World journal for pediatric & congenital heart surgery最新文献

{"title":"The Benefits of an Intracardiac Conduit in the Fontan Operation for Complex Systemic Venous Anomalies in Patients with Single Ventricle Physiology.","authors":"Teerapong Tocharonechok, Chodchanok Vijarnsorn, Prakul Chanthong, Paweena Chungsomprasong, Supaluck Kanjanauthai","doi":"10.1177/21501351261432652","DOIUrl":"10.1177/21501351261432652","url":null,"abstract":"<p><p><b>Background:</b> Systemic venous anomalies pose challenges to cavopulmonary connections in univentricular patients. At our unit, the intracardiac conduit (ICC) Fontan has been introduced for cases involving apicocaval juxtaposition (ACJ). This addresses issues of a long-curved extracardiac conduit (ECC) to the contralateral pulmonary artery (PA) and potential compression of the ECC to the ipsilateral PA. <b>Methods:</b> We present four patients at various stages who underwent an ICC Fontan operation. This includes primary Glenn connections with the setup for the cath lab Fontan. <b>Results:</b> The ICC placement was done in four levocardic patients. The first patient had an interrupted inferior vena cava (IVC) who previously underwent the Kawashima operation on the left side with pulmonary arteriovenous malformation. The ipsilateral drainage hepatic veins (HVs) were connected to the right PA using an ICC. The second and third patients with left ACJ and preexisting bilateral Glenns underwent IVC to the right PA connection using an ICC. The fourth patient had bilateral superior vena cava, left ACJ, ipsilateral HV drainage, and presented at 10 years of age having had no prior operations. He underwent construction of a bilateral bidirectionalGlenn, right HV to conduit baffling, and IVC to the main PA connection using an ICC with two fenestrations (to allow a gradual ventricular preload change; discharge saturation of 80%). This set him up for interventional closure of the larger fenestration later for physiologic Fontan completion. All the patients recovered with unobstructed conduits and were anticoagulated without thromboembolic/bleeding events. <b>Conclusions:</b> The ICC Fontan operation provides a safe and effective cavopulmonary connection in selected patients with complex systemic venous anomalies.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"726-732"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694673","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":"Neighborhood Opportunity and Long-Term Outcomes Following Pediatric Extracorporeal Membrane Oxygenation.","authors":"Caitlin J Cain-Trivette, Christopher Nemeh, Yeu Sanz Wu, Alysala Malik, Christian Welch, Brooks Melnyk, Claire Gerall, Chunhui Wang, Paul Kurlansky, Eva Cheung, Vincent P Duron, William Middlesworth","doi":"10.1177/21501351261432651","DOIUrl":"10.1177/21501351261432651","url":null,"abstract":"<p><p>ObjectiveTo evaluate whether neighborhood-level opportunity, measured by the Child Opportunity Index (COI), is associated with short- and long-term outcomes following pediatric extracorporeal membrane oxygenation (ECMO).DesignRetrospective observational cohort study.SettingSingle quaternary academic children's hospital.PatientsChildren supported on ECMO between 2009 and 2023 (<i>n = </i>472).InterventionsNone.Measurements and Main ResultsCOI quintiles were derived from geocoded residential addresses at the time of ECMO cannulation. Primary outcomes were survival to discharge and one-year survival. Secondary outcomes included ECMO duration, hospital length of stay, and one-year functional morbidity (gastrostomy tube, tracheostomy, or residence in a facility). Multivariable logistic and Cox regression models adjusted for age, sex, race, ethnicity, weight, and comorbidities. Children residing in the lowest COI quintile had lower adjusted odds of survival to discharge (aOR: 0.60, 95% CI: 0.38-0.95) and one-year survival (aOR: 0.57, 95% CI 0.35-0.93). Survival differences emerged early and persisted over time (adjusted HR for mortality 1.36, 95% CI 0.99-1.87). Among cardiac ECMO patients, low COI was associated with significantly higher odds of gastrostomy tube placement and residence in a facility at one year.ConclusionsNeighborhood opportunity is independently associated with survival and long-term morbidity following pediatric ECMO, particularly among cardiac patients. These findings highlight the importance of incorporating social context into prognostication, post-ECMO planning, and survivorship care in pediatric critical illness.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"743-750"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694678","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":"Fontan Failure in Adult Patients: From Physiology to Solutions.","authors":"Egor A Karev, Oksana F Stovpyuk, Daria V Alekseeva, Diana S Malishevskaya, Lev M Malishevsky, Anton A Avramenko","doi":"10.1177/21501351261443997","DOIUrl":"10.1177/21501351261443997","url":null,"abstract":"<p><p>The adult population with congenital heart defects of varying complexity is growing rapidly. This includes a significant number of patients over the age of 18 who underwent surgery in early childhood to correct conotruncal anomalies and septal defects. While patients with a functional single ventricle palliated with the Fontan procedure are still relatively rare in developing countries, the expertise gained from managing these patients in expert centers in Europe and the United States of America, as well as the success of pediatric cardiac surgery, has drawn increasing attention to this subject. In this review article, we aim to discuss the unique pathophysiology of Fontan circulation and clinical issues in the management of adult patients, with a particular focus on identifying specific predictors of heart failure decompensation and potential complications in this population.