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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Left ventricular retraining in
corrected transposition: Relationship between pressure
Mainwaring, MD, William L. Patrick, MD, Alisa
Arunamata, MD, Frandics Chan, MD, Beverley Newman, MD,
Tatiana R. Rosenblatt, BA, Komal Kamra, MD, Frank L.
ventricular (LV) retraining can be accomplished with a
high degree of success in patients with congenitally
corrected transposition of the great arteries, and
there is a predictable relationship between LV mass and
Commentary: No pain no
gain—what is the best retraining pathway for patients
with corrected transposition?
M. Chen, MD
Better characterization of the
relationship between changes in LV mass and
pressure for patients with corrected transposition
who undergo pulmonary artery banding may help
determine optimal candidacy for double-switch
The utility of aortic valve
leaflet reconstruction techniques in children and young
Luke M. Wiggins, MD,
Branko Mimic, MD, PhD, Richard Issitt, PhD, Slobodan
Ilic, MD, PhD, Beatrice Bonello, MD, Jan Marek, MD,
Martin Kostolny, MD
leaflet reconstruction techniques may offer a valuable
alternative in children and young adults with aortic
Commentary: Are pediatric
aortic leaflet reconstructions a long run for a short
slide or a home run?
Eckhauser, MD, MS
Aortic leaflet reconstructions in
children provide acceptable hemodynamics and
midterm outcomes and should be considered as a
potential therapeutic option in children with
aortic valve disease.
Commentary: Aortic valve
reconstruction and the Ozaki procedure in
children—Finding the best fit
Shashidharan, MD, Paul Chai, MD
Aortic valve repair can have
acceptable short-term results. Effective patient
selection will yield optimal results.
Commentary: Continue to
imitate the nature: We are getting closer
Tricuspidalization for aortic valve
reconstruction in young patients works. Keep a
close eye on the long-term outcome.
AORTIC VALVE FEATURED VIDEO
leaflet repair in a 6-year-old child with a bicuspid
Secondary repair of incompetent
pulmonary valves after previous surgery or intervention:
Patient selection and outcomes
Gregory T. Adamson,
MD, Doff B. McElhinney, MD, George Lui, MD, Alison K.
Meadows, MD, PhD, Joseph Rigdon, PhD, Frank L. Hanley,
MD, Shiraz A. Maskatia, MD
pulmonary valve repair is durable in patients with
chronic regurgitation following surgery for pulmonary
outflow tract hypoplasia. Valve leaflet measurements
identify candidates for repair.
Commentary: (1) Spare the
valve; (2) sacrifice the valve; or (3) park valve
rudiments in situ, as growable inventory, for future
P. Bichell, MD
Reconstitution of a functional
pulmonary valve after a transannular repair is
feasible for some. Whether more leaflets suitable
for secondary repair can be cultivated by a
thoughtful primary repair remains an open question.
Commentary: Management of
late pulmonary regurgitation: Moving from certain
palliation toward potential cure
B. Clark, MD
In the setting of favorable leaflet
anatomy, secondary pulmonary valve repair may
provide a living, durable valve at the pulmonary
position and may offer a long-term cure in selected
DOUBLE OUTLET RIGHT VENTRICLE
Biventricular repair of
double-outlet right ventricle with noncommitted
ventricular septal defect using intraventricular conduit
Ting Lu, MD, Jia Li,
MD, PhD, Jianguo Hu, MD, PhD, Can Huang, MD, Ling Tan,
MD, Qin Wu, MD, Zhongshi Wu, MD, PhD
technique using an intraventricular conduit to connect
the VSD to the aorta in biventricular repair of
DORVncVSD in patients aged more than 2 years had lower
mortality and morbidity compared with other techniques.
conduit repair for double-outlet right ventricle with
noncommitted ventricular septal defect—How bright is
the light at the end of the tunnel?
Jaggers, MD, Matthew Stone, MD, PhD
DORV with NC-VSD continues to pose
surgical challenges. Risk of late LVOTO persists.
Midterm results of intraventricular conduit repair
are favorable. But is it the light at the end of
Commentary: Another technique
for biventricular repair of double-outlet right
ventricle with noncommitted ventricular septal defect
This new technique of using an
intraventricular conduit to repair DORV
noncommitted VSD could be indicated in select
cases. Longer follow-up is needed to evaluate risk
of late subaortic obstruction.
NEUROPROTECTION: BASIC SCIENCE
A novel target to reduce
microglial inflammation and neuronal damage after deep
hypothermic circulatory arrest
Mingyue Liu, MD, PhD,
Yongnan Li, MD, PhD, Sizhe Gao, PhD, Shujie Yan, MD,
Qiaoni Zhang, MD, PhD, Gang Liu, MD, Bingyang Ji, MD,
increased in the brain during DHCA, and the inhibition
of CIRP induced a powerful neuroprotection effect by
alleviating microglia activation, which might be
mediated through Brd2-NF-κB pathway.
Commentary: A therapeutic
Jedi mind trick: A neuroprotective target to counteract
deep hypothermic circulatory arrest
D. Andersen, MD, Mohammed K. Alsarraj, BS, Joseph W.
Turek, MD, PhD
A neuroprotective strategy blocking
CIRP shows promise in a rat model of deep
hypothermic circulatory arrest.
Commentary: The brain's
response to temperature stress involves shock proteins,
RNA-binding proteins and microglia—Should cardiac
A. Ferraris, MD, PhD
Responses to cold stress in the
central nervous system involve microglia and
multiple proinflammatory mediators. Limiting harm
from these mediators provides optimal DHCA-related
Commentary: U-CIRP-ing the
neurological effects of deep hypothermic circulatory
Sorabella, MD, Ming-Sing Si, MD
A new study reveals the role of CIRP
in DHCA and neurological injury.
CARDIAC REGENERATION: BASIC SCIENCE
Neonatal heart regeneration:
Moving from phenomenology to regenerative medicine
Hesham A. Sadek, MD,
PhD, Enzo R. Porrello, PhD
mammalian heart retains a transient capacity for
regeneration for a short period after birth. A recent
study suggests that thyroid hormone governs the
developmental loss of regenerative capacity.
Commentary: Harnessing the
regenerative potential of the human heart
Mazine, MD, MSc
Understanding the hormonal
mechanisms that control cardiac regenerative
capacity is essential to develop cardiac
rejuvenation and stem-cell based therapies.
Commentary: Alas, we are not
T. Ryan, MD, Todd K. Rosengart, MD
Leveraging intrinsic cardiomyocyte
repair mechanisms may allow for restoration of
myocardial function in heart failure, but extensive
further preclinical validation of these strategies