World journal for pediatric & congenital heart surgery最新文献

{"title":"Contemporary Practice of Native Coarctation in Children Greater Than One Year of Age: A Society of Thoracic Surgeons Analysis.","authors":"Awais Ashfaq, Edo Bedzra, Konrad T Rajab, Levi N Bonnell, Ashok Muralidaran, Mark Bleiweis, David L S Morales, Robert H Habib, Jeffrey Jacobs, James A Quintessenza","doi":"10.1177/21501351241311276","DOIUrl":"10.1177/21501351241311276","url":null,"abstract":"<p><p>ObjectiveLimited data exist on surgical repairs for native coarctation of the aorta (Native-CoA) after year-one of life. We sought to establish surgical outcomes benchmark of older Native-CoA repair patients.MethodsAll patients greater than one year of age who underwent off-pump Native-CoA repair were identified from the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) between January 1998 and December 2022.ResultsA total of 2,898 patients older than one year (mean age: 6.1 years; mean weight: 23.7 kg) underwent Native-CoA repair through left thoracotomy at 131 STS-CHSD centers. Vascular syndromes including Turners, Williams, and Alagille, were relatively rare at 1.8%. The most common procedures were extended end-to-end (1,309/2898, 45.2%) end-to-end 1,107/2898, (38.2%), and patch aortoplasty ((239/2898, 8.2%). From 1998 to 2018, there was an overall increase in the number of patients (14 vs 156), explained largely by the increased number of hospitals (4 vs 70). However, after 2018, case counts declined by nearly 50%. Operative mortality was rare (n = 3). An average of 1.2 complications per patient (438 total) occurred in 365/2898 (12.6%) patients. The most common complications included chylothorax (101/2898, 3.5%), unplanned 30-day readmission (28/1917, 1.5%), and arrhythmia requiring drug therapy (17/1917, 0.9%). Median length of hospital stay was four days, with hospital stay >6 days in 248 patients (14.8%).ConclusionsFrequency of off-pump Native-CoA repairs (age >1 year) is decreasing despite no notable change in total participating hospitals and case counts. This is likely due to increased percutaneous interventions despite very low documented mortality and morbidity of off-pump surgical repairs.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"439-445"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257704","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":"Outcomes in Late Presenting Obstructed Infracardiac Total Anomalous Pulmonary Venous Connection-Single Centre Experience.","authors":"Kartik Patel, Deepti Kakkar, Himani Pandya, Shyam S Kothari, Megha Sheth, Herin Patel, Trushar Gajjar, Amit Mishra","doi":"10.1177/21501351241305133","DOIUrl":"10.1177/21501351241305133","url":null,"abstract":"<p><p>BackgroundSurvival beyond one month of age is rare in children born with obstructed infracardiac total anomalous pulmonary venous connection (TAPVC). There are limited data available on surgical outcomes of the same subset. We conducted this retrospective study to identify risk factors associated with surgical outcomes in this patient population.MethodWe present a retrospective study of patients presenting at our institute with obstructed infracardiac TAPVC surviving beyond one month of age during the period from January 2015 to August 2019 (n = 14). Data reviewed included demographic parameters, preoperative laboratory results, echocardiogram images, and computed tomography if performed. Intraoperative as well as postoperative data including type of surgery, use of deep hypothermic arrest, mortality, and morbidity were noted. Follow-up clinical data were also collected from institutional record or telephonically. We have also collected echocardiographic data on follow up.ResultsThe mean age of our study cohort was 2.14 ± 0.68 months. Out of 14 total patients 3 patients eventually died. Risk factors that were significantly associated with mortality were low weight (odds ratio [OR] = 7.8, <i>P</i> = .005), preoperative bilirubin level (OR = 7.4, <i>P</i> = .007), use of deep hypothermic circulatory arrest (OR = 4.6, <i>P</i> = .031), tricuspid regurgitation grade (OR = 3.8, <i>P</i> = .050), and pulmonary artery hypertension (OR = 10.5, <i>P</i> = .001). Mean follow up for the study cohort was 2189 ± 538 days. One patient has mild flow acceleration across the anastomosis with a gradient of 5/3 mm Hg without any symptoms. The remainder of the patients are alive with excellent clinical as well as echocardiographic outcome.ConclusionThe presentation of infants with obstructed infracardiac TAPVC beyond one month of age is very rare. However, timely intervention can provide acceptable early and excellent late outcomes in this rare patient cohort.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"462-468"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049387","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":"Surgical Repair of the Aorta in a Neonate With Arterial Tortuosity Syndrome.","authors":"Yuriy Y Kulyabin, Dmitriy S Zemel, Nataliya R Nichay, Alexey N Arkhipov, Darya A Dulceva, Ilya A Soynov","doi":"10.1177/21501351251322161","DOIUrl":"10.1177/21501351251322161","url":null,"abstract":"<p><p>Arterial tortuosity syndrome (ATS) is an autosomal-recessive genetic connective tissue disorder that affects the aorta and medium-sized arterial vessels.¹ We report a case of successful surgical management of the descending aorta in a ten-day-old patient with ATS who presented with multiorganic failure. The aortic reconstruction with a pulmonary homograft patch was performed using full-flow body perfusion.