Pediatric Cardiac Surgery Annual最新文献_第4页

What is the Optimal Surgical Technique for Anomalous Aortic Origin of a Coronary Artery? 冠状动脉异常起始的最佳手术技术是什么？

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 Epub Date: 2025-02-15 DOI: 10.1053/j.pcsu.2025.02.006

Carlos M. Mery MD, MPH , Ziv Beckerman MD

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Staged Treatment for Critically Ill Neonates With Ebstein Anomaly: Cone Repair After Starnes Procedure 危重新生儿Ebstein异常的分阶段治疗：Starnes手术后椎体修复

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 Epub Date: 2025-02-14 DOI: 10.1053/j.pcsu.2025.02.007

Luciana da Fonseca da Silva MD , Victor Morell MD , Mario Castro Medina MD , Jose Pedro da Silva MD

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Donation After Circulatory Determination of Death in Congenital Heart Disease: Should We Embrace? 先天性心脏病患者血液循环确定死亡后的捐赠：我们应该接受吗？

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 Epub Date: 2025-02-13 DOI: 10.1053/j.pcsu.2025.02.005

Reshma M. Biniwale MD

{"title":"Donation After Circulatory Determination of Death in Congenital Heart Disease: Should We Embrace?","authors":"Reshma M. Biniwale MD","doi":"10.1053/j.pcsu.2025.02.005","DOIUrl":"10.1053/j.pcsu.2025.02.005","url":null,"abstract":"<div><div>The lack of donors that are age and size appropriate has compromised pediatric heart transplantation. There may be poor outcomes following mechanical circulatory support as a bridge to heart transplant in certain younger patient cohorts, which combined with the scarcity of donors, increases the morbidity and mortality in children waiting for a heart transplant. Transplantation of hearts donated after circulatory determination of death (DCDD) has been utilized to increase the pool of pediatric donor allografts. The original approach included direct procurement and perfusion in the recipient (DPP), and recently ex-situ normothermic machine perfusion (NMP). However, NMP is expensive, and this methodology does not allow for a functional assessment in a loaded state of the donor organ prior to transplantation. NMP is also not available to the smallest pediatric patients. An alternative method, normothermic regional perfusion (NRP), can overcome the limitations of NMP. NRP is a thoraco-abdominal dynamic in-situ organ assessment method and is instituted following declaration after determination of circulatory death. In-situ tissue perfusion is established to the transplantable organs using a bypass circuit based on strict, prespecified guidelines that do not violate the “dead donor rule.”</div><div>The first pediatric DCDD heart transplant using NRP was performed in 2019, and since then, several centers have reported immense success. Ethical concerns for cerebral reperfusion have not been substantiated by clinical data. Utilization of DCDD donors can vastly expand the donor pool in congenital heart disease (CHD).</div></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"28 ","pages":"Pages 124-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948351","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}

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Ross Procedure in Adolescence: Replacement is Better Than Repair, Mostly 青少年罗斯手术：大多数情况下，替代比修复好

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 Epub Date: 2025-03-21 DOI: 10.1053/j.pcsu.2025.03.005

Justin Robinson MD , David S. Winlaw MBBS, MD

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Addressing Complexities in Fontan Combined Heart-Liver Transplantation: A Collaborative Perspective 解决Fontan联合心肝移植的复杂性：合作的视角

Pediatric Cardiac Surgery Annual Pub Date : 2025-01-01 Epub Date: 2025-02-17 DOI: 10.1053/j.pcsu.2025.02.004

Jeannette Lin MD , Lorraine Lubin MD , Leigh Reardon MD , Gentian Lluri MD, PhD , Jamil Aboulhosn MD , Daniel Cruz MD, PhD , Darko Vucicevic MD , Christopher Wray MD , Sammy Saab MD , Robert Venick MD , Fady Kaldas MD , Ming-Sing Si MD , Reshma Biniwale MD , Glen Van Arsdell MD

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Partial Heart Transplantation - How to Change the System 部分心脏移植--如何改变系统

Pediatric Cardiac Surgery Annual Pub Date : 2024-01-01 Epub Date: 2024-01-23 DOI: 10.1053/j.pcsu.2024.01.002

Douglas M. Overbey MD, MPH , Taufiek K. Rajab MD , Joseph W. Turek MD, PhD, MBA

{"title":"Partial Heart Transplantation - How to Change the System","authors":"Douglas M. Overbey MD, MPH , Taufiek K. Rajab MD , Joseph W. Turek MD, PhD, MBA","doi":"10.1053/j.pcsu.2024.01.002","DOIUrl":"10.1053/j.pcsu.2024.01.002","url":null,"abstract":"<div><p>Partial heart transplantation<span><span> is the first clinically successful approach to deliver growing heart valve<span> implants. To date, 13 clinical partial heart transplants have been performed. However, turning partial heart transplantation into a routine procedure that is available to all children who would benefit from growing heart valve implants poses formidable logistical challenges. Firstly, a supply for partial heart transplant donor grafts needs to be developed. This challenge is complicated by the scarcity of donor organs. Importantly, the donor pools for orthotopic heart transplants, partial heart transplants and cadaver </span></span>homografts overlap. Secondly, partial heart transplants need to be allocated. Factors relevant for equitable allocation include the indication, anatomical fit, recipient clinical status and time on the wait list. Finally, partial heart transplantation will require regulation and oversight, which only recently has been undertaken by the Food and Drug Administration, which regulates human cellular and tissue-based products. Overcoming these challenges will require a change in the system. Once this is achieved, partial heart transplantation could open new horizons for children who require growing tissue implants.</span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"27 ","pages":"Pages 100-105"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635538","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}

