Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 1 2024 01 31 2096 2096 Erratum JTHC - 2024 05 18 No Abstract No Abstract No Abstract https://rhythm.tums.ac.ir/index.php/jthc/article/view/2096

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 1 2024 01 31 1 5 Masih Tajdini 1-Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2-Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, USA. Amir Hossein Behnoush Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Amirmohammad Khalaji Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Satish Raj Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 2023 06 20 2024 04 02 Vasovagal syncope (VVS), characterized by transient loss of consciousness, is among the most prevalent reasons for emergency visits worldwide. Although benign in nature, VVS can be accompanied by traumatic injury, leading to morbidity and decreased quality of life, especially in those with VVS recurrence. The management includes non-pharmacologic and pharmacologic therapies (if resistant), patient education and reassurance, salt and fluid intake increase, and physical counter-pressure maneuvers. Among medications, midodrine has shown promising results in reducing VVS recurrence and positive head-up tilt tests. Fluoxetine and atomoxetine also might be suitable candidates for VVS therapy. Permanent pacemakers, such as closed-loop stimulation, are under research and can be effective in cases unresponsive to medical treatment. In summary, while data are scarce regarding the definite treatment of VVS, there is a need for further research with novel, easy-to-use and cost-effective therapeutic methods to enhance quality of life and prevent traumatic injury. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1875

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 1 2024 01 31 6 13 EN Hadi Rezaeeyan Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Iranian Blood Transfusion Organization (IBTO), Tehran, Iran. Bahareh Moghimian-Boroujeni Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Mehrnaz Abdolalian 1-Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Iranian Blood Transfusion Organization (IBTO), Tehran, Iran. 2-Ramsar Campus, Mazandaran University of Medical Sciences, Sari, Iran. Mohammadreza Javan Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada. 2023 05 19 2023 12 05 Background: Cardiovascular disease (CVD) is one of the principal causes of mortality in the world. Various factors have been identified in the pathogenesis of CVD. Leukemia inhibitory factor (LIF) as a secretory cytokine is one of these factors. The LIF receptor is located on endothelial cells and plays a role in the expression of specific genes in these cells. Endothelial cells are the innermost cells of blood vessels, and defects in these cells cause endothelial dysfunction and eventually CVD. Methods: The present study is based on PubMed database information (1982–2022) using the following words: “cardiovascular disease,” “endothelial cells,” “leukemia inhibitory factor,” and “angiogenesis.” Results: LIF can cause arteriosclerotic plaques by activating inflammatory mechanisms in monocytes through the induction of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression. LIF can also induce vascular endothelial growth factor expression by activating signaling pathways, eventually leading to angiogenesis. Additionally, it can activate the coagulation cascade by factor VII production promotion within endothelial cells. Conclusion Understanding the interplay between LIF and the inflammation pathways, coagulation, and angiogenesis as key factors in CVD occurrence raises the possibility of targeting this factor as a potential strategy to mitigate CVD risk. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1858

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 1 2024 01 31 14 24 Faezeh Sadat Naji Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mehrzad Mirshekari Clinical Pharmacy Department, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Soha Namazi 1- Clinical Pharmacy Department, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2- Research Center for Rational Use of Drugs, Tehran University of Medical Science, Tehran, Iran. Hesam Aldin Varpaei College of Nursing, Michigan State University, East Lansing, MI, USA. Alireza Esteghamati Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahboobeh Hemmatabadi Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nooshin Shirzad 1- Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2022 12 25 2024 02 07 Background: Lipid metabolism disorders are among the most common metabolic diseases that are increasing globally and are associated with chronic metabolic disturbances. The present study aimed to determine the knowledge and practice of internal medicine physicians concerning lipid disorders according to the AHA, AACE, ESC-EAS, and NCEP-ATP-III guidelines. Methods: This descriptive-analytical cross-sectional study selected a convenience sample of 220 internal medicine specialists from January through September 2021 in Tehran and some other Iranian cities. A 25-item researcher-designed questionnaire was used. Suggested scenarios were designed by emphasizing the points of difference in the guidelines. Content validity was approved by 10 tenured faculty members, and reliability was tested with the test-retest method. Results: Women comprised 60% of the population. In addition, 3.2% (n=7) of the physicians had poor knowledge, 95.0% (n=209) had moderate knowledge, and 1.8% (n=4) had good knowledge of lipid disorders based on international guidelines. Moreover, performance regarding lipid disorders was poor in 25 (11.4%), moderate in 164 (74.5%), and good in 31 (14.1%) physicians. The knowledge score decreased, whereas the practice score increased with age. The knowledge score of female physicians was significantly higher than that of their male counterparts. The knowledge score was negatively correlated with the physician’s years of experience. Conclusion: The knowledge and performance of internists regarding dyslipidemia were rated moderate according to the AHA, AACE, ESC-EAS and NCEP-ATP III guidelines. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1784

