384 results match your criteria Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual[Journal]


Ventricular Assist Devices for Neonates and Infants.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:9-14

Departments of Cardiothoracic Surgery, Stanford University, Stanford, California.

Heart transplant waitlist survival in pediatric patients has been substantially improved since the introduction of pediatric-specific ventricular assist device. In neonates and infants, however, the waitlist mortality remains very high. The only long-term device currently approved for use in the United States is the Berlin Heart EXCOR, but this device has several important limitations because of the paracorporeal, pulsatile nature of the underlying technology. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.005DOI Listing
March 2018
4 Reads

Surgical Approaches to Total Anomalous Pulmonary Venous Connection.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:83-91

Hospital for Sick Children, Division of Cardiovascular Surgery, Toronto, Ontario, Canada. Electronic address:

Total anomalous pulmonary venous connection (TAPVC) constitutes a spectrum of congenital lesions whereby the pulmonary veins remain connected to systemic venous vessels or aberrantly connect to the right atrium. Definitive management requires surgical intervention and, in patients with obstruction to pulmonary venous flow, urgent operation is required. Use of temporizing catheter-based interventions allow for optimization in hemodynamically unstable neonates. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10929126173001
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http://dx.doi.org/10.1053/j.pcsu.2017.11.010DOI Listing
March 2018
14 Reads

Comprehensive Management of Major Aortopulmonary Collaterals in the Repair of Tetralogy of Fallot.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:75-82

Department of Cardiothoracic Surgery, School of Medicine, Stanford University, Lucile Packard Children's Hospital, Stanford, CA, USA.

The heterogenous anatomy of Tetralogy of Fallot with major aortopulmonary collateral arteries has engendered a similar degree of diversity in its management and, ultimately, outcome. We summarize our comprehensive treatment paradigm for this lesion evolved over 15 years of experience through 458 patients and the results obtained. An updated analysis of 307 patients treated primarily at our institution is included. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.002DOI Listing
March 2018
5 Reads

Approaches to Pulmonary Atresia With Major Aortopulmonary Collateral Arteries.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:64-74

Department Cardiac Surgery, Birmingham Children's Hospital, UK.

Pulmonary atresia with major aortopulmonary collateral arteries (MAPCAs) is one of the most challenging surgical conditions to manage-not only because of the technical complexity of the surgery but also in terms of defining the anatomy of the pulmonary vasculature, the timing of surgery, and decision making on staged vs complete repair. The importance of early definition of pulmonary blood supply is paramount, establishing which areas of the lung are supplied by MAPCAs alone and which have dual supply with the native system (noting that 20% of patients have absent intrapericardial native vessels). Early unifocalization (3-6 months) is ideal, with closure of the ventricular septal defect (VSD) performed if 15 or more out of 20 lung segments can be recruited. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.001DOI Listing
March 2018
6 Reads

Nikaidoh vs Réparation à l'Etage Ventriculaire vs Rastelli.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:58-63

Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.

This review describes the different surgical options for transposition of the great arteries, ventricular septal defect (VSD), and left ventricular outflow tract obstruction. When the pulmonary valve can be used, an arterial switch operation with VSD closure and resection of pulmonary stenosis may be possible. This is not the scope of our review: we focus on the Rastelli, REV (Réparation à l'Etage Ventriculaire), and Nikaidoh techniques, and we also describe the "en bloc rotation" technique. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.10.001DOI Listing
March 2018
19 Reads

Repair for Congenital Mitral Valve Stenosis.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:46-57

Department of Cardiothoracic and Vascular Surgery, Cardio Centrum Berlin, Berlin, Germany.

