Cardiac surgery-associated acute kidney injury in neonatal Norwood procedure: incidence, risk factors and impact on mortality and outcomes.

Objectives: Acute kidney injury commonly complicates congenital heart surgery with cardiopulmonary bypass, increasing morbidity and mortality. This study aimed to evaluate risk factors for postoperative acute kidney injury and its impact on outcomes after the Norwood procedure.

Methods: Neonates undergoing the Norwood procedure from 2001 to 2022 were reviewed.

Impact of Systemic Ventricular Morphology on Age-Adjusted (zlog-)NT-proBNP in Children with Univentricular Hearts.

As a marker of cardiac wall stress, NT-proBNP offers high prognostic and diagnostic potential in patients with a functional single ventricle (fSV). Its levels depend on both age and stage of palliation. However, the impact of systemic ventricular morphology on this biomarker remains unclear.

Comparison of outcomes following the Fontan procedure between patients with previous ductus stent and aortopulmonary shunt.

Objectives: In this study, we aimed to compare the outcome after the Fontan procedure in patients after an initial ductus stenting or a surgical aortopulmonary shunt.

Methods: We reviewed infants with single ventricle and ductal-dependent pulmonary blood flow who underwent ductus stenting or an aortopulmonary shunt between 2009 and 2022, and subsequently underwent the staged Fontan procedure.

Results: A total of 93 patients were included (39 ductus stenting and 54 aortopulmonary shunts).

Impact of pulmonary artery size on early haemodynamic and laboratory variables following total cavopulmonary connection.

Objective: Current research suggests that a small pulmonary artery can cause adverse events and reduce exercise capacity after the Fontan procedure. This study aimed to evaluate the impact of pulmonary artery size on early haemodynamic and laboratory variables after total cavopulmonary connection.

Methods: We reviewed all patients who underwent staged Fontan between 2012 and 2022.

Impact of previous left pulmonary artery stent on the outcome of a total cavopulmonary connection†.

Objectives: This study aimed to investigate the impact of left pulmonary artery stenting on outcomes after Fontan procedure in patients with single ventricle physiology.

Methods: Patients who underwent staged Fontan palliation between 1994 and 2023 were reviewed. The records of patients who had left pulmonary artery stents implanted were analysed, and their impact on outcomes after Fontan completion was evaluated.

Thrombus formation after the Norwood procedure: Incidence, risk factors, and its impact on late outcomes.

Objective: Thrombus formation is a feared complication after congenital heart surgery. We aimed to clarify the clinical characteristics associated with thrombus formation after the Norwood procedure.

Methods: All neonates who underwent the Norwood procedure between 2001 and 2022 were reviewed.

Impact of left ventricular rehabilitation on surgical outcomes in patients with borderline left heart hypoplasia.

Objective: The clinical significance of left ventricular rehabilitation for borderline left ventricular hypoplasia is controversial. This study aimed to review the surgical results of patients with borderline left ventricular hypoplasia and to evaluate the impact of left ventricular rehabilitation on outcomes.

Methods: Patients diagnosed with borderline left ventricular hypoplasia and surgically treated from 2018 to 2022 were included.

Benefits and risks of implantable cardioverter-defibrillators in children and young adults with congenital heart disease, primary electrical disease or paediatric cardiomyopathy†.

Objectives: This study aimed to investigate the benefits and potential risks of implantable cardioverter-defibrillators in paediatric and congenital heart disease (CHD) patients in the current era.

Methods: All patients with CHD, paediatric cardiomyopathy or primary electrical disease, who underwent implantation of a defibrillator from 2001 to 2023, were examined. The occurrence of appropriate therapy, unplanned surgeries due to device complications, inappropriate shocks and associated risk factors were analysed.

Usefulness of serial N-terminal pro-B-type natriuretic peptide values after biventricular repair in patients with borderline hypoplastic left ventricle.

Objectives: Biventricular repair (BVR) for patients with borderline hypoplastic left ventricle is challenging, and a predictor of failing BVR has not been clarified. This study aimed to analyse the z-log N-terminal pro-B-type natriuretic peptide and evaluate its usefulness in predicting outcomes after BVR.

Methods: Patients who were diagnosed with borderline left heart hypoplasia and underwent BVR from 2012 to 2022 were included.

Impact of diaphragm paralysis and its surgical interventions on outcomes after the staged Fontan procedure.

Objectives: This study aimed to investigate the incidence of diaphragm paralysis and its impact on outcomes after the Fontan procedure in patients with single ventricles.

Methods: Patients undergoing staged Fontan palliation between 1994 and 2023 were reviewed. Patients who had diaphragm paralysis were identified, and the impact of diaphragm paralysis on outcomes after Fontan completion was evaluated.

Relationship of pulmonary artery size and venovenous collaterals during staged single ventricle reconstruction and their impact on outcomes after Fontan procedure.

Objectives: This study aimed to evaluate the relationship between pulmonary artery size and venovenous collaterals (VVCs) during staged single ventricle reconstruction.

