Contemporary outcomes for functional single ventricle with total anomalous pulmonary venous connection.

Objective: In 2004, we reported improved early survival for patients with functional single ventricle anatomy and total anomalous pulmonary venous connection. This study sought to discover if outcomes have been ameliorated in the contemporary era.

Methods: This was a single-center review of patients with single ventricle anatomy and total anomalous pulmonary venous connection who were admitted from 1984 to 2021.

A novel home- and community-based mobile outreach detoxification service for individuals identifying problematic substance use: implementation and program evaluation.

Setting: Substance use remains a pervasive public health issue throughout Canada, exerting substantial economic, social, and political pressure on health care systems, while impacting lives of affected individuals. The advent of COVID-19 has been doubly perilous; it restricts existing programming, while exacting a worsening toll on mental health and substance use fronts across the demographic landscape.

Intervention: In response to the crisis, the Mobile Withdrawal Management Service (MWMS) was established in 2019 through a Winnipeg-based community health centre.

Transition to Ductal Stenting for Single Ventricle Patients Led to Improved Survival: An Institutional Case Series.

Background: The use of systemic-to-pulmonary shunts (SPS) in neonates with single ventricle heart defects and ductal-dependent pulmonary blood flow (ddPBF) was historically associated with high morbidity and mortality at our center. As a result, we transitioned to the preferential use of ductus arteriosus stents (DS) when feasible. This report describes our initial results with this strategy.

Implantation of a HeartMate 3 ventricular assist device in a 21-kg pediatric patient with Fontan failure.

Aims: The HeartMate 3 (HM3) ventricular assist device (VAD) is gaining popularity in adults due to a favorable risk profile. However, reports of HM3 use in children are limited, potentially due to concerns with device size.

Materials And Methods: Here we report the successful use of an HM3-VAD as a bridge to transplantation in a 21 kg (BSA 0.

The Evolving Surgical Burden of Fontan Failure: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.

Background: Fontan failure often requires surgical therapy in the form of Fontan revision or heart transplantation. We sought to characterize national trends in the surgical burden of Fontan failure and identify risk factors for adverse outcomes.

Methods: Fontan patients undergoing Fontan revision or transplantation from January 2010 to June 2018 were included.

Survival, Morbidities, and Developmental Outcomes among Low Birth Weight Infants with Congenital Heart Defects.

Objective: Prematurity and low birth weight (LBW) are risk factors for increased morbidity and mortality in infants with congenital heart defects (CHDs). We sought to describe survival, inhospital morbidities, and 2-year neurodevelopmental follow-up in LBW infants with CHD.

Study Design: We included infants with birth weight (BW) <2,500 g diagnosed with CHD (except isolated patent ductus arteriosus) admitted January 2013 to March 2016 to a single level-IV academic neonatal intensive care unit.

Initial Application of a Bicuspid Aortic Annuloplasty Ring in Pediatric Cardiac Surgery.

Aortic stenosis and aortic insufficiency (AI) are common valvular conditions that may necessitate repair or replacement of the aortic valve. Aortic valve replacement is associated with higher long-term complications and thus, a consistent, reliable method of repair is needed. This is especially true in the pediatric population where lifelong anticoagulation and development of recurrent aortic stenosisor aortic insufficiency are especially problematic.

Proteomic Analysis of Infants Undergoing Cardiopulmonary Bypass Using Contemporary Ontological Tools.

Background: Cardiopulmonary bypass (CPB) is essential for the repair of many congenital cardiac defects in infants but is associated with significant derangements in hemostasis and systemic inflammation. As a result, hemorrhagic complications and thrombosis are major challenges in the management of children requiring CPB or extracorporeal membrane oxygenation. Conventional clinical laboratory tests capture individual hemostatic derangements (low platelets, elevated fibrinogen) but fail to describe the complex, overlapping interactions among the various components of coagulation, including cellular interactions, contact activation, fibrinolysis, and inflammation.

Recent Advances in Congenital Heart Surgery: Alternative Perfusion Strategies for Infant Aortic Arch Repair.

Purpose Of Review: This paper will discuss current cannulation strategies for infant aortic arch repair and compare them to more traditionally used techniques.

Recent Findings: Aortic arch reconstruction in infants has traditionally involved deep hypothermic circulatory arrest which results in total body ischemia. This has been associated with an increased risk of morbidity including bleeding, renal dysfunction, and neurologic injury.

Double-Blind, Randomized, Placebo-Controlled Trial Comparing the Effects of Antithrombin Versus Placebo on the Coagulation System in Infants with Low Antithrombin Undergoing Congenital Cardiac Surgery.

Objectives: To determine whether precardiopulmonary bypass (CPB) normalization of antithrombin levels in infants to 100% improves heparin sensitivity and anticoagulation during CPB and has beneficial effects into the postoperative period.

Design: Randomized, double-blinded, placebo-controlled prospective study.

Setting: Multicenter study performed in 2 academic hospitals.

Clinical pharmacology considerations for children supported with ventricular assist devices.

The ventricular assist device is being increasingly used as a "bridge-to-transplant" option in children with heart failure who have failed medical management. Care for this medically complex population must be optimised, including through concomitant pharmacotherapy. Pharmacokinetic/pharmacodynamic alterations affecting pharmacotherapy are increasingly discovered in children supported with extracorporeal membrane oxygenation, another form of mechanical circulatory support.

Electrodeposition of tin nanowires from a dichloromethane based electrolyte.

Tin was electrodeposited from a dichloromethane-based electrolyte at ambient temperature into gold coated anodic alumina membranes with nanoscale pores. The tin nanowires are mainly 〈200〉 aligned, together with some 〈101〉 and 〈301〉 wires. Partial filling of the structure and a distribution of wire lengths was found.

Exploration of the Smallest Diameter Tin Nanowires Achievable with Electrodeposition: Sub 7 nm Sn Nanowires Produced by Electrodeposition from a Supercritical Fluid.

Electrodeposition of Sn from supercritical difluoromethane has been performed into anodic alumina templates with pores down to 3 nm in diameter and into mesoporous silica templates with pores of diameter 1.5 nm. Optimized deposits have been characterized using X-ray diffraction, scanning electron microscopy, and scanning transmission electron microscopy (bright field, high-angle annular dark field, and energy-dispersive X-ray elemental mapping).

HLA-A, B, DRB1, DQA1, DQB1 alleles and haplotype frequencies in Dene and Cree cohorts in Manitoba, Canada.

Background: First Nations in the Canadian province of Manitoba have disproportionately high rates of epidemic and endemic TB. Gene polymorphisms that modulate HLA Class I and II antigens are among the risk markers for TB, along with other biologic, and social determinants of health. HLA-A, B, DRB1, DQA1, DQB1 were typed in two Manitoba First Nation indigenous groups to identify and compare the frequency of gene polymorphisms that may influence susceptibility or resistance to TB.

Comparison of right ventricle-pulmonary artery shunt position in the Single Ventricle Reconstruction trial.

Objective: Placement of a right ventricle-pulmonary artery shunt to the left or right of the neoaorta may influence reinterventions, pulmonary artery development, and survival after the Norwood procedure because of differences in shunt and pulmonary artery geometry and blood flow.

Methods: We analyzed the Pediatric Heart Network Single Ventricle Reconstruction Trial public use dataset. Comparisons were made between patients who received a left- or right-sided right ventricle-pulmonary artery shunt during the Norwood procedure in both the overall (n = 274) and the propensity score-matched (67 pairs) patient cohorts.