World journal for pediatric & congenital heart surgery最新文献

{"title":"Evaluation of Residual Right Ventricular Outflow Tract Obstruction After Pulmonary Valve-Sparing Repair of Tetralogy of Fallot: An Echocardiographic Study.","authors":"Roberta Iacobelli, Priscilla Tifi, Gianluigi Perri, Zaccaria Ricci, Gianluca Brancaccio, Laura Ragni, Victoria d'Inzeo, Sergio Filippelli, Matteo Trezzi, Lorenzo Galletti","doi":"10.1177/21501351251336234","DOIUrl":"https://doi.org/10.1177/21501351251336234","url":null,"abstract":"<p><p>BackgroundPulmonary valve-sparing repair (PVSR) of Tetralogy of Fallot (TOF) provides good results in selected patients. However, recurrent right ventricular outflow tract obstruction (RVOTO) can occur requiring surgical revision. We sought to evaluate the course of RVOTO after PVSR by serial echocardiographic (ECHO) assessment.MethodsA retrospective analysis was conducted in patients who underwent PVSR of TOF at our institution. Demographic, anatomical, surgical and 2D-ECHO data were collected. The cohort was divided into two groups: no reintervention group (group 1) and reintervention group (group 2).ResultsNinety-one patients were included in this study; 13 patients (14%) required reintervention. Right ventricular outflow tract ECHO peak gradient was significantly higher in group 2 at intraoperative transesophageal ECHO (iTEE) (<i>P</i> = .009), at hospital discharge (<i>P</i> = .021), at six months follow-up (<i>P</i> = .0001) and 12 to 36 months follow-up (<i>P</i> = .0001). A more prevalent subvalvular stenosis was found in group 2 at six months (<i>P</i> = .0011) and 12 to 36 months follow-up (<i>P</i> = .00069). An RVOT ECHO peak gradient of 30 mm Hg at iTEE (<i>P</i> = .025) and discharge (<i>P</i> = .011) was statistically associated with the need for reintervention.ConclusionsRight ventricular outflow tract peak gradient was significantly higher in group 2 than in group 1 at iTEE, discharge and follow-up, with an ECHO peak gradient of 30 mm Hg being predictive of reintervention At follow-up, residual RVOTO was prevalent at the subvalvular level in group 2. This information will be useful in clinical decision-making for TOF patients undergoing pulmonary valve sparing repair.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251336234"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083119","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 Increasing Utilization of the Impella Device as a Bridge-to-Transplantation in Pediatric Heart Centers Across the United States.","authors":"Amir Mehdizadeh-Shrifi, Hosam F Ahmed, Grant Chappell, Muhammad Faateh, Tanya Perry, Angela Lorts, David L S Morales, Awais Ashfaq","doi":"10.1177/21501351251330272","DOIUrl":"https://doi.org/10.1177/21501351251330272","url":null,"abstract":"<p><p>ObjectiveReports on the use of the Impella device in children undergoing heart transplantation have been limited. We sought to provide what is to our knowledge the first multi-institutional national report of pediatric Impella device utilization as a bridge-to-heart transplant strategy.MethodsAll patients (<18 years) who underwent Impella placement in the United Network for Organ Sharing (UNOS) from the first use in 2013 to June 2024 were identified. Descriptive analysis was performed, and posttransplant survival analyzed using Kaplan-Meier survival analysis.ResultsFifty children who underwent Impella placement were identified. All UNOS regions utilized the Impella device in pediatric patients. The earliest use was in 2013. Starting in 2022, use as a bridge-to-transplantation experienced a more than two-fold increase, with a consistent rise to 11 devices in 2023 and 10 devices as of June 2024. The median age at Impella implantation was 15 years [13-17]. The median weight was 61 kg [48-82], and the median height was 167 cm [153-172]. The most frequent listing diagnosis was cardiomyopathy (N = 35/50, 70%), followed by congenital heart disease (N = 10/50, 20%). The median device duration was 12 days [6-21], and among all 50 children, 84% (N = 42) underwent heart transplantation the one-year survival was 94.45% [91.23%-97.59%].ConclusionThis report demonstrates the diverse and increasing use of the Impella device as a bridge-to-heart transplantation strategy in children. While early outcomes are promising, investigation is warranted to understand how this less invasive and versatile device can maximize outcomes for children.