Invited Commentary: What Is the Significance of the Konno Incision in Pediatric Ross Procedures?
Published: July 26, 2024.
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Yishay Orr
World Journal for Pediatric and Congenital Heart Surgery, Volume 15, Issue 4, Page 419-420, July 2024.
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Invited Commentary: Pulmonary Artery Stenosis After the Arterial Switch Operation: Ounces of Prevention Better Than Pounds of Cure
Published: July 26, 2024.
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Joshua L. Hermenson; Petros V. Anagnostopoulos
World Journal for Pediatric and Congenital Heart Surgery, Volume 15, Issue 4, Page 430-431, July 2024.
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Surgical Repair of Total Anomalous Pulmonary Venous Connection into the Superior Vena Cava: A Case Report
Published: August 22, 2024.
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Alwaleed Al-Dairy; Batoul Ali; Ayah Aldagher
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
Total anomalous pulmonary venous connection is a rare congenital anomaly that has four anatomical subtypes. In the supracardiac type, the common pulmonary vein confluence usually drains into the left innominate vein via a vertical vein; however, it may drain into the superior vena cava. Herein, we present a successful surgical repair of a rare type of total anomalous pulmonary venous connection in which the common pulmonary vein confluence was draining directly into the superior vena cava without a vertical vein.
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A Simplified Staged Left Ventricular Recruitment Strategy to Achieve Biventricular Repair in a Neonate With Hypoplastic Left Heart Variant
Published: August 22, 2024.
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Ranjit Philip; Jason Johnson; Ronak J. Naik; Adegbemisola A. Perkins; Shyam Sathanandam; Christopher J. Knott-Craig; Umar Boston
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
Hypoplastic left heart complex presents a diverse spectrum of variants. Traditional management has been dichotomous, involving either single ventricle palliation or high-risk biventricular repair. Surgical approaches to achieve biventricular repair in children with borderline left ventricle are continually evolving. One such method is the staged left ventricular recruitment (SLVR) strategy. Here, we illustrate a unique surgical approach to SLVR, achieving biventricular repair over 22 months in a neonate with hypoplastic left heart variant.
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Durability of Aortic Homografts in Pulmonary Atresia and Major Aortopulmonary Collateral Arteries
Published: August 21, 2024.
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Daniel K. Ragheb; Elisabeth Martin; Yulin Zhang; Ayush Jaggi; Ritu Asija; Lynn F. Peng; Michael Ma; Frank L. Hanley; Doff B. McElhinney
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
Objectives: It is well-known that right ventricle-to-pulmonary artery homograft conduit durability is worse for smaller conduits and smaller/younger patients. However, there is limited literature on age and conduit-size specific outcomes, or on the role of conduit oversizing. Methods: Patients diagnosed with tetralogy of Fallot and major aortopulmonary collateral arteries undergoing right ventricular outflow tract (RVOT) reconstruction with a valved aortic homograft conduit from November 2001 through March 2023, at our institution were included. Conduits were grouped and evaluated by diameter, diameter Z-score, and patient age at implant. The primary time-related outcome was freedom from RVOT reintervention. Factors associated with freedom from time-related outcomes were assessed with univariable Cox regression analysis. Results: A total of 863 RVOT conduits were implanted in 722 patients. On multivariable analysis, younger age, male sex, Alagille syndrome, smaller diameter of the conduit, and smaller Z-score were associated with shorter freedom from reintervention. Among patients with smaller diameter conduits, larger Z-scores were associated with longer freedom from conduit reintervention (P < .001). Transcatheter interventions were commonly used to extend conduit lifespan across ages and conduit sizes. Conclusions: Larger conduit diameter, older age, and higher conduit Z-score were associated with longer freedom from reintervention in patients undergoing RVOT reconstruction in this cohort. Oversizing of conduits, even beyond a Z-score of 4, is generally appropriate.
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The Pediatric Heart Center Melting Pot: Sharing Recipes for Success: Proceedings from the 8th World Congress of Pediatric Cardiology and Cardiac Surgery
Published: August 21, 2024.