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 1 2024 01 31 25 30 Fahimeh Valizadeh-shiran 1-Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2-Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Negin Sadat Hosseini Mohammadi 1-Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2-Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Kiarash Tavakoli 1-Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2-Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Arash Jalali 1-Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2-Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Seyed Hossein Ahmadi Tafti Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Yaminisharif Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2023 08 17 2024 03 07 Background: The rate of lead extraction has steadily increased alongside the extensive use of cardiovascular implantable electronic devices. Data on the complications and safety of this challenging procedure are limited. We investigated in-hospital and midterm outcomes following lead extraction. Methods: Data were retrieved from 51 patients who underwent pacemaker/defibrillator lead extraction procedures at Tehran Heart Center between 2016 and 2021. The procedural success rate, patients’ demographic characteristics, and in-hospital and midterm procedure-related complications were investigated. Results: Fifty-one patients were enrolled, including 44 men (86.3%). A total of 109 leads were extracted, with a 90.2% complete procedural success rate. In-hospital death occurred in 4 patients (7.8%): 1 patient (1.9%) died from pneumonia, 1 (1.9%) from septic shock, and 2 (3.9%) from septic shock besides heparin‐induced thrombocytopenia. Adverse events in 3 patients (5.8%) were directly related to the procedure: 1 patient (1.9%) suffered lung laceration and hemorrhage, 1 (1.9%) sustained subclavian injury, and 1 (1.9%) developed tamponade. Neither reinfection nor rehospitalization was observed during follow-up. Conclusion: Lead extraction can be considered a highly successful procedure with a low rate of death-related events and complications. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1916

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 1 2024 01 31 31 37 Maryam Keramat Kar 1-Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. 2-Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran. Arash Ghiasvand Mohammad Kani Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran. Ahad Alizadeh Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. Majid Hajikarimi Clinical Research Development Unit, Qazvin University of Medical Sciences, Qazvin, Iran. 2022 11 10 2023 12 06 Background: Myocardial infarction is one of the leading causes of death in the world and accounts for 23% of mortalities. Self-care for senior patients with myocardial infarction can reduce complications, multiple hospitalizations, and financial costs. Methods: This clinical trial was performed on 128 older adults with myocardial infarction. Available sampling was done via block random sampling among patients at the Heart Clinic of Booali Hospital, Qazvin, Iran. Data were collected through interviews and demographic and self-care questionnaires regarding heart disease. Data analysis was conducted using R software, version 4.1.0, and via the mixed-effects model method and post hoc and contrast tests. Results: The mean age of the study population was 65.54±4.50 years. Before the intervention, self-care maintenance was not significantly different between the 2 groups. After the intervention, a statistically significant difference was observed between the groups (P=0.001). No statistically meaningful difference concerning self-care monitoring existed between the 2 groups at the beginning of the study (P=0.03); however, a significant difference emerged after the intervention (P=0.001). A difference existed between the groups regarding self-care confidence study commencement in that the self-care confidence level in the control group was higher (P=0.013), but no difference was observed following the intervention. Nonetheless, after 1 month, the groups were significantly statistically different (P=0.003) in that the self-care confidence level in the intervention group increased. Conclusion: Mobile health could improve self-care in older adults with myocardial infarction. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1754

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 1 2024 01 31 38 46 EN Ahmadreza Rasouli 1 Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran Hamid Khederlou Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Narges Milkarizi Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Shahram Arsang-Jang Department of Biostatistics and Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Houshang Bavandpour Karvane Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Akbarzade Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Shahrokh Karbalai Saleh Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Alireza Oraii Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Azadeh Sadatnaseri Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mostafa Roozitalab Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Zahra Shajari Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shima sadat Ghaemmaghami Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Haleh Ashraf 1- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2022 10 26 2023 10 14 Background: The present study aimed to investigate the association between acute cardiac injury (ACI) and outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19) in Iran. Methods: The current cohort study enrolled all consecutive hospitalized patients with COVID-19 (≥ 18 y) who had serum high-sensitivity cardiac troponin-I (hs-cTnT) measurements on admission between March 2020 and March 2021. ACI was determined as hs-cTnT levels exceeding the 99th percentile of normal values. Data on demographics, comorbidities, clinical and laboratory characteristics, and outcomes were collected from Web-based electronic health records. Results: The study population consisted of 1413 hospitalized patients with COVID-19, of whom 319 patients (22.58%) presented with ACI. The patients with ACI had a significantly higher mortality rate than those without ACI (48.28% vs 15.63%; P<0.001) within a mean follow-up of 218.86 days from symptom onset. ACI on admission was independently associated with mortality (HR, 1.44; P=0.018). In multivariable logistic regression, age (OR, 1.034; P<0.001), preexisting cardiac disease (OR, 1.49; P=0.035), preexisting malignancy (OR, 2.01; P=0.030), oxygen saturation reduced to less than 90% (OR, 2.15; P<0.001), leukocytosis (OR, 1.45; P=0.043), lymphopenia (OR, 1.49; P=0.020), reduced estimated glomerular filtration rates (eGFRs) (OR, 0.99; P=0.008), and treatment with intravenous immunoglobulin during hospitalization (OR, 4.03; P=0.006) were independently associated with ACI development. Conclusion: ACI occurrence on admission was associated with long-term mortality in our hospitalized patients with COVID-19. The finding further underscores the significance of evaluating ACI occurrence on admission, particularly in individuals more prone to ACI, including older individuals and those with preexisting comorbidities, reduced oxygen saturation, and increased inflammatory responses. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1745