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"551-553"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702412","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":"Invited Commentary: Kommerell Diverticulum-The Definitive Alternative.","authors":"Carl L Backer","doi":"10.1177/21501351251335641","DOIUrl":"10.1177/21501351251335641","url":null,"abstract":"","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"450-451"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113303","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":"Liposomal Bupivacaine Versus Plain Bupivacaine for Pain Control Following Congenital Cardiac Surgery.","authors":"Brandon M Tanner, Jeremy Herrmann, Riad Lutfi, Mouhammad Yabrodi, Rania K Abbasi","doi":"10.1177/21501351241293157","DOIUrl":"10.1177/21501351241293157","url":null,"abstract":"<p><p>BackgroundPain control following cardiac surgery can be challenging, and inadequate pain control is associated with postoperative complications. Liposomal bupivacaine can improve postoperative pain control due to its prolonged duration compared with plain bupivacaine. However, there is a paucity of data regarding its efficacy in congenital cardiac surgery. The primary outcome was to compare opioid requirements between liposomal bupivacaine and plain bupivacaine for local infiltration in pediatric patients undergoing cardiac surgical procedures via a median sternotomy approach. Secondary outcomes included antiemetic use, adjunct pain medication use, length of stay, and pain scores.MethodsThis single center retrospective study analyzed data from 2017 to 2022 involving patients who underwent congenital cardiac surgery via median sternotomy. Sixty-three patients who received liposomal bupivacaine were matched with 33 patients who received plain bupivacaine. Patient data were extracted from the electronic medical record and underwent statistical analysis using Wilcoxon, χ², and Fisher exact tests.ResultsThere were no demographic differences between the two groups. Postoperative opioid use did not differ significantly between the liposomal bupivacaine and plain bupivacaine groups. The liposomal bupivacaine group had increased acetaminophen and antiemetic use, while the plain bupivacaine group had increased ketorolac use. Otherwise, there were no significant differences in secondary outcomes, including length of stay.ConclusionLiposomal bupivacaine may not offer any advantage over plain bupivacaine in congenital cardiac postoperative pain control.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"478-482"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635461","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":"Right Atrial Rhabdomyosarcoma; 35-Year Disease-Free Survival Following Radical Resection With Right Internal Thoracic Artery Bypass.","authors":"Aeleia F Hughes, Genevieve Yedlicka, Gurion Lantz, Randall Caldwell, John W Brown","doi":"10.1177/21501351251318723","DOIUrl":"10.1177/21501351251318723","url":null,"abstract":"<p><p>Cardiac rhabdomyosarcomas (RMS) are rare malignant tumors of the heart with a poor prognosis, even when appropriate treatment regimens are initiated. We present the case of a 12-year-old male who underwent radical resection of a right atrial mass, which was confirmed to be a primary cardiac RMS. He has received regular follow-up for the last 35 years, representing what is to our knowledge the longest reported disease-free survival in a patient with a primary cardiac RMS.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"528-529"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525758","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":"Understanding Early Fontan Failure in Vietnam: Incidence and Clinical Predictors.","authors":"Dac-Dai Tran, Ngoc-Thanh Le, Hai-Van T Dang, Hoang-Long Vo","doi":"10.1177/21501351241299412","DOIUrl":"10.1177/21501351241299412","url":null,"abstract":"<p><p>BackgroundWe aimed to determine the incidence of early Fontan failure (EFF) in a contemporary series of patients from Vietnam and identify risk factors for EFF.MethodsA total of 145 consecutive patients underwent the Fontan procedure at E hospital in Vietnam from August 2012 through December 2019. We analyzed predictive factors for EFF based on clinical evaluation, literature review, and our institutional database. The primary outcome assessed was EFF.ResultsThe incidence of EFF was 9.66%. In a univariate analysis of preoperative data, the anatomic diagnosis of unbalanced atrioventricular (AV) septal defect, situs inversus, AV valve regurgitation, large aortopulmonary circulation on Doppler echocardiogram, elevated pulmonary artery pressure (PAP), and elevated pulmonary vascular resistance (PVR) were significantly associated with EFF. Four intraoperative risk factors influencing EFF included pulmonary artery reconstruction, AV valve repair, bleeding, and elevated PAP. Postoperative edema was also significantly associated with EFF. A total of 22 potential independent variables were put into a model with multivariate logistic regression analysis. A final reduced model following utilizing a stepwise backward selection strategy indicated preoperative elevated PAP (odds ratio [OR]: 1.84, 95% CI: 1.12-3.00, <i>P</i> = .016), AV valve repair at Fontan (OR: 65.85, 95%CI: 1.95-2228.14, <i>P</i> = .020), and postoperative elevated PAP (OR: 1.66, 95%CI: 1.19-2.33, <i>P</i> = .004) were independent predictors for EFF.ConclusionEarly Fontan failure was relatively high in our case series and was associated with a significant mortality rate. Patients with single ventricle physiology having preoperative elevated PAP, intraoperative AV valve repair, and postoperative elevated PAP were identified as independent risk factors to predict EFF. Particularly, in the context of a developing country with limited health care resources, a comprehensive management strategy that targets the variable predictors for EFF should be incorporated with previously known risk factors to avoid EFF.