William Foot MBBS, Nelson Alphonso FRACS, Prem Venugopal FRACS
{"title":"Shunt or Primary Repair in Symptomatic Neonates With Tetralogy of Fallot: The Time has Come for a Randomised Trial to Settle the Debate","authors":"William Foot MBBS, Nelson Alphonso FRACS, Prem Venugopal FRACS","doi":"10.1016/j.hlc.2025.08.007","DOIUrl":"10.1016/j.hlc.2025.08.007","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 873-874"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xin Tao Ye MD , Soichiro Henmi MD, PhD , Edward Buratto MBBS, PhD , Mitchell C. Haverty MS , Can Yerebakan MD , Tyson Fricke MBBS, PhD , Christian P. Brizard MD, MS , Yves d’Udekem MD, PhD , Igor E. Konstantinov MD, PhD
{"title":"Symptomatic Neonates With Tetralogy of Fallot: Shunt or Primary Repair?","authors":"Xin Tao Ye MD , Soichiro Henmi MD, PhD , Edward Buratto MBBS, PhD , Mitchell C. Haverty MS , Can Yerebakan MD , Tyson Fricke MBBS, PhD , Christian P. Brizard MD, MS , Yves d’Udekem MD, PhD , Igor E. Konstantinov MD, PhD","doi":"10.1016/j.hlc.2025.01.009","DOIUrl":"10.1016/j.hlc.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>The optimal management strategy for symptomatic neonates with tetralogy of Fallot is unclear. We compared the outcomes of staged repair (SR) (shunt palliation followed by complete repair) and primary repair (PR) in two institutions that have each exclusively adopted one of these strategies.</div></div><div><h3>Method</h3><div>We retrospectively compared 65 symptomatic neonates who underwent shunt palliation between 1993 and 2021 at the Royal Children’s Hospital, Melbourne, Australia with 38 symptomatic neonates who underwent PR between 2005 and 2018 at the Children’s National Hospital, Washington, USA. Median follow-up duration was 8.0 (interquartile range 2.9–13.5) years.</div></div><div><h3>Results</h3><div>After the initial procedure, hospital mortality (shunt 4.6% vs PR 7.9%; p=0.50) and 5-year survival (shunt 94%; 95% confidence interval [CI] 84%–98% vs PR 89%; 95% CI 72%–96%; p=0.21) were not significantly different. The SR group had shorter durations of cardiopulmonary bypass and intensive care admission during the neonatal period, but a higher burden of unplanned re-interventions before discharge. Five-year freedom from re-interventions was not significantly different (shunt 63%; 95% CI 49%–74% vs PR 49%; 95% CI 29%–66%; p=0.13). Postoperative morbidity, mortality, and re-interventions were not significantly different among 13 propensity score–matched pairs balanced for operative weight. For neonates weighing <3 kg, PR was associated with significantly more early re-interventions.</div></div><div><h3>Conclusions</h3><div>In symptomatic neonates with tetralogy of Fallot operated at two institutions with distinct treatment protocols, no statistically significant difference in medium-term survival and re-intervention was observed between the two strategies. SR was associated with lower neonatal morbidity but more unplanned re-interventions before discharge. PR in neonates weighing <3 kg may result in more early re-interventions.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 935-950"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health for Every Heart – the Heart Foundation’s 25-year vision for heart health in Australia","authors":"","doi":"10.1016/j.hlc.2025.08.004","DOIUrl":"10.1016/j.hlc.2025.08.004","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Page 984"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sushma R. Rao PhD , Thalia Salagaras BSc , Yung-Chih Chen PhD , Christina A. Bursill PhD , Karlheinz Peter MD, PhD , Marten F. Snel PhD , Peter J. Psaltis MBBS, PhD