We report the techniques and long-term outcome of mitral valve (MV) repair to correct congenital mitral stenosis in children. Between 1986 and 2014, 137 children (mean age 4.1 ± 5. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10929126173000
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http://dx.doi.org/10.1053/j.pcsu.2017.11.008DOI Listing
March 2018
9 Reads

Repair Techniques for Mitral Valve Insufficiency in Children.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:41-45

Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.. Electronic address:

Congenital mitral valve (MV) dysplasia is a relatively rare and highly complex cardiac disease. We sought to provide a comprehensive analysis of the current surgical techniques for treating mitral valve insufficiency and the results of mitral valve repair at our institution. Between 1972 and 2017, 104 consecutive patients underwent surgical repair of congenital MV dysplasia-insufficiency at our institution. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.004DOI Listing
March 2018
18 Reads

Aortic Valvuloplasty or Rootplasty for Aortic Regurgitation.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:33-40

Division of Pediatric Cardiac Surgery, Advocate Children's Heart Institute, Advocate Children's Hospital, Oak Lawn, Illinois. Electronic address:

At present, aortic valvuloplasty is considered an effective procedure for treatment of aortic regurgitation in pediatric patients. It has encouraging mid- and long-term results. The improved outcome is primarily related to better understanding of the functional anatomy of the normal valve and the different factors that alter it. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.009DOI Listing
March 2018
3 Reads

Direct Splanchnic Perfusion Safely Avoids Deep Hypothermia.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:28-32

Division of Pediatric Cardiac Surgery, Vanderbilt University Medical Center, Children's Hospital, Nashville, TN, USA.

Deep hypothermia for the operative correction of congenital cardiac lesions protects hypoperfused organs, mostly because of its effect on lowering metabolic demand and oxygen requirement. Deleterious cerebral and extracranial side effects of deep hypothermia itself calls for a reexamination of the therapeutic value of hypothermia, and has led to the development of alternative perfusion strategies. Here we describe the potential advantages of milder hypothermia over deep hypothermia and our method of a practical and reproducible implementation of multisite perfusion under mild hypothermia (32°C). Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.003DOI Listing
March 2018
6 Reads

Identifiable Risk Factors and Miscalculations During Listing for Pediatric Heart Transplantation.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:2-8

The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address:

The objective of this study is to describe identifiable risk factors, complications, and pitfalls while listing pediatric patients for heart transplantation, which is the standard of care for end-stage heart disease in children. Since the introduction of cyclosporine in the 1980s, the management in pediatric heart transplantation has shown consistent improvement, mainly because of technological advances and the integration of multidisciplinary teams in the field. However, the complexity of this patient population makes medical providers vulnerable to complications as a result of undesirable mistakes. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.011DOI Listing
March 2018
6 Reads

Giessen Procedure as Comprehensive Stage II Palliation With Aortic Arch Reconstruction After Hybrid Bilateral Pulmonary Artery Banding and Ductal Stenting for Hypoplastic Left Heart Syndrome.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:19-27

Department of Pediatric Cardiac Surgery, Pediatric Heart Center, Justus Liebig University, Giessen, Germany.. Electronic address:

This article reviews our experience using hybrid stage I palliation in the neonatal period and subsequently with comprehensive stage II palliation for hypoplastic left heart syndrome. Between June 1998 and April 2017, 154 patients with the diagnosis of hypoplastic left heart syndrome and variants underwent a hybrid stage I palliation (bilateral pulmonary artery banding and ductal stenting). One hundred thirty-nine patients could be further univentricularly palliated. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.007DOI Listing
March 2018
4 Reads

An Adverse Event Analysis: Inadvertent Exsanguination Following Left Ventricular Assist Device Implantation in a Child.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018 Mar;21:15-18

Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

Neurologic deficit subsequent to cardiac surgery remains a cause of postoperative morbidity and mortality. Although myriad risk factors for postoperative cognitive decline have been identified, their individual influence remains undefined. Although less emphasis is now placed on the heart lung machine as the major source of postoperative cognitive decline, the conduct of cardiopulmonary bypass and, in particular, the management of the bypass circuit remain key to patient safety. Read More

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http://dx.doi.org/10.1053/j.pcsu.2017.11.006DOI Listing
March 2018
5 Reads

Closing in on the PumpKIN Trial of the Jarvik 2015 Ventricular Assist Device.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:9-15

Jarvik Heart, Inc., New York, NY.

