Differences in Exercise Performance in Fontan Patients with Extracardiac Conduit and Lateral Tunnel: A FORCE Fontan Registry Study.

To explore the differences in exercise capacity between the extracardiac conduit (ECC) and lateral tunnel (LT) Fontan. 2169 patients (36% LT ( = 774); 64% ECC ( = 1395)) underwent a Fontan operation between 2000 to 2023 in a multi-institutional Fontan registry. LT patients were age-matched to ECC patients, and cardiopulmonary exercise test (CPET) results were compared.

The long-term effect of the Fontan fenestration on clinical outcomes: A FORCE registry study.

Background: The long-term effect of open fenestration in Fontan patients is unclear, leading to wide practice variation of fenestration creation and closure. We evaluated the long-term outcomes of the fenestration using data from the Fontan Outcome Registry using Cardiac Magnetic Resonance Examinations (FORCE) Study.

Methods: Patients were categorized by fenestration status determined by post-Fontan cardiac magnetic resonance imaging (CMR) as open fenestration, nonfenestrated Fontan, spontaneous closure, and device closure.

Single and Double Root Translocation for Transposition and Malposition of the Great Arteries.

Aortic root translocation and double root translocation have emerged as potentially valuable surgical options for complex transposition of the great arteries or double outlet right ventricle with VSD and LV outflow tract obstruction (LVOTO). These complex approaches offer excellent laminar LV outflow tracts with almost no late LVOT reinterventions. Whilst the advantages for the LVOT are clear, there is an early cost in terms of prolonged operative ischemic times compared with the Rastelli procedure or even arterial switch with LVOTO resection.

Staged Treatment for Critically Ill Neonates With Ebstein Anomaly: Cone Repair After Starnes Procedure.

Following the Starnes procedure, a progressive reduction in the RV cavity occurs, suggesting that the RV was unsuitable for a biventricular repair. For that reason, those patients traditionally followed the single ventricle pathway. In 2019, we performed the initial tricuspid valve (TV) repair cases after Starnes.

Epigenetic mechanisms controlling human leukemia stem cells and therapy resistance.

Cancer stem cells are essential for initiation and therapy resistance of many cancers, including acute myeloid leukemias (AML). Here, we apply functional genomic profiling to diverse human leukemias, including high-risk MLL- and NUP98-rearranged specimens, using label tracing in vivo. Human leukemia propagation is mediated by a rare quiescent label-retaining cell (LRC) population undetectable by current immunophenotypic markers.

Medical students' perceptions of mentorship in cardiothoracic surgery: A Thoracic Surgery Medical Student Association Nationwide Survey.

Objective: The study objective was to explore medical students' perceptions of mentorship in cardiothoracic surgery in the United States.

Methods: A voluntary, anonymous electronic survey was distributed to medical students through the Thoracic Surgery Medical Student Association. The survey included 28 questions across 4 domains: demographic information, current mentorship status, goals and qualities sought in mentorship, and self-reported barriers to mentorship.

Anatomic and non-anatomic substrates in infants with two ventricles undergoing aortic arch repair.

Objectives: We sought to examine the relative importance of surgical lesion complexity versus the presence of genetic/syndromic/extracardiac anomalies (GSAs) in determining survival, morbidity or need for reinterventions following repair for aortic arch hypoplasia.

Methods: A single-centre, retrospective cohort study of infants undergoing biventricular aortic arch repair sternotomy from 2010 to 2021 was conducted. Survival analysis was performed using Kaplan-Meier methods, with additional Bayesian survival modelling for subgroups.

The cone repair allows right ventricle rehabilitation with excellent tricuspid valve function following the Starnes procedure.

Background: We present a case series of right ventricle (RV) rehabilitation after the Starnes procedure in patients with Ebstein anomaly (EA), applying the Cone repair of the tricuspid valve (TV) to achieve 2-ventricle or 1.5-ventricle physiology.

Methods: This is a retrospective database analysis from 2 institutions in North America.

Long-term Outcome After Repair of Transposition of the Great Arteries With Aortic Arch Obstruction.

Background: This study compares the long-term outcomes of patients after repair of transposition of the great arteries (TGA) with and without aortic arch obstruction (AAO).

Methods: This is a single-institution, retrospective study between October 2004 and February 2023. Patients who underwent arterial switch operation and aortic arch repair (ASO-AAR group) with patch augmentation were compared with those without AAO (ASO group).

Midterm Outcomes After Aortic Valve Neocuspidization (Ozaki Procedure) in Adults.

Background: Trileaflet aortic valve neocuspidization (AVN) using autologous pericardium (Ozaki procedure) is an emerging surgical treatment option for aortic valve diseases. Although excellent results have been reported from Japan, data pertaining to its use in the United States are sparse.

