The following is a collection of
featured congenital cardiac articles in press 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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HYPOPLASTIC LEFT HEART SYNDROME
Autologous stem cell therapy for
hypoplastic left heart syndrome: Safety and feasibility
of intraoperative intramyocardial injections
Harold M. Burkhart, MD, Muhammad
Yasir Qureshi, MBBS, Joseph W. Rossano, MD, Susana
Cantero Peral, MD, Patrick W. O'Leary, MD, Matthew
Hathcock, MS, Walter Kremers, PhD, Timothy J. Nelson,
MD, PhD the Wanek HLHS Consortium Clinical Pipeline
1 clinical trial showed that delivering autologous
umbilical cord blood-derived mononuclear cells directly
into the right ventricle myocardium during planned
stage II surgical palliation was safe and feasible.
Myocardial regeneration with stem cells—Hope was never
Desai, MD, Lok Sinha, MD, Can Yerebakan, MD
Regenerative strategies bear the
potential to become a sustained part of the
surgical and medical management for congenital
heart disease in the future.
Cross my heart and stick a needle in it—I hope to live
K. Woods, MD, PhD
Epicardial injection of cord
blood–derived cells does not appear to be
associated with adverse events.
Cavopulmonary assist: Long-term reversal
of the Fontan paradox
Mark D. Rodefeld, MD, Alison
Marsden, PhD, Richard Figliola, PhD, Travis Jonas, BS,
Michael Neary, MS, Guruprasad A. Giridharan, PhD
implantable blood pump that can safely and reliably
reverse the Fontan paradox for the long term may enable
a physiologically curative strategy for
single-ventricle heart disease.
Cavopulmonary assist: Closing in on the white whale of
D. Andersen, MD, Sonya Kirmani, MD, Joseph W. Turek,
A novel mechanical impeller designed
specifically for subpulmonary support of the Fontan
circulation might revolutionize the care of
single-ventricle heart disease.
The future fourth stage of single-ventricle palliation
With continued technologic
advancements, it is likely that mechanical
circulatory support of the Fontan circulation will
become the fourth stage of single-ventricle
Subpulmonary pump in Fontan circulation: Can it be a
breakthrough in treatment of the single ventricle?
Maeda, MD, PhD
Optimization of Fontan has reached a
plateau and major modification might not be
expected in the near future. It might be time to
move on to the next step, which is adding energy
source from a mechanical device.
Video 1 Legend: Primary (external)
flow path. With an open static circuit, flow is induced
by the pump. Yellow and blue contrast represent systemic
venous inflow. The green outflow represents left and
right pulmonary arterial flow. Mixing indicates
symmetric hepatic factor distribution.
Video 2 Legend:Secondary
(internal) flow path. With an open static circuit, flow
is induced by the pump. Contrast injection flows
selectively through the internal flow path, with
dispersion of outflow at the equatorial midline.
Internal path flow is essential to pump function for
heat dissipation, for bearing flushing, and to reduce
risk of recirculation, stasis, and thrombosis.
Time for evidence-based, standardized
donor size matching for pediatric heart transplantation
Kyle W. Riggs, MD, Courtney M.
Giannini, BS, Nicholas Szugye, MD, Jason Woods, PhD,
Clifford Chin, MD, Ryan A. Moore, MD, David L.S.
Morales, MD, Farhan Zafar, MD
great variation of acceptable donor-tocandidate weight
ratio in pediatric heart transplant. A higher ratio
benefits critically ill children but uniformity in
listing practices should be sought.
Improving donor size matching in pediatric heart
transplantation—Moving beyond body weight
Maeda, MD, PhD, John C. Dykes, MD
Body weight alone is a poor marker
for donor-candidate size matching in pediatric
heart transplantation. Alternative methods of
size-matching are needed to maximize donor
Is donor acceptance a bigger problem than donor
availability? Time for a realistic look
D. St Louis, MD, Mark Plunkett, MD
Outcomes after heart transplantation
have improved in the pediatric population. Refusal
of “adequate” organs for unproven reasons may have
a tremendous effect on donor availability.