The Infant Jarvik ventricular assist device (VAD; Jarvik Heart, Inc., New York, NY) has been developed to support the circulation of infants and children with advanced heart failure. The first version of the device was determined to have elevated hemolysis under certain conditions. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5189910PMC
January 2017
15 Reads

Tetralogy Surgery - Back To Baltimore 70 Years Later: Melbourne Heritage and Group Tribute to Juan Comas.

Authors:
George E Sarris

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:84-88

Director, Athens Heart Surgery Institute; Chief, Department of Pediatric Cardiac Surgery, Iaso Children's Hospital, Athens, Greece. Electronic address:

Surgery for Tetralogy of Fallot progressed rapidly from the palliative arterio-pulmonary Blalock-Taussig shunt, introduced in Baltimore 70 years ago, to the "classic" complete transventricular repair technique, with which excellent early results were achieved soon thereafter. However, as duration of follow-up increased, so did the awareness of development of troubling late complications, including severe pulmonary insufficiency, right ventricular dilatation and dysfunction, and tricuspid valve insufficiency, all contributing to increasing incidence of late reoperations, as well as to arrhythmias and sudden death. This realization fueled the initial introduction of the transatrial-transpulmonary repair technique by Kawashima, as well as the subsequent firm establishment of this technique within the framework of an integrated surgical approach by Roger Mee in Melbourne. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.013DOI Listing
January 2017
2 Reads

Valve-Sparing or Valve Reconstruction Options in Tetralogy of Fallot Surgery.

Authors:
Emile Bacha

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:79-83

Columbia University College of Physicians and Surgeons, Congenital and Pediatric Cardiac Surgery, New York, NY; and New York-Presbyterian Morgan Stanley Children's Hospital (CHONY), New York, NY. Electronic address:

This review deals with a relatively new field in congenital heart surgery, valve preservation or, in cases of more severe pulmonary valve stenosis or dysplasia, valve reconstruction during tetralogy of Fallot repair. We describe the stepwise approach utilized, starting with simple maneuvers such as commissurotomy and valve dilation for mild pulmonary stenosis to commissurotomy and intraoperative balloon dilation for moderate stenosis, and finally transection of the annulus and valve reconstruction using a patch that acts as a modified monocusp. Results are presented and have been gratifying. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10929126163001
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http://dx.doi.org/10.1053/j.pcsu.2016.09.001DOI Listing
January 2017
6 Reads

The American Board of Thoracic Surgery Congenital Fellowship: Have We Lost Our International Heritage?

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:77-78

Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA. Electronic address:

Since 2005 there have been very few (if any) individuals trained outside of the United States in congenital surgery. Confining congenital training to only programs in the US has with it some unintended consequences. First, we need to recognize that progress is made around the world and not only in the US. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.006DOI Listing
January 2017
8 Reads

The ACGME Fellowship in Congenital Cardiac Surgery: The Graduates' Perspective.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:70-76

Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.

The creation of structured fellowship programs in congenital heart surgery (CHS) in the United States appears to have improved the training of congenital heart surgeons. However, the transition process between fellowship and clinical practice and the lack of senior mentorship continue to be major problems. We report the results of a survey of all graduates of accredited programs in CHS. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.005DOI Listing
January 2017
3 Reads

Congenital Heart Surgery Subspecialty Certification: How Is It Working? The American Board of Thoracic Surgery Perspective.

