Timing of Arterial Switch Operation in Dextro-Transposition of Great Arteries with Intact Septum: Factors Associated with Delay, Practice Variation, and Associated Outcomes.

We examined the current practice, factors associated with delay, and impact of timing of arterial switch operation (ASO) on outcomes of d-transposition of great arteries (d-TGA) with intact ventricular septum (IVS). Neonates with d-TGA + IVS undergoing ASO were identified from the Pediatric Health Informational System database. Factors associated with delayed repair, practice trends, and outcomes related to surgical timing were analyzed.

Aspirin Use Following the Arterial Switch Operation in the United States: Variability, Trends, and Perioperative Outcomes.

BackgroundAspirin has the potential of offering coronary arterial protection from thromboembolism for patients following the arterial switch operation (ASO) but is used inconsistently and the benefits are unknown. We sought to discern trends and outcomes associated with the use of aspirin following the ASO.MethodsPatients undergoing the ASO were identified from the Pediatric Health Information System and divided into two groups: those who received aspirin post-ASO versus the nonaspirin group to evaluate trends, variations, and outcomes.

The Increasing Utilization of the Impella Device as a Bridge-to-Transplantation in Pediatric Heart Centers Across the United States.

ObjectiveReports on the use of the Impella device in children undergoing heart transplantation have been limited. We sought to provide what is to our knowledge the first multi-institutional national report of pediatric Impella device utilization as a bridge-to-heart transplant strategy.MethodsAll patients (<18 years) who underwent Impella placement in the United Network for Organ Sharing (UNOS) from the first use in 2013 to June 2024 were identified.

Is timing as critical for repair of dextro-transposition of the great arteries with ventricular septal defect without outflow tract obstruction?

Objective: We sought to explore the role of timing on outcomes of the arterial switch operation + ventricular septal defect closure.

Methods: Neonates undergoing the arterial switch operation + ventricular septal defect closure from the Pediatric Health Information System database (2004-2022) were identified. Patients with outflow tract obstruction were excluded.

Can Children With a VAD Overcome Intellectual and Motor Disabilities After Heart Transplantation in the United States?

Background: Ventricular assist devices (VADs) can be associated with high rates of neurologic complications. This study investigated whether children with VADs continue to exhibit psychomotor impairment after heart transplantation (HTx).

Methods: The United Network for Organ Sharing was queried for children who underwent VAD implantation and HTx (2008-2024).

Fate of Semilunar Valves From Discarded Hearts at the Time of Pediatric Heart Retransplantation.

Background: Partial heart transplantation (PHT) is a novel procedure for children in need of a growing valve replacement option. One challenge is identifying suitable donor valves. Semilunar heart valves from patients receiving a retransplant may be a source, however their functionality and growth potential especially at the time of retransplant are unknown.

Unintended Sequalae of Long-Term Transvenous Pacemaker Leads in a Patient With Congenital Heart Disease.

Long-term use of transvenous pacemakers, a common modality used for symptomatic bradyarrhythmias, can lead to rare but significant complications, especially in patients with congenital heart disease. We present a complex and challenging surgical lead extraction for a patient with long-standing superior vena cava syndrome resulting from prolonged transvenous leads.

Outcomes of Concomitant Cardiac Surgical Procedures Performed During Pediatric Lung Transplantation in the United States.

Data on concomitant cardiac surgery (CCS) performed during pediatric lung transplantation (LTx) is limited. Therefore, we conducted a multi-institutional analysis to identify the incidence and outcomes of CCS in pediatric (< 18 years) LTx recipients by merging data (2004-2023) from the United Network for Organ Sharing (UNOS) and Pediatric Health Information System (PHIS) databases. Of the total of 596 pediatric LTx recipients, 87 (15%) underwent CCS.

The Burden of Stroke in Neonates Undergoing Congenital Heart Surgery: A Large Multicenter Analysis.

Background: Stroke affects surgical decision making and outcomes of neonatal cardiac surgery (CHS). We sought to assess the burden of stroke in this population from a large multicenter database.

Methods: We analyzed neonates undergoing CHS with cardiopulmonary bypass from the Pediatric Health Information System database (2004-2022).

Association of abdominal aortic aneurysm diameter indexed to patient height with symptomatic presentation and mortality.

Background: The current guidelines have recommended repair of abdominal aortic aneurysms (AAAs) according to the maximal AAA diameter and/or its growth rate. However, many studies have suggested that the AAA diameter alone is not sufficient to predict the risk of rupture or symptomatic presentation. Several investigators have attempted to relate the AAA diameter to the body surface area in predicting for rupture.

Frailty as a predictor of outcomes for patients undergoing carotid artery stenting.

Objective: The concept of frailty has been proposed to capture the vulnerability resulting from aging and has been implemented for the prediction of perioperative outcomes. Carotid artery stenting (CAS) is considered an appropriate minimally invasive procedure for patients considered to high risk to undergo carotid endarterectomy. Recently, the predictive accuracy for perioperative outcomes using the five-item modified frailty index (5mFI) has been reported to be relatively poor for cardiovascular surgery compared with other surgeries.

Comparison of open- and closed-cell stent design outcomes after carotid artery stenting in the Vascular Quality Initiative.

Background: The association between stent design and outcomes after carotid artery stenting (CAS) has remained controversial. The available data are conflicting regarding the superiority of any specific stent design. The present study investigated the association between cell design and outcomes after carotid artery stenting (CAS) in a real world setting.