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251330272"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996066","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":"Rhythm Disturbances in Children With Down Syndrome who Underwent Surgery for Congenital Heart Defects.","authors":"Khadijah Maghrabi, Mohammed Alhabdan","doi":"10.1177/21501351251333687","DOIUrl":"https://doi.org/10.1177/21501351251333687","url":null,"abstract":"<p><p><b>Background:</b> Down syndrome is the most common chromosomal abnormality in live-born infants, and approximately 40% to 60% of children with Down syndrome are diagnosed with congenital heart defects. Corrective cardiac surgery can be performed in these individuals with good outcomes. In this study, we aimed to determine the incidence and outcomes of postoperative arrhythmias in patients with Down syndrome who underwent cardiac surgery. <b>Methods:</b> We conducted a retrospective analysis of patients < 18 years of age who were diagnosed with Down syndrome and had cardiac surgery between 2008 and 2023 at two tertiary cardiac centers. <b>Results:</b> Of 328 total patients, the most frequently encountered lesions were complete atrioventricular septal defect (145/328, 44%), ventricular septal defect (85/328, 26%), and partial atrioventricular septal defect (38/328, 11%). The incidence of postoperative arrhythmias was 24% (87 events in 80 patients). Of these arrhythmias, 27/87 (31%) were tachyarrhythmias (junctional ectopic, atrial ectopic, and reentrant paroxysmal supraventricular tachycardia) and 60/87 (69%) were bradyarrhythmias. These included third-degree atrioventricular [AV] block (n = 56) and sinus node dysfunction (n = 4). Twenty-four patients required permanent pacemaker implantation for persistent postoperative AV block (7% of all the study group cohorts). This incidence was higher than the reported incidence of 1% to 3% in the literature and higher than that in infants without Down syndrome who underwent cardiac repair at our two centers (2.4%). <b>Conclusion:</b> Children with Down syndrome who undergo cardiac surgery have a higher incidence of complete AV block requiring permanent pacemaker implantation when compared to children without Down Syndrome. This information is important for the preoperative counseling of families of these patients and postoperative planning.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251333687"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053813","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":"Rapid Aneurysmal Degeneration of CorMatrix Patch Following Coarctation Repair.","authors":"Chance Benner, Marcus Haw","doi":"10.1177/21501351251334314","DOIUrl":"https://doi.org/10.1177/21501351251334314","url":null,"abstract":"<p><p>We present a case of rapid aneurysmal degeneration and pseudoaneurysm formation following a coarctation repair that utilized an acellular extracellular matrix (ECM) patch. Patch excision and aortic arch reconstruction using aortic homograft were performed. The child recovered without complications. This case questions the durability of ECM patches in arterial reconstruction.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251334314"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059607","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":"Reader Comment on: A Low-Cost Workflow to Generate Virtual and Physical Three-Dimensional Models of Cardiac Structures.","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1177/21501351241313330","DOIUrl":"10.1177/21501351241313330","url":null,"abstract":"","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"427"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257713","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":"Response to Reader Comment on: A Low-Cost Workflow to Generate Virtual and Physical Three-Dimensional Models of Cardiac Structures. If You Can Make it Here, You Can Make it Anywhere.","authors":"Alexander Schneller, Philippe Grieshaber","doi":"10.1177/21501351241313331","DOIUrl":"10.1177/21501351241313331","url":null,"abstract":"","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"428"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470208","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":"Epicardial Lead Performance Trends in Pediatric and Congenital Heart Disease.","authors":"Brynn E Dechert, Vikram Sood, Martin J LaPage","doi":"10.1177/21501351241293722","DOIUrl":"10.1177/21501351241293722","url":null,"abstract":"<p><p><b>Background:</b> Epicardial pacing systems, rather than transvenous systems, are utilized in pediatric patients who are too small to undergo transvenous access and/or have complex congenital heart disease (CHD) anatomically precluding a transvenous system. Longitudinal performance studies indicate that epicardial leads have higher failure rates when compared with transvenous leads but there are limited data on lead measurement changes in the acute phase after implantation. The objective of this study was to assess epicardial lead performance in the acute postimplant period and at one-year follow-up. <b>Methods:</b> This is a retrospective single center study of children and adult patients with CHD undergoing epicardial bipolar pacing lead and generator implantation between January 2012 and June 2022. We empirically selected 2 V as a critical lead threshold. <b>Results:</b> There were 256 leads implanted in 127 patients (mean age 6.1 ± 9.8 years), including 201/256 (79%) leads in patients with CHD. At the time of implant, 47/256 leads (18%) had a lead threshold of ≥2 V. Of those, 42 of 47 (89%) had recorded threshold values on postoperative day 1 (POD1) and 37 of 42 (88%) had decreased to a more acceptable threshold that was <2 V. For patients with an implant threshold of ≥2 V; impedance >1000 ohms, presence of CHD, perioperative or acute postop status, and location of the lead (atrial vs ventricular) did not significantly impact the odds of having a persistently high threshold (≥2 V) on POD1. <b>Conclusion</b>: Epicardial pacing lead thresholds generally improve in the immediate postop period and in our experience most leads with a high implant threshold improved to <2 V by POD1.