Authors:
James S Tweddell

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:67-69

The Heart Institute, Cincinnati Children's Hospital Medical Center, Professor of Surgery, University of Cincinnati, Cincinnati, OH. Electronic address:

Congenital heart surgery is among the most challenging fields in all of medicine. The unique skills and knowledge base required prompted the American Board of Thoracic Surgery (ABTS) to establish the Subspecialty Certificate in Congenital Heart Surgery (CHS). Standards for operative experience and fellowship training programs were established by the ABTS and the Accreditation Council for Graduate Medical Education. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.002DOI Listing
January 2017
3 Reads

Aortic Arch Advancement and Ascending Sliding Arch Aortoplasty for Repair of Complex Primary and Recurrent Aortic Arch Obstruction.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:63-66

Division of Congenital Heart Surgery, Texas Children's Hospital; Michael E. DeBakey Department of Surgery, Baylor College of Medicine; Houston, TX. Electronic address:

The optimal treatment of patients with complex coarctation of the aorta and hypoplastic aortic arch is controversial. Children undergoing repair of obstructive arch lesions are at lifelong risk of recurrence. Multiple techniques have been described to address complex primary and recurrent coarctation. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.007DOI Listing
January 2017
28 Reads

Valve-Sparing Aortic Root Replacement in Pediatric Patients: Lessons Learned Over Two Decades.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:56-62

Division of Cardiac Surgery, The Johns Hopkins University, Baltimore, MD.

Valve-sparing aortic root replacement has been utilized in children with aneurysms of the proximal aorta as a valid alternative to composite mechanical or biologic prostheses. While the majority of pediatric patients with aortic root aneurysms have various forms of connective tissue disorders, other diagnostic groups have emerged, such as patients with various forms of congenital heart disease and non-syndromic thoracic aortic aneurysms. We present our experience with valve-sparing procedures in pediatric patients, highlighting the technical aspects of the operation as well as some of the pitfalls and complications we have encountered over the last two decades. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.10.001DOI Listing
January 2017
3 Reads

A Word of Caution in Public Reporting.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:49-55

The Children's Hospital of Philadelphia, Philadelphia, PA.

Public reporting in its current form will lead to confusion amongst physicians, administrators, families, and the media. It is unclear that we are giving the families information they really need. At the current time there is no evidence that public reporting really leads to improved outcomes. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.014DOI Listing
January 2017
4 Reads

The Society of Thoracic Surgeons Congenital Heart Surgery Database Public Reporting Initiative.

Authors:
Jeffrey P Jacobs

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:43-48

Division of Cardiovascular Surgery, Department of Surgery, Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, FL; Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address:

Three basic principles provide the rationale for the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (CHSD) public reporting initiative: (1) Variation in congenital and pediatric cardiac surgical outcomes exist. (2) Patients and their families have the right to know the outcomes of the treatments that they will receive. (3). Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.008DOI Listing
January 2017
5 Reads

The Neonatal Arterial Switch Operation: Technical Pearls.

Authors:
Charles D Fraser

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:38-42

Surgeon-in-Chief, Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX. Electronic address:

The neonatal arterial switch operation has become the standard of care for transposition of the great arteries, including transposition with intact ventricular septum, transposition with ventricular septal defect with or without aortic arch hypoplasia, and double outlet right ventricle with subpulmonary ventricular septal defect (Taussig-Bing anomaly). While technically demanding, the operation is enormously gratifying and exciting for the congenital heart surgeon. In the current era, outcomes and expectations for the neonatal arterial switch operation are extremely high with many centers, including our own, reporting 30-day or hospital survivorship approaching 100%. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.10.002DOI Listing
January 2017
8 Reads

Rescuing the Late Failing Fontan: Focus on Surgical Treatment of Dysrhythmias.

Authors:
Carl L Backer

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:33-37

Division Head, Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago; and the Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address:

Patients with a failing Fontan frequently have dysrhythmias. This review will focus on the treatment of those dysrhythmias based on the 140 patients who have had a Fontan conversion with arrhythmia surgery at Ann & Robert H. Lurie Children's Hospital of Chicago (Chicago, IL). Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.012DOI Listing
January 2017
8 Reads

The Evolution of an Adult Congenital Heart Surgery Program: The Emory System.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:28-32

Division of Cardiology, Emory University, Atlanta, GA.

