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
Our phase 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.
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Commentary: Myocardial regeneration with stem cells—Hope was never the problem!
Manan 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.
Commentary: Cross my heart and stick a needle in it—I hope to live
Ronald K. Woods, MD, PhD
Epicardial injection of cord blood–derived cells does not appear to be associated with adverse events.
FONTAN
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
An 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.
Commentary: Cavopulmonary assist: Closing in on the white whale of single-ventricle palliation
Nicholas D. Andersen, MD, Sonya Kirmani, MD, Joseph W. Turek, MD, PhD
A novel mechanical impeller designed specifically for subpulmonary support of the Fontan circulation might revolutionize the care of single-ventricle heart disease.
Commentary: The future fourth stage of single-ventricle palliation
Ryan R. Davies, MD
With continued technologic advancements, it is likely that mechanical circulatory support of the Fontan circulation will become the fourth stage of single-ventricle palliation.
Commentary: Subpulmonary pump in Fontan circulation: Can it be a breakthrough in treatment of the single ventricle?
Katsuhide 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.
FEATURED VIDEOS
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.
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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.
TRANSPLANTATION
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
There is 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.
Commentary: Improving donor size matching in pediatric heart transplantation—Moving beyond body weight
Katsuhide 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 utilization.
Commentary: Is donor acceptance a bigger problem than donor availability? Time for a realistic look
James 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.