Standard and Strain Measurements by Echocardiography Detect Early Overloaded Right Ventricular Dysfunction: Validation against Hemodynamic and Myocyte Contractility Changes in a Large Animal Model.

Background: Early detection of right ventricular (RV) failure is required to improve the management of patients with congenital heart diseases. The aim of this study was to validate echocardiography for the early detection of overloaded RV dysfunction, compared with hemodynamic and myocyte contractility assessment.

Methods: Using a porcine model reproducing repaired tetralogy of Fallot, RV function was evaluated over 4 months using standard echocardiography and speckle-tracking compared with hemodynamic parameters (conductance catheter).

Long-term outcomes of pulmonary arterial hypertension under specific drug therapy in Eisenmenger syndrome.

Background: The long-term effectiveness of pulmonary arterial hypertension-specific drug therapy (PAH-SDT) in Eisenmenger syndrome is controversial. We investigated short-term and long-term hemodynamic changes under PAH-SDT and their associations with outcomes in a bicentric cohort.

Methods: Over 20 years, we included 69 patients with congenital heart disease, an indexed pulmonary vascular resistance (PVRi) >8 WU·m, and 292 standardized catheterizations at baseline and after PAH-SDT initiation or intensification.

The mid-term outcome of primary open valvotomy for critical aortic stenosis in early infancy - a retrospective single center study over 18 years.

Background: The objective of this study was to examine early and long-term results of surgical aortic valvotomy in neonates and infants aged less than four months and to identify predictors of outcome.

Methods: Between August 1994 and April 2012, 83 consecutive patients younger than 4 months of age underwent open heart valvotomy for critical aortic stenosis in our institution. Median age was 17 days (range 0-111 days).

Long-term outcomes of the arterial switch operation for transposition of the great arteries and ventricular septal defect and/or aortic arch obstruction.

Objectives: Long-term outcomes after the arterial switch operation (ASO) for complex transposition of the great arteries (TGA) should be clarified.

Methods: A retrospective study was conducted in patients operated on between 1982 and 1998. Overall 220 postoperative survivors, 79.

Subaortic Area at Risk for Development of Obstruction After Surgical Repair of Atrioventricular Septal Defect: Myth or Reality?

Background: Morphology of the left ventricular outflow tract (LVOT) in atrioventricular septal defects (AVSDs) has been reported to be at risk for development of obstruction. The purpose of the present study was to identify the incidence, the risk factors, and the surgical outcomes of subaortic stenosis in repaired AVSDs.

Methods: Records of 427 consecutive patients who underwent anatomical repair for all types of AVSDs from January 2000 to December 2012 were reviewed.

Critical Congenital Heart Diseases in Preterm Neonates: Is Early Cardiac Surgery Quite Reasonable?

Prematurity is a recognized risk factor for morbidity and mortality following cardiac surgery. Postoperative and long-term outcomes after cardiac surgery performed in the preterm period are poorly described. The aim of this study was to analyze a population of preterm neonates operated on for critical congenital heart disease (CHD) before 37 weeks of gestational age (wGA) with special attention given to early and late mortality and morbidity.

Diagnosis of functionally significant coronary stenosis with exercise CT myocardial perfusion imaging.

Purpose: To assess the feasibility of exercise perfusion computed tomography (CT) in patients suspected of having hemodynamically significant coronary stenosis.

Materials And Methods: This study had institutional review board approval, and all patients gave informed consent. Thirty-two consecutive patients (26 men [mean age, 63 years] and six women [mean age, 71 years]) with 55 coronary stenoses of at least 50% underwent coronary CT angiography (one stenosis in 13 patients, two stenoses in 15 patients, and three stenoses in four patients).

Right ventricular failure secondary to chronic overload in congenital heart diseases: benefits of cell therapy using human embryonic stem cell-derived cardiac progenitors.

Objective: Despite the increasing incidence of right ventricular (RV) failure in adult patients with congenital heart disease, current therapeutic options are still limited. By contrast to left-heart diseases, cell-based myocardial regeneration applied to the right ventricle is poorly studied, even though it may be a therapeutic solution. As human embryonic stem cell-derived cardiac progenitors seem to be good candidates owing to their proliferation capacity, our aim was to assess, in a large animal model of overloaded RV dysfunction, the feasibility and effects of such a cell therapy.

Late outcomes after arterial switch operation for Taussig-Bing anomaly.

Objective: To assess the long-term results of the arterial switch operation (ASO) for Taussig-Bing Anomaly (TBA) and identify risk factors affecting outcomes.

Methods: Retrospective review and late follow-up was performed for all TBA patients from 1997 to 2010 (follow-up >3 years). Selection criteria included the absence of mitro-pulmonary continuity.

The modified Fontan procedure with use of extracardiac conduit in adults: analysis of 32 consecutive patients.

Background: Uncommonly, adults with functionally univentricular hearts are becoming candidates for a Fontan procedure. The purpose of this study was to evaluate the course of patients undergoing the modified Fontan procedure with an extracardiac conduit in recent years.

Methods: Between January 2003 and December 2013, 32 adult patients (17 female and 15 male) underwent total cavopulmonary connection (TCPC) with extracardiac conduit.

Transcatheter closure of large atrial septal defects: feasibility and safety in a large adult and pediatric population.

Background: Data are needed on the safety and efficacy of device closure of large atrial septal defects.

