World journal for pediatric & congenital heart surgery最新文献

{"title":"Multidisciplinary Surgical Care for a Cervical Esophageal Duplication Cyst.","authors":"Harikrishan S Sachdev, Andrew Well, James Attra, Carlos Mery, Charles D Fraser, Neil Venardos","doi":"10.1177/21501351241294234","DOIUrl":"10.1177/21501351241294234","url":null,"abstract":"<p><p>We present a case of a three-month-old male who presented with a cervical esophageal duplication cyst requiring early surgical intervention. The patient presented with feeding difficulties, poor weight gain, and respiratory distress. Due to the position of the cervical esophageal duplication cyst and airway compression, this unique case required a multidisciplinary surgical approach involving both otolaryngology and cardiothoracic surgery.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"409-411"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635466","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":"Randomized Trial of Pulsatile and Nonpulsatile Flow in Cyanotic and Acyanotic Congenital Heart Surgery.","authors":"Krishna Patel, Tracie K Lin, Joseph B Clark, Gary D Ceneviva, Jason R Imundo, Debra Spear, Allen R Kunselman, Neal J Thomas, John L Myers, Akif Ündar","doi":"10.1177/21501351241288835","DOIUrl":"10.1177/21501351241288835","url":null,"abstract":"<p><p>BackgroundThe study objective was to determine the impact of cardiopulmonary bypass perfusion modalities on cerebral hemodynamics and clinical outcomes in congenital cardiac surgery patients stratified by acyanotic versus cyanotic heart disease.MethodsA total of 159 pediatric (age <18 years) cardiac surgery patients were prospectively randomized to pulsatile or nonpulsatile cardiopulmonary bypass and stratified by type of congenital heart disease: acyanotic versus cyanotic. Intraoperative cerebral gaseous microemboli counts and middle cerebral artery pulsatility index were assessed. Organ injury was quantified by Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score at 24, 48, and 72 h postoperatively. Additional outcomes included Pediatric Risk of Mortality-3 score, vasoactive-inotropic score, duration of mechanical ventilation, intensive care and hospital length of stay, and 180-day mortality. Heterogenous variance linear models (ie, ANOVA and mixed models) and χ² tests were used to compare groups for continuous and categorical variables, respectively.ResultsWithin congenital heart disease subgroups, patients randomized to nonpulsatile versus pulsatile bypass had similar preoperative and operative characteristics. While the intraoperative pulsatility index was higher in the pulsatile subset of both acyanotic and cyanotic groups (<i>P</i> < .05), regional cerebral oxygen saturation, mean arterial pressure, and gaseous microemboli counts were similar. Postoperative PELOD-2 scores decreased at similar rates in the acyanotic and cyanotic subgroups regardless of the perfusion modality utilized. There were also no significant between-group differences in the additional postoperative outcomes by perfusion modality in either acyanotic or cyanotic groups.ConclusionsDespite patients undergoing pulsatile cardiopulmonary bypass experiencing a more physiologic pulsatility index in both acyanotic and cyanotic groups, no significant differences in cerebral hemodynamics or clinical outcomes were appreciated.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"329-337"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879293","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":"A Juxta-Arterial and Perimembranous Confluent Ventricular Septal Defect in Transposition of the Great Arteries.","authors":"Shinya Yokoyama, Ryohei Fukuba, Rei Tonomura, Kazuhiro Mitani, Hideki Uemura","doi":"10.1177/21501351241305131","DOIUrl":"10.1177/21501351241305131","url":null,"abstract":"<p><p>Transposition of the great arteries (TGA) with a rare form of ventricular septal defect (VSD) needs careful attention when choosing the optimal strategy for repair. A neonate with TGA and an atypical VSD, which extended from the perimembranous to the juxta-arterial regions, underwent the arterial switch procedure. The large VSD was successfully closed via a trans-tricuspid combined with a trans-aortic valve approach concomitantly with the arterial switch maneuver. Surgeons need to be aware aware that the types of VSD are diverse in TGA.