Congenital: Hypoplastic Left Heart Syndrome
Hybrid strategy in neonates with ductal-dependent systemic circulation and multiple risk factors
The study objective was to analyze outcomes of the hybrid strategy for ductal-dependent systemic circulation consisting of bilateral pulmonary artery banding with or without ductal stenting followed by delayed Norwood-type palliation or comprehensive stage II operation in high-risk neonates.Combined Norwood and cavopulmonary shunt as the first palliation in late presenters with hypoplastic left heart syndrome and single-ventricle lesions
A primary cavopulmonary shunt as a component of the initial Norwood palliation could be an option in patients with hypoplastic left heart syndrome and single-ventricle lesions. We present our initial experience with this approach in carefully selected patients with unrestricted pulmonary blood flow and low pulmonary vascular resistance.COVID-19 as a confounding factor in a child submitted to staged surgical palliation of hypoplastic left heart syndrome: One of the first reports of SARS-CoV-2 infection in patients with congenital heart disease
In December 2019, in the province of Wuhan, China, authorities identified an outbreak of pneumonia caused by a novel coronavirus, colloquially referred at COVID-19. The virus has now spread worldwide, reaching pandemic proportions.1 Although adult patients with cardiovascular comorbidities are at increased risk of progressing with the severe form of the disease,2 it is not known whether the same holds true for children with congenital heart disease (CHD). Furthermore, both the incidence of infection and severity of disease seem to be much lower in children than in adults.Flow disturbances and the development of endocardial fibroelastosis
Endothelial-to-mesenchymal transition (EndMT) has been identified as the underlying mechanism of endocardial fibroelastosis (EFE) formation. The purpose of this study was to determine whether hemodynamic alterations due to valvar defects promote EndMT and whether age-specific structural changes affect ventricular diastolic compliance despite extensive surgical resection of EFE tissue.The interannular bridge: A new technique for the management of tricuspid regurgitation in hypoplastic left heart syndrome
For patients with hypoplastic left heart syndrome (HLHS), it is essential to control moderate to severe tricuspid regurgitation (TR) so that the Norwood procedure can be tolerated. Because of the vulnerability and future growth potential of the valve leaflet, it is difficult to adopt a conventional procedure for immobilizing the leaflets and annulus. We report here a case in which we used the interannular bridge technique to control central TR in an infant with HLHS who had undergone the Norwood procedure.Autologous stem cell therapy for hypoplastic left heart syndrome: Safety and feasibility of intraoperative intramyocardial injections
Staged surgical palliation for hypoplastic left heart syndrome results in an increased workload on the right ventricle serving as the systemic ventricle. Concerns for cardiac dysfunction and long-term heart failure have generated interest in first-in-infant, cell-based therapies as an additional surgical treatment modality.Outcomes related to immediate extubation after stage 1 Norwood palliation for hypoplastic left heart syndrome
Immediate extubation may have outcome benefits when judiciously instituted after neonatal congenital cardiac surgery. We sought to evaluate the outcomes of immediate extubation specifically in neonates undergoing stage 1 Norwood palliation of hypoplastic left heart syndrome.Pathology of valved venous homografts used as right ventricle-to-pulmonary artery conduits in congenital heart disease surgery
Although valved venous homografts (VVHs) are used for establishing right ventricle-to-pulmonary artery continuity in some complex heart defects, the tissue changes that occur in situ have not been described. We review the gross and microscopic changes observed in explanted VVH conduits and their effects on functionality.
