The following is a collection of
featured congenital articles from the Journal of Thoracic and Cardiovascular
Surgery (JTCVS). To read the latest issue, or
browse the feature video library and other journal
highlights, please visit www.jtcvs.org.
Please add firstname.lastname@example.org to your
Safe Sender list.
ANOMOLOUS CORONARY ARTERY
Following Anomalous Aortic Origin of a Coronary Artery
Repair: A Congenital Heart Surgeons’ Society Study
Anusha Jegatheeswaran, MD PhD,
Paul J. Devlin, MD MSc, William G. Williams, MD, Julie
A. Brothers, MD, Marshall L. Jacobs, MD, William M.
DeCampli, MD PhD, Craig E. Fleishman, MD, James K.
Kirklin, MD, Luc Mertens, MD PhD, Carlos M. Mery, MD
MPH, Silvana Molossi, MD PhD, Christopher A. Caldarone,
MD, Nabi Aghaei, Richard O. Lorber, MD, Brian W.
McCrindle, MD MPH
repair may relieve ischemia with low mortality, but can
result in important morbidity varying by
presentation/anatomy/repair. Avoiding commissural
manipulation may reduce risk of developing AI.
Surgery for an anomalous aortic origin of a coronary
artery: To do, or not to do? That is the question
S. Naimo, MD, Edward Buratto, MBBS, PhD, Igor E.
Konstantinov, MD, PhD, FRACS
The role of surgery, despite its low
risk, in asymptomatic patients with AAOCA is
No free lunch: What we talk about when we talk about
anomalous aortic origin of a coronary artery
M. Chen, MD
Operations to repair AAOCA are not
without consequences, and these must be considered
in evaluating the risk/benefit ratio of
intervention versus observation.
I guess I'm just confused…isn't this information
D. Fraser Jr., MD
AAOCA is being diagnosed in many
people; some are symptomatic, but most are
asymptomatic. Many of these patients end up
undergoing cardiac surgery at a time where
indications for operation are not completely clear.
Are these operations safe? What are the current
complication rates? We really have to know, and the
data suggest reason for more attention.
vascular remodeling in pulmonary vein obstruction
Naoki Masaki, MD, PhD, Osamu
Adachi, MD, PhD, Shintaro Katahira, MD, PhD, Yuriko
Saiki, MD, PhD, Akira Horii, MD, PhD, Shunsuke
Kawamoto, MD, PhD, Yoshikatsu Saiki, MD, PhD
cells dedifferentiation and mTOR pathway activation may
be involved in progression of PVO. Externally applied
rapamycin-eluting films can transiently suppress PVO
Hands off the pulmonary veins!
Caldaroni, MD, Yves d’Udekem, MD, PhD
Careful handling of the pulmonary
veins is the key to reducing vascular remodeling,
and anti-proliferative agents may enhance the
success rate in the most vulnerable period.
The dam, the river, and the riverbank—Should we look at
pulmonary vein obstruction from a different
Lo Rito, MD
Pulmonary vein obstruction is a
lethal disease without effective therapy. We are
looking for new treatments, such as the rapamycin
patch, but we probably miss the overall picture to
Targeting neointimal lesions in pulmonary vein
stenosis: Fact or fiction?
D. Vanderlaan, MD, PhD
Neointimal formation is the hallmark
of PVS. Understanding the molecular mechanisms
underlying myofibroblast deposition will help
design effective novel therapies.
uncrossing and tracheobronchopexy corrects tracheal
compression and tracheobronchomalacia associated with
circumflex aortic arch
Ali Kamran, MD, Kevin G. Friedman,
MD, Russell W. Jennings, MD, Christopher W. Baird, MD
uncrossing without circulatory arrest and concomitant
tracheobronchopexy is effective in treating symptomatic
airway compression and tracheobronchomalacia associated
with circumflex aortic arch.
Circumflex aorta: Entering uncrossed territory
The aortic uncrossing operation
should be considered for vascular ring patients
with a circumflex aorta. There are innovative
technical strategies for this procedure.
Surgical management of persistent respiratory symptoms
after vascular ring division
Bryant III, MD
The aortic uncrossing procedure is
an effective adjunctive surgical technique to
address residual respiratory symptoms in patients
who have undergone repair of a circumflex aorta or
double aortic arch.
A long haul and a short slide?
E. Mitchell, MD
Aortic uncrossing, combined with
advanced tracheal procedures, might play an
important role when performed correctly and applied
Preoperative computed tomography
scan demonstrating right aortic arch and left
descending aorta passing behind the trachea and
esophagus, causing posterior compression.
monitoring and artificial intelligence: A bright future
in cardiothoracic surgery
David Kalfa, MD, PhD, Sunil
Agrawal, PhD, Nimrod Goldshtrom, MD, Damien LaPar, MD,
Emile Bacha, MD
learning and AI techniques have the potential to be
used in conjunction with wireless monitoring systems to
transform our specialty. Cardiothoracic surgeons should
not miss this opportunity.