The Emory Adult Congenital Heart (Emory University, Atlanta, GA) program was founded in 2001. In 2004, the surgical component transitioned from a pediatric facility to an adult facility. The aim of this article is characterize the program as a whole, outline changes in the program, and discuss the challenges of the transition process. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.011DOI Listing
January 2017
5 Reads

Mechanical Circulatory Support of the Fontan Patient.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:20-27

Department of Pediatrics, Division of Critical Care, Medical College of Wisconsin, Milwaukee, WI; Herma Heart Center, Children's Hospital of Wisconsin, Milwaukee, WI.

Because of the inadequacies inherent to a circulation supported by a single ventricle, many Fontan patients will experience failure of their circulation. To date, there is no medical regimen that reliably and consistently restores circulatory function in these patients. Because of the shortage of donor organs and the fact that many of these patients present with features that either preclude or render heart transplantation a high risk, there is an intense need to better understand how mechanical circulatory support (MCS) may benefit these patients. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.009DOI Listing
January 2017
10 Reads

Current Status of Pediatric Ventricular Assist Device Support.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:2-8

Chief, Congenital Heart Surgery, Donovan Chair, Texas Children's Hospital; and Susan V. Clayton Chair, Professor of Surgery and Pediatrics, Baylor College of Medicine, Houston, TX.

The last decade has witnessed significant advancement in the field of ventricular assist device (VAD) support. Although device options for pediatric patients were previously severely limited because of body size constraints, this frustrating situation has gradually been changing, owing to ongoing device miniaturization. Recognition of the superiority of VAD support compared with conventional extracorporeal membrane oxygenation support has spurred enthusiasm for VAD support in children. Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.010DOI Listing
January 2017
4 Reads

The 50/50 cc Total Artificial Heart Trial: Extending the Benefits of the Total Artificial Heart to Underserved Populations.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20:16-19

Department of Pediatric Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address:

While use of the total artificial heart (TAH) is growing, the use of the device is not uniform across the gender and age spectrum because the vast majority of implants are in adult males. SynCardia has recently developed a smaller 50 cc TAH that was designed to accommodate patients with a body surface area as low as 1.2 m (potentially even lower using virtual implantation). Read More

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http://dx.doi.org/10.1053/j.pcsu.2016.09.004DOI Listing
January 2017
7 Reads

Introduction.

Authors:
Charles D Fraser

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2017 Jan;20

Texas Children's Hospital, Houston, Texas.

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http://dx.doi.org/10.1053/j.pcsu.2016.11.001DOI Listing
January 2017
3 Reads

Mechanical Pulmonary Valve Replacement.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):82-9

Department of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, MN. Electronic address:

Although most valve operations performed annually address lesions of the aortic or mitral valves, the frequency of pulmonary valve replacement (PVR) is increasing because most patients with congenital heart disease are surviving into the adult years. The vast majority of patients, especially children that require PVR, obtain a tissue valve because of the relative good durability and the lack of a need for anticoagulation. Because the need for repeat operation is inevitable for most patients, and the population of adults with congenital heart disease continues to grow, there are increasing situations in which a mechanical pulmonary prosthesis may be appropriate. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10929126153001
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http://dx.doi.org/10.1053/j.pcsu.2015.12.003DOI Listing
January 2017
7 Reads

Preservation of the Pulmonary Valve During Early Repair of Tetralogy of Fallot: Surgical Techniques.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):75-81

Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. Electronic address:

During the last decade interest in preserving pulmonary valve (PV) function has stimulated a few surgeons to apply valve-sparing techniques in repairing tetralogy of Fallot (TOF), with the aim of preserving long-term right ventricular function. Since June 2007, we embarked upon a program for preserving PV function in selected patients during TOF repair. More recently, the introduction of more complex PV plasty techniques allowed us to further extend the applicability of PV preservation techniques. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.12.008DOI Listing
January 2017
10 Reads

Transcatheter/Hybrid Aortic Valves in the Young.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):68-74

Department of Cardiac Surgery, Kerckhoff-Klinik Bad Nauheim, Germany.

