Melody versus Mechanical Mitral Valve Replacement in Young Children: A Single-Center Propensity Matched Analysis.

Background: To examine outcomes of Melody versus mechanical mitral valve replacement (MVR) in young children.

Methods: We retrospectively reviewed 36 patients <2 years of age who underwent Melody or mechanical MVR between 2005-2023. Propensity score matching was performed to account for baseline differences, yielding 2 groups of 12 patients.

Novel size-adjustable pulmonary valve US early feasibility study: One-year outcomes.

Objective: The Autus Size-Adjustable Valve (ASAV) is a novel surgically implanted fully synthetic expandable pulmonary valve designed for pediatric patients. This first-in-human study evaluated initial device feasibility and safety.

Methods: This was a Food and Drug Administration-approved prospective, single-arm, multicenter Investigational Device Exemption Early Feasibility Study to evaluate safety and preliminary effectiveness of the ASAV in pediatric patients aged 18 months to 16 years who require pulmonary valve replacement.

Arrhythmias in congenitally corrected transposition of the great arteries: an international study.

Background And Aims: There is a paucity of data on arrhythmia burden in patients with congenitally corrected transposition of the great arteries (ccTGAs). The present study sought to quantify the incidence of atrial arrhythmia (AA), ventricular arrhythmia (VA), and complete atrioventricular block (CAVB) in patients with ccTGA and identify associated factors.

Methods: An international, multi-centre, retrospective cohort study was conducted in 29 tertiary hospitals (six countries) between 1990 and 2018.

Assessing the Efficacy of Pathogen-Reduced Platelet Transfusions for Hemostasis in Children Undergoing Cardiopulmonary Bypass Surgery.

Background: Children undergoing cardiopulmonary bypass (CPB) surgery are vulnerable to bleeding and often require transfusions. Pathogen-reduced (PR) platelets may reduce microbial contamination but are associated with decreased platelet count increments and increased transfusions. We sought to evaluate hemostasis in children undergoing CPB surgery receiving PR platelets vs large-volume delayed sampling (LVDS) platelets.

The Ross/Ross-Konno operation in neonates and infants: A salvage strategy and a durable repair.

Objective: To review a single-center experience of the Ross operation in neonates and infants with severe aortic valve disease.

Methods: Retrospective review identified patients younger than age 1 year who underwent Ross operation between 2010 and 2024. Primary outcome was cumulative incidence of death with transplant as a competing risk.

Critical congenital heart disease in extreme prematurity: Surgical outcomes from a specialized neonatal cardiac intensive care unit.

Objectives: Prematurity is a risk factor for in-hospital mortality after cardiac surgery. Among preterm infants, very preterm (VPT) infants are at the greatest risk of mortality. We evaluated risk factors for in-hospital mortality in VPT infants born at <34 weeks of gestational age with critical congenital heart disease (CHD) who underwent cardiac surgery at our institution.

Surgical pathways and risk categories in the management of hypoplastic left heart syndrome and variants.

Objective: The distribution of risk factors in neonates with hypoplastic left heart syndrome is heterogeneous, and their impact remains unclear. We describe the risk categories, surgical strategies, and outcomes in this population.

Methods: Retrospective chart review was performed for 233 consecutive neonates undergoing surgery for hypoplastic left heart syndrome and variants at a single center in 2006-2023.

Cerebral Autoregulation and Optimal Blood Pressure from Birth to Surgery in Neonates with Critical Congenital Heart Disease.

Increased time to surgery has been correlated with increasing cerebral fractional oxygen extraction without compensatory increase in cerebral blood flow in neonates with critical congenital heart disease (cCHD) suggesting an overwhelmed cerebral autoregulation system. Autoregulation analysis can provide precision targets such as optimal blood pressure but it remains unclear how autoregulation evolves in days preceding surgery. Our hypothesis is that longer wait times between birth and surgery are associated with increasing periods of impaired autoregulation.

Mid-Term Outcomes of Valve-Sparing Repair With Intraoperative Balloon Dilation in Tetralogy of Fallot.

