Pediatric Cardiac Surgery Annual最新文献_第8页

Mechanical Support for The Failing Single Ventricle at Pre-Fontan Stage: Current State of The Field and Future Directions 单侧心室衰竭前阶段的机械支持:该领域的现状和未来方向

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.04.004

Kriti Puri MBBS , Iki Adachi MD

{"title":"Mechanical Support for The Failing Single Ventricle at Pre-Fontan Stage: Current State of The Field and Future Directions","authors":"Kriti Puri MBBS , Iki Adachi MD","doi":"10.1053/j.pcsu.2021.04.004","DOIUrl":"10.1053/j.pcsu.2021.04.004","url":null,"abstract":"<div>With the substantial growth of pediatric ventricular assist device (VAD) support, there has been an expansion of the target population towards more complex patients, including congenital heart disease (CHD) with single ventricle (SV) physiology. The outcomes of Stage I and Stage II SV-CHD patients on VAD support from the Pedimacs database are poor, with less than 50% survival on VAD by the 3-month mark in both. The primary objective of this article is to describe the current state of VAD support for the failing Stage I and II SV-CHD circulation, to provide insight into potential areas of outcome improvement. We reviewed the published literature in the form of database and registry reports as well as single-center studies to discuss the outcomes of Stage I and Stage II SV-CHD patients on VAD support. Registry-based studies suggest that VAD support for the failing Stage I and Stage II SV-CHD circulations is challenging. However, the more promising outcomes in several single-institutional reports for both Stage I and Stage II SV-VAD indicate that the grim picture from the databases does not reflect the best outcomes that are possible to be achieved, potentially at experienced centers with higher volumes. Areas of future study and potential improvement including timely initiation of VAD support in the cohort of patients expected to not be a candidate for standard SV palliations, pump selection and the benefits of continuous-flow devices, and the decision-making for setting up the optimum circulation for VAD support, be it Fontan completion if feasible or takedown to shunt physiology.</div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"24 ","pages":"Pages 10-18"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39085013","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: 17

Corrigendum to “Congenitally Corrected Transposition of the Great Arteries: Anatomic, Physiologic Repair, and Palliation” [Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann 2019;22:32–42] “先天性大动脉转位:解剖、生理修复和缓解”的勘误表[Semin胸心外科儿科卡外科2019;22:32-42]

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.05.001

Zachary Spigel MD , Ziyad M. Binsalamah MD, MSc, FRCSC , Christopher A. Caldarone MD, FRCSC

引用次数: 1

Advanced Therapies for Severe Tracheobronchomalacia: A Review of the Use of 3D-Printed, Patient-Specific, Externally Implanted, Bioresorbable Airway Splints 重度气管支气管软化症的先进疗法:3d打印、患者特异性、外部植入、生物可吸收气道夹板的使用综述

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.02.001

Vikram Sood MD , Glenn E. Green MD , Andrea Les PhD , Richard G Ohye MD

{"title":"Advanced Therapies for Severe Tracheobronchomalacia: A Review of the Use of 3D-Printed, Patient-Specific, Externally Implanted, Bioresorbable Airway Splints","authors":"Vikram Sood MD , Glenn E. Green MD , Andrea Les PhD , Richard G Ohye MD","doi":"10.1053/j.pcsu.2021.02.001","DOIUrl":"10.1053/j.pcsu.2021.02.001","url":null,"abstract":"<div>Tracheobronchomalacia is a condition of dynamic collapse of the trachea and mainstem bronchi. The clinical significance of tracheobronchomalacia depends on its severity. Mild cases may be medically managed with limited symptomology, while severe cases require advanced therapies, lengthy hospital stays, and carry significant morbidity and mortality. Current therapies for severe tracheobronchomalacia include tracheostomy with prolonged mechanical ventilation, aortopexy, tracheobronchopexy, and intraluminal metallic, silicone, or bioresorbable stents. Three-dimensional (3D)-printed, patient-specific, bioresorbable airway splinting is a novel treatment option that is undergoing investigation in a cohort of critically ill children with severe tracheobronchomalacia. At the time of our last review of our data, 29 splints had been implanted in 15 children with intrathoracic tracheobronchomalacia. The median follow-up was 8.5 months. There were 12 long-term survivors, and all but one lived at home. This article discusses the details of our institution's development and use of 3D-printed, patient-specific, bioresorbable splints for treatment of severe tracheobronchomalacia in the pediatric population.</div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"24 ","pages":"Pages 37-43"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39005268","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: 6

Left Ventricular Recruitment in Patients With Hypoplastic Left Heart Syndrome 左心发育不全综合征患者左心室功能恢复

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.03.001

Peter Chiu MD, Sitaram Emani MD

引用次数: 5

Mechanical Circulatory Support for the Failing Sub-Aortic Right Ventricle in Adults 成人主动脉下右心室衰竭的机械循环支持

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.04.003

S. Lucy Roche MB, ChB, MRCPCH , David S Crossland MB, ChB, MRCPCH , Iki Adachi MD , Christopher Broda MD , Katrijn Jansen MD , Edward Hickey FRCSC