Transcatheter aortic valve implantation (T-AVI) has been established as an alternative to conventional aortic valve replacement. The number of procedures is steadily rising and has reached comparable implant rates to conventional aortic valve replacement. The success of T-AVI is easily explained by their true minimally invasive nature, ease of use, and excellent hemodynamics. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10929126153001
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http://dx.doi.org/10.1053/j.pcsu.2015.12.002DOI Listing
January 2017
7 Reads

Are Bioprosthetic Valves Appropriate for Aortic Valve Replacement in Young Patients?

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):63-7

Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA.

Selection of a prosthetic aortic valve for use in the young patient is complicated by a variety of important considerations. Age, growth potential, activity and life style expectations, child bearing, and social factors, in addition to anatomic considerations, are all important to the recommendation of a prosthetic valve choice. We review the clinical experience and expectations of currently available prosthetic aortic valves available for the young patient, and describe the advantages and disadvantages for each. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.12.005DOI Listing
January 2017
3 Reads

Long-Term Clinical and Imaging Follow-Up After Reinforced Pulmonary Autograft Ross Procedure.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):59-62

Clinic for Cardiovascular Surgery, University Hospital and University of Bern, Switzerland.

The Ross operation remains a controversially discussed procedure when performed in the full root technique because concern exists regarding late dilatation of the pulmonary autograft and regurgitation of the neo-aortic valve. In 2008, we published our short-term experience when using external reinforcement of the autograft, which was inserted into a prosthetic Dacron graft. This detail was thought to prevent neoaortic root dilatation. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.11.005DOI Listing
January 2017
4 Reads

When and How to Enlarge the Small Aortic Root.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):55-8

Department of Paediatric Cardiac Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address:

Successful enlargement of the small aortic root in children has remained a management challenge, particularly in the neonates and small infants. Achieving this aim requires thorough understanding of the anatomic features of the left ventricular outflow tract, careful patient selection, and skilful execution of complex surgery. This article reviews the anatomical principles upon which the surgical techniques rely, the decision-making, the timing of surgery, the surgical options, and the outcomes. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.11.007DOI Listing
January 2017
5 Reads

Is Four Stage Management the Future of Univentricular Hearts? Destination Therapy in the Young.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):50-4

Duke Children's Hospital and Department of Surgery, Division of Cardiothoracic Surgery, Duke University School of Medicine, Durham, NC.

For the child born with a functionally univentricular heart, multi-stage surgical palliation culminating in the Fontan operation is now well established as the standard of care. Though this is an effective approach, there are several inherent disadvantages to the Fontan circulation: subnormal resting cardiac output, impaired exercise capacity, increased risk of thromboembolism, and increased risk of arrhythmia. Perhaps most importantly, the long-term deleterious effects of substantial systemic venous hypertension, which is necessary to "drive" blood through the pulmonary vascular bed, include progressive dysfunction of other organ systems, particularly renal, lymphatic, gastrointestinal, and hepatic systems. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.12.004DOI Listing
January 2017
3 Reads

Heart Transplantation in Children after a Fontan Procedure: Better than People Think.

Authors:
Kirk R Kanter

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):44-9

Division of Cardio-Thoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address:

Previous studies have reported that children with a prior Fontan procedure have decreased survival after heart transplantation. We examined 273 primary pediatric heart transplants. Since 1988, 33 (12. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.11.004DOI Listing
January 2017
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The Relentless Effects of the Fontan Paradox.

