World journal for pediatric & congenital heart surgery最新文献

{"title":"Safety and Feasibility of Implanting Dual-Chamber Permanent Pacemakers in Patients Under 3 kg.","authors":"Hosam F Ahmed, Amir Mehdizadeh-Shrifi, Grant Chappell, Alan O'Donnell, Awais Ashfaq, Shankar Baskar, David L S Morales, David G Lehenbauer","doi":"10.1177/21501351251345811","DOIUrl":"https://doi.org/10.1177/21501351251345811","url":null,"abstract":"<p><p><b>Purpose:</b> Permanent pacing in the young pediatric population can be challenging, especially in small neonates. We describe our institutional experience with the surgical placement of dual-chamber permanent pacemaker (PPM) systems in neonates weighing <3 kg at the time of implantation. <b>Methods:</b> The Cincinnati Children's Hospital database was used to identify patients who had an epicardial dual-chamber PPM and weighed <3 kg at implantation from 2000 to 2022. Descriptive analyses focused on surgical techniques, postimplant complications, and survival. <b>Results:</b> Twenty patients underwent dual-chamber PPM implantation. Median age at implantation was 6.0 days [3.0-27.0], weight 2.6 kg [2.2-3.0], with the smallest being 1.9 kg. Eight of 20 patients (40%) were premature (<37 weeks), and 2/20 (10%) had Trisomy 21. Most implantations were via median sternotomy [17/20 (85%)]. Most had generator placement in the left upper quadrant [13/20 (65%)] above the posterior fascia and below the rectus muscle. Surgical indication for implantation was congenital heart block [18/20 (90%)], of which 4/18 (22%) were due to maternal lupus. Two patients had PPM secondary to postoperative heart block and 3/20 (15%) had emergent temporary epicardial wires placed before PPM. Pacemaker-related complications occurred in 1/20 (5%) patient on postoperative day 20 related to minor wound dehiscence, without infection, leading to a dual-chamber PPM exchange for a single-chamber device. Another patient (5%) developed a seroma requiring drainage on postoperative day 16. There were no PPM-related in-hospital mortalities or other complications, including late PPM infections. <b>Conclusions:</b> Dual-chamber epicardial PM implantation in neonates <3 kg is feasible with minimal complications and good outcomes based on our reported technique.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251345811"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610769","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":"Improved Surgical Management of Complex Neonates With Heterotaxy Syndrome.","authors":"Alexander C Mills, Ashley E Dawson, Michael C Scott, Alexis M Kennedy, Beau A Bequeaith, Ioannis Zoupas, Jorge D Salazar, Damien J LaPar","doi":"10.1177/21501351251345791","DOIUrl":"https://doi.org/10.1177/21501351251345791","url":null,"abstract":"<p><p><b>Background:</b> Neonatal management of congenital heart defects (CHD) among heterotaxy patients remains challenging due to significant heterogeneity in cardiac and visceral phenotypes. This study evaluated contemporary surgical outcomes and identified high-risk anatomic substrates. <b>Methods:</b> A total of 41 heterotaxy CHD patients who underwent neonatal surgical repair and/or palliation over a 10-year period were evaluated at a single institution. Heterotaxy anatomy was characterized according to right atrial isomerism (RAI) or left atrial isomerism (LAI), and other cardiac defects. Multivariate Cox regression and Kaplan-Meier analyses evaluated operative and intermediate-term outcomes. <b>Results:</b> Median age at initial operation was 7.0 days, and median operative weight was 3.1 kg. Median follow-up was 2.3 years. Of the total 41 patients, 27 (66%) had RAI, and 14 (34%) had LAI. Functional single ventricle anatomy was present in 30/41 patients (73%); 28/30 (93.3%) patients achieved stage II bidirectional Glenn and 14/30 (46.7%) achieved stage III Fontan completion; 1/30 (2%) patient underwent biventricular conversion. Operative mortality was 9.8% (4/41) after the initial operation. Permanent pacemaker placement was more common in patients with LAI. Interstage death rate was 10%, with no deaths after Fontan. Obstructed total anomalous pulmonary venous connection (TAPVC) was a risk factor for overall mortality (hazard ratio [6.0]; 95% confidence interval, 1.2-31.2; <i>P</i> = .033). Kaplan-Meier survival analysis demonstrated decreased five-year survival in RAI patients, LAI patients with single ventricle physiology, and RAI patients with obstructed TAPVC. <b>Conclusions:</b> Cardiac surgical outcomes for neonates with heterotaxy syndrome have significantly improved. Right atrial isomerism anatomy, single ventricle LAI patients, and RAI patients with obstructed TAPVC are associated with increased operative risk.