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.
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PULMONARY VALVE
Long-term durability of bioprosthetic valves in pulmonary position: Pericardial versus porcine valves
Jae Gun Kwak, MD, PhD, Ji Hyun Bang, MD, Sungkyu Cho, MD, PhD, Eung Re Kim, MD, Beatrice Chia-Hui Shih, MD, Chang-Ha lee, MD, PhD, Woong-Han Kim, MD, PhD
We compared long-term results of 2 different types of bioprosthetic valves, porcine and pericardial valve, in pulmonary portion in the patients with congenital heart diseases.
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Commentary: Looking for the ideal pulmonary valve
Gianluigi Perri, MD, PhD, Lorenzo Galletti, MD, PhD
The long-term performance of bioprostheses in the pulmonary position is limited, especially when implanted in younger patients. Porcine valves seem to have a slight advantage in term of valve deterioration, but no definitive data are available. A randomized prospective study is needed to compare the results between different types of bioprostheses at the pulmonary position.
Commentary: Finding the best pulmonary bioprosthetic valve: An unobtainable target?
Reilly D. Hobbs, MD, Ming-Sing Si, MD
Determining the best pulmonary bioprosthetic valve is difficult, if not impossible.
Commentary: The conundrum of pulmonary valve substitutes
Lucia Cocomello, MD, Massimo Caputo, MD, FRCS
Considering their significant tissue degeneration at follow-up, is it time to reverse the trend toward using bioprosthetic valves for pulmonary valve replacement in young patients for the next decade?
VENTRICULAR SEPTAL DEFECT
Visualization and quantification of the atrioventricular conduction axis in hearts with ventricular septal defect using phase contrast computed tomography
Shuichi Yoshitake, MD, Yukihiro Kaneko, MD, PhD, Kiyozo Morita, MD, PhD, Masato Hoshino, PhD, Yoshihiro Oshima, MD, PhD, Masashi Takahashi, MD, PhD, Robert H. Anderson, MD, PhD, on behalf of theSPring 8 Cardiovascular Structure Analyzing Research Group
Use of phase contrast computed tomography revealed the precise location of the atrioventricular conduction axis in the setting of ventricular septal defect, providing information that should help surgeons repair such defects without producing any conduction disturbance.
Commentary: Advanced imaging technologies may help to eliminate the need for pacemaker implantation following repair of ventricular septal defect
Thierry Carrel, MD
New imaging and 3D reconstructive technologies may help to avoid pacemaker implantation following repair of complex congenital malformations associated with ventricular septal defect.
Commentary: Validation of our understanding of atrioventricular conduction anatomy using phase-contrast computed tomography
Bahaaldin Alsoufi, MD
Phase-contrast computed tomography validates our existing knowledge of atrioventricular conduction relationship to ventricular septal defects based on previous histologic studies.
Commentary: What is invisible to the eye could be seen through the heart: How advancements to the visualization of the conduction tissue can improve surgical and electrophysiology procedures
Nicholas H. Von Bergen, MD, Petros V. Anagnostopoulos, MD, MBA
A novel imaging technology provides detailed anatomic information on the location of the cardiac conduction system and creates exciting possibilities for the future.
FEATURE VIDEO
The video shows the reconstructed block created by 3-dimensional software simulating surgical closure of the defect. We are able to know the relationship between the hypothetical suture line and the conduction axis.
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CONGENITAL HEART SURGERY
Three-dimensional printing in congenital cardiac surgery—Now and the future
Glen S. Van Arsdell, MD, Nabil Hussein, MBChB, Shi-Joon Yoo, MD
3D printing is changing the landscape for surgical training and surgical planning in complex congenital heart disease.
Commentary: Three-dimensional printing in congenital cardiac surgery: The future is now
Harold M. Burkhart, MD, Arshid Mir, MD
Three-dimensional printing is rapidly evolving and the time to incorporate it into congenital cardiac surgical training has arrived.
CEREBRAL PROTECTION
Benefits of progesterone on brain immaturity and white matter injury induced by chronic hypoxia in neonatal rats
Gang Liu, M.D, Bowen Shi, MD, Yichen Yan, MD, Junrong Huang, MD, Hongwei Mu, MD, Cong Li, MD, Huiwen Chen, MD PhD, Zhongqun Zhu, MD PhD
Chronic hypoxia led to brain immaturity and WM injury by inducing microglial activation. The benefits of progesterone to the brain were achieved by switching microglial activation state from M1 to M2.
Commentary: Progesterone the protector?
Matthew C. Henn, MD, Marc R. Moon, MD
Progesterone is a promising therapy for neuroprotection in states of hypoxia in small animals, but further studies in man are needed to confirm its clinical applicability to cyanotic heart disease.
Commentary: It's not that we can't find a solution, it's that we can't isolate the problem
Underlying causes of neurologic deficits in neonates with congenital heart disease are still not defined and likely multifactorial, accumulative, and synergetic.
PERIOPERATIVE MANAGEMENT
COVID-19: Crisis management in congenital heart surgery
Elizabeth H. Stephens, MD, PhD, Joseph A. Dearani, MD, Kristine J. Guleserian, MD, David M. Overman, MD, James S. Tweddell, MD, Carl L. Backer, MD, Jennifer C. Romano, MD, MS, Emile Bacha, MD
As our specialty faces unprecedented challenges to the delivery of care to congenital heart disease patients secondary to the COVID-19 pandemic, we offer guidance for crisis management.