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Left Ventricular Outflow Tract Obstruction in Congenital Heart Disease: The Role of Cardiovascular Computed Tomography in Surgical Decision Making 先天性心脏病的左心室流出道梗阻：心血管计算机断层扫描在手术决策中的作用

Pediatric Cardiac Surgery Annual Pub Date : 2024-01-01 Epub Date: 2023-12-16 DOI: 10.1053/j.pcsu.2023.12.004

B. Kelly Han MD , Edem Binka MD , Eric Griffiths MD , Reilly Hobbs MD , Aaron Eckhauser MD , Adil Husain MD , David Overman MD

{"title":"Left Ventricular Outflow Tract Obstruction in Congenital Heart Disease: The Role of Cardiovascular Computed Tomography in Surgical Decision Making","authors":"B. Kelly Han MD , Edem Binka MD , Eric Griffiths MD , Reilly Hobbs MD , Aaron Eckhauser MD , Adil Husain MD , David Overman MD","doi":"10.1053/j.pcsu.2023.12.004","DOIUrl":"10.1053/j.pcsu.2023.12.004","url":null,"abstract":"<div><p>Patients with many forms of congenital heart disease (CHD) and hypertrophic cardiomyopathy undergo surgical intervention to relieve left ventricular outflow tract obstruction (LVOTO). Cardiovascular Computed Tomography (CCT) defines the complex pathway from the ventricle to the outflow tract and can be visualized in 2D, 3D, and 4D (3D in motion) to help define the mechanism and physiologic significance of obstruction. Advanced cardiac visualization may aid in surgical planning to relieve obstruction in the left ventricular outflow tract, aortic or neo-aortic valve and the supravalvular space. CCT scanner technology has advanced to achieve submillimeter, isotropic spatial resolution, temporal resolution as low as 66 msec allowing high-resolution imaging even at the fast heart rates and small cardiac structures of pediatric patients ECG gating techniques allow radiation exposure to be targeted to a minimal portion of the cardiac cycle for anatomic imaging, and pulse modulation allows cine imaging with a fraction of radiation given during most of the cardiac cycle, thus reducing radiation dose. Scanning is performed in a single heartbeat or breath hold, minimizing the need for anesthesia or sedation, for which CHD patents are highest risk for an adverse event. Examples of visualization of complex left ventricular outflow tract obstruction in the subaortic, valvar and supravalvular space will be highlighted, illustrating the novel applications of CCT in this patient subset.</p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"27 ","pages":"Pages 11-18"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192248","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

Endocardial Fibroelastosis Resection: When it Works and When it Does Not 心内膜纤维瘤切除术--何时有效，何时无效

Pediatric Cardiac Surgery Annual Pub Date : 2024-01-01 Epub Date: 2023-12-22 DOI: 10.1053/j.pcsu.2023.12.006

Gregor Gierlinger MD, Sitaram M. Emani MD

{"title":"Endocardial Fibroelastosis Resection: When it Works and When it Does Not","authors":"Gregor Gierlinger MD, Sitaram M. Emani MD","doi":"10.1053/j.pcsu.2023.12.006","DOIUrl":"10.1053/j.pcsu.2023.12.006","url":null,"abstract":"<div><p><span><span>Endocardial fibroelastosis (EFE) is a thickening of the </span>endocardial<span> layer by accumulation of collagen and elastic fibers<span>. Endothelial to mesenchymal transformation is proposed to be the underlying mechanism of formation. Although EFE can occur in both right and left ventricles, this article will focus on management of left ventricular EFE. Through its fibrous, nonelastic manifestation EFE restricts the </span></span></span>myocardium<span><span> leading to diastolic and systolic ventricular dysfunction and prevents ventricular growth in neonates and infants. The presence of EFE may be a marker for underlying </span>myocardial fibrosis<span> as well. The extent of EFE within the left ventricular cavity can be variable ranging from patchy to confluent distribution. Similarly the depth of penetration and degree of infiltration into myocardium can be variable. The management of EFE is controversial, although resection of EFE has been reported as part of the staged ventricular recruitment therapy. Following resection, EFE recurs and infiltrates the myocardium after primary resection. Herein we review the current experience with EFE resection.</span></span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"27 ","pages":"Pages 19-24"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139188683","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}

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Hypertrophic Cardiomyopathy: Preadolescence, Mitral Valve Disease, and Midventricular Obstruction 肥厚型心肌病：早衰、二尖瓣病变和中室阻塞

Pediatric Cardiac Surgery Annual Pub Date : 2024-01-01 Epub Date: 2023-12-10 DOI: 10.1053/j.pcsu.2023.12.001