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 18 3 2023 07 30 207 213 EN Mehdi Goudarzi Medicinal Plant Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Jafar Fatahi Asl Department of Radiologic Technology, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Hamed Shoghi Department of Physiology, Pharmacology and Medical physics, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran. 2023 01 14 2023 09 09 Background: Electromagnetic radiation (EMR) causes stable aggregation of reactive oxygen species (ROS), producing oxidative stress. Rosmarinic acid (RA), a plant-origin antioxidant, has been proposed against the side effects of cell phone and ultrahigh-frequency waves. Methods: Forty-two male Wistar rats were randomly divided into 6 groups. Group 1 (controls) received 5 mL of normal saline with the gavage method, Group 2 received 915 MHz radiation, Group 3 received 2450 MHz radiation, Group 4 received RA plus 915 MHz radiation, Group 5 received RA plus 2450MHz radiation, and Group 6 received oral RA (5 mg/kg). Treatment and radiation (1 hour per day) continued for up to 30 days. Results: EMR significantly reduced the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), the content of glutathione (GSH), and the level of total antioxidant capacity (TAC) and significantly increased oxidative stress indices, such as the levels of malondialdehyde (MDA) and nitric oxide (NO), and the content of protein carbonyl (PC). In contrast, RA significantly elevated TAC level (all groups), GSH content (the RA/cell phone radiation group), GPx activity (the RA/ultrahigh-frequency radiation group), SOD activity (all groups), and CAT activity (RA/ultrahigh-frequency radiation group) and conversely reduced MDA level (all groups), NO level (all groups), and PC content (all groups) in the RA/cell phone and RA/ultrahigh-frequency radiation groups compared with the NS/cell phone and NS/ultrahigh-frequency radiation groups, respectively. The administration of RA resulted in a significant reversal of cardiac markers in EMR-intoxicated rats. Conclusion: RA treatment showed a significant protective effect against EMR-induced cardiotoxicity. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1794

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 18 3 2023 07 30 214 217 Yavuzer Koza Department of Cardiology, Faculty of Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey. Oğuzhan Birdal Department of Cardiology, Faculty of Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey. Rauf Macit Department of Cardiology, Faculty of Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey. Hakan Taş Department of Cardiology, Faculty of Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey. Ednan Bayram Department of Cardiology, Faculty of Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey. 2022 10 11 2023 07 03 We report a case of a myocardial infarction (MI) due to multiple culprit vessels in a young woman. MI caused by more than 1 culprit vessel is very rare. Oral contraceptives (OCSs) are used for birth control. Despite a few case reports, the association between the new-generation OCS use and the MI risk remains controversial. A 53-year-old woman who had been consuming combined OCS-Yasmin (30 µg of ethinyl estradiol and 3 mg of drospirenone) for 2 years was admitted to our hospital with chest pain. Her past medical history revealed no coronary risk factors except for smoking. No hemodynamic instability was noted at admission. The admission electrocardiogram revealed slight ST elevations in D1 and aVL leads. An urgent coronary angiography showed distal occlusions in the right coronary, left anterior descending, first diagonal, and left circumflex coronary arteries. Unfractionated heparin and abciximab were administered during the procedure, with the latter continued for 12 hours after the procedure. During the hospital course, the patient complained of recurrent anginal attacks. A repeat coronary angiography demonstrated the persistence of thrombotic occlusions. After 24 hours, she experienced chest pain, and her electrocardiogram revealed diffuse ST elevations with a blood pressure of 60/40 mm Hg. She was urgently transferred to the catheterization laboratory. Multiple balloon inflations with intracoronary alteplase (10 mg over 5-10 min) injections failed to restore coronary flow, and she developed cardiovascular collapse. Despite maximal mechanic and mechanical support, she passed away.   https://rhythm.tums.ac.ir/index.php/jthc/article/view/1730 https://rhythm.tums.ac.ir/index.php/jthc/article/download/1730/1074

