Pediatric Cardiac Surgery Annual最新文献

Borderline Left Ventricle: Criteria for Surgical Decision Making With an Emphasis on Cardiac Magnetic Resonance Imaging 边缘左心室：手术决策的标准，重点是心脏磁共振成像

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.02.003

Christopher Z. Lam MD , Shi-Joon Yoo MD, PhD , Osami Honjo MD, PhD , David J. Barron MBBS, MD

引用次数: 0

Single and Double Root Translocation for Transposition and Malposition of the Great Arteries 单根和双根移位治疗大动脉转位和错位

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.01.001

Bari Murtuza MD , Juan Lehoux MD , Victor O. Morell MD

{"title":"Single and Double Root Translocation for Transposition and Malposition of the Great Arteries","authors":"Bari Murtuza MD , Juan Lehoux MD , Victor O. Morell MD","doi":"10.1053/j.pcsu.2025.01.001","DOIUrl":"10.1053/j.pcsu.2025.01.001","url":null,"abstract":"<div><div>Aortic root translocation and double root translocation have emerged as potentially valuable surgical options for complex transposition of the great arteries or double outlet right ventricle with VSD and LV outflow tract obstruction (LVOTO). These complex approaches offer excellent laminar LV outflow tracts with almost no late LVOT reinterventions. Whilst the advantages for the LVOT are clear, there is an early cost in terms of prolonged operative ischemic times compared with the Rastelli procedure or even arterial switch with LVOTO resection. This appears to translate into a degree of perioperative morbidity. Further, concerning double root translocation, a clear benefit above a single root approach with no right ventricle-pulmonary artery conduit, should be demonstrable. Adoption of root translocation should not come at the expense of a higher incidence of neo-aortic incompetence or mitral regurgitation as has been reported in some series. We suggest that the best outcomes are likely to be achieved where the strategy is tailored to individual patient anatomy and pathophysiology, particularly taking into account: the relative size of the native pulmonary-to-aortic valve; complexity of LVOTO; and presence of abnormal coronary artery patterns or associated lesions. Additional long-term data for these relatively recent techniques are still awaited, although there are some early suggestions that for the most complex reconstructions, there may be some late occurrence of heart failure. Judicious intra-operative assessment is often the final arbiter for the best approach in a given patient.</div></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"28 ","pages":"Pages 51-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

State of the Art: Complex Peripheral Pulmonary Artery Reconstruction Techniques 最新进展：复杂的肺动脉外周重建技术

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.03.002

Elisabeth Martin MD, MPH, Michael Ma MD, Frank L Hanley MD

{"title":"State of the Art: Complex Peripheral Pulmonary Artery Reconstruction Techniques","authors":"Elisabeth Martin MD, MPH, Michael Ma MD, Frank L Hanley MD","doi":"10.1053/j.pcsu.2025.03.002","DOIUrl":"10.1053/j.pcsu.2025.03.002","url":null,"abstract":"<div><div>Over the last several years, we developed and improved our surgical approach to patients requiring pulmonary artery reconstruction in the setting of TOF-PA-MAPCA and other forms of peripheral pulmonary artery stenosis (PPAS). PPAS is a relatively rare form of congenital heart disease and typically associated with genetic syndromes, such as Williams or Alagille syndromes. We no longer do a staged approach and use a midline incision in all cases.</div><div>We have now operated on almost 1000 patients with TOF-PA-MAPCA or extensive bilateral PPAS. Early mortality ranges from 2.1% (3/145 PPAS) to 4.9% (38/780 TOF-PA-MAPCA, total cohort). In our TOF-PA-MAPCA cohort, independent factors for early mortality were Alagille syndrome (HR 2.8, 95% CI: 1.4-5.7; <em>P</em> < 0.004), any preoperative respiratory support (HR 2.0, 95% CI: 1.2-3.3; <em>P</em> < 0.008), and previous palliative surgery at our center (HR 3.5, 95% CI: 2.3-5.4; <em>P</em> < 0.001) on multivariable Cox regression analysis. Complete intracardiac repair was achieved in 90% (704/780) of this cohort.</div><div>This document reports our surgical approach to pulmonary artery reconstruction with emphasis on certain key concepts. Our surgical strategy is applicable to essentially every patient with TOF-PA-MAPCA or PPAS.</div></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"28 ","pages":"Pages 101-106"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Learning from Small-Volume Congenital Heart Programs 从小容量先天性心脏项目中学习

