Safety of direct oral anticoagulants in surgical bioprosthetic heart valves: a paediatric institution's experience.

Introduction: Surgical pulmonary valve replacement is commonly required to palliate patients with CHD affecting the right ventricular outflow tract; however, concerns remain about mid- and long-term durability. Post-operative short-term anticoagulation has been hypothesised to improve valve durability.

Methods: This is a single-centre, retrospective study of paediatric patients who underwent surgical pulmonary valve replacement and received a direct oral anticoagulant in addition to aspirin post heart valve insertion.

Clinical Status and Reintervention in Neonates With Symptomatic Tetralogy of Fallot: A Landmark Analysis.

Background: In symptomatic neonates with tetralogy of Fallot (sTOF), the initial treatment strategy significantly affects early outcomes, but its long-term impact remains less well defined.

Objectives: The aim of the study was to compare primary (PR) vs staged repair (SR) in sTOF with respect to reintervention (RI) rates and types, clinical and echocardiographic outcomes, and medication use.

Methods: Neonates with sTOF undergoing PR or SR and with >1 year of follow-up after complete repair were included.

En-Bloc Versus Bilateral Sequential Technique for Pediatric Lung Transplantation.

Background: Lung transplantation is the primary surgical therapy for end-stage lung disease in children. Bilateral sequential lung transplantation (BSLT) is the most widely used technique across the United States. En-bloc lung transplantation (EBLT) was put forward as an alternative to avoid the complications associated with bronchial anastomoses in smaller children.

Surgical Reinterventions After Primary vs Staged Yasui Operation.

Background: The Yasui procedure combines the elements of the Norwood and Rastelli operations. It can be performed in a single stage during the neonatal period or as a staged procedure. Long-term survival and reintervention data are limited.

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.

Coronary Sinus Blues: A Word of Caution When Placing the Coronary Sinus Ostium in the Left Atrium.

Complications related to the coronary sinus following cardiac surgery are rare and require a high index of suspicion to ensure timely diagnosis and treatment. We describe the clinical presentation and management of a patient with atrioventricular septal defect who developed coronary sinus ostial obstruction following left atrioventricular valve replacement. This manifested as a decline in ventricular function and supraventricular arrhythmias.

Sex-Based Disparities in Heart Transplantation in Teenagers.

Background: Heart transplantation in teenagers has not been well studied. Teenage recipients have unique considerations that influence outcomes-complexity of cardiac disease, wide range of donor sizing and age, mechanical support options, and medication nonadherence. We sought to analyze the outcomes of heart transplantation in teenagers, focusing on sex-based disparities.

Pulmonary Artery Banding and Arch Repair vs Norwood for Unbalanced Atrioventricular Canal Defect.

Background: The outcomes of single-ventricle palliation in unbalanced atrioventricular canal defect with coarctation of aorta (uAVC+CoA) have not been well studied. Systemic ventricle outflow tract obstruction has a propensity to develop in these patients after aortic arch repair with pulmonary artery banding (arch-PAB), which may adversely affect survival and Fontan candidacy.

Methods: A retrospective review was performed of patients who underwent single-ventricle palliation for uAVC+CoA from 2000 to 2022.

Neonatal heart transplantation in the United States: Trends and outcomes.

Background: Heart transplantation in the neonatal period is associated with excellent survival. However, outcomes data are scant and have been obtained primarily from two single-center reports within the United States. We sought to analyze the outcomes of all neonatal heart transplants performed in the United States using the United Network for Organ Sharing (UNOS) dataset.

Mitral Valve Replacement in Infants and Children: Experience Using a 15-mm Mechanical Valve.

Background: Reports using a 15-mm mechanical valve for mitral valve replacement (MMVR) in children are limited. We review our center's operative and postoperative experience with this valve.

Methods: We performed a single-center retrospective chart review identifying patients having undergone MMVRs between 2009 and 2022.

Cardiac surgery in children with trisomy 13 or trisomy 18: How safe is it?

Objective: Surgery for heart defects in children with trisomy 13 or 18 is controversial. We analyzed our 20-year experience.

Methods: Since 2002, we performed 21 operations in 19 children with trisomy 13 (n = 8) or trisomy 18 (n = 11).

Incidence and recovery of post-surgical heart block in children following cardiac surgery.

Background: A subset of patients who develop post-surgical heart block have recovery of atrioventricular node function. Factors predicting recovery are not understood. We investigated our centre's incidence of post-surgical heart block and examine factors associated with recovery of atrioventricular node function.

Impact of Management Strategy on Feeding and Somatic Growth in Neonates with Symptomatic Tetralogy of Fallot: Results from the Congenital Cardiac Research Collaborative.

Objective: To evaluate early growth following primary or staged repair of neonatal symptomatic tetralogy of Fallot (sTOF).

Study Design: We performed a retrospective, multicenter cohort study of consecutive infants with sTOF who underwent initial intervention at age ≤30 days, from 2005 to 2017. Management strategies were either primary repair or staged repair (ie, initial palliation followed by complete repair).

Autologous Cardiac Stem Cell Injection in Patients with Hypoplastic Left Heart Syndrome (CHILD Study).

Mortality in infants with hypoplastic left heart syndrome (HLHS) is strongly correlated with right ventricle (RV) dysfunction. Cell therapy has demonstrated potential improvements of RV dysfunction in animal models related to HLHS, and neonatal human derived c-kit cardiac-derived progenitor cells (CPCs) show superior efficacy when compared to adult human cardiac-derived CPCs (aCPCs). Neonatal CPCs (nCPCs) have yet to be investigated in humans.

Palliation Strategy to Achieve Complete Repair in Symptomatic Neonates with Tetralogy of Fallot.

Neonates with symptomatic tetralogy of Fallot (sTOF) may undergo palliations with varying physiology, namely systemic to pulmonary artery connections (SPC) or right ventricular outflow tract interventions (RVOTI). A comparison of palliative strategies based on the physiology created is lacking. Consecutive sTOF neonates undergoing SPC or RVOTI from 2005-2017 were reviewed from the Congenital Cardiac Research Collaborative.

Comparative Costs of Management Strategies for Neonates With Symptomatic Tetralogy of Fallot.

Background: Recent data have demonstrated that overall mortality and adverse events are not significantly different for primary repair (PR) and staged repair (SR) approaches to management of neonates with symptomatic tetralogy of Fallot (sTOF). Cost data can be used to compare the relative value (cost for similar outcomes) of these approaches and are a potentially more sensitive measure of morbidity.

Objectives: This study sought to compare the economic costs associated with PR and SR in neonates with sTOF.

Bioprosthetic Pulmonary Valve Dysfunction in Congenital Heart Disease.

Background: We aim to identify the incidence and timing of dysfunction and failure of stented bioprosthetic valves in the pulmonary position in congenital heart disease patients.

Methods: A total of 482 congenital heart disease patients underwent 484 stented bioprosthetic pulmonary valve implantations between 2008 and 2018. There were 164 porcine valves (Porcine) and 320 bovine pericardial valves (Pericardial) implanted.