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"416-418"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019430","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":"Long-Term Coronary Artery Complications Following the Arterial Switch Operation for Transposition of the Great Arteries-A Scoping Review.","authors":"Rachel S Lim, Jeffrey Lefkovits, Samuel Menahem","doi":"10.1177/21501351241311280","DOIUrl":"10.1177/21501351241311280","url":null,"abstract":"<p><p>Coronary artery complications following the arterial switch operation (ASO) for transposition of the great arteries have become increasingly relevant as those affected are exposed to the comorbidities of later years. A scoping review was undertaken to explore the incidence, clinical features, and management of the long-term coronary complications after the ASO. The selection criteria yielded 73 articles They recorded few long-term coronary artery complications following the ASO, which were difficult to recognize as most affected patients' symptoms were absent or nonspecific. In patients with suspected coronary artery involvement, coronary angiography or computed tomography provided confirmation, with significant stenosis generally managed by percutaneous trans-catheter interventions.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"402-408"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257707","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":"Cerebral Hemodynamic Monitoring via Transcranial Doppler Ultrasound and Near-Infrared Spectroscopy for Risk-Stratified Pediatric Cardiac Surgery Patients.","authors":"Krishna Patel, Marc J Lussier, Yongwook Dan, Natalie Gurevich, Allen R Kunselman, Tracie K Lin, Jason R Imundo, John L Myers, Akif Ündar","doi":"10.1177/21501351251322112","DOIUrl":"10.1177/21501351251322112","url":null,"abstract":"<p><p>BackgroundThe objective of this study was to evaluate mean cerebral blood flow velocity, gaseous microemboli (GME) counts, regional cerebral oxygen saturation (rSO₂), and clinical outcomes using multimodality neuromonitoring in risk-stratified congenital cardiac surgery patients and by cyanotic and acyanotic heart disease.MethodsA total of 377 pediatric patients undergoing congenital cardiac surgery with cardiopulmonary bypass (CPB) were stratified by the Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) mortality categories and by classification of cyanotic and acyanotic heart disease. Intraoperative mean cerebral blood flow velocity, GME counts, and rSO₂ were assessed at multiple time points. Clinical outcomes were compared between patients of each STAT mortality category and cyanotic classification.ResultsMean cerebral blood flow velocities of STAT Mortality Category 5 patients decreased drastically from baseline values after cross-clamp (down to 56%) and after off-bypass (down to 32%), while rSO₂ values increased significantly during CPB. Patients in STAT mortality category 5 experienced higher GME counts (1.3- to 4.4-fold greater) compared with patients in all other STAT categories. When compared with acyanotic patients, cyanotic patients experienced significantly lower mean blood flow velocity, significantly greater rSO₂ during CPB, and greater GME counts than acyanotic patients (1.3-fold greater). Although 29 patients experienced neurological injury confirmed by electroencephalogram and magnetic resonance imaging, instances of injury were not correlated with GME counts among risk-stratified and cyanotic versus acyanotic patients.ConclusionsUtilization of intraoperative transcranial Doppler, in addition to near-infrared spectroscopy, may help to identify other parameters for cerebral protection, such as drastically decreased cerebral blood flow velocity and increased cerebral microemboli counts, particularly in STAT Mortality Category 5 and cyanotic patients.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"338-351"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627304","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":"Impact of an Adult Congenital Heart Disease Order Set in a Pediatric Cardiac Intensive Care Unit.","authors":"Ashley Park, Brynn Connor, Pranava Sinha, Melissa Jones, Ricardo Munoz, Aminah Baxter, Seiji Ito, Anitha John","doi":"10.1177/21501351241279126","DOIUrl":"10.1177/21501351241279126","url":null,"abstract":"<p><p><b>Background:</b> Patients with congenital heart disease (CHD) are increasingly surviving to adulthood. Given their age- and condition-specific needs, the optimal postoperative setting for these patients is not yet determined. This study aims to evaluate the utility of an adult-specific order set in improving clinical outcomes for these patients in a pediatric cardiovascular intensive care unit (ICU). <b>Methods:</b> Adults with CHD (ACHD) admitted to the cardiovascular ICU following cardiac surgery at a pediatric tertiary care center were identified for a retrospective cohort study. Health care delivery metrics and clinical outcomes of participants who received the adult-specific order set were compared with control patients admitted prior to the intervention. Categorical outcomes were compared using the χ² test of independence or Fisher exact test, and continuous outcomes were assessed using the <i>t</i> test. <b>Results:</b> A total of 130 ACHD patients received the intervention, with no significant differences observed in clinical outcomes when compared with 89 controls. While there was additionally no reduction in hospital-related mortality (2.3% vs 7.8%, RR 0.3; <i>P</i> = .1), clinician ordering behaviors were better aligned with best-practices following the intervention. Among patients with moderate or greater anatomic complexity, a <i>post hoc</i> analysis demonstrated reduced in-hospital mortality from those who received the adult order set. <b>Conclusions:</b> The implementation of an adult-specific order set in a pediatric care setting did not improve clinical outcomes for all ACHD patients. Patients with moderate and greater anatomic complexity did see a mortality benefit, suggestive that targeted electronic tools may most benefit those who have the highest risk.