Authors:
Jack Rychik

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):37-43

Single Ventricle Survivorship Program, The Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address:

The Fontan operation is the anticipated palliative strategy for children born with single-ventricle type of congenital heart disease. As a result of important circulatory limitations, a series of end-organ complications are now increasingly recognized. Elevated central venous pressure and impaired cardiac output are the hallmarks of cavo-pulmonary flow, which result in a cascade of pathophysiological consequences. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10929126153001
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http://dx.doi.org/10.1053/j.pcsu.2015.11.006DOI Listing
January 2017
11 Reads

Anomalous Aortic Origin of a Coronary Artery Is Not Always a Surgical Disease.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):30-6

Division of Pediatric Cardiology, NYU Langone Medical Center, New York, NY. Electronic address:

Anomalous aortic origin of the coronary artery (AAOCA) from the opposite sinus of Valsalva with an interarterial course has become a high-profile lesion as a result of its association with sudden cardiac death in otherwise young and healthy individuals. Despite our incomplete knowledge of its pathophysiology and natural history, surgical intervention is often recommended. Evidence now shows AAOCA to be relatively common, with lower than previously suspected rates of sudden cardiac death. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.12.006DOI Listing
January 2017
8 Reads

Anomalous Aortic Origin of a Coronary Artery is Always a Surgical Disease.

Authors:
Pascal R Vouhé

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):25-9

Department of Pediatric Cardiac Surgery, University Paris Descartes, Sorbonne Paris Cité; and APHP, Sick Children Hospital, Paris, France. Electronic address:

Anomalous aortic origin of a coronary artery is a congenital anomaly in which a major coronary artery arises from the wrong sinus of Valsalva (left coronary from right sinus or right coronary from left sinus) and courses between the great arteries before reaching its normal epicardial course. Although the risk of sudden death is clearly established, the indications for surgery remain controversial. The risk of sudden death is increased in symptomatic patients, in anomalous left coronary artery, as well as in the presence of some risk factors (intense physical activity, young age [<35 years], aggravating anatomical features [intramural interarterial course, slit-like ostium, acute angle of take-off]). Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.12.007DOI Listing
January 2017
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Larger Centers Produce Better Outcomes in Pediatric Cardiac Surgery: Regionalization is a Superior Model - The Con Prospective.

Authors:
Mark H D Danton

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):14-24

Royal Hospital for Children, Glasgow, Scotland, UK. Electronic address:

Regionalization, in the context of congenital heart surgery, describes a process where smaller units close and patients are redistributed to larger centers. Proponents argue this will produce superior patient outcome based primarily on a volume-outcome effect. The potential disadvantage is that, as distance to center increases, access to service is compromised. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.11.003DOI Listing
January 2017
6 Reads

Larger Centers May Produce Better Outcomes: Is Regionalization in Congenital Heart Surgery a Superior Model?

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):10-3

Department of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX. Electronic address:

Efforts to correlate outcomes of children undergoing heart surgery with center volume and characteristics are not novel. In the current era, outcomes are defined as, and in many cases limited to, mortality rates. Over the past two decades, several investigators have explored various aspects of the volume-mortality relationship. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.11.001DOI Listing
January 2017
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Neonatal Aortic Stenosis is a Surgical Disease: An Interventional Cardiologist View.

Authors:
Lee Benson

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):6-9

Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, University of Toronto School of Medicine, Toronto, Canada. Electronic address:

The application of balloon valvotomy as primary treatment for neonatal congenital aortic stenosis is contentious. In this debate, we discuss data comparing outcomes of a percutaneous and surgical strategy between two tertiary centers that have adopted opposite therapeutic strategies. The outcomes with surgical and balloon therapies appear comparable. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.11.008DOI Listing
January 2017
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Neonatal Aortic Stenosis Is a Surgical Disease.