Safety of carotid artery revascularization procedures in patients with atrial fibrillation.

Background: Atrial fibrillation (Afib) is a major contributor to cerebrovascular events. Coexisting carotid artery disease is not uncommon in Afib patients, yet they have been excluded from major randomized clinical trials. Therefore, the aim of this study was to evaluate the safety of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in Afib patients.

Pediatric Frontal Bone and Sinus Fractures: Cause, Characteristics, and a Treatment Algorithm.

Background: The purpose of this study was to assess the incidence, cause, characteristics, presentation, and management of pediatric frontal bone fractures.

Methods: A retrospective cohort review was performed on all patients younger than 15 years with frontal fractures that presented to a single institution from 1998 to 2010. Charts and computed tomographic images were reviewed, and frontal bone fractures were classified into three types based on anatomical fracture characteristics.

Hemodialysis and peritoneal dialysis access related outcomes in the pediatric and adolescent population.

Background: There is paucity of comparative data on the objective performance of arteriovenous fistulas (AVF), grafts (AVG), hemodialysis (HD) catheter and peritoneal dialysis (PD) catheter in the pediatric population.

Methods: A retrospective analysis of all patients <21 years in the United States Renal Database System who had an AVF, AVG, HD catheter or PD catheter placed for dialysis access between 1/2007 and 12/2014 was performed. Multivariable cox regression was used to evaluate mortality, patency (primary, primary-assisted and secondary), maturation and catheter survival.

Trend and Economic Burden of Intravenous Narcotic Analgesic Utilization in Major Vascular Interventions in the United States.

Background: The use of IV narcotic analgesics (IVNA) within the context of vascular procedures is not fully described. We sought to evaluate the burden of IVNA including narcotic analgesia-related adverse drug events (NARADE), associated mortality and hospitalization cost in open and endovascular vascular procedures, and to compare it with nonnarcotic analgesia (IVNNA).

Methods: Retrospective cross-sectional study in hospitals participating in Premier database (2009-2015).

Gender-Based Utilization and Outcomes of Autogenous Fistulas and Prosthetic Grafts for Hemodialysis Access.

Background: To evaluate gender-based patterns of utilization and outcomes of arteriovenous fistulas (AVFs) and grafts (AVGs) in a population-based cohort of hemodialysis (HD) patients.

Methods: A retrospective analysis of all patients in the United States Renal Data System who had an AVF or AVG placed for HD access (January 2007 to December 2014). Outcomes were access maturation, conduit patency, infection, and mortality.

The Vascular Quality Initiative 30-day stroke/death risk score calculator after transfemoral carotid artery stenting.

Objective: Carotid artery stenting (CAS) was introduced as an alternative carotid revascularization procedure in patients deemed to be at high risk for carotid endarterectomy. Although techniques and selection criteria for patients have dramatically improved, CAS continues to have higher risk of stroke and death in comparison to carotid endarterectomy. Several risk factors are known to be associated with worse outcomes.

Absorbable Fixation Devices for Pediatric Craniomaxillofacial Trauma: A Systematic Review of the Literature.

Background: The purpose of this study was to investigate surgical outcomes with the use of resorbable plating systems for the repair of craniomaxillofacial trauma in the pediatric population.

Methods: A systematic review of the literature was performed. A descriptive analysis, operative technical data, outcomes, and postoperative complications with the use of absorbable plating systems for craniomaxillofacial trauma were included.

Platelet Depletion/Transfusion as a Lethal Factor in a Colitis-associated Cancer Mouse Model.

Background/aim: TLR-4 Knock-out (KO) mice are protected from colitis-associated cancer in the established AOM/DSS mouse model. The aim of this study was to assess whether the TLR4 KO mice would still be protected from carcinogenesis after platelet depletion and transfusion with TLR4 wild-type platelets.

Materials And Methods: Thirty-two female C57BL6 mice were divided into 6 groups.

Risk of emergent carotid endarterectomy varies by type of presenting symptoms.

Background: The timing of carotid revascularization in symptomatic patients is a matter of ongoing debate. Current evidence indicates that carotid endarterectomy (CEA) within 2 weeks of symptoms is superior to delayed treatment. However, there is little evidence on the outcomes of emergent CEA (eCEA).

Pediatric Nasoorbitoethmoid Fractures: Cause, Classification, and Management.

Background: Currently, there is a paucity of information on the presentation and proper management of pediatric nasoorbitoethmoid fractures. The purpose of this study was to examine the incidence, cause, associated injuries, and management of these fractures. Furthermore, the authors sought to assess outcomes after transnasal wiring or suture canthopexy for type III nasoorbitoethmoid fractures.

Outcomes and cost of fenestrated versus standard endovascular repair of intact abdominal aortic aneurysm in the United States.

Background: Fenestrated endovascular aneurysm repair (FEVAR) has expanded the indications of this minimally invasive procedure to include patients with pararenal aneurysms. The actual cost of this relatively newer technology compared with standard endovascular aneurysm repair (EVAR) has not been studied before. Thus, the aim of this study was to analyze in-hospital costs and adverse outcomes in patients undergoing FEVAR vs EVAR for intact abdominal aortic aneurysms (AAAs).

Statins reduce mortality and failure to rescue after carotid artery stenting.

Objective: The benefit of statins has been well established in reducing morbidities and mortality after carotid endarterectomy. However, the potential advantage of statin use in patients undergoing carotid artery stenting (CAS) remains largely unknown. The purpose of this study was to evaluate the effect of statins on postoperative outcomes after CAS.