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 18 3 2023 07 30 218 223 EN Mehrnoush Toufan Tabrizi Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Rezayat Parvizi Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Elnaz Javanshir Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 2023 04 07 2023 09 03 Bacteria, especially staphylococcal groups, cause aortic graft infection. Infection stems from synthetic materials that repair aneurysms or artery blockages. Aortic stent infection and vegetation formation are rare, and heterogeneous presentations and ambiguous findings in routine diagnostic modalities render the diagnosis challenging. A 25-year-old man with a history of catheter-based aortic stenting for hypertension associated with severe aortic coarctation was referred to our tertiary care hospital. Five months before the presentation, the patient had been infected with COVID-19, but he recovered after mild symptoms. Nevertheless, 3 months later, he developed erythematous lesions, progressive anorexia, epigastric pain, fever, and weakness. The results of blood tests, blood cultures, transthoracic echocardiography, plain chest radiography, computed tomography angiography, and electrocardiography were unremarkable. We found severe infectious aortitis, crescent thickness surrounding the aorta, pseudoaneurysm development, and a mass with dimensions of 17 mm×8 mm within the aortic stent on transesophageal echocardiography (TEE). Broad-spectrum antibiotic therapy was initiated, and the patient was transferred to the operating room, where the infected stent and adhesive vegetation were removed. The patient recovered remarkably after the surgery and was discharged. At 6 months’ follow-up, he was in good condition. Our findings highlight the significance of maintaining vigilance and a high level of clinical suspicion for the possibility of vegetation formation and aortitis as the possible sequelae of COVID-19, particularly in patients with an implanted stent. Furthermore, we strongly suggest TEE in patients with implanted stents to detect vegetation and aortitis. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1831 https://rhythm.tums.ac.ir/index.php/jthc/article/download/1831/1082

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 18 3 2023 07 30 224 227 EN Mogtaba Gorji Department of Pediatric Cardiology, Children’s Medical Center (Pediatric Center of Excellence), Tehran University of Medical Sciences, Tehran, Iran Maryam Taraz Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran. Behdad Gharib Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran. Vahid Ziaee Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2023 05 12 2023 11 06 Kawasaki disease is an acute self-limiting systemic vasculitis in childhood, resulting in arterial swelling or inflammation and eventually leading to cardiovascular problems, such as coronary artery aneurysms. Based on previous studies, serum sodium ≤133 mmol/L, albumin ≤3.2 g/dL, alanine transaminase ≥80 U/L, and neutrophil percentage ≥80% at diagnosis are risk factors for intravenous immunoglobulin (IVIg). However, the prevalence of resistance to Ig among children with Kawasaki disease varies among different countries due to diversity in evaluation, treatment, and diagnosis. Approximately, 10% to 20% of patients have IVIg-resistant Kawasaki disease. As the probability of coronary artery damage associated with IVIg-resistant Kawasaki disease is higher than that with IVIg-sensitive Kawasaki disease, the early detection and appropriate treatment of IVIg-resistant Kawasaki disease can decrease the probability of damage to coronary arteries and hospital lengths of stay and cost. Kawasaki disease in early infancy is uncommon, and sometimes it occurs with thrombosis and peripheral gangrene. A positive genetic background may play a role in susceptibility to thrombosis. We herein describe a patient suffering from an IVIg-resistant Kawasaki disease with severe coronary artery thrombosis and positive genetic mutation. Medical treatment resolved the thrombosis, but the coronary arteries remained dilated. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1856 https://rhythm.tums.ac.ir/index.php/jthc/article/download/1856/1076

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 18 3 2023 07 30 228 231 EN Elahe Radmehr 1-Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2-Universal Scientific Education and Research Network (USERN), Tehran, Iran. Hassan Radmehr Department of Pediatric Cardiac Surgery, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Shahidi Department of Pediatrics, Besat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran. Keyhan Sayadpour Zanjani Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2023 08 21 2023 10 05 Partial anomalous pulmonary venous return (PAPVR) is a rare congenital heart malformation in which 1 or more pulmonary veins drain into the systemic venous circulation or directly into the right atrium instead of the left atrium. It may occur alongside other congenital heart defects, including atrial septal defect (ASD). All patients with newly diagnosed ASD must be evaluated thoroughly for the likelihood of PAPVR to select surgical or percutaneous procedures. Here, we describe a 10-year-old girl with PAPVR who underwent percutaneous device closure of her secundum ASD with her PAPVR neglected at 3 years of age. We had to correct the anomalous venous connection by removing the device during an intricate procedure. The typical connection of the pulmonary veins to the left atrium was reported on her postoperative echocardiography 1 day after surgery. The patient was discharged without complications, and her first follow-up visit 7 days