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.

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.

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.

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.

Effect of cardiopulmonary bypass on coagulation factors II, VII and X in a primate model: an exploratory pilot study.

Objectives: The use of cardiopulmonary bypass (CPB) in cardiac surgery is a major risk factor for postoperative bleeding. We hypothesized that consumptive coagulopathy and haemodilution influence the coagulation factors; therefore, we aimed to estimate the activity profiles of coagulation factors II, VII and X during CPB circulation.

Methods: A 120-min bypass was surgically established in cynomolgus monkeys (n = 7).

Myeloid Progenitor Inhibitory Factor-1 (CCL23) Inhibits Lung Leukocyte Recruitment in a Primate Cardiopulmonary Bypass-Induced Pulmonary Ischaemia Model.

Background: Bone marrow (BM)-derived polymorphonuclear leukocytes (PMNs) and monocytes (MO) induced by cardiopulmonary bypass (CPB) are highly proteolytic and cause postoperative lung injury. Although CCL23/Myeloid progenitor inhibitory factor-1 is a human CC chemokine with potent suppressor effects on myeloid progenitor cells, in vivo inhibitory effects on BM-derived leukocyte kinetics associated with CPB are unknown.

Methods: Two-hour CPB was surgically performed in cynomolgus monkeys and BM-derived leukocytes kinetics were monitored postoperatively by flow cytometry with 5'-bromo-2'-deoxyuridine (BrdU) and cytokine ELISA.

Arterial switch operation with coronary button extension and neo-pulmonary trunk realignment for a rare coronary pattern.

Coronary anatomy is key for arterial switch operations as reimplantation for coronary artery patterns originating from the same sinus is often challenging. We experienced an extremely rare coronary artery anatomy case (Leiden convention: 1 R, 1LCx) and successfully performed an arterial switch operation with coronary button extension and neo-pulmonary trunk realignment maneuver.

Pediatric delirium is associated with increased brain injury marker levels in cardiac surgery patients.

Despite global consensus on the importance of screening pediatric delirium, correlations between pediatric delirium during acute brain injury and adult delirium are unclear. Therefore, we hypothesized that similar pediatric biomarkers reflect acute brain injury as in adult delirium. We observed pediatric cardiac surgery patients from neonatal age to 18 years, who were admitted to our pediatric intensive care unit after cardiovascular operations between October 2019 to June 2020, up to post-operative day 3 (4 days total).

Successful surgical resection plus surgical cryoablation for the treatment of a large left ventricular fibroma.

Residual tumor mass after large cardiac fibroma resection carries long-term risk, but cryoablation is useful during surgery to remove such tissue. Here, we present a case of a large cardiac fibroma of the posterior wall of the left ventricle, discovered during long-term, episodic ventricular tachycardia. Resection with cryoablation completely removed the tumor, eliminating postoperative, distant ventricular arrhythmias.

Expanded Polytetrafluoroethylene Patching for Recurrent Pulmonary Venous Obstructions.

Recurrent postoperative pulmonary venous obstruction after total anomalous pulmonary venous connection repair is a challenging complication. Here, we present such a case that required 4 reoperations, focusing on a sutureless method with an expanded polytetrafluoroethylene patch for the fourth reoperation. The use of artificial patch materials to reconstruct the atrial septum and neoatrial roof could be a promising alternative approach of this method to expand its applicability.

Pediatric cardiac tamponade caused by metallic wire penetration into the heart: A case report and literature review.

Thin, metallic wires can easily penetrate the gastrointestinal system if ingested and cause serious cardiac issues in children. We report a pediatric case of such an object that caused cardiac tamponade after lodging in the left ventricle. The wire was extracted without cardiopulmonary bypass and a full recovery was made.

Congenital Tricuspid Valve Calcification Necessitating Neonatal Surgical Intervention.

We report a case of isolated idiopathic congenital tricuspid valve calcification that necessitated urgent neonatal surgical intervention. Hemodynamic analysis revealed circular shunt caused by severe tricuspid regurgitation, pulmonary regurgitation, and a hypoplastic right ventricle. The patient successfully underwent tricuspid valve repair at postnatal day 10.

Conduction disorders after perimembranous ventricular septal defect closure: continuous versus interrupted suturing techniques.

Objectives: The aim of this study was to investigate postoperative conduction disorder differences between continuous and interrupted suturing techniques for the closure of perimembranous outlet-type ventricular septal defects (VSDs) in both tetralogy of Fallot (ToF) and isolated VSD cases.

Methods: Patients aged 4 years or younger who underwent VSD closure for ToF (n = 112) or isolated perimembranous outlet-type VSD (n = 73) from April 2010 to December 2018 at 3 centres were reviewed. Patients either received continuous suturing for ToF (C-ToF, n = 58) or isolated VSD (C-VSD, n = 50), or interrupted suturing for ToF (I-ToF, n = 54) or isolated VSD (I-VSD, n = 23).

Architecture matters: Tissue preservation strategies for tetralogy of Fallot repair.

Background: Great variability exists in repair strategies for the tetralogy of Fallot. While transannular patching, as introduced by Kirklin, was a breakthrough for primary repair, pulmonary regurgitation and a need for reoperation have led to the development of methods that preserve the natural morphology of the right ventricular outflow tract.

Methods: State-of-the-art details of tetralogy of Fallot repair are explained from the standpoint of architectural preservation, especially with regard to sparing native tissue such as the annulus, valve, or infundibulum.