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"821-833"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221397","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":"Neonatal Common Atrioventricular Valve Replacement After Failed Staged Biventricular Repair.","authors":"Kazuki Tanimoto, Tomomitsu Kanaya, Ken Hayashi, Dai Asada, Hisaaki Aoki, Sanae Tsumura","doi":"10.1177/21501351261491180","DOIUrl":"https://doi.org/10.1177/21501351261491180","url":null,"abstract":"<p><p>Balanced complete atrioventricular septal defect (cAVSD) with aortic coarctation (CoA) is generally considered amenable to staged biventricular repair (BVR). However, anatomic suitability does not necessarily guarantee functional stability. We report a 3.5-kg neonate with balanced cAVSD (Rastelli type A), severe common atrioventricular valve regurgitation (CAVVR), and CoA. Preoperative echocardiography indicated suitability for BVR. At 9 days of age, arch repair and pulmonary artery banding (PAB) were performed. However, weaning the patient from cardiopulmonary bypass was impossible because of profound hypotension, and transesophageal echocardiography demonstrated worsening of CAVVR. PAB adjustment and removal were ineffective. Intraoperative inspection revealed a severely dysplastic valve morphology incompatible with durable repair. After myocardial recovery with extracorporeal membrane oxygenation support, the patient was converted to a univentricular pathway. The patient subsequently underwent common atrioventricular valve replacement, Damus-Kaye-Stansel anastomosis, and right ventricle-to-pulmonary artery shunt placement. Postoperative ventricular function was preserved without residual regurgitation. This case underscores the importance of flexible intraoperative decision-making guided by direct valve assessment and timely strategic conversion in high-risk neonates with cAVSD and severe CAVVR.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351261491180"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248277","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":"Perioperative Challenges of Unrepaired Tetralogy of Fallot in a Child With Severe Secondary Erythrocytosis: Lessons for the Modern Era.","authors":"Ruchika Kamojjala, Samuel M Hoenig, Lukman A Faniyi, Sahithi Bhavana, Yvette Zhu, Lindsey Stumh, John Clark, Robert D Stewart, Tara Karamlou","doi":"10.1177/21501351261472481","DOIUrl":"https://doi.org/10.1177/21501351261472481","url":null,"abstract":"<p><p>In the United States, secondary erythrocytosis in children with unrepaired Tetralogy of Fallot (ToF) is rare yet may present in children from underresourced environments. We report our experience caring for a 5-year-old male with unrepaired ToF from a low-resourced country presenting with a hematocrit of 76.2%, requiring unique perioperative considerations. This work aligns with the unifying mission among congenital heart providers to improve access to high-quality surgery globally through collaboration.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351261472481"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149241171","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":"Neonatal and Infant Aortic Arch Surgery: Moving Beyond What Works.","authors":"David S Winlaw","doi":"10.1177/21501351261497309","DOIUrl":"https://doi.org/10.1177/21501351261497309","url":null,"abstract":"","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351261497309"},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149241152","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":"Abstracts of the 53^rd Annual Meeting of the Congenital Heart Surgeons' Society; October 24-25, 2026; Chicago, Illinois.","authors":"","doi":"10.1177/21501351261497463","DOIUrl":"https://doi.org/10.1177/21501351261497463","url":null,"abstract":"","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351261497463"},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229748","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":"The Congenital Heart Surgeons' Society Center for Research and Quality 2025 Annual Report.","authors":"Jeffrey Phillip Jacobs, William M DeCampli, Hani K Najm, Osami Honjo, Bahaaldin Alsoufi, Tara Karamlou, Anusha Jegatheeswaran, James D St Louis, Linda M Lambert, Cedric Manlhiot, S Ram Kumar, Alison Howell, James K Kirklin, Christo I Tchervenkov, Erle H Austin, David M Overman, Joseph A Dearani, Jennifer C Romano, Lars G Svensson, William G Williams, Marshall Lewis Jacobs, Eugene H Blackstone, Robert D B Jaquiss","doi":"10.1177/21501351261477040","DOIUrl":"https://doi.org/10.1177/21501351261477040","url":null,"abstract":"<p><p>The Congenital Heart Surgeons' Society (CHSS) is viewed by many as one of the most prestigious professional societies dedicated to pediatric and congenital cardiac surgery. The CHSS Center for Research and Quality (CRQ) Fall 2025 Work Weekend was held in Chicago on Saturday, October 25, 2025. The purpose of this article is to summarize the proceedings of the CHSS CRQ Fall 2025 Work Weekend and to provide a 2025 Annual Report of the CHSS CRQ. At the CHSS CRQ Fall 2025 Work Weekend, multiple topics were discussed related to ongoing CHSS research and quality initiatives. The CHSS CRQ is evolving to keep pace with the rapid evolution of medical informatics and the ever-evolving regulatory issues of clinical research. This 2025 Annual Report of the CHSS CRQ summarizes some of the ongoing initiatives at CHSS CRQ designed to assure that the CHSS CRQ continues to lead innovative and collaborative clinical research to improve pediatric and congenital cardiac care.