Methods: All adult patients who underwent AVN (AVN group) or surgical aortic valve replacement (SAVR) with a bioprosthetic valve (SAVR group) between 2015 and 2022 were identified.

Optimizing Surgical Selection for Transposition With Left Ventricular Outflow Tract Obstruction.

Background: Studies that have assessed the Rastelli and Nikaidoh operations for transposition of the great arteries (TGA) with obstructed left ventricular outflow tract obstruction (LVOTO) have not fully evaluated the anatomic drivers that may contribute to surgical selection. We present our procedural selection process for optimizing outcomes of complex TGA in the modern era.

Methods: This is a single-center, retrospective study that included pediatric patients who underwent either a Nikaidoh or Rastelli operation for the treatment of TGA-LVOTO, congenitally corrected TGA-LVOTO, or double-outlet right ventricle TGA type-LVOTO from June 2004 to June 2021.

Pulmonary Homograft vs Handmade Polytetrafluoroethylene-Valved Conduits After the Ross Procedure.

Background: This study aimed to longitudinally compare expanded polytetrafluoroethylene (ePTFE)-valved conduits vs pulmonary homograft (PH) conduits after right ventricular outflow tract reconstruction in the Ross procedure.

Methods: Patients undergoing a Ross procedure from June 2004 to December 2021 were identified. Echocardiographic data, catheter-based interventions, or conduit replacements, as well as time to first reintervention or replacement, were comparatively assessed between handmade ePTFE-valved conduits and PH conduits.

Coronary transfer for complex looping and intramural variants in the arterial switch procedure.

Achieving a safe and accurate coronary transfer in the context of the precise geometry of the realigned great arterial connections is the essence of the arterial switch operation for transposition. Because the incidence of variant coronary patterns is not low, one needs to be familiar with techniques to transfer all types of coronary patterns when performing the arterial switch operation. Both closed and open techniques for coronary transfer have been widely adopted for the arterial switch operation.

Predictors of Mediastinal Exploration While on Extracorporeal Membrane Oxygenation After Pediatric Cardiac Surgery.

Cardiac surgical patients requiring extracorporeal membrane oxygenation (ECMO) are at increased risk for hemorrhage due to necessary anticoagulation, in-situ cannulas, and disturbed hemostasis. We performed a retrospective, cross-sectional study of patients 0-18 years old in our cardiac intensive care unit (CICU) cannulated to ECMO within 48 h of cardiopulmonary bypass. The 69 patients included in the study were divided into three analysis groups based on serial chest tube output per hour: no bleeding (NB) on admission to the CICU (21/69, 30%), bleeding stopped (BS) with medical management (26/69, 38%), bleeding requiring emergent mediastinal exploration (BME) (22/69, 32%).

Multimodality Imaging in Ebstein Anomaly.

Ebstein anomaly is the most common form of tricuspid valve congenital anomalies. The tricuspid valve is abnormal with different degrees of displacement of the septal leaflet and abnormal rotation of the valve towards the right ventricular outflow tract. In severe forms, it results in significant tricuspid regurgitation and requires surgical repair.

The effect of receiving an award from the American Association for Thoracic Surgery Foundation.

Objective: This study's objective was to evaluate the scholastic and career effects of receiving either the American Association for Thoracic Surgery (AATS) Foundation research scholarship or surgical investigator program.

Methods: AATS annual reports and recipient listings were used to generate the awardees. MEDLINE and SCOPUS were used to assess publications, citations, and H-Index for awardees.

Anatomic Position and Durability of Polytetrafluoroethylene Conduit ≥18 mm: Single-Center Experience.

Background: Conduit longevity after right ventricular outflow tract (RVOT) reconstruction is determined by the interaction of different factors. We evaluated the relationship between conduit anatomic position and long-term durability among ≥18 mm polytetrafluoroethylene (PTFE) conduits.

Methods: A single-institution RVOT reconstructions using a PTFE conduit ≥18 mm were identified.

Standardized Aortic Valve Neocuspidization for Treatment of Aortic Valve Diseases.

Background: Aortic valve replacement is the traditional surgical treatment for aortic valve diseases, yet standardized aortic valve neocuspidization (AVNeo) is a promising alternative that is gaining popularity. The purpose of this article is to review the available published literature of AVNeo using glutaraldehyde-treated autologous pericardium, also known as the Ozaki procedure, including indications, outcomes, potential benefits, and modes of failure for the reconstructed valve.

Methods: A comprehensive literature search was performed using keywords related to aortic valve repair, AVNeo, or Ozaki procedure.