Cardiothoracic Surgery

Stent Implantations Are an Option for Small Patients
Stent Implantations Are an Option for Small Patients 1024 670 Mary Bates, PhD

Stents that can be dilated to adult size are safe and effective for the treatment of coarctation of the aorta in young patients. Studies have demonstrated stent implantation is more effective and safer than balloon angioplasty for the treatment of coarctation of the aorta in adult and older pediatric patients. In smaller patients, however, particularly…

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Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients
Cylinder Mitral Valve Construct is a Safe and Durable Alternative for Young Patients 1024 752 Mary Bates, PhD
Top-down view of heart valves

The new technique could potentially reduce the number of lifetime surgeries required by these patients, researchers say. In a new study, researchers from Nationwide Children’s Hospital report that pediatric patients who underwent cylinder mitral valve construct, a new technique for replacing the mitral valve, had improved left ventricular function over time. In addition, there were…

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Occurrence and Cost of Infections After Heart Transplant
Occurrence and Cost of Infections After Heart Transplant 150 150 Mary Bates, PhD

Researchers identify risk factors, long-term outcomes of vaccine-preventable infections following heart transplantation in pediatric patients. Recently, a study using the Pediatric Health Information System (PHIS) database found that one in six pediatric solid organ transplant recipients were hospitalized with respiratory syncytial virus (RSV) or vaccine-preventable illness in the first five years after transplant. Within this…

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Incidence and Impact of Acute Kidney Injury in Patients With Hypoplastic Left Heart Syndrome
Incidence and Impact of Acute Kidney Injury in Patients With Hypoplastic Left Heart Syndrome 150 150 Abbie Roth

While incidence of severe kidney injury after surgery for hypoplastic left heart syndrome is low, it may be linked to increased 30-day mortality. Acute kidney injury – the abrupt decline of renal function – following pediatric heart surgery leads to worse outcomes, including increased mortality. The overall incidence of acute kidney injury (AKI) after pediatric…

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Transplant-Free Survival Among Children With Hypoplastic Left Heart Syndrome Undergoing Hybrid Palliation
Transplant-Free Survival Among Children With Hypoplastic Left Heart Syndrome Undergoing Hybrid Palliation 1024 683 Katie Brind'Amour, PhD, MS, CHES
Young child

The first long-term evaluation of kids with hypoplastic left heart syndrome undergoing hybrid palliation procedures finds transplant-free survival similar to that of the standard treatment at age 15 years. As one of the few teams in the world almost exclusively performing hybrid palliation surgery for babies with hypoplastic left heart syndrome (HLHS) and related congenital…

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From Expectant Parents to Advocates: One Family’s Journey With Hypoplastic Left Heart Syndrome
From Expectant Parents to Advocates: One Family’s Journey With Hypoplastic Left Heart Syndrome 1024 575 Abbie Roth

Mila’s parents wanted her to have the best chance at surviving her high-risk comprehensive stage 2 surgery – their journey led them to The Heart Center at Nationwide Children’s. Mid-way into their pregnancy, Jacob and Kayla went in for their 20-week ultrasound. “We were very excited to get into things like paint colors for our…

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Technical Aspects of Fetal Aortic Valvuloplasty Predict Success of the Procedure
Technical Aspects of Fetal Aortic Valvuloplasty Predict Success of the Procedure 1024 575 Mary Bates, PhD
Fetus in utero receiving valvuloplasty

The procedure is often successful but comes with significant risks to fetal health and life. Fetal aortic valvuloplasty (FAV) is a procedure performed mid-gestation in a subset of fetuses with aortic stenosis who would likely develop hypoplastic left heart syndrome with no intervention. Although often successful, it is a high-risk procedure that is associated with…

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Study Supports Expanded Use of Ventricular Assist Devices in Children With Complex Congenital Heart Disease
Study Supports Expanded Use of Ventricular Assist Devices in Children With Complex Congenital Heart Disease 150 150 JoAnna Pendergrass, DVM

New multicenter study shows that the HeartMate3 ventricular assist device is associated with low morbidity and adverse events in pediatric patients with complex CHD. Ventricular assist devices (VADs), such as the HeartMate3 (HM3) continuous-flow VAD, provide critical heart function support in patients with advanced heart failure. Although design improvements in VADs have reduced complication rates…

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For Some Fetuses With HLHS, One Follow-up Echocardiogram May Be Enough
For Some Fetuses With HLHS, One Follow-up Echocardiogram May Be Enough 1024 575 Kevin Mayhood

“Not every patient with hypoplastic left heart syndrome, also known as HLHS, is the same: there appears to be a high-risk group that has significant atrioventricular valve regurgitation, atrial septal restriction or other concerns; and a low-risk group that, on their first scan, has none of these comorbidities of the heart,” says Bernadette Richards, FASE,…

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When is Palliative Care Right for Families of Children With Single Ventricle Congenital Heart Defects?
When is Palliative Care Right for Families of Children With Single Ventricle Congenital Heart Defects? 150 150 Kevin Mayhood

Practitioners suggest involving a palliative care team early after diagnosis Single ventricle congenital heart defects (SV) disrupt critical blood flow and require a series of complex operations in order for a child to survive. As few as 80% of children born with SV live to age 1, 70% to age 20. Because of the high…

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Regular Physical Activities Tied to Improved Quality of Life in Adults With Fontan Circulation
Regular Physical Activities Tied to Improved Quality of Life in Adults With Fontan Circulation 150 150 Kevin Mayhood