Methods: Patients who underwent staged Fontan palliation between 2003 and 2023 were reviewed. The relationship between the pulmonary artery index and the development of VVCs was determined.

Postoperative atrioventricular block after surgery for congenital heart disease: incidence, recovery and risks.

Objectives: We aimed to determine the incidence of postoperative complete atrioventricular block, the time to recovery or permanent pacemaker implantation and the predictors for postoperative atrioventricular block after congenital heart surgery.

Methods: Patients who underwent open-heart surgery from January 2001 to January 2024 were analysed and predictors of atrioventricular block were identified using a logistic regression model.

Results: Among 9765 congenital heart surgeries, 333 (3.

Clinical outcomes of Kawashima procedure and subsequent hepatic vein incorporation†.

Objective: We aimed to evaluate outcomes after Kawashima procedure with special regard to the development of pulmonary arterio-venous malformations.

Methods: All patients who underwent Kawashima procedure between 1992 and 2022 were reviewed.

Results: Twenty-one patients underwent Kawashima procedure at a median age of 14.

Perioperative prediction of adverse events with age-adjusted NT-proBNP in children undergoing Norwood surgery.

Background: Due to the high postoperative mortality, tools for an adaequate risk stratification are important to identify high-risk patients undergoing the Norwood procedure. As a marker of ventricular wall stress, NT-proBNP might be of particular interest in these children.

Objectives: This study evaluated whether NT-proBNP's age-adjusted z-score ("zlog-NT-proBNP") predicts outcomes after stage I Norwood procedure.

Impact of Atretic Aortic Valve on Systemic Ventricular Function After the Norwood Procedure.

Background: Aortic atresia (AA) is considered a risk for the Norwood procedure. This study aimed to compare the longitudinal ventricular function (VF) and atrioventricular valve (AVV) regurgitation in patients with AA and aortic stenosis (AS).

Methods: Using serial echocardiographic images in patients undergoing the neonatal Norwood procedure between 2001 and 2020, systemic VF assessed by ejection fraction and the degree of AVV regurgitation were compared between the patients with AA and AS.

Systemic venous collaterals between Glenn and Fontan: prevalence, therapy, and impact on outcomes.

Objective: This study aimed to evaluate veno-venous collaterals between bidirectional cavopulmonary shunt and total cavopulmonary connection.

Methods: Patients who underwent staged total cavopulmonary connection between 1995 and 2022 were reviewed. Veno-venous collaterals between bidirectional cavopulmonary shunt and total cavopulmonary connection were depicted using angiograms.

Serial changes of systemic ventricular function and atrioventricular valve function in patients with failing Fontan.

Objectives: This study investigated the longitudinal changes in ventricular function and atrioventricular valve function to clarify the timing and the mechanisms of failing Fontan.

Methods: Patients who underwent total cavopulmonary connection between 1994 and 2023 were reviewed, and longitudinal echocardiographic examinations of ventricular function and atrioventricular valve regurgitation were analysed.

Results: A total of 650 patients were included.

Surgical outcome of the borderline hypoplastic left ventricle: impact of the left ventricle rehabilitation strategy.

Objective: This study aims to assess the surgical outcome of borderline hypoplastic left ventricle before and after the induction of the left ventricle rehabilitation strategy.

Methods: A retrospective review investigated patients with borderline hypoplastic left ventricle who underwent surgical intervention between 2012 and 2022. The patient cohort was stratified into two groups based on the initiation of left ventricle rehabilitation: an early-era group (E group, 2012-2017) and a late-era group (L group, 2018-2022).

Outcomes after bidirectional cavopulmonary shunt with antegrade pulmonary blood flow in high-risk patients.

Objective: We have left antegrade pulmonary blood flow (APBF) at bidirectional cavopulmonary shunt (BCPS) only for high-risk patients. This study evaluates the indication and the outcomes of patients with APBF, compared to those without APBF.

Methods: Patients with APBF after BCPS were identified among patients who underwent BCPS between 1997 and 2022.

Quantification of ventricular stress in univentricular hearts during early childhood using age-independent zlog-NT-proBNP.

Background: Children with univentricular hearts (UVH) undergo up to three palliative surgical procedures to achieve complete circulatory separation (Fontan circulation). As a marker of cardiac wall stress, NT-proBNP is a promising tool to assess systemic ventricular load in these patients. However, different reference intervals (RI) apply to each stage, as NT-proBNP is highly age-dependent.

Bioactive adrenomedullin (bio-ADM) is associated with endothelial dysfunction in infants and children with complex congenital heart disease undergoing open-heart surgery on cardiopulmonary bypass.

Objectives: Children with congenital heart disease (CHD) undergoing cardiac surgery on cardiopulmonary bypass (CPB) are at risk for systemic inflammation leading to endothelial dysfunction associated with increased morbidity. Bioactive adrenomedullin (bio-ADM) is a peptide regulating vascular tone and endothelial permeability. The aim of this study was to evaluate the dynamics of plasma bio-ADM in this patient cohort and its role in capillary leak.