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251345791"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610767","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":"Results of Urgent Interventions in Patients with Tetralogy of Fallot Within the First Three Months of Age.","authors":"Amr Ashry, Sophia Khan, Heba M Mohammed, Robyn Lotto, Arul Narayanan, Salim Jivanji, Ramesh Kutty, Ram Dhannapuneni, Attilio A Lotto","doi":"10.1177/21501351251347931","DOIUrl":"https://doi.org/10.1177/21501351251347931","url":null,"abstract":"<p><p>BackgroundMost Tetralogy of Fallot (TOF) patients undergo reparative surgery at approximately 6 months of age. However, some patients experience severe cyanotic spells in the neonatal or infancy period requiring urgent procedures to increase pulmonary blood flow.MethodsRetrospective review of patients younger than 3 months with TOF who needed interventions between 2015 and 2021. In total, 42 babies required urgent procedures (19 surgical procedures in group 1 and 23 transcatheter interventions in group 2).ResultsMedian age and weight were 38 days (interquartile range [IQR] 19-70 days) and 3.7 Kg (IQR 3.4-4.2 Kg) in group 1 and 29 days (19-43 days) and 3.2 Kg (2.9-3.7 kg) in group 2, respectively. Group 1 had nine full surgical repairs (9/42, 21.4%), eight modified Blalock-Taussig-Thomas (BTT) shunts (8/42, 19%), one isolated transannular patch (1/42, 2.4%) and one right ventricle to pulmonary artery conduit (1/42, 2.4%). Six of the patients in Group 1 had their surgical intervention after an abandoned transcatheter procedure. Group 2 included nine patent ductus arteriosus (PDA) stents (9/42, 21.4%), nine right ventricular outflow tract (RVOT) stents (9/42, 21.4%), three pulmonary valve balloon dilatations (3/42, 7%) and two RVOT balloon dilatations (2/42, 4.8%). Median intensive care unit and hospital stays were 4 days (3-8) and 9 days (7.5-20) in group 1, compared with 1 day (1-1.5) and 5 days (3-15.5) in group 2, respectively. One patient (1/42, 2.4%) in group 1 needed reintervention before full repair, while five patients (5/42, 11.9%) in group 2 required further catheter reinterventions before full repair.ConclusionIn TOF patients requiring urgent early intervention, when catheter or surgical approach are tailored according to the anatomical substrate, excellent outcomes are expected. In patients with favorable anatomy, we believe that full repair can be performed as a primary procedure with good early and mid-term outcomes.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251347931"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610768","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":"Complications After Congenital Heart Surgery: Review With a Focus on Computed Tomography Imaging.","authors":"Kardos Marek","doi":"10.1177/21501351251347937","DOIUrl":"https://doi.org/10.1177/21501351251347937","url":null,"abstract":"<p><p>Patients who have undergone congenital heart surgery often require evaluation for potential complications in the immediate postoperative period, as well as ongoing imaging surveillance to monitor for long-term complications. Computed tomography is an excellent modality for evaluating potentional complications after congenital heart surgery. The purpose of this article is to provide a pictorial review of the potential complications of a wide spectrum of congenital heart surgical procedures.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251347937"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602733","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":"Off-Pump Coronary Artery Bypass Grafting for Congenital Left Main Coronary Artery Stenosis in a Six-Month-Old Infant: A Novel Approach.","authors":"Manoj Kumar Daga, Nitish Kumar, Subhendu Mandal, Gaur Hari Das, Pravir Kumar Das, Anurag Agarwal, Madhurima Ghosh","doi":"10.1177/21501351251330841","DOIUrl":"https://doi.org/10.1177/21501351251330841","url":null,"abstract":"<p><p>We report a case of congenital left main coronary artery stenosis surgically treated at our center in a six-month-old patient using an off-pump coronary artery bypass grafting (CABG) approach. The infant presented with respiratory distress, feeding difficulties, and diaphoresis and