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"384-387"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635450","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":"Highlights of the 18^th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion.","authors":"Robert A Niebler, Akif Undar","doi":"10.1177/21501351241269942","DOIUrl":"10.1177/21501351241269942","url":null,"abstract":"<p><p>The 18^th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion was held in Milwaukee, WI, USA, on May 9 and 10, 2024. The conference was hosted by the Herma Heart Institute of Children's Wisconsin at the Pfister Hotel in downtown Milwaukee. This communication provides the highlights of the proceedings.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"306-308"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157087","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":"Heart Transplantation Outcomes for Fontan Patients When Using Contemporary Strategies: Heart-Liver Transplantation and Ventricular Assist Device Therapy.","authors":"Spencer J Hogue, Jason W Greenberg, Amir Mehdizadeh-Shrifi, Chet R Villa, Clifford Chin, Angela Lorts, Alexander R Opotowsky, David G Lehenbauer, David L S Morales","doi":"10.1177/21501351241305127","DOIUrl":"10.1177/21501351241305127","url":null,"abstract":"<p><p>BackgroundWith an increasing number of Fontan patients surviving into adulthood, the burden of end-stage heart failure is increasing. Prior studies have reported suboptimal heart transplantation (HTx) outcomes. Therefore, the authors describe their institutional experience of HTx in patients with Fontan circulation failure, including <i>en-bloc</i> heart-liver transplantation (HLTx) and pretransplant systemic ventricular assist device (SVAD) therapies.MethodsAll consecutive Fontan-palliated patients undergoing HTx or HLTx between 2013 and 2022 at the authors' institution were included. Pretransplant characteristics and posttransplant outcomes were recorded.ResultsTwenty-six transplant recipients, including 5 (19%) HLTx recipients, were identified. The majority (n = 16, 62%) of patients had a cardiac diagnosis of hypoplastic left heart syndrome. Seven (26%) patients were bridged to transplant on an SVAD; the median duration of support was 104 [IQR 39-543] days. Transplantation occurred at a median of 10.6 [IQR 6.8-15.6] years post-Fontan. Fourteen (54%) patients had ≥1 in-hospital complication and 4 (15%) patients required an in-hospital reoperation. Postdischarge reinterventions included tricuspid valve repair (n = 1, 4%) and retransplantation (n = 1, 4%). Two (8%) in-hospital mortalities [22 days (post-HLTx), 2.9 months (post-HTx] and 4 (15%) postdischarge mortalities [5.4 months, 3.1 years, 5.7 years, 7.1 years (all post-HTx)] occurred. Overall survival was excellent, with in-hospital, one-year, and five-year actuarial survival being 92%, 89%, and 80%, respectively.ConclusionsThe current series demonstrates that excellent posttransplant outcomes are achievable for patients with Fontan circulation failure using a comprehensive approach including SVAD and HLTx therapies. Pretransplant optimization, sometimes including SVAD implantation, and meticulous operative planning are imperative strategies for successful patient outcomes.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"368-375"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019434","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":"Classical Ozaki Procedure in a Seven-Month-Old Infant.","authors":"Aleksei Ye Chernogrivov, Aleksei I Kim, Frank Cetta, Tatyana V Rogova, Inessa Ye Nefedova, Igor E Chernogrivov, Aleksandr A Esayan, Vera I Dontsova, Alina S Sarkisyan","doi":"10.1177/21501351241297712","DOIUrl":"10.1177/21501351241297712","url":null,"abstract":"<p><p>We present a case study of neotricuspidization of the aortic valve with neocusp suturing based on templates similar to those used in the Ozaki procedure but adapted for infants. This is an alternative for patients when valve reconstruction is impossible or risky. A good postoperative hemodynamic outcome was obtained, but it is necessary to evaluate this approach on the basis of long-term results.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"413-416"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796754","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}