology especially because the patient is immunosuppressed after cardiac transplant. A case of 36-year-old man, known with heart transplant, immunosuppressive treatment and chronic renal frailer, who arrived to Emergency Department, with severe abdominal pain and abdominal distention which started after a traumatic accident. Investigations revealed acute pancreatitis that needed three surgeries for acute necrotic hemorrhagic pancreatitis, acute bleeding, left subphrenic abscess and intensive care therapy. With favorable postoperative evolution, patient is discharged 60 days later He�s follow up reveled no gastrointestinal or cardiac complication with an improved quality of life.

Left ventricular anevrysm (LVA) is the effect of left ventricular (LV) remodeling after myocardial infarction (MI). The surgical technique to improve cardiac function is geometric reconstruction of the LV. The aim of this paper is to highlight the importance of restoring left ventricle geometry. We report a case of 53 year-old man, without any known cardiovascular history, with acute anterior myocardial infarction, left ventricular aneurysm and massive left ventricular thrombus, who arrived into the emergency department 24 hours after the onset of symptomatology. After hemodynamic stabilization, we performed geometric reconstruction of the left ventricle. With favorable postoperative evolution, patient is discharged 14 days later. At the periodic checkups it is noted that he�s postoperative ejection fraction (EF) improved and also the quality of life.

Introduction. With an estimated incidence of 6 cases to 1000 births worldwide, congenital cardiac malformations (CHM) are one of the main causes of death during the first year of life. The main issues regarding CHM management in Romania are the lack of data that describe the true incidence on population level, lack of standardized diagnosis and CHM reporting at national level. In Romania we see only local attempts at establishing such a CHM registry. Objectives. Measuring and analyzing the incidence of CHM in children within the Pediatric Cardiovascular center of the Emergency Cardiovascular and Transplant Institute in Targu Mures (IUBCvT) in order to determine de rate of enrollment, contouring the registration and follow-up form for CHM. Material and methods. We have conducted a retrospective, descriptive study concerning children discharged between 2008-2013, with a main diagnosis or comorbidity belonging to the category Q20-Q28 (Congenital cardiac malformations – ICD 10 AM), belonging to the Pediatric Cardiovascular center of IUBCvT. The study group was made up of 839 new-born babies discharged from the Neonatology clinic of the Mures County Emergency Clinical Hospital (SCJU) and 2181 children discharged from IUBCvT. Results. The incidence of CHM in new-born babies discharged from SCJU varied between 5.23% and 11.47%. Of the total 839 new-born babies, 139 underwent surgery in the IUBCvT within the first 30 days of life. The most frequent malformations found were interatrial communication (46.52%), persistent ductus arteriosus (22.10%), interventricular communication (9.04%). Disease group based morbidity within the IUBCvT demonstrates the large share of interventricular communication (20.05%), interatrial communication (15.98%) respectively of persistent ductus arteriosus (13.05%). Of the 1255 children that underwent surgery, the most frequent procedures (17.93%) were conducted for interatrial communication. Conclusions. Establishing a CHM clinical registry is important for the screening, diagnosing, monitoring of congenital cardiac malformations as well as aiding in choosing the right treatment path.