was diagnosed with dilated cardiomyopathy with severe left ventricular dysfunction. Diagnostic imaging with computed tomography (CT) angiography and coronary angiography identified severe stenosis (>90%) of the left main coronary artery with normal right-sided coronary anatomy. A left internal thoracic artery to left anterior descending coronary artery anastomosis was performed using off-pump CABG, a novel intervention in an infant with congenital left main coronary artery stenosis. Postoperative recovery was smooth and three-year follow-up demonstrated normal development with significant improvement in left ventricular function (ejection fraction 55%). To our knowledge, this case represents the first successful application of off-pump CABG in an infant with congenital left main coronary artery stenosis, marking a pioneering step in pediatric cardiac surgery.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251330841"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593323","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":"Outcome of the Arterial Switch Operation After One Month of Age in Infants With Transposition of the Great Arteries and Intact Ventricular Septum.","authors":"Pheng Hian Tan, Ahmad Nazrin Datuk Ja'apar, Ahmad Sallehuddin","doi":"10.1177/21501351251347950","DOIUrl":"https://doi.org/10.1177/21501351251347950","url":null,"abstract":"<p><p><b>Background:</b> The arterial switch operation (ASO) is the preferred surgical treatment for transposition of the great arteries with intact ventricular septum (TGA/IVS). Delays beyond the first month of life may lead to left ventricular deconditioning. This study evaluated the perioperative outcomes of the neonatal ASO within the first month versus later in life in a middle-income country where late presentations are common, aiming to assess the safety of the ASO beyond early intervention. <b>Method:</b> This retrospective study included 295 TGA/IVS patients who underwent the ASO from January 2010 to December 2023. We excluded those with other significant cardiac anomalies or deconditioned left ventricle (LV). Preoperatively, we evaluated the left ventricular ejection fraction and the posterior LV wall thickness to ascertain the adequacy of the LV. Study outcomes included in-hospital mortality, postoperative chest reexploration, extracorporeal membrane oxygenation use, and the duration of ventilation and hospitalization. <b>Results:</b> One hundred and fifty of 295 patients (51%) had the ASO within 30 days of life (early group) whereas 145 patients (49%) had the ASO beyond 30 days of life (late group). The mean age was 20.3 ± 5.7 days for the early group and 80.0 ± 60.0 days for the late group (<i>P</i> < .001). The late group had significantly lower in-hospital mortality (4.8% vs 14.0%, <i>P</i> = .007) and a lower incidence of chest reexploration (8.3% vs 17.3%, <i>P</i> = .020), with odds ratio of 0.312 and 0.430, respectively. <b>Conclusion:</b> Our findings indicate that the ASO performed after 30 days of life for those with a preserved LV is associated with satisfactory perioperative outcomes, underscoring the importance of carefully selecting patients who present late for the ASO.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251347950"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546752","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":"Prolonged Impella 5.5 Support in a Pediatric Patient With Genetic Cardiomyopathy.","authors":"David Rekhtman, Michaela Asher, Cindy Song, Amit Iyengar, Marisa Cevasco, Katsuhide Maeda, Constantine D Mavroudis","doi":"10.1177/21501351251347948","DOIUrl":"https://doi.org/10.1177/21501351251347948","url":null,"abstract":"<p><p>Temporary mechanical circulatory support (tMCS) has been utilized as a bridge to heart transplantation with increasing duration of support. We describe the clinical course of a 14-year-old patient, with TNNT2 and KCNQ1 mutations, requiring Impella 5.5 support for 76 days. We discuss the patient's underlying genetic etiology, potential complications of prolonged tMCS, and the importance of multidisciplinary support. To our knowledge, this is the first published case in which a patient has this specific combination of genetic mutations and the longest published support duration of an Impella 5.5 in a pediatric patient.