Side Cell Dilation of Jailed Pulmonary Veins After Stenting Improves Vessel Preservation in Pediatric Pulmonary Vein Stenosis.

Introduction: Endovascular stent placement for pulmonary vein stenosis (PVS) provides effective obstruction relief. Due to small patient size and limited length options of available stents, pulmonary vein branches can be covered ("jailed") during stenting. The natural history of jailed veins, and whether side cell dilation (SCD) modifies this natural history, is unknown.

An Initial Experience in the Use of 3D ICE for the Periprocedural Guidance of Percutaneous ASD Closure at a Tertiary Pediatric Center.

The dynamic, multiplanar nature of the atrial septum can make ASDs challenging to characterize with 2D imaging. 3D imaging instantly profiles defect(s) in a single, en face view. 2D ICE-guided ASD device closure in the pediatric population has been reported, but 3D ICE-guided closure has not, and the correlation of 3D ICE measurements with fluoroscopic balloon-sizing diameter (BSD) remains unstudied.

Pre-Catheterization Computed Tomography Angiography Aids in the Selection of Ductus Arteriosus Stent Length for Ductal-Dependent Pulmonary Blood Flow.

PDA stenting is increasingly utilized for patients with ductal-dependent pulmonary blood flow. Predicting optimal stent length prior to and during the intervention remains a challenge. The utility of pre-catheterization computed tomography angiography (CTA) to predict stent length was evaluated.

Differences in outcomes between surgical pericardial window and pericardiocentesis in children with postpericardiotomy syndrome.

Children with postpericardiotomy syndrome may develop hemodynamically significant pericardial effusions warranting drainage by surgical pericardial window or pericardiocentesis. The optimal approach is unknown. We performed a retrospective observational study at two pediatric cardiac centers.

Interventions on residual lesions in patients with heterotaxy syndrome following orthotropic heart transplantation: A single-center experience.

Background: Heterotaxy syndrome (HS) is a defect in lateralization which often results in complex intra and extracardiac abnormalities. Orthotropic heart transplantation (OHT) in HS involves intricate and individualized modifications to surgical technique. Post-OHT outcomes are worse in patients with HS, however, the impact of post-OHT residual lesions has not yet been characterized.

Histopathology, mRNA expression profile, and donor-derived cell-free DNA for assessment of rejection in pediatric heart transplantation.

Background: The relationship between histopathologic and molecular ("MMDx"®) assessments of endomyocardial biopsy (EMB) and serum donor-derived cell-free DNA (ddcfDNA) in acute rejection (AR) assessment following pediatric heart transplantation (HT) is unknown.

Methods: EMB sent for MMDx and histopathology from November 2021 to September 2022 were reviewed. MMDx and histopathology results were compared.

Late Diagnosis of Residual Major Aortopulmonary Collateral in a Patient with Tetralogy of Fallot.

• Residual MAPCAs result in post-tricuspid shunt and PH. • Distinction between PH and conduit stenosis requires attention to TTE findings. • Management of complex adult CHD should be reserved for centers with expertise.

Left Atrial Hypertension and Respiratory Failure Requiring Venoarterial ECMO After Transcatheter Pulmonary Valve Replacement.

A 33-year-old woman with aortic valve stenosis status-post Ross at age 6 years developed symptomatic right heart failure from right ventricle to pulmonary artery conduit stenosis. Conduit rehabilitation and transcatheter pulmonary valve replacement resulted in acute left atrial hypertension and respiratory failure requiring venoarterial extracorporeal membrane oxygenation and atrial septal defect creation as a bridge to recovery.

Echocardiogram-Guided Balloon Valvuloplasty of the Aortic Valve in Neonates and Infants Reduces Contrast Exposure with Maintained Efficacy and Less Aortic Regurgitation.

Balloon aortic valvuloplasty (BAV) is performed in children with significant aortic stenosis (AS). Traditionally, contrast angiography measures the annulus and assesses aortic regurgitation (AR) after each dilation. Echocardiographic guidance is hypothesized to reduce contrast and radiation exposure, without compromising efficacy or safety.

