Pediatric Cardiac Surgery Annual最新文献

{"title":"Surgical Heritage: You Had to Be There, Ross: The Comeback Kid","authors":"Magdi H. Yacoub OM, FRS ,&nbsp;Maximiliaan L. Notenboom BSc ,&nbsp;Giovanni Melina MD, PhD ,&nbsp;Johanna J.M. Takkenberg MD, PhD","doi":"10.1053/j.pcsu.2023.10.001","DOIUrl":"10.1053/j.pcsu.2023.10.001","url":null,"abstract":"<div><p>Half a century after the first pulmonary autograft operation (Ross operation), performed in 1967 by Donald Ross in central London, there is a very strong conviction that the Ross operation is the best available valve substitute today, not only for children, but also for younger and older adults. The Ross operation has stimulated a lot of science to do with tissue-engineering and biology of heart valves, which is a promising avenue for the future. For one of us (M.Y.), it has certainly been a privilege to be associated with the comeback of the Ross operation.</p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"27 ","pages":"Pages 37-41"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1092912623000200/pdfft?md5=e57738be2d51fa2337af1812dcc76deb&pid=1-s2.0-S1092912623000200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Support with Single Ventricle-Ventricular Assist Device (sVAD) in Patients with Functionally Univentricular Circulation Prior to Fontan Operation","authors":"Mark S. Bleiweis MD,&nbsp;Joseph Philip MD, FAAP,&nbsp;James C. Fudge MD,&nbsp;Himesh V. Vyas MD,&nbsp;Giles J. Peek MD, FRCS, CTh, FFICM,&nbsp;Andrew D. Pitkin MBBS, MRCP, FRCA,&nbsp;Gregory M. Janelle MD, FASE, FASA,&nbsp;Kevin J. Sullivan MD,&nbsp;Yuriy Stukov MD,&nbsp;Connie S. Nixon RN,&nbsp;Omar M. Sharaf BS,&nbsp;Dan Neal MS,&nbsp;Jeffrey P. Jacobs MD, FACS, FACC, FCCP","doi":"10.1053/j.pcsu.2022.12.002","DOIUrl":"10.1053/j.pcsu.2022.12.002","url":null,"abstract":"&lt;div&gt;&lt;p&gt;&lt;span&gt;Some patients with functionally univentricular circulation develop cardiac failure refractory to maximal management and are supported with a ventricular assist device&lt;span&gt; (VAD). The purpose of this manuscript is to summarize our previous publications related to single ventricle-ventricular assist device (sVAD) support in patients&lt;span&gt; with functionally univentricular circulation and to describe our current institutional approach at University of Florida to sVAD support in neonates, infants, and children prior to Fontan. Our programmatic philosophy at University of Florida is to strive to identify the minority of neonates with functionally univentricular circulation who are extremely high-risk prior to initiating staged palliation and to stabilize these neonates with primary preemptive sVAD in preparation for &lt;/span&gt;&lt;/span&gt;&lt;/span&gt;cardiac transplantation; our rationale for this approach is related to the challenges associated with failed staged palliation and subsequent bail-out sVAD support and transplantation. A subset of extremely high-risk neonates and infants with functionally univentricular ductal-dependent circulation undergo primary preemptive sVAD insertion and subsequent cardiac transplantation. Support with VAD clearly facilitates survival on the waiting list during prolonged wait times and optimizes outcomes after Norwood (Stage 1) by providing an alternative pathway for extremely high-risk patients. Therefore, the selective utilization of sVAD in extremely high-risk neonates facilitates improved outcomes for all patients with functionally univentricular ductal-dependent circulation.&lt;/p&gt;&lt;p&gt;&lt;span&gt;At University of Florida, our programmatic approach to utilizing sVAD support as a bridge to transplantation in the minority of neonates with functionally univentricular circulation who are extremely high-risk for staged palliation is associated with Operative Mortality after Norwood (Stage 1) Operation of 2.9% (2/68) and a one-year survival of 91.1% (82/90) for all neonates presenting with &lt;/span&gt;hypoplastic left heart syndrome&lt;span&gt;&lt;span&gt; (HLHS) or HLHS-related malformation with functionally univentricular ductal-dependent &lt;/span&gt;systemic circulation.&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Meanwhile, at University of Florida, for all 82 consecutive neonates, infants, and children supported with pulsatile paracorporeal VAD: Kaplan-Meier survival estimated one year after VAD insertion = 73.3% (95% confidence interval [CI] = 64.1–83.8%), and Kaplan-Meier survival estimated five years after VAD insertion = 68.3% (95% CI = 58.4–79.8%). For all 48 consecutive neonates, infants, and children at University of Florida with biventricular circulation supported with pulsatile paracorporeal VAD: Kaplan-Meier survival estimated one year after VAD insertion = 82.7% (95% CI = 72.4–94.4%), and Kaplan-Meier survival estimated five years after VAD insertion = 79.7% (95% CI = 68.6–92.6%). For all 34 consecutive neonates, infants, and children at University of Florida with","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 26-39"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9355295","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}