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"469-477"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627294","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":"Three-Dimensional Printed Cardiac Models Demonstrating Extensive Cardiac Calcification Assist in Preprocedural Planning.","authors":"Ross Foley, Kevin Walsh, Eoin O'Cearbhaill, Colin J McMahon","doi":"10.1177/21501351241313319","DOIUrl":"10.1177/21501351241313319","url":null,"abstract":"<p><p>Cardiac calcification is common in adults with congenital heart disease, typically affecting surgical sites and prosthetic material. Understanding the precise location and degree of calcification is important during the decision-making process prior to possible intervention but can be difficult to determine in different imaging modalities. Advances in three-dimensional (3D) modeling and printing have made it possible to distinguish different tissue types and accurately display them in different colors on printed models. We present two adult congenital heart disease patients where advanced 3D printing was used to demonstrate cardiac calcification and aided the preprocedural planning process.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"543-546"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257715","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":"Coronary Sinus Blues: A Word of Caution When Placing the Coronary Sinus Ostium in the Left Atrium.","authors":"Clayton J Rust, Mohan M John, Joshua M Rosenblum, Glen J Iannucci, Dennis W Kim, Paul J Chai","doi":"10.1177/21501351251329927","DOIUrl":"10.1177/21501351251329927","url":null,"abstract":"<p><p>Complications related to the coronary sinus following cardiac surgery are rare and require a high index of suspicion to ensure timely diagnosis and treatment. We describe the clinical presentation and management of a patient with atrioventricular septal defect who developed coronary sinus ostial obstruction following left atrioventricular valve replacement. This manifested as a decline in ventricular function and supraventricular arrhythmias. Surgical enlargement of the coronary sinus ostium was initially successful but failed to produce a durable result.Meeting presentation: Oral presentation at the Congenital Heart Surgeons' Society Annual Meeting; October 19, 2023; Boston, MA.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"557-559"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033891","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":"Outcomes of Atrioventricular Septal Defect Repair: Two-Institutions, 10-Year Experience in Cordoba, Argentina.","authors":"Ignacio Juaneda, Lucca Pizzulli, Paula Ferrari, Rodrigo Molinas, Juan Diaz, Irma Azar, Alejandro Allub, Ernesto Juaneda, James St Louis, Alejandro Peirone, Jenkins Kathy","doi":"10.1177/21501351241305135","DOIUrl":"10.1177/21501351241305135","url":null,"abstract":"<p><p>BackgroundOutcomes following surgical repair of atrioventricular septal defect have improved over the last decades. Global mortality for repair of this defect is approximately 3.5%. We describe contemporary surgical outcomes from two institutions in Argentina.Material and MethodsA retrospective two-institution review was performed of patients operated on for atrioventricular septal defect (partial, transitional, and complete) at Hospital Privado Universitario de Cordoba and Hospital de Niños Cordoba, from January 2014 to December 2023. We analyzed demographic characteristics, operative data, mortality, and outcomes.ResultsOne hundred and ten patients were operated for atrioventricular septal defect: There were 78 patients with complete atrioventricular septal defect, 10 with partial atrioventricular septal defect, and 22 with transitional atrioventricular septal defect. Mean age and weight at operation were 1.17 year (range 0.04-13 years) and 7.53 kg (2.8-55 kg), respectively. For the complete atrioventricular septal defect subgroup, surgeries with the modified single patch technique had shorter cardiopulmonary bypass times when compared with the two patch technique (95.6 vs 139.7 min, respectively, <i>P</i> < .001). Hospital mortality was 4.5% (5 of 110 patients), all with complete atrioventricular septal defect operated with the double patch technique. Mean follow-up of the entire cohort was 57.4 months (1-118 months). Five patients underwent a reoperation at a mean time from the first operation of 14.4 months (6-24 months).ConclusionsAtrioventricular septal defect surgical repair was successfully achieved in different ages and anatomical subtypes in most patients. Complete atrioventricular septal defect had higher mortality when compared with other subgroups. Our review shows similar outcomes following repair of atrioventricular septal defect compared with an international aggregate in a resource-limited practice.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"509-515"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070614","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}