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Sarah A. Teele; Liz Crowe; Joshua Koch; Uri Pollak; Emile Bacha; Michael P Mulreany; Stephen Trice; Christine M. Riley; David S. Winlaw; Joseph W. May; Rashmin C. Savani; Gil Wernovsky
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
The challenges of present-day healthcare are urgent; there is a shortage of clinicians, patient care is increasingly complex, resources are limited, clinician turnover seems ever-increasing, and the expectations of providers and patients are monumental. To transform problems into innovative opportunities, diverse perspectives and a sense of possibility are needed. The following is a collaborative manuscript authored by the speakers of the 8th World Congress of Pediatric Cardiology and Cardiac Surgery session, “Teamwork, Culture Change, and Strategy.” Although this panel was diverse in the clinical roles, nationalities, and genders represented, several consistent themes emerged which are explored in this work.
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Psychological Distress and Its Associated Factors Among Parents of Children With Congenital Heart Disease: A Cross-Sectional Mixed Method Study at the National Cardiothoracic Center, Ghana
Published: August 21, 2024.
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Kow Entsua-Mensah; John Tetteh; George Ekem-Ferguson; Swithin M. Swaray; Innocent I. Adzamli; Nana-Akyaa Yao; Mark M. Tettey
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
BackgroundThe aim of this study was to examine the prevalence and factors associated with psychological distress among parents of children with congenital heart disease (PCCHD) receiving treatment at the National Cardiothoracic Centre (NCTC), Accra.MethodsA cross-sectional mixed method study involving 248 parents of children with congenital heart disese receiving treatment at the NCTC was employed. Systematic sampling was used to select participants. The outcome variables were depression, anxiety, and somatization, assessed using the brief symptom inventory. A semistructured interview guide was used to understand the contextual factors that contribute to parents’ psychological distress. Poisson regression and inductive thematic analyses were employed for quantitative and qualitative data, respectively.ResultsThe prevalence of depression, anxiety, and somatization was 42.9% [95%CI = 36.7-49.3], 42.4% [95%CI = 36.3-48.9], and 41.2% [95%CI = 35.1-47.6] respectively. Parents who were divorced [aPR (95%CI) = 1.60(1.02-2.51)], hadonly basic level education [aPR (95%CI) = 2.13(1.34-3.39)], were without a religious affiliation [aPR (95%CI)= 2.24(1.58-3.19)], and in the low asset quintile significantly increased the likelihood of psychological distress. Delay/postponement of scheduled surgery, worsening state of child’s condition, feeling a sense of helplessness, societal stigma, and lack of funding or health insurance for the treatment of the condition were contextual factors that contributed to increased psychological distress among parents.ConclusionThe prevalence of psychological distress was quite high among parents of children with congenital heart disease in Ghana and was associated with both parent and patient factors. Psychosocial care should be integrated into the clinical health services of this group of patients and their parents to improve psychological health outcomes.
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A Rare Variant of Aorto-Atrial Fistula; Left Sinus of Valsalva Fistula to Superior Vena Cava and Right Atrium in a Neonate
Published: August 20, 2024.
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Naveen Srinivasan
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
Aorta-atrial fistula (AAF) is defined as the communication of blood flow between the aorta and the atrium. Most of the fistula occurs between the ascending aorta and the right atrium. Aorta-atrial fistula occurs mostly due to acquired causes. Congenital causes remain a minority. We report a very rare variant of AAF in a two-day-old neonate in whom the fistula was arising from the left sinus of Valsalva of the aortic root and draining into the superior vena cava and the right atrium. The child underwent successful surgical ligation of the fistula on a beating heart and is doing well on a two-year follow-up.
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Establishment of a Global Platform for the Treatment of Congenital Heart Disease by “Creation and Unification of National Congenital Heart Surgery Databases and Registries”: It’s Time!
Published: August 09, 2024.
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James D. St Louis; Jeffrey P. Jacobs; Brian P. Bateson; Christo I. Tchervenkov; Erle H. Austin; James K. Kirklin
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
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Revisiting the Role of Balloon Atrial Septostomy Prior to the Arterial Switch Operation
Published: August 09, 2024.