{"title":"Mechanical Circulatory Support for the Failing Sub-Aortic Right Ventricle in Adults","authors":"S. Lucy Roche MB, ChB, MRCPCH , David S Crossland MB, ChB, MRCPCH , Iki Adachi MD , Christopher Broda MD , Katrijn Jansen MD , Edward Hickey FRCSC","doi":"10.1053/j.pcsu.2021.04.003","DOIUrl":"10.1053/j.pcsu.2021.04.003","url":null,"abstract":"<div>Patients with ccTGA or d-TGA managed via atrial switch (Mustard or Senning operations) have biventricular circulations with a sub-aortic right ventricle (2V-RV). Other than in a tiny percentage of ccTGA patients, premature heart failure (HF) is common, driven by chronic RV dilatation and dysfunction and/or tricuspid regurgitation. These patients are different from the general HF population in that they are younger, more heterogeneous, are predisposed to pulmonary hypertension and present unique and complex surgical challenges. Despite their young age, they experience disproportionately poor access to advanced therapies and are often disqualified for transplant by pulmonary hypertension, HLA sensitization, program risk-tolerance and psychosocial issues. Mechanical support of the subaortic RV with ventricular assist device (subaortic RVAD, also known as SVAD), although technically challenging, can be an effective alternative to palliative care and offers high likelihood of bridging patients to heart transplant candidacy. In addition, temporary trans-catheter SVAD Impella support has been advantageous for stabilization of decompensated 2V-RV patients or as bridge to durable SVAD support. Improved awareness of and access to specialist ACHD-HF teams offering mechanical support (and transplantation) for 2V-RV patients is increasingly urgent for this aging population, and will improve options and outcomes for these patients as HF emerges.</div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"24 ","pages":"Pages 2-9"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39005264","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: 6

Replacement of the Mitral Valve Under One Year of Age: Size Matters 一岁以下的二尖瓣置换术:大小问题

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.03.006

Federica Caldaroni MD , Christian P. Brizard MD , Yves d'Udekem MD, PhD

引用次数: 3

The Ross Procedure in Children: The Gold Standard? 儿童罗斯手术:黄金标准?

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.03.002

Luke M. Wiggins MD , S. Ram Kumar MD, PhD , Vaughn A. Starnes MD

引用次数: 2

Stem Cell Therapy in Single-Ventricle Physiology: Recent Progress and Future Directions 干细胞治疗在单心室生理学:最新进展和未来方向

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.03.003

Mohamed Abdullah MD, PhD , Samantha Kegel BS , Muthukumar Gunasekaran PhD , Progyaparamita Saha PhD , Xuebin Fu PhD , Rachana Mishra PhD , Sudhish Sharma PhD , Sunjay Kaushal MD, PhD

{"title":"Stem Cell Therapy in Single-Ventricle Physiology: Recent Progress and Future Directions","authors":"Mohamed Abdullah MD, PhD , Samantha Kegel BS , Muthukumar Gunasekaran PhD , Progyaparamita Saha PhD , Xuebin Fu PhD , Rachana Mishra PhD , Sudhish Sharma PhD , Sunjay Kaushal MD, PhD","doi":"10.1053/j.pcsu.2021.03.003","DOIUrl":"10.1053/j.pcsu.2021.03.003","url":null,"abstract":"<div>Current surgical and medical treatment options for single ventricle physiology conditions remain palliative. On the long term, despite treatment, the systemic ventricle has a significant risk of developing failure. There are unmet needs to develop novel treatment modalities to help ameliorate the ventricular dysfunction. Advances in the field of stem cell therapy have been promising for the treatment of heart failure. Numerous stem cell populations have been identified. Preclinical studies in small and large animal models provide evidence for effectiveness of this treatment modality and reveal several mechanisms of action by which stem cells exert their effect. Many clinical trials have been designed to further investigate the therapeutic potential that stem cell therapy may hold for pediatric populations with single ventricle physiology. In this review, we discuss the stem cell types used in these populations, some preclinical studies, and the clinical trials of stem cell therapy in single ventricle patients.</div>","PeriodicalId":38774,"journal":{"name":"Pediatric Cardiac Surgery Annual","volume":"24 ","pages":"Pages 67-76"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017498","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: 2

Debate - Replacement of the Mitral Valve Under One Year of Age: Mechanical Valves Should Be Used 争论-一岁以下的二尖瓣更换:应该使用机械瓣膜

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.03.005

David G. Lehenbauer MD, James S. Tweddell MD, David S. Winlaw MBBS, MD, FRACS

引用次数: 0

Is There Any Clinical Utility to Genetic Testing for Patients With Congenital Heart Disease? 基因检测对先天性心脏病患者有临床意义吗?

Pediatric Cardiac Surgery Annual Pub Date : 2021-01-01 Epub Date: 2021-06-08 DOI: 10.1053/j.pcsu.2021.04.002

Richard W. Kim MD

引用次数: 0