{"title":"Proteomic Effects of Colchicine on Human Macrophages Loaded With Oxidised Low-Density Lipoprotein Cholesterol","authors":"Sushma R. Rao PhD , Thalia Salagaras BSc , Yung-Chih Chen PhD , Christina A. Bursill PhD , Karlheinz Peter MD, PhD , Marten F. Snel PhD , Peter J. Psaltis MBBS, PhD","doi":"10.1016/j.hlc.2025.04.071","DOIUrl":"10.1016/j.hlc.2025.04.071","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 980-983"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early and Midterm Outcomes of INSPIRIS RESILIA Versus AVALUS: A Propensity Score Matching Analysis","authors":"Takuya Narita MD, PhD , Taisuke Nakayama MD, PhD , Shuhei Nishijima MD , Yoshitsugu Nakamura MD, PhD","doi":"10.1016/j.hlc.2025.02.110","DOIUrl":"10.1016/j.hlc.2025.02.110","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the early and midterm clinical outcomes of aortic valve replacement (AVR) using the INSPIRIS RESILIA bioprosthesis (IR-B) with AVR using the AVALUS bioprosthesis (AV-B).</div></div><div><h3>Methods</h3><div>This single-centre retrospective study analysed the perioperative clinical outcomes of 256 consecutive patients who underwent AVR with either IR-B (n=156) or AV-B (n=100) at this institution between 1 August 2018 and 30 June 2023. After propensity score matching, freedom from death, freedom from major adverse cardiovascular events (MACE), and echocardiographic data were compared between the two groups during the follow-up period.</div></div><div><h3>Results</h3><div><span><span>Propensity score matching resulted in the addition of 79 patients to each group. The 1-year survival rates in the propensity score-matched cohort were 93.8% and 94.5% in the IR-B and AV-B groups, respectively, while the 3-year survival rates remained unchanged, with no statistically significant differences between groups (p=0.88). At 3 years postoperatively, freedom from MACE was 93.2% and 92.8% in the IR-B and the AV-B groups, respectively, which was not statistically significant (p=0.90). The mean </span>aortic pressure gradient after AVR remained stable in both the IR-B and AV-B groups (IR-B group, 10.7–11.3 mmHg vs AV-B group, 11.5–12.1 mmHg), and there was no significant difference observed between the two groups during the follow-up period. The absolute change from the baseline left ventricular mass index in both the IR-B and AV-B groups decreased in each group over time (IR-B group, −20.8 to −38.6 g/m</span><sup>2</sup> vs AV-B group, −16.6 to −35.5 g/m<sup>2</sup>). However, these changes were statistically insignificant between the two groups over the 3-year follow-up.</div></div><div><h3>Conclusion</h3><div>The early and midterm clinical outcomes were comparable between the IR-B and AV-B groups.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 908-917"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xander Jacquemyn BSc , Sruti Rao MD , Ashish N. Doshi MD, PhD , David A. Danford MD , Shelby Kutty MD, PhD, MHCM
{"title":"Rapid Progression of Right Ventricular Deterioration and Timing of Pulmonary Valve Replacement in Repaired Tetralogy of Fallot","authors":"Xander Jacquemyn BSc , Sruti Rao MD , Ashish N. Doshi MD, PhD , David A. Danford MD , Shelby Kutty MD, PhD, MHCM","doi":"10.1016/j.hlc.2025.03.014","DOIUrl":"10.1016/j.hlc.2025.03.014","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to identify a progressive phenotype in repaired tetralogy of Fallot (rTOF), characterised by accelerated changes in right ventricular (RV) parameters on cardiac magnetic resonance (CMR) and assess its association with an accelerated course to pulmonary valve replacement (PVR).</div></div><div><h3>Method</h3><div>This was a retrospective study of patients with rTOF who had two or more CMRs (2005–2022). Clinical variables and CMR data were collected, and annualised changes in CMR data were calculated. “Rapid progressors” were classified as those with annual RV ejection fraction decreases>3.5% or RV end-diastolic volume index (RVEDVi) increases>3.5 mL/m<sup>2</sup>.</div></div><div><h3>Results</h3><div>A total of 112 patients with rTOF (median age 14.7 years, 63 males) were included, with 60 identified as rapid progressors (12 based on RV ejection fraction, 48 based on the RVEDVi criteria). Baseline RV volumes and function were similar between groups, although rapid progressors had a higher pulmonary regurgitant fraction (PRF) (38.2±16.3 vs 31.4±15.4%; p=0.033). Pulmonary regurgitant fraction (PRF) (odds ratio 1.03; 95% confidence interval [CI] 1.00–1.05; p=0.037) and RV end-diastolic volume/left ventricular end-diastolic volume ratio (odds ratio 2.75; 95% CI 1.13–7.35; p=0.032) were significant predictors of the rapid progressive phenotype. During follow-up (median 9.3 years, interquartile range 6.8–13.8), 48 patients underwent PVR. Rapid progressors had a five-fold increased risk of PVR (hazard ratio 5.44; 95% CI 2.75–10.8; p<0.001). Adjusting for age, sex, transannular patch use, baseline RVEDVi, and PRF, the risk of PVR remained over five-fold higher in rapid progressors (hazard ratio 5.18; 95% CI 4.39–5.97; p<0.001).