DOUBLE AORTIC ARCH - A CASE REPORT

Double Aortic Arch is a rare congenital cardiovascular anomaly. Its first successful surgery was performed by Robert Gross in 1945 at Children Hospital Boston, USA. It accounts for 0.4 to 1% of all congenital cardiac defects. Patients having a Double Aortic Arch mostly present with symptoms in the 1st week of life but depending upon the severity of symptoms can present at any age in childhood. We present a case report of two month old baby with noisy breathing, intermittent cough, gross jugular notch retraction and sub costal recession. His Cardiac CT was subsequently done which showed a Double Aortic Arch of left dominant variety encircling the trachea. Surgery was done and the encircling artery compressing the trachea was recognized, dissected and interrupted. Marked relief of tracheal and/or esophageal compression was evident from operation day. Post operative recovery was speedy. Patient’s follow up of was done at 1, 4 and 24 weeks. His recovery was unremarkable. Currently he was thriving well.

Pioneers and champions for the little hearts: A history of pediatric cardiology in Nepal

Heart disease in a child requires complex set of expertise as physiology and challenges presented in pediatric cardiology are much different from adult cardiology. In preclinical era of renaissance, children and adults were examined by the same physician. At the outset of 20th century, the need for a special center for children with heart disease was identified as several authors began to add specific sections devoted to congenital heart disease in books of anatomy and pediatrics. A major milestone was reached when Helen Taussig, in charge of cardiac clinic in Harriet Lane Hospital, Baltimore, USA, established pediatric cardiology center for the first time. Pediatric cardiology gained further prominence in 1938 when Robert Gross successfully ligated the patent ductus arteriosus in a seven year old girl. The first successful creation of systemic to pulmonary shunt by Blalock and Taussig in 1944 boldly introduced surgical interventions. The field of pediatric cardiology has been making remarkable developments, with dramatic improvements in diagnostic tools, and with cardiac surgeons constantly pushing the envelope, culminating in being first subspecialty board of pediatrics in USA in 1961. These developments have changed the outlook of cardiac diseases in children and instilled hope for cure in previously untreatable disorders. Interestingly, advances made in pediatric cardiology have provided

Caracterización clínico epidemiológica de las cardiopatías congénitas en niños. Instituto Hondureño de Seguridad Social

Antecedentes: Las malformaciones congénitas que más frecuentemente determinan malformaciones infantiles son las cardiopatías, producen 30% de las muertes en pacientes pediátricos. Desde que en 1939 Robert Gross realizó la primera intervención quirúrgica de un paciente con cardiopatía congénita (CC), éstas han cobrado gran importancia para la medicina y la salud pública.Objetivo: del estudio fue caracterizar clínica y epidemiológicamente los pacientes que presentaron cardiopatías congénitas en la consulta externa de cardiología del Hospital Regional del Norte- Instituto Hondureño de Seguridad Social (HRNIHSS) durante el período de enero a octubre del 2015.Pacientes y Métodos: Se realizó un estudio de enfoque cuantitativo, descriptivo transversal en la consulta externa HRN-IHSS, la población fue de 859 pacientes atendidos y la muestra 551 pacientes en quienes se confirmó la presencia de cardiopatía. Los datos se obtuvieron de los informes de atenciones diarias entre los meses de enero a octubre del 2015.Resultados: Se obtuvieron 551 pacientes con cardiopatías congénitas. 294 (53.35%) de los pacientes eran del género masculino y 257 (46.65%) del género femenino. 265(48.1%) estaban en edades comprendidas entre 1-2 años. 191 (34.66%) de los niños tenían comunicación interauricular (CIA).Conclusiones: El género masculino y los lactantes fueron los más afectados por cardiopatías congénitas.Acta Pediátrica Hondureña, Vol. 6, No. 1 Abril 2015 a Septiembre 2015: 415-420

The History of Multimodal Treatment of Wilms’ Tumor

Multimodal therapy—surgery, radiation therapy, and chemotherapy—the foundation of modern cancer treatment, has led to dramatic improvements in survival. How the three disciplines coalesced to conquer Wilms’ tumor is a compelling story that includes two of history's greatest discoveries, X-rays and antibiotics. By the mid-20th century both fields had matured to where dedicated clinicians and creative scientists could apply them to Wilms’ tumor and achieve successive improvements in survival. William Ladd was able to achieve a zero operative mortality by 1940, but was left with a 32 per cent survival with surgery alone. Robert Gross and Edwin Neuhauser combined surgery and radiotherapy and achieve 47 per cent survival rate in 1950. Sidney Farber and his colleagues added an antibiotic, dactinomycin, to the treatment regimen and reached 80 per cent survival rate in 1966. The National Wilms’ Tumor Study, organized in 1968, was a multidisciplinary effort of surgeons, radiotherapists, and pediatric oncologists across the country. By the 1990s, the National Wilms’ Tumor Study achieved survival rates above 95 per cent while minimizing long-term effects through shortening courses of chemotherapy and radiation. The story of Wilms’ tumor serves as a paragon for all types of cancer, in both children and adults.