We sought to investigate the inter- and intra-country variation in paediatric heart transplantation (HTx) and mechanical circulatory support (MCS) availability and practice in Europe. Data was obtained through a survey circulated to paediatric transplant cardiologists identified through the Association of European Paediatric and Congenital Cardiology between November 2022 and March 2023. Twenty-eight respondents from twenty-eight European countries completed the survey. Twenty-four (86%) had paediatric and 25 (89%) had adult congenital HTx services. National paediatric HTx centre density ranged from 0.00 to 5.35 per 10 million inhabitants. Eighteen (64%) countries followed either Eurotransplant or Scandiatransplant protocols for organ allocation and 59% of the surveyed countries had low HTx volumes (< 4 paediatric HTx annually), based on the self-reported numbers. A ventricular assist device (VAD) programme was operational in 22 (79%) countries. In only 9 countries (38%), there were dedicated resources for HTx as part of the hospital budget; however, a vast majority (77%) reported that families suffered no cost when a VAD was utilised. Twenty-one countries (78%) reported limited intensive care unit beds and 14 (54%) reported that HTx impacted on congenital heart surgery cases. Only 12 of 27 countries (44%) had a standardised national protocol for post-HTx care. There was no correlation between paediatric HTx centre density, population or GDP per capita. Conclusion: There is a high degree of variation both within and between the surveyed European countries with regard to paediatric HTx centre density, VAD availability, listing protocols, and post-HTx management. Multiple factors contribute to this heterogeneity, which makes standardisation of HTx listing and VAD criteria challenging. Increased cross-national collaborative efforts between European countries may strengthen both HTx and MCS availability and outcomes, especially in regions with several smaller neighbouring countries. What is Known: • The care of paediatric heart transplant (HTx) and mechanical support (MCS) patients varies across Europe. What is New: • This paper elucidates the differences in transplant service organisation and the care of transplant and MCS patients in twenty-eight European countries. • These findings could potentially encourage broader open dialogue and facilitate collaboration across European paediatric HTx centres with development of standardised listing criteria, improved collective European registry data and creation of standards for screening post-HTx patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-026-06927-1.

Heart-rhythm disorders and related congenital anomalies in children often remain silent until physical activitybrings on symptoms. We report an 11-year-old girl who experienced her first signs of heart disease only after exertion. Although late detection of such anomalies can sometimes be fatal, careful clinical examination may reveal these conditions early.

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare heart defect present at birth. In this condition, the left coronary artery, which normally comes from the aorta, instead starts from the pulmonary artery. This abnormal connection can lead to reduced blood flow to the heart muscle, causing damage like heart attacks and increasing the risk of serious heart rhythm problems or sudden cardiac arrest (SCA). Diagnosis is made through imaging studies, and treatment often involves surgical correction to restore normal coronary circulation. The prognosis of ALCAPA largely depends on the age at which it is diagnosed and the timing of treatment. Early intervention is crucial for improving outcomes. This case report presents a 11-year-old girl, who is an athlete, with late presentation of ALCAPA syndrome in the form of ventricular fibrillation leading to SCA. She had no previous symptoms, the electrocardiogram showed no abnormalities except for left axis deviation and the several echocardiograms showed no enlargement of the left ventricle, with possible big right coronary artery. ALCAPA has been confirmed by computed tomography coronary angiographyscan. Child was surgically treated by coronary artery transfer for ALCAPA with satisfactory outcome. The implantation of an implantable cardioverter defibrillator is still under consideration.

Introduction: The impact of nutrition on human health has become a central topic in modern research. The Mediterranean diet, rich in fruits, vegetables, fish, whole grains, and olive oil, has been associated with a lower risk of cardiovascular diseases. However, the effects of non-Mediterranean diets, particularly among students, remain insufficiently explored. This study aimed to examine differences in the dietary habits of health sciences students in two cities in Bosnia and Herzegovina (Mostar and Sarajevo) and Split, Croatia. Methods: A cross-sectional descriptive study was conducted between February and November 2024, including 473 students (Mostar: 125, Sarajevo: 230, Split: 118). Dietary habits were assessed using a validated food frequency questionnaire and the Mediterranean Diet Adherence Screener. Statistical analysis included Pearson’s chi-square test, with significance set at p < 0.05. Results: Students from Split showed significantly higher adherence to Mediterranean dietary habits, including greater consumption of vegetables (p = 0.009), fish (p = 0.035), legumes (p = 0.036), and tomato sauce (p = 0.022). Students in Sarajevo reported the highest intake of sugary drinks (p < 0.01), while those in Split consumed the least margarine and cream-based fats (p = 0.003). No significant differences were found in fruit consumption. Conclusion: Given the importance of diet in preventing chronic diseases, targeted nutrition education programs are needed to promote healthier eating habits among students. Future research should explore the underlying causes of these dietary differences and their long-term health implications.

Atherosclerosis, one of the leading causes of death in developed countries is characterized by lumen reduction of blood vessels due to local thickening of internal blood vessels caused by plaque/atheroma. It begins in childhood, goes for a long time without manifesting symptoms, increasing with age it begins to seriously threaten health. The most important risk factors for the development of atherosclerotic disease are: hyperlipidemia, hypertension, smoking, diabetes, high fibrinogen, excessive weight, increased level of homocysteine, physical inactivity, heredity and immune response in some diseases. The primary intention of prevention is to preclude the occurrence of risk factors for atherosclerosis, and the secondary is to prevent the development or aggravation of the illness along with the reduction or control of existing risks. There is an increasing number of studies that show that children are overweight, which in adolescence is certainly a risk factor for the onset of many chronic diseases, namely: cardiovascular, type 2 diabetes, orthopedic, and psychological diseases. The obesity epidemic is one of the most serious health problems of today affecting individuals of all ages. Atherosclerosis demands action with the aim of early detection and treatment as well as the reduction of development of risk factors for coronary artery diseases. Finding the most effective preventive measures for obesity in each country requires precise epidemiological data on the number of obese children and youth, as well as on their eating and activity habits.

