Total atrioventricular (AV) block is inconvenient and serious complication of open heart surgery. Permanent total AV block requires the implantation of permanent pacemaker in order to allow normal hemodynamics and patient’s survival. In infancy additional challenge is the surgical approach, the selection of electrodes and PM, as well as place of implantation. We are publishing case report of successful double-chamber DDD pacemaker implantation at an infant born with Fallot tetralogy and with low birth weight due to complete AV block after primary surgical correction of these congenital defects.

The aim of this study was to assess the quality of life children after cardiac surgery for congenital heart disease (CHD) and to compare these results with healthy children. To assess the quality of life children after surgery for CHD we performed a cross-sectional study of 114 patients who were patients at the Department of Paediatrics in Tuzla, between the ages of 2 and 18 years, of both sexes, and with one of their parents. We used the "PedsQL 4.0 Generic Core Scales", with both child self-report and parent proxy-reports. By self assessment, the PedsQL total scores for quality of life were statistically significantly different between children after cardiac surgery for ages 13 to 18 years and healthy children, while by parent report PedsQL total scores were statistically significantly different between children after cardiac surgery for ages 5 to 7 years and healthy children. By self assessment, children after cardiac surgery for ages from 5 to 7 and 13 to 18 years reported that they have a statistically significantly lower quality of life in the segment school functioning compared to the healthy children. By parental assessment, children after cardiac surgery for ages 2 to 4, 5 to 7 and 8 to 12 years have a statistically significantly lower quality of life in the segments of physical and psychosocial health, emotional, social and school functioning. The results of our study indicate that children after cardiac surgery for CHD by self and parent assessment have a lower quality of life than healthy children.

Hypertrophic obstructive cardiomyopathy (HOCM) is a primary, usually familial and genetically fixed myocardial hypertrophy, with dynamic left ventricular outflow tract obstruction. An alternative to surgical myectomy in the treatment of severe, drug refractory, HOCM is percutaneous transluminal septal myocardial ablation (PTSMA). We report a case of 24 year old female patient who had the first septal myectomy but because of progression of her disease, the percutaneous treatment of hypertrophic obstructive cardiomyopathy was performed. A year after the PTSMA the patient was without of symptoms.

Angina pectoris may be associated with normaln coronary arteries. Normal coronary arteries status is defined as absence of visible disease or the irregularity of lumen (less than 50%) as assessed visually on the interventional cardiologists. In our retrospective study among 1130 patients we have identified 181 patients with normal angiographic findings with various risk factors, as male sex, body mass index (BMI), lipid disorders, smoking, hypertension, diabetes mellitus type 2. The analysis results suggest that 56.3% patients of 181 verified normal coronary findings involve female patients with high BMI, unregulated hypertension and lipid disorders. In order to find real causes of chest pain, patients with normal coronary status need careful examination and treatment. The reduction of risk factors and adequate medications are important preconditions for the good quality of life in these patients.

In this study we analyzed patients glucose levels taken before and after coronary artery bypass surgery. The data are taken from University of Sarajevo Clinics Centre- medical documentation of Heart Center from January 1st, 2007 to October 31st, 2007. Therefore, the entire study is done retrospectively. The patients considered in this analysis were divided into three groups. The patients in the first group were treated with peroral antidiabetics. The second group included patients treated with insulin while the third group consisted of patients without diabetes and acted as control group. All the patients had increased BMI. In the first two groups glucose levels were elevated before the surgery. Data analysis showed that three patients from the first group changed from peroral antidiabetics to insulin during postoperative period, and they were dismissed from hospital with this therapy. In the control group, peroral antidiabetis were introduced in four patients. The study results show that all the three groups have had high glycaemia on the first postoperative day. This may be caused by a number of reasons: inadequate pre-operative antidiabetic therapy, the impact of stress during surgery, inadequate pre-operative treatment of glycaemia or avoidance of the proscribed therapy by patients themselves. Stress during operation and administration of several medications after operation may also cause increased insulin resistance and distort glycaemia control.