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Sujata Subramanian; Sagar Jani; Andrew Well; Matthew F. Mikulski; Hitesh Agrawal; D Byron Holt; Neil Venardos; Carlos M. Mery; Charles D. Fraser
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
ObjectivesPatients with dextro-transposition of the great arteries (d-TGA) frequently undergo balloon atrial septostomy (BAS) prior to the arterial switch operation (ASO) to promote atrial-level mixing. Balloon atrial septostomy has inherent risks as an invasive procedure and may not always be necessary. This study revisits the routine utilization of BAS prior to ASO.MethodsSingle-center, retrospective review of d-TGA patients undergoing the ASO from July 2018 to March 2023. Preoperative patient characteristics, pulse oximetry oxygen saturations (SpO2), cerebral/renal near-infrared spectroscopy (NIRS) readings along with prostaglandin status at the time of the ASO were analyzed with descriptive and univariate statistics.ResultsThirty patients underwent the ASO. Of these, 7 (23%) were female, 25 (83%) were white, and median weight at ASO was 3.2 kg (range 0.8-4.2). Twenty-two (73%) patients underwent BAS. There were no demographic differences between BAS and no-BAS patients. Of those who underwent BAS, there was a significant increase in SpO2 (median 83% [range 54-92] to median 87% [range 72-95], P = .007); however, there was no change in NIRS from pre-to-post BAS. Six (27%) patients in the BAS group were prostaglandin-free at ASO. Balloon atrial septostomy patients underwent the ASO later compared with no-BAS patients (median 8 [range 3-32] vs 4 [range 2-10] days old, P = .016) and had a longer hospital length of stay (median 13 [range 7-43] vs 10 [range 8-131] days, P = .108).ConclusionsWhile BAS is an accepted preoperative procedure in d-TGA patients to improve oxygen saturations, it is also an additional invasive procedure, does not guarantee prostaglandin-free status at the time of ASO, and may increase the interval to ASO. Birth to direct early ASO, with prostaglandin support, should be revisited as an alternative, potentially more expeditious strategy.
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Use of Hybrid Stage I to Stratify Between Single Ventricle Palliation and Biventricular Repair
Published: August 09, 2024.
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Justin Smith; Jeffrey D. Zampi; Sowmya Balasubramanian; Bryan Mosher; Karen Uzark; Ray Lowery; Sunkyung Yu; Jennifer C. Romano
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
Background: Hybrid stage I palliation (HS1P) has been utilized for patients with single ventricle (SV) congenital heart disease (CHD). To date, reports on the use of HS1P for other indications including biventricular (BiV) CHD have been limited. Methods: We performed a single-center retrospective cohort study of patients who underwent HS1P with an anticipated physiologic outcome of BiV repair, or with an undetermined SV versus BiV outcome. Patient characteristics and outcomes from birth through definitive repair or palliation were collected and reported with descriptive statistics. Results: Nineteen patients underwent HS1P with anticipated BiV repair. Extracardiac and intracardiac risk factors (ICRF) were common. Ultimately, 13 (68%) patients underwent BiV repair, 1 (5%) underwent SV palliation, and 5 (26%) died prior to further palliation or repair. Resolution of ICRF tracked with BiV outcome (6/6, 100%), persistence of ICRF tracked with SV outcome or death (3/3, 100%). Twenty patients underwent HS1P with an undetermined outcome. Ultimately, 13 (65%) underwent BiV repair, 6 (30%) underwent SV palliation, and 1 (5%) underwent transplant. There were no deaths. Intracardiac risk factors were present in 15 of 20 patients (75%); BiV repair only occurred when all ICRF resolved (67%). Post-HS1P complications and reinterventions occurred frequently in both groups, through all phases of care. Conclusions: Hybrid stage 1 palliation can be used to defer BiV repair and to delay decision between SV palliation and BiV repair. Resolution of ICRF was associated with ultimate outcome. In this high-risk group, complications are common, and mortality especially in the marginal BiV patient is high.
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Pediatric Quadricuspid Aortic Valve: Morphology, Characteristics, Clinical Outcomes, and Literature Review
Published: July 25, 2024.
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Jordan Holthe; Rabia Javed; Frank Cetta; Elizabeth H. Stephens; Jonathan N. Johnson; Donald J. Hagler; Talha Niaz
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
BackgroundQuadricuspid aortic valve (QAV) is an exceedingly rare congenital heart defect (CHD) which has not been well-defined in a pediatric population.MethodsThe Mayo Clinic echocardiography database was retrospectively analyzed to identify patients ≤18 years diagnosed with QAV from January 1990 to December 2023. Patients with truncus arteriosus were excluded. All images were independently reviewed to define morphology of the QAV by using the Hurwitz and Roberts classification.ResultsFourteen patients with QAV were identified with a median age at time of diagnosis being 10.5 years (interquartile range [IQR] 6-14 years). Male-to-female ratio was 3:1. Associated CHDs were present in 50% (n = 7) patients. The most common morphological subtypes of QAV were Type D in 43% (n = 6) and Type B in 29% (n = 4). Aortic regurgitation was the most frequently associated valvular abnormality affecting 86% (n = 12) cases, with greater than moderate regurgitation in only two patients. Aortic valve stenosis was observed in 14% (n = 2) patients. Ascending aortic dilatation was present in 21% (3/14) of the cohort, but only 14% (1/7) of isolated QAV patients. At a mean follow up of 11 ± 6.6 years and a median follow-up age of 22 years (IQR 14-27 years), survival was 100% with no primary interventions on the aortic valve or aorta. However, four patients required surgical interventions for associated CHDs.ConclusionAmong children with QAV, almost half of the patients had additional CHD. Aortic regurgitation was the predominant hemodynamic abnormality. Long-term survival was excellent with minimal progression during childhood and adolescence.