</div></div><div><h3>Conclusions</h3><div>This study identifies imaging biomarkers in the rTOF subpopulation that were more likely to have an early PVR.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 951-960"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sleiman Sebastian Aboul-Hassan MD, PhD , Grzegorz Hirnle MD, PhD , Bartlomiej Perek MD, PhD , Marek Jemielity MD, PhD , Szymon Kocanda MD, PhD , Tomasz Hirnle MD, PhD , Miroslaw Brykczynski MD, PhD , Radoslaw Gocol MD, PhD , Marek Deja MD, PhD , Jan Rogowski MD, PhD , Michal Krejca MD, PhD , Wojciech Pawliszak MD, PhD , Kazimierz Widenka MD, PhD , Jerzy Pacholewicz MD, PhD , Pawel Bugajski MD, PhD , Krzysztof Wrobel MD, PhD , Bohdan J. Maruszewski MD, PhD , Tomasz Hrapkowicz MD, PhD , Romuald Cichon MD, PhD , KROK Investigators
{"title":"Impact of Deep Sternal Wound Infection on Long-Term Survival Based on Revascularisation Strategy: Results From the Polish National Registry","authors":"Sleiman Sebastian Aboul-Hassan MD, PhD , Grzegorz Hirnle MD, PhD , Bartlomiej Perek MD, PhD , Marek Jemielity MD, PhD , Szymon Kocanda MD, PhD , Tomasz Hirnle MD, PhD , Miroslaw Brykczynski MD, PhD , Radoslaw Gocol MD, PhD , Marek Deja MD, PhD , Jan Rogowski MD, PhD , Michal Krejca MD, PhD , Wojciech Pawliszak MD, PhD , Kazimierz Widenka MD, PhD , Jerzy Pacholewicz MD, PhD , Pawel Bugajski MD, PhD , Krzysztof Wrobel MD, PhD , Bohdan J. Maruszewski MD, PhD , Tomasz Hrapkowicz MD, PhD , Romuald Cichon MD, PhD , KROK Investigators","doi":"10.1016/j.hlc.2025.03.016","DOIUrl":"10.1016/j.hlc.2025.03.016","url":null,"abstract":"<div><h3>Background</h3><div>This multicentre study aimed to investigate the impact of deep sternal wound infection (DSWI) on long-term survival among patients undergoing coronary artery bypass grafting (CABG) using multiple arterial grafting (MAG) or single artery with saphenous vein grafts (SAG).</div></div><div><h3>Methods</h3><div>Data were obtained from the Polish National Registry of Cardiac Surgery Procedures database. Between January 2012 and December 2020, 81,136 patients who underwent CABG for multivessel disease were included in the study. Patients were divided into four groups: MAG with DSWI (n=219), MAG without DSWI (n=8,611), SAG with DSWI (n=1,432), and SAG without DSWI (n=70,874). Inverse probability of treatment weighting based on the generalised propensity score was used to minimise imbalance between the groups.</div></div><div><h3>Results</h3><div>In the weighted sample, DSWI in patients who received MAG was associated with reduced long-term survival when compared with patients without DSWI and MAG (hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.29–2.78; Bonferroni corrected p=0.01). Deep sternal wound infection in patients who received SAG was associated with reduced long-term survival when compared with patients without DSWI and SAG (HR 1.92, 95% CI 1.69–2.17; Bonferroni corrected p=0.01). In patients who did not develop DSWI, MAG was associated with improved long-term survival compared with SAG (HR 0.68, 95% CI 0.63–0.74; Bonferroni corrected p=0.01). However, patients who received MAG and developed DSWI had similar long-term survival when compared with patients who received SAG and did not develop DSWI (HR 1.31, 95% CI 0.90–1.92; Bonferroni corrected p=0.63). A landmark analysis excluding the first 6 months of follow-up was performed to exclude the risk of acute mortality due to DSWI. In the weighted sample, the results were consistent with the main analysis.</div></div><div><h3>Conclusion</h3><div>Deep sternal wound infection is associated with worse survival in patients receiving MAG and SAG. Moreover, the superior effect of MAG over SAG diminishes once DSWI develops.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"34 9","pages":"Pages 961-968"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}