Elaine M. Griffeth MD, Elizabeth H. Stephens MD, PhD, Joseph A. Dearani MD

{"title":"Hypertrophic Cardiomyopathy: Preadolescence, Mitral Valve Disease, and Midventricular Obstruction","authors":"Elaine M. Griffeth MD, Elizabeth H. Stephens MD, PhD, Joseph A. Dearani MD","doi":"10.1053/j.pcsu.2023.12.001","DOIUrl":"https://doi.org/10.1053/j.pcsu.2023.12.001","url":null,"abstract":"<div><p><span><span>Septal myectomy is indicated </span>in patients with </span>obstructive hypertrophic cardiomyopathy<span><span> (HCM) who have persistent symptoms<span><span> despite medical therapy, intolerance of medication side effects, or severe resting or provocable gradients. Septal myectomy at high volume centers is safe, with low operative mortality (1%) and low rates of complications such as </span>complete heart block or </span></span>ventricular septal defect<span><span><span><span> (3% and 0.5%, respectively). Additionally, improved survival following myectomy has been observed when compared to patients with obstructive HCM managed medically or those with nonobstructive HCM. As a longstanding, quaternary referral center for septal myectomy, our institution has built significant experience and expertise in the surgical and medical management of HCM, including atypical HCM, defined as preadolescent patients, those with </span>mitral valve disease, and those with isolated midventricular obstruction. The most important factor of septal myectomy in achieving complete resolution of obstruction and avoiding recurrence is the apical extent of the myectomy trough, which must extend to the septum opposite the </span>papillary muscles. If this cannot be fully achieved via a transaortic exposure, especially in preadolescents and patients with midventricular obstruction, then a transapical approach may be needed. </span>Mitral valve repair<span> is rarely necessary as SAM-mediated MR resolves with adequate myectomy alone, but mitral repair is performed in cases of intrinsic valvular disease. In this manuscript we provide a summary of current operative techniques and outcomes data from our institution on the management of these various categories of HCM.</span></span></span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"27 ","pages":"Pages 69-77"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190886","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

Long-Term Outcomes of Mechanical Aortic Valve Replacement in Children 儿童主动脉瓣机械置换术的长期疗效。

Pediatric Cardiac Surgery Annual Pub Date : 2024-01-01 Epub Date: 2023-12-12 DOI: 10.1053/j.pcsu.2023.12.003

Michael Z.L. Zhu MBBS , Edward Buratto MBBS, PhD, FRACS , Damien M. Wu MD , Shuta Ishigami MD, PhD , Antonia Schulz MD , Christian P. Brizard MD, MS , Igor E. Konstantinov MD, PhD, FRACS

{"title":"Long-Term Outcomes of Mechanical Aortic Valve Replacement in Children","authors":"Michael Z.L. Zhu MBBS , Edward Buratto MBBS, PhD, FRACS , Damien M. Wu MD , Shuta Ishigami MD, PhD , Antonia Schulz MD , Christian P. Brizard MD, MS , Igor E. Konstantinov MD, PhD, FRACS","doi":"10.1053/j.pcsu.2023.12.003","DOIUrl":"10.1053/j.pcsu.2023.12.003","url":null,"abstract":"<div><p><span><span>When the options of aortic valve repair or the </span>Ross procedure<span><span><span> are not feasible or have been exhausted, mechanical aortic valve replacement (AVR) may provide a reliable and structurally durable alternative, but with the limitations of long-term </span>anticoagulation, thrombosis risk and lack of valve growth potential. In this article, we review the longitudinal outcomes of mechanical AVR in children in our institution and compare them to those recently reported by others. From 1978 to 2020, 62 patients underwent mechanical AVR at a median age of 12.4 years (interquartile range (IQR): 8.6-16.8 years). The most common underlying diagnoses were: conotruncal anomalies (40%, 25/62), congenital </span>aortic stenosis<span> (16%, 10/62), rheumatic valve disease (16%, 10/62), </span></span></span>connective tissue disease<span> (8.1%, 5/62) and infective endocarditis (6.5%, 4/62). Thirty-two patients (52%, 32/62) had at least 1 prior aortic valve surgery<span> prior to mechanical AVR. Early death was 3.2% (2/62). Median follow-up was 14.4 years (IQR: 8.4-28.2 years). Kaplan-Meier survival was 96.8%, 91.9%, 86.3%, and 81.9% at 1, 5, 10, and 20 years. On competing risk analysis, the proportion of patients alive without aortic valve reoperation<span> at 1, 5, 10, and 20 years was 95.2%, 87.0%, 75.5% and 55.4%, respectively, while the proportion of patients that had aortic valve reoperation (with death as a competing event) at 1, 5, 10, and 20 years was 1.6%, 4.9%, 12.8%, and 28.5%, respectively. In conclusion, when the options of aortic valve repair or the Ross procedure are not feasible in children, mechanical AVR is an alternative, yet the long-term rates of mortality and need for aortic valve reoperation are of concern.</span></span></span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"27 ","pages":"Pages 52-60"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139189085","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