{"title":"Training on Congenital 3D Cardiac Models – Will Models Improve Surgical Performance?","authors":"David J Barron MD, FRCS(CT) ,&nbsp;Nabil Hussein MBChB, PhD ,&nbsp;Shi-Joon Yoo MD, PhD","doi":"10.1053/j.pcsu.2022.12.001","DOIUrl":"10.1053/j.pcsu.2022.12.001","url":null,"abstract":"<div><p>Technical skill development in congenital heart surgery (CHS) is challenging due to numerous factors which potentially limit the hands-on operative exposure in surgical training. These challenges have stimulated the growth of simulation-based training through the development of 3D-printed models, providing hands-on surgical training (HOST). From its inception in 2015, the models used in the HOST program have constantly improved, and now include valvar/subvalvar apparatus and better materials that mimic real tissue. Evidence shows that deliberate, regular simulation practice can improve a surgeon's technical skills across the spectrum of CHS. Furthermore, surgical trainees who undergo simulation training are able to translate this improved performance into the operative environment with improved patient outcomes. Despite evidence to support the incorporation of simulation methods into congenital training, its widespread adoption into training curricula remains low. This is due to numerous factors including funding, lack of dedicated time or proctorship and access to models—all of which can be overcome with the newer generation of models and committed trainers. Training programs should consider incorporating simulation-methods as a routine component of congenital training programs.</p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 9-17"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9355296","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}

{"title":"Toward More Granular Guidelines in AAOCA: Associating Anatomical Details With Specific Surgical Strategies","authors":"Anusha Jegatheeswaran MD, PhD, FRCSC ,&nbsp;William M. DeCampli MD, PhD","doi":"10.1053/j.pcsu.2022.12.007","DOIUrl":"10.1053/j.pcsu.2022.12.007","url":null,"abstract":"<div><p><span>Patients with anomalous aortic origin of a coronary artery (AAOCA) require imaging to clarify the multiple potential anatomic sites of obstruction (fixed or dynamic). Once repaired, the pathway of blood to the </span>myocardium<span> must not encounter: (1) intrinsic ostial stenosis, (2) obstruction from compression or distortion near the commissure or the intercoronary pillar, (3) stenosis where the artery exits the aortic wall (due to an acutely angled “take-off”), (4) compression due to a pathway between the great vessels, (5) stenosis or compression along an intramural course, or (6) compression due to an intramuscular (intraseptal/intraconal) course. Detailed anatomic evaluation of each of these locations allows the surgeon to select an appropriate repair strategy, and each of these abnormal anatomic features should be “matched” with a particular surgical correction. We speculate that the most common surgical repair, unroofing with or without tacking, is often inadequate, as in isolation, it may not allow for correction with a large orifice from the appropriate sinus, without an interarterial course. While the evidence base is insufficient to call these recommendations formal guidelines, these recommendations should serve as a basis for further validity testing, and ultimate evolution to more granular guidelines on AAOCA management.</span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 63-74"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9340319","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}

{"title":"Catheter-based Interventions to Reduce or Modify Surgical Risk in High-Risk Adult Congenital Heart Disease Patients","authors":"Weiyi Tan MD, MPH ,&nbsp;Jamil Aboulhosn MD","doi":"10.1053/j.pcsu.2022.12.005","DOIUrl":"10.1053/j.pcsu.2022.12.005","url":null,"abstract":"<div><p>The field of adult congenital heart disease<span> has changed greatly over the past sixty years. As patients are now surviving longer into adulthood due to various improvements in surgical technique and medical technology<span>, the demographic of patients with congenital heart disease<span> (CHD) has changed, such that there are now more adults with CHD than there are children with CHD. This older and more medically complex population needs more interventions to treat residual defects or sequelae of their initial surgeries, and many of these patients are now deemed high risk for surgery. When the surgical risk becomes too great, either due to patient complexity, surgical complexity, or both, then transcatheter procedures may have a role in either mitigating or avoiding the risk altogether.</span></span></span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 89-97"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9340320","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}

