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Cardiothoracic Surgery

Investigating a Minimally Invasive Alternative to Surgery for Transverse Aortic Arch Obstruction
 Investigating a Minimally Invasive Alternative to Surgery for Transverse Aortic Arch Obstruction 150 150 Erin Gregory
By: Erin Gregory

A new study evaluates the safety and efficacy of percutaneous balloon-expandable stents for transverse aortic arch obstruction, a form of congenital heart disease. A new study published in Circulation: Cardiovascular Interventions, conducted by Arash Salavitabar, MD, FSCAI, FPICS, FACC, FAAP, a congenital interventional cardiologist at Nationwide Children’s Hospital, and colleagues, evaluates the efficacy and safety…

Stem Cell Study Opens Door to Understanding Development of Rare Form of Congenital Heart Disease
 Stem Cell Study Opens Door to Understanding Development of Rare Form of Congenital Heart Disease 150 150 Pam Georgiana
By: Pam Georgiana

Researchers use induced pluripotent stem cell technology and single-cell genomics to pinpoint abnormal cell development in hypoplastic right heart syndrome. A rare form of hypoplastic right heart syndrome (HRHS), pulmonary atresia with intact ventricular septum (PA-IVS), occurs when the structures on the right side of the heart are malformed. Specifically, in PA-IVS, the pulmonary valve…

Increasing the Donor Pool for Young Children Waiting for Heart Transplants
 Increasing the Donor Pool for Young Children Waiting for Heart Transplants 150 150 Pam Georgiana
By: Pam Georgiana

The one-year survival rate following a pediatric heart transplant is over 90%, However, waitlist mortality in the United States for children remains high at 17%. Young and highly sensitized children typically experience longer waitlist times for a heart transplant, which increases their waitlist mortality. In response, doctors utilize various strategies to potentially increase the number…

Changing the Odds: Survival Trends in Children With Down Syndrome and Congenital Heart Defects
 Changing the Odds: Survival Trends in Children With Down Syndrome and Congenital Heart Defects 1024 683 Pam Georgiana
By: Pam Georgiana
Smiling baby with Down syndrome

About half of the children born with Down syndrome also have congenital heart defects (CHD). As a transplant cardiologist, Lydia K Wright, MD, wanted to learn if CHD was still the most significant mortality risk for these patients before age five. [1] “Our aim was to assess whether the survival rate of kids with Down…

Preemptive Stenting of the Left Pulmonary Artery During Surgery for Hypoplastic Left Heart Syndrome
 Preemptive Stenting of the Left Pulmonary Artery During Surgery for Hypoplastic Left Heart Syndrome 150 150 Lauren Dembeck
By: Lauren Dembeck

Perioperative stenting during the comprehensive stage 2 surgery does not negatively impact overall outcomes. However, Preemptive stenting has a survival advantage of babies relative to those who had reactionary stenting.   Each year, approximately 1,000 babies in the United States are born with one of the most common critical congenital heart defects—hypoplastic left heart syndrome.…

Tissue Engineering and Fetal Medicine: A New Frontier for Congenital Heart Disease
 Tissue Engineering and Fetal Medicine: A New Frontier for Congenital Heart Disease 1024 575 Abbie Miller
By: Abbie Miller
Fetus in utero receiving valvuloplasty

Procedures that utilize cardiac catheterization to improve fetal heart development are often successful, but they are not without risk. And even if they can successfully prevent the development of single ventricle disease, there is always ongoing heart valve disease (HVD). HVD may not be as life-threatening as single ventricle disease, but it requires lifelong care.…

The PROMISE Program Reduces Cardiac Arrests in High-Risk Patients
 The PROMISE Program Reduces Cardiac Arrests in High-Risk Patients 600 400 Mary Bates, PhD
By: Mary Bates, PhD

This proactive quality improvement initiative improved outcomes for high-risk pediatric cardiology patients undergoing cardiac intervention. Faculty within The Heart Center at Nationwide Children’s recently initiated proactive risk mitigation strategies to reduce post-procedural cardiac arrests in high-risk congenital heart patients. In a new paper, the team used quality improvement methodology to show that their efforts resulted…

Celebrating More Than 100 Heart Transplants — And a Host of Other Heart Program Achievements
 Celebrating More Than 100 Heart Transplants — And a Host of Other Heart Program Achievements 1024 746 Deipanjan Nandi, MD, MSc
By: Deipanjan Nandi, MD, MSc

Deipanjan Nandi, MD, MSc, shares an update about treating heart failure at Nationwide Children’s Hospital. From transplant to ventricular assist devices and pharmaceutical options, the patient-centered care offers innovative options for patients with heart failure.

First In Human
 First In Human 1024 752 Abbie Miller
By: Abbie Miller
Top-down view of heart valves

The Heart Center at Nationwide Children’s Hospital has a long history of helping to bring innovations from the lab to the patient. The latest, the Autus Valve, aims to improve care and outcomes for children with pulmonary valve disease. In December 2021, Mark Galantowicz, MD, cardiothoracic surgeon and director of The Heart Center at Nationwide…

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

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
By: 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…

Occurrence and Cost of Infections After Heart Transplant
 Occurrence and Cost of Infections After Heart Transplant 1024 683 Mary Bates, PhD
By: Mary Bates, PhD
Dr. Emily Hayes

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…

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 Miller
By: Abbie Miller

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…

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
By: 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…

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 Miller
By: Abbie Miller

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…

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
By: 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…

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
By: 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…

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
By: 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,…

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
By: 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…

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
By: 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…

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
By: 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,…

The National Mortality Rate for the Comprehensive Stage 2 Procedure
 The National Mortality Rate for the Comprehensive Stage 2 Procedure 1024 575 Jeb Phillips
By: 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”…

Building Heart Valves From Extracellular Matrix
 Building Heart Valves From Extracellular Matrix 150 150 Abbie Miller
By: Abbie Miller

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…

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
By: 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…

Family Focus Restructures Single Ventricle Care
 Family Focus Restructures Single Ventricle Care 150 150 Brianne Moore
By: 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…

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 Miller
By: Abbie Miller

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…

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

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
By: 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…

A New Use for Kangaroo Care
 A New Use for Kangaroo Care 150 150 Kevin Mayhood
By: 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…

The Transfusion Evolution
 The Transfusion Evolution 576 367 Abbie Miller
By: Abbie Miller

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…

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