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The Fate of the Left Ventricular Outflow Tract Following Interrupted Aortic Arch Repair
Published: July 25, 2024.
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Shuhua Luo; Paul H. Schoof; Edward Hickey; Conall Morgan; Nina A. Korsuize; Heynric B. Grotenhuis; Luc Mertens; Jaymie Varenbut; Mimi Xiaoming Deng; Maruti Haranal; William Border; Brian Schlosser; Glen Van Arsdell; Bahaaldin Alsoufi
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
Objectives: To examine the probability of left ventricular outflow tract (LVOT) reintervention following interrupted aortic arch (IAA) repair in neonates with LVOT obstruction (LVOTO) risk. Methods: This retrospective multicenter study included 150 neonates who underwent IAA repair (2003-2017); 100 of 150 (67%) had isolated IAA repair (with ventricular septal defect closure) and 50 of 150 (33%) had concomitant LVOT intervention: conal muscle resection (n = 16), Ross-Konno (n = 7), and Yasui operation (n = 27: single-stage n = 8, staged n = 19). Demographic and morphologic characteristics were reviewed. Factors associated with LVOT reoperation were explored using multivariable analysis. Results: Concomitant LVOT intervention was more likely in neonates with type B IAA, bicuspid aortic valve, aberrant right subclavian artery, smaller aortic valve annulus, and ascending aorta dimensions. On follow-up, five-year freedom from LVOT reoperation was highest following Ross-Konno (100%), 77% following Yasui (mainly for neo-aortic regurgitation), 77% following isolated IAA repair (mainly for LVOTO), and 47% following IAA repair with concomitant conal resection, P = .033. While all patients had low peak LVOT gradient at time of discharge, those who had conal resection developed higher gradients on follow-up (P = .007). Ross-Konno and Yasui procedures were associated with higher right ventricular outflow tract (RVOT) reoperation. In the cohort following isolated IAA repair, aortic sinus Z score was associated with LVOT reoperation. Conclusions: Both Yasui and Ross-Konno operations effectively mitigate late LVOTO risk. The highest risk of reintervention for LVOTO was associated with conal muscle resection while the lowest risk is associated with Ross-Konno. The RVOT reoperation risk in patients who had Ross-Konno or Yasui does not seem to affect survival.
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Common Arterial Trunk Repair at the Red Cross War Memorial Hospital, Cape Town: A 20-Year Review of Surgical Practice and Outcomes
Published: July 23, 2024.
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A Moodley; HM Meyer; S Salie; P Human; L J Zühlke; A Brooks
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
BackgroundThis study describes the 20-year experience of managing common arterial trunk (CAT) in a low-and-middle-income country and compares the early and medium-term outcomes following the transition from conduit to nonconduit repair at the Red Cross War Memorial Children’s Hospital.MethodsSingle-center retrospective study of consecutive patients aged less than 18 years who underwent repair of CAT from January 1999 to December 2018 at the Red Cross War Memorial Children’s Hospital. Patients with interrupted aortic arch or previous pulmonary artery banding were excluded.ResultsFifty-four patients had CAT repair during the study period. Thirty-four (63.0%) patients had a conduit repair, and 20 (37.0%) patients had a nonconduit repair. There were two intraoperative deaths. Thirty-day in-hospital mortality was 22.2% (12/54). Overall, in-hospital mortality was 29.6% (16/54). Eight (21.1%) late mortalities were observed. The actuarial survival for the conduit group was 77.5%, 53.4%, and 44.5% at 6, 12, and 27 months, respectively, and the nonconduit group was 58.6% at six months. The overall freedom from reoperation between the conduit group and nonconduit group was 66.2% versus 86.5%, 66.2% versus 76.9%, and 29.8% versus 64.1% at 1, 2, and 8 years, respectively.ConclusionsThe outcomes following the transition to nonconduit repair for CAT in a low- and middle-income setting appear to be encouraging. There was no difference in mortality between conduit and nonconduit repairs, and importantly the results suggest a trend toward lower reintervention rates.