Authors:
Viktor Hraška

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1):2-5

German Pediatric Cardiac Center, Sankt Augustin, Germany. Electronic address:

Neonates with critical aortic stenosis represent a challenging group of patients with severe obstruction at a valvar level and with symptoms of heart failure. If biventricular repair is chosen, open valvotomy (OV) has been firmly established as the most effective initial treatment. In comparison with blind ballooning, OV, with exact splitting of fused commissures and shaving of obstructing nodules, can produce a better valve with a maximum valve orifice, without causing regurgitation. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.11.002DOI Listing
January 2017
6 Reads

Introduction.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2016 ;19(1)

Professor of Surgery and Pediatrics, Chief of Pediatric Heart Surgery, Duke University School of Medicine, Durham, NC.

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http://dx.doi.org/10.1053/j.pcsu.2015.12.001DOI Listing
January 2017
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Three-dimensional echocardiography for the assessment of atrioventricular valves in congenital heart disease: past, present and future.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2015 ;18(1):62-71

Division of Pediatric Cardiology, Department of Pediatrics, University of Alberta, and Stollery Children's Hospital, Edmonton, Alberta, Canada. Electronic address:

Echocardiography has developed as an imaging technology over 60 years to become the mainstay for investigating heart disease, providing invaluable structural and functional information. In the last 20 years, 3-dimensional echocardiography (3DE) has emerged as an adjunct to 2-dimensional echocardiography in adult and congenital heart disease. Early work with 3-dimensional imaging of the mitral valve describing normal annular shape and function significantly changed the understanding of mitral valve dynamics. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.01.003DOI Listing
February 2016
5 Reads

Tracheobronchial issues in congenital heart disease.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2015 ;18(1):57-61

Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address:

In children with congenital heart disease, tracheobronchial compromise is uncommon but potentially life-threatening. Airway lesions in these patients may be congenital or acquired, and may be stenotic, compressive, or malacic in nature. We present an overview of the etiologies of tracheobronchial lesions typically seen in children with congenital heart disease and review management options for these lesions. Read More

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http://dx.doi.org/10.1053/j.pcsu.2014.12.001DOI Listing
February 2016
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Improving pacemaker therapy in congenital heart disease: contractility and resynchronization.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2015 ;18(1):51-6

Section of Cardiology, Department of Pediatrics, The Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI. Electronic address:

Designed as effective therapy for patients with symptomatic bradycardia, implantable cardiac pacemakers initially served to improve symptoms and survival. With initial applications to the elderly and those with severe myocardial disease, extended longevity was not a major concern. However, with design technology advances in leads and generators since the 1980s, pacemaker therapy is now readily applicable to all age patients, including children with congenital heart defects. Read More

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http://dx.doi.org/10.1053/j.pcsu.2014.12.002DOI Listing
February 2016
4 Reads

Checklists and safety in pediatric cardiac surgery.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2015 ;18(1):43-50

Division of Cardiothoracic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

In rebuilding Tulane's pediatric heart center after Hurricane Katrina, the use of checklists proved to be essential, not only in rebuilding inventory and systems, but the culture of continued debriefing around their use was seminal in establishing a culture of safety and trust between caregivers; safety that ultimately benefitted our patients. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.01.006DOI Listing
February 2016
12 Reads

Left ventricular retraining: theory and practice.

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2015 ;18(1):40-2

Section of Pediatric Cardiovascular Surgery, Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI.

Congenitally corrected transposition of the great arteries or l-transposition of the great arteries is characterized by discordance of both the atrioventricular and ventriculoarterial connections. Physiologic repair of associated conditions, whereby the morphologic right ventricle remains the systemic ventricle, has resulted in unsatisfactory long-term outcomes due to the development of right ventricular failure and tricuspid valve regurgitation. While intuitively attractive, anatomic repair also has inherent challenges and risks, particularly for those patients who present late and require left ventricular retraining. Read More

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http://dx.doi.org/10.1053/j.pcsu.2015.01.002DOI Listing
February 2016
3 Reads