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251347948"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546753","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":"A Coronary Challenge: Management of Dextro-Transposition With Levo-Malposed Great Vessels.","authors":"Mark B Lewis, John D Cleveland, Julie Fenske, Luke M Wiggins","doi":"10.1177/21501351251322158","DOIUrl":"10.1177/21501351251322158","url":null,"abstract":"<p><p>A full-term neonate was transferred to our facility after a postnatal diagnosis of dextro (D)-transposition and a ventricular septal defect (VSD). Initial transthoracic echocardiogram revealed atrial situs solitus (S), D-looped ventricles, ventriculo-arterial discordance, and levo-malposition of the great arteries. A single coronary artery was found to be originating from the rightward and anterior sinus of the aortic root. Therefore, we discussed our operative plan as a multidisciplinary team given the atypical anatomy and ultimately decided upon a full repair with an arterial switch operation and VSD closure. We describe our operative technique employed to tackle this uncommon anatomy.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"549-551"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733847","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":"Native Tricuspid Valve Endocarditis Delayed Glenn Procedure: A Case Report.","authors":"Madison B Argo, Joshua L Hermsen, Luke Lamers, Mike Wilhelm, Charles Bergstrom, Petros V Anagnostopoulos","doi":"10.1177/21501351251316231","DOIUrl":"10.1177/21501351251316231","url":null,"abstract":"<p><p>Infective endocarditis in infants with congenital heart disease is exceedingly rare and thus, treatment guidelines and expected outcomes are understudied. We present a 3-month-old girl diagnosed with native tricuspid valve endocarditis at the time of her pre-Glenn cardiac catheterization. She had resultant tricuspid valve and right ventricular dysfunction. After initiating intravenous antibiotics, she underwent an operation including a bidirectional Glenn, Sano shunt extirpation, tricuspid valve repair, and central pulmonary artery stent insertion. At 9 months postoperatively, the patient continues to do well with good right ventricular and tricuspid valve function. Surgical treatment of infective endocarditis may be performed during a Glenn operation with satisfactory short-term results.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"546-548"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461311","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":"Aortopexy With Plication of Kommerell Diverticulum Is an Effective Alternative to Diverticulum Resection and Reimplantation of the Aberrant Left Subclavian Artery for Surgical Management of Vascular Rings in Children.","authors":"Adegbemisola Aregbe Perkins, Ana-Lucia Tomescu, Christopher J Knott-Craig, Umar Boston, Thomas Spentzas, Karthik Vaidyanathan Ramakrishnan","doi":"10.1177/21501351251329912","DOIUrl":"10.1177/21501351251329912","url":null,"abstract":"<p><p>BackgroundRight aortic arch with an aberrant left subclavian artery arising from a Kommerell diverticulum is the most common form of vascular ring. We report the outcomes of plication and pexy of the diverticulum in addition to division of the left-sided ligamentum to treat this lesion in children.MethodsForty-four patients were included in the study; 22 patients underwent division of the ligamentum arteriosum alone, while the other half underwent plication and/or pexy of the Kommerell diverticulum in addition to division of the ligamentum. The primary outcome of interest was reintervention for persistent symptoms following the initial operation. The other outcome studied was symptom relief on follow-up.ResultsThe baseline characteristics were similar between the two groups. There was no difference in the ratio of the size of the Kommerell diverticulum to the size of the left subclavian artery between the groups (1.6 vs 1.8, <i>P</i> = .22). The incidence of reoperation was similar in both groups (5% in each group, <i>P</i> = 1); 7/22 (32%) had persistent symptoms after ligamentum division alone, while only 1/22 (5%) had persistent symptoms after plication and/or pexy (<i>P</i> = .05).ConclusionPlication of the Kommerell diverticulum with pexy along with division of the ligamentum arteriosum is an effective alternative for treatment of right aortic arch with an aberrant left subclavian artery arising from the diverticulum.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"446-449"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061161","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}