The following is a collection of
featured congenital articles from the Journal of Thoracic and Cardiovascular
Surgery (JTCVS). To read the latest issue,
browse the feature video library and other journal
highlights please visit www.jtcvs.org
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VENTRICULAR SEPTAL DEFECT
membrane oxygenation as a novel management strategy for
interventricular septal hematoma following ventricular
septal defect repair
Anusha Jegatheeswaran, MD, PhD,
Meryl S. Cohen, MD, J. William Gaynor, MD, Christopher
E. Mascio, MD, Thomas L. Spray, MD, Stephanie Fuller,
post-VSD repair can cause hemodynamic instability and
death. We present the novel use of ECMO despite the
need for anticoagulation, with repeated imaging to
assess hematoma expansion.
Rescue is feasible—Prevention is preferred
Do, MD, David Bichell, MD
ECMO can be successful support for
an unstable patient with septal hematoma. Early
detection of this rare complication may inform
intervention, averting instability and obviating
the need for rescue.
Postoperative interventricular septal hematoma—Never
M. Burkhart, MD, Jess L. Thompson, MD, Klayton W.
septal hematoma seldom occurs and can be
successfully managed expectantly or, if necessary,
with extracorporeal membrane oxygenation support.
VENTRICULAR SEPTAL DEFECT FEATURED VIDEO
interventricular septal hematoma on 4-chamber view.
ANOMALOUS CORONARY ARTERY
outcomes for anomalous left coronary artery from the
pulmonary artery: Influence of late presentation
Wen Zhang, MD, Renjie Hu, MD,
Yifan Zhu, MD, Weituo Zhang, PhD, Xiafeng Yu, MD,
Yanjun Sun, MD, Hongbin Zhu, MD, Haibo Zhang, MD, PhD
at repair for ALCAPA with impaired preoperative left
ventricular function is associated with suboptimal
Anomalous left coronary artery from the pulmonary
artery—Time is of the essence
H. Stephens, MD, PhD, Joseph A. Dearani, MD
Early diagnosis of anomalous left
coronary artery from the pulmonary artery with
immediate surgery has the best early and late
Why the difference?
There is a dramatic difference in
outcomes for children with ALCAPA when comparing
the results from Shanghai Children's with centers
from North America. What accounts for this?
ANOMALOUS CORONARY ARTERY FEATURED VIDEO
Surgical repair for anomalous left
coronary artery (LCA) from the pulmonary artery by
coronary reimplantation technique.
artery obstruction following surgical repair of
congenital heart disease
Michael P. Goldsmith, MD,
Catherine K. Allan, MD, Ryan Callahan, MD, Aditya K.
Kaza, MD, Douglas Y. Mah, MD, Joshua W. Salvin, MD,
MPH, Kimberlee Gauvreau, ScD, Diego Porras, MD
time to diagnosis and treatment of acute postoperative
coronary artery obstruction following surgical repair
of congenital heart disease is associated with adverse
A high index of suspicion for coronary problems after
congenital heart surgery is critical
A. Bacha, MD, Damien J. LaPar, MD
Coronary problems have to be
actively thought out and dealt with promptly in
cases of atypical postoperative course, even after
operations that did not involve the coronary
Time is muscle
Early detection of impaired
myocardial blood flow is crucial and should lower
the threshold for invasive diagnostic
Survival after coronary injury—it's about time
Abdullah, MD, Zohair Al-Halees, MD
Survival after postoperative
coronary artery obstruction for congenital heart
disease is dependent on timely recognition and
FONTAN: BASIC SCIENCE
implantation of 3-dimensional printed customized branched
tissue engineered vascular graft in a porcine model
Enoch Yeung, MBBS, Takahiro Inoue,
MD, PhD, Hiroshi Matsushita, MD, Justin Opfermann, MS,
Paige Mass, BS, Seda Aslan, MS, Jed Johnson, PhD, Kevin
Nelson, PhD, Byeol Kim, BS, Laura Olivieri, MD, Axel
Krieger, PhD, Narutoshi Hibino, MD, PhD
integrated virtual surgical planning and flow dynamic
profile optimization prove the feasibility of providing
an optimized anatomy and hemodynamic parameter of the
3D printed, customized vascular graft.
Something made from nothing—impressive, but will it
K. Woods, MD, PhD
An assessment of the potential
utility of tissue-engineered vascular grafts
requires longer-term follow-up.
Promise of personalized tissue-engineered vascular
grafts for congenital heart surgery
A new milestone has been achieved in
personalized congenital heart surgery.
FONTAN FEATURED VIDEO
Objectives and methodology of
optimization and in vivo implantation of the customized
branched tissue engineered vascular graft.
of hemodynamics is delayed in patients with a single
ventricle after pediatric heart transplantation
Elizabeth H. Stephens, MD, PhD,
Paul Tannous, MD, PhD, Michael C. Mongé, MD, Osama
Eltayeb, MD, Paul J. Devlin, MD, MSc, Carl L. Backer,
MD, Joseph M. Forbess, MD, MBA, Elfriede Pahl, MD
with a single ventricle (Glenn and Fontan) demonstrated
delayed normalization of hemodynamics after heart
transplant compared with patients with DCM, without
differences in survival.
How long until a new heart is a “normal” heart in
transplanted single-ventricle patients?
Baez Hernandez, MD, Ryan R. Davies, MD
Delayed normalization of
hemodynamics is common following transplantation
for failed single-ventricle palliation, but the
underlying mechanisms and the impact on graft
function and long-term outcomes are uncertain.
It isn't easy being single
Purifoy, MD, Iki Adachi, MD
Single-ventricle physiology presents
unique challenges before and after heart transplantation.
Stephens et al. describe delayed resolution of
abnormal hemodynamics post-transplant in these
The environment matters: The effects of passive
circulation are not quickly reversed by a change of
Thangappan, MD, David L.S. Morales, MD
Single-ventricle physiology creates
an environment that is challenging for a new heart
to normalize; however, with time, the effects left
behind by the passive circulation will eventually
in cerebral hemodynamics and changes with surgical
intervention in neonates with congenital heart disease
Henry H. Cheng, MD, Silvina L.
Ferradal, PhD, Rutvi Vyas, MS, Daniel Wigmore, BS,
Erica McDavitt, MS, Janet S. Soul, MDCM, Mari A.
Franceschini, PhD, Jane W. Newburger, MD, MPH, P. Ellen
with congenital heart disease (CHD) show altered
cerebral hemodynamics versus controls, most notably in
single-ventricle (SV) CHD. Neonates with TGA and SV may
compensate with increased oxygen extraction.
Casting near-infrared light on cerebral oxygen economy
in neonatal congenital heart disease
monitoring utilizing near infrared light may be
used to better understand cerebral oxygen supply
and demand relationships in neonatal congenital
The oxygen metabolism of the brain transparent
Desai, MD, Can Yerebakan, MD
Improved noninvasive monitoring of
perioperative brain metabolism in congenital heart
disease—are we going to know better how much we
Near-infrared technology continues to evolve, but the
holy grail remains elusive
A. Jonas, MD
Biomedical optical techniques
continue to evolve; however the holy grail of
intracellular cytochrome a,a3 measurement remains