Postoperative arrhythmias are commonly seen in pediatric cardiac intensive care units and are linked to higher rates of both morbidity and mortality in children with congenital heart disease. However, the incidence of early postoperative arrhythmias in the pediatric population is unclear, varying from 7.3% to 48% in the literature. We searched the PubMed, Embase, and Web of Science databases from 2000 to 2025 with the aim to perform a systematic review of the existing literature on the incidence and risk factors of early arrhythmias following heart surgery. A total of 16 cross-sectional observational studies, including 5,563 patients who underwent surgery for congenital heart disease and 901 patients who developed early postoperative arrhythmias, met the inclusion criteria. Patients developing early postoperative dysrhythmias were younger, with a lower body weight, and the duration of cardiopulmonary bypass was significantly longer. Other incriminated risk factors for the occurrence of early postoperative arrhythmias were hemodynamic instability, complexity of the surgical procedure, and higher vasoactive-inotropic scores. Pediatric patients with congenital heart disease who undergo cardiac surgery face increased morbidity and mortality due to the risk associated with the multifactorial complication of early postoperative arrhythmias. The reported incidence of these arrhythmias varies greatly among different studies and a better understanding of risk factors and pathophysiological mechanisms would improve postoperative outcomes for this notably exposed population.

Background: Peripheral artery disease (PAD), traditionally affecting older adults, is increasingly diagnosed in younger patients, highlighting the need for early, non-invasive biomarkers such as the leukocyte glycemic index (LGI) that reflect the inflammatory mechanisms driving atherosclerosis. The aim of this study was to determine whether the LGI can be associated with the presence of symptomatic atherosclerotic disease on patients under 45 years. Methods: We conducted a retrospective observational study, enrolling all patients under the age of 45 years who were admitted to the Department of Vascular Surgery of Targu Mures County Emergency Clinical Hospital between January 2019 and May 2024. Patients were categorized into two groups based on the presence or absence of systemic atherosclerosis. Results: Patients with systemic atherosclerosis had a higher incidence of cerebrovascular events (p = 0.006) and ischemic heart disease (p = 0.038), as well as elevated counts of white blood cells (WBCs) (p = 0.003), platelets (p = 0.038), neutrophils (p = 0.002), monocytes (p = 0.024), lymphocytes (p = 0.01), and LGI (p = 0,006). At the receiver operating characteristics analysis, we observed a significant correlation between the baseline values of the LGI and systemic atherosclerosis (p = 0.004). The area under the curve (AUC) was determined to be 0.707, with an optimal cut-off value established at 0.683, resulting in a sensitivity of 79.2% and a specificity of 60.6%. Additionally, elevated baseline values for platelets (OR 2.18; p = 0.017), WBCs (OR 2.06; p = 0.020), neutrophils (OR 2.75; p = 0.004), lymphocytes (OR 2.47; p = 0.021), monocytes (OR 2.03; p = 0.021), and LGI (OR 2.90; p = 0.024) were also identified as predictive factors of systemic atherosclerosis. Conclusions: Elevated values of LGI are associated with the presence of symptomatic atherosclerotic disease in patients under 45 years.

Introduction: Abdominal aortic aneurysm (AAA)-associated mortality has remained high in Romania over the past decade. The aim of this study was to evaluate whether the recent introduction of endovascular aneurysm repair (EVAR) has contributed to a decrease in AAA- related mortality in northwestern and central Romania and to identify the main determinants of procedure-related costs. Methods: We conducted a double-center observational study comparing outcomes and costs in a prospective EVAR arm and a retrospective open surgical reconstruction (OSR) arm. Results: A total of 117 patients were included (48.7% treated with EVAR; 39.3% presented with ruptured AAAs). OSR was associated with significantly higher post-intervention morbidity (greater number of complications, p < 0.01; longer intensive care unit stay, p < 0.001) and higher in-hospital mortality (p = 0.03). Overall mortality was similar to that reported in Romania before the widespread adoption of EVAR (25.6% vs. 20.3%, p = 0.36). EVAR-related average costs were significantly higher than those associated with OSR, at €13,734 (range: €10,016–€40,363) vs. €5,989 (range: €690–€68,205) (p < 0.001). Conclusions: The selective introduction of EVAR for elective cases was not associated with a decrease in AAA-related mortality. EVAR remains more expensive than OSR in Romania. These findings suggest that reorganizing AAA management, particularly in emergency settings, might be an important objective in the northwestern and central regions of Romania.

Background: Cardiovascular diseases (CVDs) represent a leading cause of global mortality, with acute myocardial infarction (AMI) a significant contributor. Although advancements in treatment and preventive strategies have improved outcomes in many regions, disparities persist, particularly in Eastern European countries like Romania, where CVD-related mortality remains disproportionately high. This study investigated temporal trends in AMI management and stroke incidence within a Romanian regional AMI network over three consecutive first quarters (Q1 2022–2024). Materials and methods: A total of 722 patients were included. Patients were classified as STEMI or NSTEMI according to ESC guidelines. Data were collected on clinical management, including pPCI timing, coronary angiography, pharmacological treatments, radial access, LDL-cholesterol evaluation, and stroke history or in-hospital stroke events. Results: Timely primary percutaneous coronary intervention (pPCI) for STEMI patients improved significantly, both in overall use and in administration within 120 minutes of symptom onset. Radial access rates remained consistently high. Significant gains were noted in LDL-cholesterol evaluation and, among patients with LVEF <40%, in ACE inhibitor/ARB and beta-blocker prescriptions. Although timely coronary angiography increased in NSTEMI patients, this change was not statistically significant. Stroke history and in-hospital occurence varied across study periods. Conclusions: The study’s findings highlight advancements in AMI care while emphasizing the continued need to address disparities and the crucial role of timely intervention, reflecting the ‘time is tissue’ principle for optimal patient outcomes.

Introduction: Coronary artery dissection caused by trauma is a rare but serious condition that can lead to acute coronary syndrome. The dissection may result from various mechanisms, including thrombus formation and intramural hematoma, leading to intraluminal occlusion. This report presents a case of acute myocardial infarction secondary to right coronary artery dissection in a traumatic context. Case Presentation: We report the case of a 30-year-old male patient who presented to the emergency department with constrictive chest pain after sustaining direct blunt thoracic trauma caused by a pig. Clinical and imaging findings were suggestive of an acute coronary event. Coronary angiography and optical coherence tomography confirmed an acute occlusion of the right coronary artery due to dissection with intramural hematoma. A drug-eluting stent was placed to restore vessel patency. The patient had a favorable outcome, with improved ventricular function at discharge compared to admission. Conclusion: Although uncommon, coronary artery dissection should be considered in patients presenting with acute chest pain following thoracic trauma. Prompt diagnosis and timely interventional treatment are essential to improving prognosis and minimizing longterm impairment of ventricular function.