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Outcomes of Patients Undergoing the Kawashima Procedure at an Early Age: A Single Center Experience
Published: July 23, 2024.
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Brian P. Bateson; Matthew Files; Lyubomyr Bohuta
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
BackgroundPrevious reports have demonstrated the safety and efficacy of performing early Kawashima procedure (KP). Despite this, more recent studies have shown that the average age at the time of operation remains greater than one year of age. We report our experience with performing KP at an earlier age than previously reported.MethodsA retrospective review was completed of patients undergoing KP at a single center (January 2000 to June 2020). Clinical outcomes were examined.ResultsInitial palliation was performed in 11 out of 12 patients. Age and weight at time of KP were 8.25 months (6.4-9.7) and 7.7 kg (6.5-8.6). Intensive care unit stay was 3.16 days (1-12), overall length of stay was 9.5 days (3-22). There was one unplanned reoperation, and no mortality in the cohort. Discharge oxygen saturation was 88% (80%-98%). Seven patients developed pulmonary arteriovenous malformations (PAVMs) with six proceeding to hepatic vein incorporation (HVI). Interval time to development of PAVMs was 42.3 months (16-121). Four of the 12 patients were left with antegrade pulmonary blood flow (PBF) and three (75%) remain without PAVMs. Median follow-up was 10 years (1.5-22) with 11 of 12 (91.67%) survival for the cohort.ConclusionsThe KP can be done at a younger age than previously reported with adequate early and late results. Most patients will go on to develop PAVMs and require HVI but leaving patients with some antegrade PBF is likely protective but will need further investigation to show definitive benefit.
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PA-VSD Without MAPCA(s): Review of Long-Term Outcomes and Reinterventions
Published: July 23, 2024.
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Elizabeth H. Stephens; Joseph A. Dearani; William R. Miranda; Jason H. Anderson
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
BackgroundPulmonary atresia with ventricular septal defect without major aortopulmonary collateral arteries (MAPCAs) is an uncommon form of congenital heart disease. As more patients with congenital heart disease live to adulthood, the objective of this article was to review the long-term results of this specific population.MethodsA review of the PubMed database was performed using pertinent key words (pulmonary atresia, tetralogy of Fallot, conduit, right ventricle-pulmonary artery) concentrating on studies from 1990-present and published in English. Most studies of pulmonary atresia-ventricular septal defect patients included those with and without MAPCAs. Analysis included examination of the entire cohort, consideration of the proportion of patients with MAPCAs, and any subgroup analysis of the patients without MAPCAs.ResultsSurvival is approximately 80% at ten years and is improved with complete repair and larger pulmonary arteries. Some studies have found genetic syndromes and extracardiac anomalies to impact survival, while others have not. Incomplete repair has been shown to be associated with worse survival. Independent of initial management strategy, patients with pulmonary atresia and ventricular septal defects without MAPCAs require repeat intervention on the right ventricular outflow tract. Hypoplastic pulmonary arteries have been shown to be a risk factor for reintervention, and decreased conduit durability has been shown with younger age at implantation of conduit.ConclusionsLong-term outcomes have improved for patients with pulmonary atresia-ventricular septal defect without MAPCAs, with complete repair and adequate pulmonary arteries favorable for survival. Long-term outcomes include reinterventions, both catheter-based and surgical, predominantly on the right ventricular outflow tract.
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Breast Milk and Necrotizing Enterocolitis in Congenital Heart Disease: A Case–Control Study
Published: July 23, 2024.