{"title":"Williams Syndrome: Supravalvar Aortic, Aortic Arch, Coronary and Pulmonary Arteries: Is Comprehensive Repair Advisable and Achievable?","authors":"Michael Ma MD ,&nbsp;Elisabeth Martin MD ,&nbsp;Claudia Algaze MD ,&nbsp;Ronnie Thomas Collins MD ,&nbsp;Doff McElhinney MD ,&nbsp;Richard Mainwaring MD ,&nbsp;Frank Hanley MD","doi":"10.1053/j.pcsu.2022.12.003","DOIUrl":"10.1053/j.pcsu.2022.12.003","url":null,"abstract":"<div><p><span>Williams syndrome, and various </span>elastin<span><span> protein mediated arteriopathies<span>, presents a clinical challenge to pediatric cardiovascular specialists. In the severest phenotypes, multilevel obstruction to the systemic and pulmonic arterial systems result in biventricular dysfunction which can be imminently life-threatening. As a longstanding, quaternary referral center for complex pulmonary arteriopathies and pediatric </span></span>connective tissue disease, Stanford Medicine Children's Health has developed a sizeable experience managing these patients. This manuscript is a summary of our current strategies, with a focus on our surgical techniques, peri-procedural considerations on timing and staging of various interventions, and long-term results.</span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 2-8"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9355294","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}

{"title":"Congenital Aortic Valve Repair When the Options aren’t Good: Truncus Arteriosus and Transposition of the Great Arteries","authors":"Igor E. Konstantinov MD, PhD, FRACS ,&nbsp;Christian P. Brizard MD, MS ,&nbsp;Edward Buratto MD, PhD, FRACS","doi":"10.1053/j.pcsu.2022.12.004","DOIUrl":"10.1053/j.pcsu.2022.12.004","url":null,"abstract":"<div><p><span>Patients with truncus arteriosus and transposition of great arteries are prone to neo-aortic valve insufficiency. Although presenting at opposite ends of the age spectrum, both conditions tend to be commonly associated with neo </span>aortic root<span> dilatation. In patients with truncus arteriosus there is an additional complexity of quadricuspid valve morphology, which make up the majority of valves requiring repair. A unified approach to all these patients would include reduction and stabilization of the annulus and sinotubular junction, as well as achieving equal and symmetrical coaptation of the valve leaflets. By systematically employing these techniques, valve replacement should be avoidable in most children.</span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 56-62"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9355293","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}

{"title":"Editor's Introduction","authors":"Glen S. Van Arsdell MD","doi":"10.1053/j.pcsu.2023.01.002","DOIUrl":"10.1053/j.pcsu.2023.01.002","url":null,"abstract":"","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Page 1"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860135","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}

{"title":"Infant Mitral Valve Replacement: Current State of the Art","authors":"David M. Overman MD ,&nbsp;Francis X. Moga MD ,&nbsp;Elizabeth H. Stephens MD, PhD ,&nbsp;Joseph A. Dearani MD ,&nbsp;Robroy H. MacIver MD, MPH","doi":"10.1053/j.pcsu.2023.01.001","DOIUrl":"10.1053/j.pcsu.2023.01.001","url":null,"abstract":"<div><p><span>Mitral valve replacement (MVR) in the very young is an imposing clinical challenge. Early and late mortality risk is substantial, severe adverse events are common, and redo mitral valve replacement is inevitable. Therapeutic options are limited. In the older infant with an annulus of 17mm or larger, mechanical MVR is associated with low risk of mortality and predictable durability. For the very young with annular </span>hypoplasia<span>, bovine jugular vein conduit MVR appears to offer equivalent or better early outcomes with the possibility of subsequent valve expansion, potentially prolonging the interval to redo MVR. Experience with cylinder MVR and other forms of surgeon-manufactured MVR is quite limited, and there is currently no information on late outcomes or durability.</span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 75-80"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9339881","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}

{"title":"Hybrid First-stage Palliation and Other Strategies to Achieve Biventricular Repair in High-Risk Neonates With Complex Heart Anomalies and Aortic Arch Obstruction","authors":"Bahaaldin Alsoufi MD","doi":"10.1053/j.pcsu.2022.12.009","DOIUrl":"10.1053/j.pcsu.2022.12.009","url":null,"abstract":"<div><p>Medical and surgical advances have allowed single-stage total repair in neonates born with complex congenital heart anomalies<span><span> and aortic arch obstruction. Nonetheless, total repair might be too complex or high risk in certain neonates with demographic, clinical or morphologic risk factors. Alternative management strategies might offer these neonates better outcomes with superior anatomic repair, shorter hospitalization, reduced morbidity, and improved survival. Alternative initial surgical strategies might include </span>aortic arch repair<span> and pulmonary artery band with or without cardiopulmonary bypass<span><span>, extracardiac repair only and pulmonary artery band, Norwood operation, and hybrid first-stage </span>palliation; all deferring complex biventricular intra-cardiac repair to later stage. The strategy choice should be personalized to each patient, taking into consideration the morphologic and clinical state, and the existent goals of care.</span></span></span></p></div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"26 ","pages":"Pages 40-49"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9339883","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}