BackgroundLate sequelae associated with chronic severe pulmonary regurgitation (PR) following transannular patch (TAP) repair of tetralogy of Fallot (TOF) have driven the use of alternative approaches. This study investigates mid-term pulmonic valve (PV) durability in TOF patients who underwent valve-sparing repair with intraoperative balloon dilation (VS-IBD).MethodsBetween 2010 and 2022, 139 TOF patients underwent VS-IBD (n = 66) or TAP (n = 73) repair at a single institution.

A Perspective on Neonatal Management of Hypoplastic Left Heart Syndrome.

Hypoplastic left heart syndrome (HLHS)-a universally fatal condition only 40 years ago-remains one of the most challenging congenital heart defects. The advancements and insights gained from historical experiences with the Norwood operation have transformed the prognosis for HLHS patients and profoundly shaped contemporary outcomes. This progress has spurred continuous refinement of surgical techniques, transcatheter interventions, and perioperative care, leading to notable improvements in both survival rates and quality of life for HLHS patients.

The American Association for Thoracic Surgery (AATS) 2025 Expert Consensus Document: Management of Ebstein anomaly in children and adults.

Objectives: Patients with Ebstein anomaly (EA) require complex management. A group of experts was commissioned by the American Association for Thoracic Surgery to provide a framework on this topic, focusing on preoperative assessment, indications for intervention, and medical management before and after surgical intervention in older children and adults. This is a companion document to a recently issued document regarding management of EA in neonates and infants.

When to Opt for Univentricular versus Biventricular Repair in Complex Congenitally Corrected Transposition of the Great Arteries.

The surgical management of complex congenitally corrected transposition of the great arteries (ccTGA) remains a subject of ongoing debate due to wide anatomic variability and limited comparative outcomes data. Available strategies include the anatomic repair, physiologic repair, 1.5-ventricular repair, and biventricular repair, each selected based on anatomic severity and the presence of associated lesions.

Association of lower noninvasive fractional flow reserve values with high risk anatomic characteristics in pediatric patients with anomalous coronary arteries.

Background: Although there are data on fractional flow reserve CT (CT-FFR) assessment for anomalous aortic origin of coronary artery (AAOCA) in adults, reports in children are limited.

Methods: Cardiac CT angiograms of patients ages 4-21 years with AAOCA performed from 2010 to 2021 ​at a single center were retrospectively identified. Characteristics historically considered high-risk -slit-like ostium, interarterial course, or intramural segment-, symptoms suggestive of ischemia, or positive provocative testing were correlated with reduced CT-FFR values of <0.

Systemic Vein Stenting in a Pediatric Patient After Total Artificial Heart Implantation.

We describe the use of a total artificial heart (TAH) (Syncardia) as a successful bridge to transplantation in a pediatric patient. The post-TAH course included obstruction of both systemic veins with decreased TAH filling and output that was successfully treated with bicaval stent placement. After stenting of the systemic veins, the patient was able to successfully rehabilitate and underwent successful cardiac repeated transplantation 6 months after TAH placement.

Hemi-Nikaidoh: Partial Aortic Root Translocation and Posterior Left Ventricular Outflow Tract Plasty.

Among repairs for ventriculoarterial discordance, ventricular septal defect, and pulmonary stenosis, aortic root translocation (Nikaidoh operation) offers the most anatomic result. With a diminutive pulmonary annulus or hypoplastic left ventricular outflow tract, the distance gained posteriorly with aortic translocation is negligible. We developed the "hemi-Nikaidoh" procedure as an alternative.

Single ventricle palliation in congenitally corrected transposition of the great arteries: An international multicenter study.

Background: Single ventricle palliation may be performed in patients with congenitally corrected transposition of the great arteries due to hypoplasia of 1 ventricle or anatomic complexity rendering biventricular repair unfeasible. There have been only a few small studies of the outcomes of single ventricle palliation in the setting of congenitally corrected transposition of the great arteries.

Methods: A multicenter, international, retrospective cohort study of patients with congenitally corrected transposition of the great arteries undergoing single ventricle palliation was conducted in 29 tertiary hospitals in 6 countries from 1990 to 2018.

The Pediatric Heart Center Melting Pot: Sharing Recipes for Success: Proceedings from the 8th World Congress of Pediatric Cardiology and Cardiac Surgery.

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.