A Volume Challenge Reveals the Diagnosis of Pediatric Restrictive Cardiomyopathy.

A healthy 11-year-old girl presented with exercise intolerance of unclear etiology, and her physical exam was notable for a 3/6 systolic ejection murmur at the left upper sternal border with radiation to the back. Extensive noninvasive workup consisted of ECG, transthoracic echocardiogram, and cardiac MRI/MRA, which were all nondiagnostic. She was ultimately referred for cardiac catheterization.

Magnetic Resonance Imaging in Pediatric Myocarditis: Trends and Associations With Cost and Outcome.

Background: Cardiac magnetic resonance (CMR) provides tissue characterization and structural and functional data. CMR has high sensitivity and specificity for myocarditis in adults and children. The relationship between pediatric CMR use, cost, and clinical outcome has not been studied.

Perspective on Cerebral Autoregulation Monitoring in Neonatal Cardiac Surgery Requiring Cardiopulmonary Bypass.

The autoregulation of cerebral blood flow protects against brain injury from transient fluctuations in arterial blood pressure. Impaired autoregulation may contribute to hypoperfusion injury in neonates and infants. Monitoring cerebral autoregulation in neonatal cardiac surgery as a guide for arterial blood pressure management may reduce neurodevelopmental morbidity.

Deployed Dimensions of the GORE® CARDIOFORM ASD Occluder as Function of Defect Size.

The GORE® CARDIOFORM ASD occluder (ASDO) is approved for closure of ASDs up to 35 mm diameter. With an adaptable central waist, each device size is suitable over a range of defect diameters. Understanding deployed dimensions across various defect sizes will assist operators.

Mortality and Factors Associated With Hemorrhage During Pediatric Extracorporeal Membrane Oxygenation.

Objectives: To quantify and identify factors associated with bleeding events during pediatric extracorporeal membrane oxygenation.

Design: Retrospective cohort study with primary outcome of bleeding days on extracorporeal membrane oxygenation.

Setting: Single tertiary care children's hospital.

Outcomes of Infants Supported With Extracorporeal Membrane Oxygenation Using Centrifugal Versus Roller Pumps: An Analysis From the Extracorporeal Life Support Organization Registry.

Objectives: To determine whether mortality differs between roller and centrifugal pumps used during extracorporeal membrane oxygenation in infants weighing less than 10 kg.

Design: Retrospective propensity-matched cohort study.

Setting: All extracorporeal membrane oxygenation centers reporting to the Extracorporeal Life Support Organization.

RBC Exposure in Pediatric Extracorporeal Membrane Oxygenation: Epidemiology and Factors Associated With Large Blood Transfusion Volume.

Objectives: To quantify and identify factors associated with large RBC exposure in children supported with extracorporeal membrane oxygenation.

Design: Retrospective cohort study.

Setting: Single tertiary care children's hospital.

Reliability of radiographic measures in infants with clubfoot treated with the Ponseti method.

Purpose: The aim of this study was two-fold: (1) to determine if radiographic measures can be reliably made in infants being treated with the Ponseti method and (2) to document radiographic changes before and after Achilles tenotomy.

Methods: A retrospective radiographic and chart review was performed on children with clubfoot treated by the Ponseti method at a single institution over a 10-year period. Five independent reviewers measured a series of angles from a lateral forced dorsiflexion radiograph taken prior to and following Achilles tenotomy.

Can Radiographs Predict Outcome in Patients With Idiopathic Clubfeet Treated With the Ponseti Method?

Background: The aim of this study was to determine if radiographic measurements, taken before tenotomy, can predict outcome in children with idiopathic clubfoot treated by the Ponseti method.

Methods: A retrospective chart and radiographic review was performed on children with idiopathic clubfoot treated with the Ponseti method over a 10-year period with minimum 2-year follow-up that had a forced dorsiflexion lateral foot radiograph before tenotomy. All angles were measured in duplicate on the pretenotomy radiographs, including: foot dorsiflexion (defined as the 90 minus the angle between the tibial shaft and a plastic plate used to dorsiflex the foot), tibio-calcaneal, talo-calcaneal, and talo-first metatarsal angles.