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2024.12.001

Christopher A. Caldarone MD , Peter C. Laussen MBBS, FANZCA, FCICM

{"title":"Learning from Small-Volume Congenital Heart Programs","authors":"Christopher A. Caldarone MD , Peter C. Laussen MBBS, FANZCA, FCICM","doi":"10.1053/j.pcsu.2024.12.001","DOIUrl":"10.1053/j.pcsu.2024.12.001","url":null,"abstract":"<div><div>The relationship between surgical volume and clinical outcomes in congenital heart surgery has been frequently studied and interpreted to indicate that higher volume programs are associated with superior outcomes after congenital heart surgery. Volume-based assumptions have been used to support the notion that volume-specific stratification of case mix would improve overall outcomes in the United States with specific attention to programs with annualized volumes of 75-200 STS index cases/year. Although not intended, some have perceived these recommendations to indicate that programs performing 75-200 annualized index cases/year offer surgical outcomes of lesser quality than higher volume programs. Nevertheless, some programs performing 75-200 annualized index cases/year consistently perform exceptionally well. Because the inherent advantages - and challenges - associated with being a program in this size range have not been frequently examined, this manuscript focuses on describing these attributes. We hypothesize that better understanding of the determinants of high (or low) performance in this size range could have significant impact on delivery of care in the United States.</div></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"28 ","pages":"Pages 130-137"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Standards in Congenital Heart Surgery Using Outcomes Data and Risk Stratification 利用结果数据和风险分层提高先心病手术标准

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.03.003

S. Ram Kumar MD, PhD, FACS

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Advice to Young Athletes With Anomalous Aortic Origin of a Coronary Artery With and Without Surgery 对冠状动脉主动脉起源异常的年轻运动员的建议，无论是否手术

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.01.002

Silvana Molossi MD, PhD , Shagun Sachdeva MD

引用次数: 0

Is the STAT Classification the Best That We Can Do? STAT分类是我们能做的最好的吗？

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.02.002

R.D.B. Jaquiss MD

引用次数: 0

Editors’ Introduction 编辑的介绍

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.03.004

Tara Karamlou MD, MSc , David J. Barron MD, FRCS(CT)

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Surgical Management of Congenital Aortic and Truncal Valve Disease: A Comprehensive Review 先天性主动脉瓣和主动脉瓣疾病的外科治疗：综合综述

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.03.001

Supreet P. Marathe MCh , Christopher W. Baird MD

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How-I-Do-It: The Ross Procedure in Adolescents With Bicuspid Aortic Valve, Aortic Regurgitation and a Dilated Annulus 我是怎么做的：罗斯手术治疗青少年二尖瓣主动脉瓣，主动脉瓣返流和主动脉环扩张

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 DOI: 10.1053/j.pcsu.2025.02.001

Vincent Chauvette MD, Elbert E. Williams MD, Lilyanne Chen MD, Ismail El-Hamamsy MD, PhD

{"title":"How-I-Do-It: The Ross Procedure in Adolescents With Bicuspid Aortic Valve, Aortic Regurgitation and a Dilated Annulus","authors":"Vincent Chauvette MD, Elbert E. Williams MD, Lilyanne Chen MD, Ismail El-Hamamsy MD, PhD","doi":"10.1053/j.pcsu.2025.02.001","DOIUrl":"10.1053/j.pcsu.2025.02.001","url":null,"abstract":"<div><div>While the Ross procedure provides optimal clinical outcomes for young patients with aortic valve disease, the presence of preoperative aortic regurgitation (AR) with a dilated aortic annulus have long been recognized as independent predictors of early autograft failure. While this had led many to abandon the Ross procedure in this setting, we sought to specifically address the clinical and anatomic features that are unique to patients with severe AR, namely a dilated aortic annulus, aortic/pulmonary annular mismatch, ascending aortic dilatation and persistent hypertension early after surgery. Using a tailored surgical approach along with strict blood pressure control postoperatively, we believe that many of the concerns with the Ross procedure in this setting can be successfully mitigated. Importantly, these adjuncts do not compromise the dynamism of the autograft root, an important feature for the long-term benefits of the Ross procedure, especially in young and adolescent populations. In this article, we describe in detail our Ross technique in the setting of young patients with bicuspid AR and a dilated aortic annulus.</div></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"28 ","pages":"Pages 79-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0