Starting regular exercise in childhood can help lay the groundwork for greater health and quality of life, pediatric cardiologists suggest. Children and adults with Fontan circulation are at risk of a sedentary lifestyle. This is due in part to physicians who advise patients restrict exercise out of concern vigorous physical activity may contribute to venous…

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How do Babies With Single Ventricles Fare Between Stage 1 and 2 Hybrid Palliation?
How do Babies With Single Ventricles Fare Between Stage 1 and 2 Hybrid Palliation? 150 150 Katie Brind'Amour, PhD, MS, CHES
Are We Turning Away Too Many Pediatric Donor Hearts?
Are We Turning Away Too Many Pediatric Donor Hearts? 150 150 Katie Brind'Amour, PhD, MS, CHES

More than half of all pediatric donor hearts are declined for use each year, despite the fact that many children die waiting for a heart. But why? And what can be done about it?   As many as one in every four infants on the heart transplant list dies awaiting an organ. For older children,…

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The National Mortality Rate for the Comprehensive Stage 2 Procedure
The National Mortality Rate for the Comprehensive Stage 2 Procedure 1024 575 Jeb Phillips

A substantial overall U.S. rate, in contrast to the low rates reported by a few single centers such as Nationwide Children’s, shows room for improvement in handling the hybrid approach for left ventricular physiology. Most published outcomes data on the pediatric Comprehensive Stage 2 procedure come from the few institutions routinely using the “hybrid approach”…

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Building Heart Valves From Extracellular Matrix
Building Heart Valves From Extracellular Matrix 150 150 Abbie Roth

Physicians at Nationwide Children’s Hospital describe the use of an extracellular matrix cylindar valve in the mitral position. At The Heart Center at Nationwide Children’s, Patrick McConnell, MD, a pediatric cardiothoracic surgeon, is using an alternative to the traditional cadaveric, mechanical or biological replacement valve. In a recent case report published in Echocardiography, Dr. McConnell and his colleagues describe the…

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Dopamine: A Rescue Therapy for Fontan Patients With Protein-Losing Enteropathy?
Dopamine: A Rescue Therapy for Fontan Patients With Protein-Losing Enteropathy? 150 150 Jeb Phillips

Patients with quickly worsening PLE saw serum albumin levels stabilize after dopamine treatment. Patients who have undergone the Fontan procedure for single ventricle congenital heart disease do not often develop protein-losing enteropathy (PLE) – but those who do are at substantial risk of mortality and morbidity. Only heart transplant has been shown to alleviate PLE…

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Family Focus Restructures Single Ventricle Care
Family Focus Restructures Single Ventricle Care 150 150 Brianne Moore

Standardize, connected care in a multidisciplinary team environment aims to improve outcomes and quality of life for patients born with single ventricle heart anatomy. Children with single ventricle anatomy, one of the most harrowing of congenital heart defects, face unique challenges that require multiple procedures and hospital admissions to treat. In most institutions, each admittance…

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Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease
Taking Innovation to Heart: Next Gen Interventions in Heart Valve Disease 1024 575 Abbie Roth

From bioengineers to interventional cardiologists, molecular biologists to cardiothoracic surgeons, experts with diverse backgrounds are focusing on the problem of heart valve disease in children. Heart valve disease affects more than 5 million Americans. And while acquired disease in the adult population certainly accounts for much of this, children with heart valve disease face multiple…

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Balancing Immune Activation and Suppression After Cardiopulmonary Bypass
Balancing Immune Activation and Suppression After Cardiopulmonary Bypass 150 150 Mary Bates, PhD

Understanding how the immune system responds to CPB could dramatically impact postsurgical outcomes. Cardiopulmonary bypass (CPB) is a relatively routine procedure, generally with favorable outcomes. However, among the risks posed to patients is the over- or under-activation of the immune system following the surgery. Mark Hall, MD, FCCM, division chief of Critical Care at Nationwide Children’s Hospital,…

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ANH Preserves Platelet Count and Function Regardless of Storage Method and Time
ANH Preserves Platelet Count and Function Regardless of Storage Method and Time 150 150 Kevin Mayhood

Length of storage during cardiac surgeries appears to have no detrimental effects on blood. Across the United States, transfusions are standard in cardiac operating rooms, but at Nationwide Children’s Hospital, a practice geared toward limiting blood transfusion has been established and finely honed. According to a recent study from The Heart Center at Nationwide Children’s, more than…

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A New Use for Kangaroo Care
A New Use for Kangaroo Care 150 150 Kevin Mayhood

A parent’s touch reduces agitation, allows infants and toddlers to remain extubated after heart surgery. A small percentage of babies and young children who have undergone congenital cardiac surgery and early tracheal extubation are treated with a calming parent’s touch at Nationwide Children’s Hospital – a strategy that physicians have found works better in some…

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The Transfusion Evolution
The Transfusion Evolution 576 367 Abbie Roth

The first successful open heart surgery with cardiopulmonary bypass was performed in 1953, but it wasn’t until the 1970s that these surgeries began to have high success rates — due in large part to the availability of fresh whole blood transfusions. However, fresh whole blood is difficult to attain. In response, blood component transfusions became…

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InSight: A Window to the Heart
InSight: A Window to the Heart 720 530 Katie Brind'Amour, PhD, MS, CHES

Cardiac MRI for Hypoplastic Left Heart Syndrome Hypoplastic left heart syndrome (HLHS) is a potentially fatal congenital heart defect affecting blood flow. It requires multiple palliative surgeries, starting within the first week of life. Nationwide Children’s employs a hybrid surgical approach. Hybrid Stage I (not shown) Bilateral branch pulmonary bands are placed to restrict blood flow.…

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