Objectives This study aimed to determine the status of training of adult congenital heart disease (ACHD) cardiologists in Europe. Methods A questionnaire was sent to ACHD cardiologists from 34 European countries. Results Representatives from 31 of 34 countries (91%) responded. ACHD cardiology was recognised by the respective ministry of Health in two countries (7%) as a subspecialty. Two countries (7%) have formally recognised ACHD training programmes, 15 (48%) have informal (neither accredited nor certified) training and 14 (45%) have very limited or no programme. Twenty-five countries (81%) described training ACHD doctors ‘on the job’. The median number of ACHD centres per country was 4 (range 0–28), median number of ACHD surgical centres was 3 (0–26) and the median number of ACHD training centres was 2 (range 0–28). An established exit examination in ACHD was conducted in only one country (3%) and formal certification provided by two countries (7%). ACHD cardiologist number versus gross domestic product Pearson correlation coefficient=0.789 (p<0.001). Conclusion Formal or accredited training in ACHD is rare among European countries. Many countries have very limited or no training and resort to ‘train people on the job’. Few countries provide either an exit examination or certification. Efforts to harmonise training and establish standards in exit examination and certification may improve training and consequently promote the alignment of high-quality patient care.

Aim To investigate the frequency of consumption of sweet and salty snacks among children aged 2-18 years in relation to their mothers' education level. Methods A descriptive epidemiological study was conducted in five dental practices at the School of Medicine of the University of Mostar from May to October 2022. The data were collected from medical records. Results: Out of a total of 477 children, 172 (36.1%) had mothers with a high school education, while 305 (63.9%) had mothers with a university degree. In the group of preschool children (aged 2-6 years), there were 42 mothers with high school education and 105 with university degree. In the group of school children (age 7-18 years) there were 130 mothers with high school education and 200 with university degree. The difference in the consumption of sweetened beverages among children of mothers with high school and university was not statistically significant. Similar results were found for the consumption of salty snacks, lollipops, caramels and candies. The frequency of the consumption of biscuits, chocolate and cakes (several times a day) was statistically significantly higher among the children of mothers with high school education (p=0.04), especially among school children. Eating habits of children, regardless of the level of education of their mothers, differed significantly only in the consumption of lollipops, caramels, and candies (p=0.03), which were consumed once a day by 79 (63.7%) schoolchildren and 45 (36.3%) of pre-schoolers. Conclusion A higher level of education among mothers does not necessarily equate to proper nutritional knowledge.

Objective. The aim of this study was to present data on the prevalence of seropositive children tested in the laboratory of the Eurofarm polyclinic in Sarajevo, from September 2020 to May 2021. Material and Methods. Peripheral blood samples were collected and anti-SARS-CoV-2 antibodies were detected using an electrochemiluminescence immunoassay. Results. In the total of 762 tested children, 187 were positive (24.5%), based on cut-off value. Of all the positive cases 42.8% were female while 57.2% were male. There were 10.1% of positive children in the first age group (0-5 years), 44.4% in the second group (6-13 years), and 45.5% in the third group (14-18 years). There was no statistically significant difference in seroprevalence between age groups and gender. The lowest seroprevalence (3.6%) was observed in October 2020 after the first pandemic wave, and the highest seroprevalence (60.3%) was observed in April 2021, corresponding to the third pandemic wave. Conclusion. The results of our study showed that the seroprevalence in children was low, especially during the first year of the pandemic. In the second year of the pandemic, there was an evident statistically significant increase in the number of seropositive children. Similar data have been shown in studies for adults.

Background: Cardiovascular diseases (CVD) are the cause of 17 million deaths a year worldwide, of which 25% are sudden cardiac deaths (SCD). In Europe cardiovascular diseases (CVD) remains a leading cause of death in Europe accounting for 3.9 million deaths each year. Even with well-known risk factors and the current standards of health care, improvement of health and quality of life of CVD patients are still remains one of the biggest public health challenges we must overcome. Objective: The aim of this study was to analize of current strategic documents and relevant facts of WHO and other appropriate institutions regarding CVDs prevention and control for potentialy use in Bosnia and Herzegovina (B&H). Methods: Authors made a narrative review to provide a brief overview of the recent and relevant documents of good practice in prevention, diagnostic and therapeutic approaches of cardiovascular diseases that should be consider as milestones for the health authorities in the Federation of B&H. Results and Discussion: Bosnia and Herzegovina is among the countries with a high risk of CVD together with Albania, Croatia, Czech Republic, Estonia, Hungary, Kazakhstan, Poland, Slovakia, and Turkey. The main public health challenge in Bosnia and Herzegovina is reducing noncommunicable diseases (NCDs): heart disease, stroke, cancer, diabetes and chronic respiratory disease. NCDs are estimated to account for 80% of the country’s annual deaths, and addressing them is the foremost public health priority in the country. Cardiovascular diseases still represent a worldwide public health problem, with some new dimensions caused by challenges caused through pandemic of COVID-19. The well-known cardiovascular risk factors require new and more efficient public health approaches to the prevention and control. Conclusion: Due to the recently developed cardiovascular guidelines that were made by the European Society of Cardiology and World Heart Federation, key priority for health authorities should be is to update the existing CVD guidelines in the Federation of BiH in accordance with the international good practice to support healthcare professionals in their efforts to reduce the burden of cardiovascular disease in both individual patients, as well as at a population level..