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Margaret R. Christian; David Bateman; Marianne Garland; Usha S. Krishnan; Emile A. Bacha; Ganga Krishnamurthy
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
Background: Necrotizing enterocolitis (NEC) is a complication that can affect infants with congenital heart disease (CHD). The objective of this study is to determine whether breast milk, which is associated with decreased incidence of NEC in preterm infants, is protective in infants with CHD. Methods: Retrospective case–control study of infants ≥ 33 weeks gestational age with CHD who underwent cardiac surgery during their admission to the Infant Cardiac Unit from 2008 to 2017. Cases were defined as infants with modified Bell’s stage ≥ II NEC. Controls were matched by date of birth, gestational age, and pre- or postcardiac surgery feed initiation. Results: A total of 926 infants with gestational age ≥ 33 weeks and CHD were admitted; 18 cases of NEC were identified and compared with 84 controls. Breast milk intake was higher in controls, but this difference was not statistically significant. Single ventricle (SV) physiology was identified as an independent risk factor for NEC by multivariable analysis. Analysis of infants with SV physiology demonstrated that median age at time of surgery was 9 days (interquartile range [IQR], 7-12) in NEC cases and 5 days (IQR, 4-9) in controls (P = .02). Conclusions: While this study is inconclusive with regard to feeding composition and risk of NEC in infants with CHD, the trend toward greater intake of breast milk in the control group suggests that breast milk may be protective for these infants. Infants with SV physiology are at high risk for NEC. Earlier time to stage I palliation may be a modifiable risk factor for NEC.
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Comparison of Blalock-Taussig-Thomas Shunts With Patent Ductus Arteriosus Ligated Versus Left Open
Published: July 23, 2024.
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Mandy W. Nasworthy; Mark Roeser; Deborah Frank; Jeffrey Vergales
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
BackgroundThe optimal approach to patent ductus arteriosus management during systemic-to-pulmonary artery shunt placement is currently unknown. The purpose of this study is to examine the outcomes of variable strategies for patent ductus arteriosus management during Blalock-Taussig-Thomas shunt surgery.MethodsA retrospective cohort study of infants who underwent shunt placement was performed, comparing those who had the ductus ligated with those who had the ductus left open. Indicators of low cardiac output syndrome, development of necrotizing enterocolitis, and secondary outcomes such as resuscitation events were examined.ResultsThirty-six infants were included all of whom had their shunt placed via median sternotomy. Twenty infants had their ductus ligated at the time of the shunt, and they were compared with 16 infants whose ductus was left open. There was no statistical difference in preoperative baseline characteristics, including corrected gestational age, age in days, weight, mechanical ventilation, vasoactive use, heterotaxy, and gastrointestinal anomalies. There was also no statistical difference in postoperative indicators of low cardiac output, including urine production, total fluids given, renal injury, maximum lactate, and vasoactive-inotropic score. Three patients had postoperative renal injury, and all were in the ligated duct group. There was also no statistical difference in any secondary outcomes, including the development of necrotizing eneterocolitis, resuscitation events, reinterventions, length of intubation, total length of stay, and mortality.ConclusionsThis study provides evidence that variable management of the ductus during shunt placement does not significantly impact outcomes. Leaving the ductus open allows for a potential rescue source of pulmonary blood flow and does not appear to increase the risk of postoperative low cardiac output.
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Atrial Septal Defect Stent Compression During Resuscitation of an Infant With Hypoplastic Left Heart Syndrome
Published: July 23, 2024.
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Chawki Elzein; Emily Pena; Narutoshi Hibino; Dhaval Patel; Luca Vricella
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
A newborn with hypoplastic left heart syndrome underwent a Norwood procedure with a Sano shunt. A month later, he had an atrial septal defect (ASD) stent placed due to ASD size and flow restriction. Three weeks later, he had sudden bradycardia and cardiac arrest in the intensive care unit. He was resuscitated and cannulated for extracorporeal membrane oxygenation (ECMO) through a right neck approach. An attempt to wean him from ECMO a week later failed due to hypoxia. Echocardiography showed ASD flow restriction and a chest x-ray showed flattening of the left atrial side of the ASD stent from chest compression resulting in a restrictive ASD. The patient underwent surgical removal of the ASD stent with ASD enlargement and was successfully weaned from ECMO after surgery.
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Truncus Arteriosus With Cardiac Type of Total Anomalous Pulmonary Venous Connection
Published: July 23, 2024.
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Neeraj Kumar; Niraj Nirmal Pandey; Sivasubramanian Ramakrishnan; Priya Jagia
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
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Neonatal Diagnosis of Berry Syndrome: Interrupted Aortic Arch, Aortopulmonary Window, Intact Ventricular Septum, and Ascending Aortic Origin of the Right Pulmonary Artery
Published: July 23, 2024.
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Nina Morgan; Arun Chandran
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
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Ebstein Anomaly: Insights on Isolated Atrial Septal Defect Device Closure
Published: July 23, 2024.
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Luciana Da Fonseca Da Silva; Mario Castro Medina; Melita Viegas
World Journal for Pediatric and Congenital Heart Surgery, Ahead of Print.
