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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Low preoperative superior vena
cava blood flow predicts bidirectional cavopulmonary
Shuhua Luo, MD, PhD,
Maruti Haranal, M Ch, Mimi Xiaoming Deng, BScH, Jaymie
Varenbut, BScH, Kyle Runeckles, MSc, Chun-Po Steve Fan,
PhD, Mike Seed, MD, Glen S. Van Arsdell, MD, Osami
Honjo, MD, PhD
SVC blood flow predicted post BCPS physiology and
clinical outcome better than other anatomic and
physiologic markers. Lower SVC blood flow was
associated with worse BCPS takedown-free survival.
Commentary: Vis a tergo—a
push from behind—is of paramount importance for the
optimal function of a bidirectional cavopulmonary shunt
Vis a tergo is a prerequisite for
the optimal function of a bidirectional
Commentary: When is a
bidirectional cavopulmonary shunt a bad idea?
Proceed with caution when cardiac
magnetic resonance imaging–derived
pre–bidirectional cavopulmonary shunt superior vena
cava blood flow is low. The “conventional” staging
sequence of palliation for a functional single
ventricle may be inappropriate in this setting.
Cone versus conventional repair
for Ebstein's anomaly
Melchior Burri, MD,
Karim Mrad Agua, MD, Julie Cleuziou, MD, PhD, Elisabeth
Beran, MD, Nicole Nagdyman, MD, PhD, Andreas Kühn, MD,
PhD, Johannes Amadeus Ziegelmueller, MD, Peter Ewert,
MD, PhD, Jose Pedro Da Silva, MD, Rüdiger Lange, MD,
repair provided a higher rate of successful repair and
a lower incidence of moderate or greater recurrent
insufficiency compared with former repair procedures.
Commentary: Is the cone a
Bacha, MD, FACS
The cone procedure has been
confirmed to be superior to other repairs for
Ebstein's anomaly. It is a difficult operation that
is rarely done. Effect on right ventricle function
and long-term survival remains unknown.
Commentary: Aristotle, the
truth, and cone reconstruction
M. Overman, MD
Emergence of the cone repair is a
milestone in the surgical treatment of Ebstein
anomaly. Yet fulfillment of its promise requires
more accumulated experience and long-term outcome
Commentary: Should the cone
repair be the only option to consider for all patients
with Ebstein's anomaly? Definitely not
Kalfa, MD, PhD
The cone repair dramatically
improved the short-term and mid-term outcomes for
patients with Ebstein's anomaly but a lot still
needs to be learned on long-term outcomes and
repair performed in a 53-year-old woman who presented
with severe TR.
Broviac catheters: Cost-effective perioperative central
venous access in infants undergoing cardiac surgery
Muhammad Owais Abdul
Ghani, MBBS, Muhammad Aanish Raees, MBBS, Alan Ruigang
Tang, BA, Dhivyaa Anandan, BA, Chevis N. Shannon, MBA,
MPH, DrPh, David P. Bichell, MD
with TBCs have fewer peripheral lines and imaging
procedures, and incur lower costs when compared with
traditional transthoracic or peripherally inserted
Commentary: Central venous
access in congenital heart surgery: Is it time for
surgeons to toe (and place) the line?
I. Sherwin, MD, Veerajalandhar Allareddy, MD,
Nicholas D. Andersen, MD
transdiaphragmatic tunneled Broviac catheter is an
innovative and less expensive alternative to
peripherally inserted central catheters in infants
undergoing cardiac surgery.
Transdiaphragmatic tunneled Broviac catheters: How
small ripples can make big waves
N. Kavarana, MD, FACS
Transdiaphragmatic tunneled Broviac
catheters provide a cost-effective, reliable, and
durable method for perioperative central venous
access during pediatric cardiac surgery.
race/ethnicity, illness severity, and mortality in
children undergoing cardiac surgery
Yuen Lie Tjoeng, MD,
MS, Kathy Jenkins, MD, MPH, Jason F. Deen, MD, Titus
Chan, MD, MS, MPP
American race is associated with higher odds of death
after congenital heart surgery, mediated by severity of
illness. Improving pre- and intraoperative factors may
improve this disparity.
Commentary: Ode to the
editorial process: Health care disparities unmasked
Jayaram, MD, MSB, Brett R. Anderson, MD, MBA, MS,
Tara Karamlou, MD, MSc
Iterative evolution of truth:
Highlighting the importance of associations between
illness severity and socioeconomic/race factors is
a critical step forward.
Commentary: Focusing the lens
on racial disparities in congenital heart surgery
D. Andersen, MD, Joseph W. Turek, MD, PhD
Racial disparities in congenital
heart surgery persist and appear to be driven
largely by preoperative illness severity.