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351261477040"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187210","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":"The Fontan Procedure in Patients with Single-Lung Physiology: Insights from a Case Report and Scoping Review.","authors":"Albert Franz Guerrero-Becerra, Andrés Felipe Rubio-Duarte, Estefania Alejandra Fontecha-Vargas, Diego Márquez-Bohorquez","doi":"10.1177/21501351261491199","DOIUrl":"https://doi.org/10.1177/21501351261491199","url":null,"abstract":"<p><p>The Fontan operation represents the third stage of single-ventricle palliation and requires optimal cardiovascular and pulmonary conditions to achieve success. We report a 6-year-old boy with tricuspid atresia, pulmonary atresia, and functional single-lung circulation secondary to severe left pulmonary artery (LPA) hypoplasia and disconnection after previous palliation. Following comprehensive clinical, hemodynamic, and anatomic evaluation, including unsuccessful attempts at LPA recruitment, the patient underwent an extracardiac fenestrated single-lung Fontan procedure. At 2 years of follow-up, he remained in good functional status without Fontan-related complications or the need for reintervention. Additionally, we present a scoping review of published case reports and case series of children with single-lung physiology undergoing the Fontan procedure, focusing on early and follow-up survival. This case, together with the available literature, suggests that single-lung Fontan completion may be feasible in carefully selected patients following meticulous multidisciplinary evaluation, although long-term outcomes remain uncertain.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351261491199"},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187282","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":"Single-Ventricle Physiology as a Dominant Determinant of Mortality, Resource Utilization, and Pulmonary Vein Reintervention in Total Anomalous Pulmonary Venous Connection: A Large Multicenter Study.","authors":"Darren Turner, Amir Mehdizadeh-Shrifi, Blue Lee, Hosam F Ahmed, Grant Chappell, Sarosh Batlivala, David Lehenbauer, Awais Ashfaq, David L S Morales, Marco Ricci","doi":"10.1177/21501351261472486","DOIUrl":"https://doi.org/10.1177/21501351261472486","url":null,"abstract":"<p><p>BackgroundChildren with single ventricle (SV) physiology and total anomalous pulmonary venous connection (TAPVC) face high surgical risk. Despite advances in single ventricle care, survival in SV/TAPVC patients has plateaued. We investigated multicenter outcomes, reintervention rates, and healthcare burden in this complex population.MethodsThe Pediatric Health Information System was queried for TAPVC repairs (2015-2024). Infants were stratified by single-ventricle versus biventricular (BiV) anatomy.ResultsAmong 1258 infants undergoing TAPVC repair, 10% (N = 120) had SV and 90% (N = 1138) had BiV anatomy. SV/TAPVC patients showed higher prematurity (11% [13/120] vs 8% [91/1138], <i>P</i> < .001), low birthweight (14% [17/120] vs 9% [102/1138], <i>P</i> < .001), and neurologic abnormalities (13% [16/120] vs 5% [60/1138], <i>P</i> < .001). Postoperatively, SV/TAPVC had increased delayed sternal closure (11% [13/120] vs 4% [45/1138], <i>P</i> < .001) and ECMO use (7% [8/120] vs 3% [34/1138], <i>P</i> < .001). Healthcare burden was substantially higher in SV/TAPVC children: 5-fold longer hospitalizations (102 vs 29 days, <i>P</i> < .001), 6-fold more hospital visits (6 vs 1, <i>P</i> < .001), and 5-fold higher costs ($1,019,390 vs $259,303, <i>P</i> < .001). Survival at 1 year after repair was severely reduced (SV: 52% vs BiV: 88%, <i>P</i> < .001). Pulmonary vein reinterventions were substantially higher (12-month cumulative incidence: 32% vs 5%, <i>P</i> < .001). Single ventricle physiology was a strong mortality predictor (HR: 3.69, <i>P</i> < .001), particularly pulmonary atresia with intact septum (HR: 6.62, <i>P</i> < .001) and hypoplastic left heart syndrome (HR: 4.42, <i>P</i> < .001).ConclusionsSingle ventricle physiology remains a powerful predictor of adverse outcome in children with TAPVC, with 1-year survival rates approaching 50%. Children with SV/TAPVC face substantially longer hospitalizations, higher reintervention rates, higher hospital visits, and overall 5-fold greater healthcare costs.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351261472486"},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187270","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}