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"376-383"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515731","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":"Bridge to Heart Transplantation Using the Impella Device in a Pediatric Patient.","authors":"Hüseyin Sicim, Mohamad Alaeddine, Daniel A Velez","doi":"10.1177/21501351251324946","DOIUrl":"https://doi.org/10.1177/21501351251324946","url":null,"abstract":"<p><p>Mechanical circulatory support options for pediatric patients with acute heart failure are limited. These patients can be challenging to manage depending on their size and the type of extracorporeal support required including the need for a left ventricular assist device. We report the case of a 12-year-old child with severely depressed left ventricular function who did not respond to medical therapy. We successfully stabilized the patient and bridged him to a successful heart transplant by implanting an Impella 5.5 device via a 10-mm Hemashield graft to the right innominate artery.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251324946"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034731","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":"Monomorphic Ventricular Tachycardia Secondary to an Epicardial Pacing Lead.","authors":"Mitchell I Cohen, Christopher Moalli, Rob Przybylski, Lucas Collazo","doi":"10.1177/21501351251333675","DOIUrl":"https://doi.org/10.1177/21501351251333675","url":null,"abstract":"<p><p>Epicardial pacing leads are frequently used in small children and in complex congenital heart disease that precludes transvenous lead placement. While lead failure is not uncommon from epicardial pacing leads, proarrhythmic events are rare. We present an eight-year-old patient who developed spontaneous nonsustained ventricular tachycardia from a chronic unipolar epicardial pacing lead. Removal of the epicardial lead with cryoablation around the lead body resolved the ventricular tachycardia. To our knowledge, this is the first case report of a suture on epicardial pacing lead causing late ventricular tachycardia.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251333675"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051161","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":"Unintended Consequences of Innominate Artery Cannulation in a Pediatric Patient: Infection of Innominate Artery Graft Stump With Subsequent Formation of Right Common Carotid Artery Pseudoaneurysm.","authors":"Andreas Polycarpou, Satoshi Miyairi, Pranava Sinha, Edward Martin-Chaffee, Syed Murfad Peer","doi":"10.1177/21501351251333657","DOIUrl":"https://doi.org/10.1177/21501351251333657","url":null,"abstract":"<p><p>Indirect arterial cannulation techniques, such as cannulation of the innominate artery (IA) using an end-to-side anastomosed vascular graft, are commonly used to establish cardiopulmonary bypass in congenital cardiac surgery. Although rare, unintended consequences, such as graft infection, may occur. We describe a case of IA graft infection with subsequent pseudoaneurysm formation in a 10-year-old child who underwent multiple procedures for Tetralogy of Fallot with absent pulmonary valve syndrome.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251333657"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061762","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":"Unexpected Finding of an Inflammatory Myofibroblastic Tumor of the Heart Causing Pulmonary Artery Obstruction in an Asymptomatic Toddler.","authors":"Sara B A Morel, Elie Fadel, Sophie W Gao, Dorothée Dal Soglio, Pierre-Luc Bernier","doi":"10.1177/21501351251322154","DOIUrl":"https://doi.org/10.1177/21501351251322154","url":null,"abstract":"<p><p>Inflammatory myofibroblastic tumor (IMT) of the heart is a very rare tumor, constituting less than 5% of primary heart tumors. This case report describes the unexpected finding of IMT of the heart causing pulmonary artery obstruction in an asymptomatic toddler.</p>","PeriodicalId":94270,"journal":{"name":"World journal for pediatric & congenital heart surgery","volume":" ","pages":"21501351251322154"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004551","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}