Methods And Results: Between 1998 and 2013, 336 patients (161 children <15 years) with large, isolated, secundum atrial septal defects (balloon-stretched diameter ≥34 mm in adults or echocardiographic diameter >15 mm/m(2) in children) were managed using the Amplatzer device, at the Marie Lannelongue Hospital. Transthoracic echocardiographic guidance was used starting in 2005 (n=219; 65.

Mitral disease: the real burden for Ross-Konno procedure in children.

Background: Aortic valve replacement and management of complex left ventricular outflow tract obstruction in early life remains a surgical challenge. We assessed our experience with the Ross-Konno procedure.

Methods: Since 2000, 49 consecutive patients (24 neonates and infants) underwent the Ross-Konno procedure.

All-age relationship between arm span and height in different ethnic groups.

The objective of the present study was to establish multiethnic, all-age prediction equations for estimating stature from arm span in males and females. The arm span/height ratio (ASHR) from 13 947 subjects (40.9% females), aged 5-99 years, from nine centres (in China, Europe, Ghana, India and Iran) was used to predict ASHR as a function of age using the lambda, mu and sigma method.

Right ventricular plasticity in a porcine model of chronic pressure overload.

Background: Ventricular-arterial coupling is a measure of the relationship between ventricular contractility and afterload. We sought to determine the relationship between ventricular-arterial coupling and right ventricular (RV) remodeling in a novel porcine model of progressive pulmonary hypertension (PH).

Methods: Chronic PH was induced in pigs by ligation of the left pulmonary artery (PA) followed by 5 weekly injections of cyanoacrylate to progressively obstruct the right lower lobe arteries (PH group, n = 10).

Reoperations for left atrioventricular valve dysfunction after repair of atrioventricular septal defect.

Objectives: Postoperative left atrioventricular valve (LAVV) dysfunction is known to be the principal risk factor influencing outcome after repair of all types of atrioventricular septal defect (AVSD). The purpose of the present study was to identify the risk factors for reoperation and to assess the outcomes after reoperation for LAVV dysfunction.

Methods: Records of 412 patients who underwent anatomical repair for different types of AVSD from January 2000 to July 2012 were reviewed.

The pattern of the coronary arterial orifices in hearts with congenital malformations of the outflow tracts: a marker of rotation of the outflow tract during cardiac development?

Outflow tract defects, including cardiac neural crest defects (so-called conotruncal defects) and transposition of the great arteries, are due to an abnormal rotation of the outflow tract during cardiac development. Coronary orifices are often abnormal in outflow tract defects, particularly in common arterial trunk (CAT). A recent study indicates that abnormal coronary artery pattern in a mouse model with common arterial outlet (Tbx1-/- mouse mutant) could be due to a reduced and malpositioned subpulmonary coronary-refractory myocardial domain.

Electrical velocimetry as a tool for measuring cardiac output in small infants after heart surgery.

Purpose: Cardiac output (CO), the product of stroke volume (SV) and heart rate, is essential to guarantee organ perfusion, especially in the intensive care setting. As invasive measurement of CO bears the risk of complications there is a need for non-invasive alternatives. We investigated if electrical velocimetry (EV) and transthoracic Doppler (Doppler-TTE) are interchangeable for the non-invasive measurement of SV and able to reflect the post-surgical SV/CO trend.

Continuous cerebral perfusion for aortic arch repair: hypothermia versus normothermia.

Background: Deep hypothermia with circulatory arrest (CA) is routinely used for aortic arch repair. Antegrade selective cerebral perfusion (ASCP) has been proposed to avoid neurologic complications. The optimal temperature during aortic arch repair with ASCP is not well established.

Coronary aorto-ostial stenosis analysed by multislice computed tomography: a new tool for percutaneous coronary intervention?

Aims: Conventional quantitative coronary angiography approaches are limited to quantify complex aorto-ostial stenosis. Multislice CT was able to detect and classify coronary plaques, compared with intravascular ultrasound (IVUS). The aim of the present study was to determine the accuracy of multislice computed tomography (CT) in addition to conventional angiography to identify aorto-ostial coronary stenosis characteristics before revascularisation.

Multidetector row computed tomography to assess changes in airways linked to asthma control.

Background: In asthma, multidetector row computed tomography (MDCT) detects abnormalities that are related to disease severity, including increased bronchial wall thickness. However, whether these abnormalities could be related to asthma control has not been investigated yet.

Objective: Our goal was to determine which changes in airways could be linked to disease control.

Reconsidering the arm span-height relationship in patients referred for spirometry.

The interpretation of pulmonary function tests relies on reference values corrected for age, sex and height. Height may be difficult to measure in patients with deformities of the thoracic cage or those unable to stand up properly. Current practice is to substitute arm span to height, once corrected either by a fixed factor or by an age- and sex-dependent regression equation.

Surgical management of congenital heart defects associated with heterotaxy syndrome.

Objective: Heterotaxy syndrome (HS) is generally associated with complex congenital cardiac defects and has a high morbidity and mortality despite recent surgical progress. Only few reports deal with an overall surgical population.

Methods: Between 1989 and 2008, 139 patients with HS entered a programme of surgical repair.

Right ventricular failure secondary to chronic overload in congenital heart disease: an experimental model for therapeutic innovation.

Objective: Mortality and morbidity related to right ventricular failure remain a problem for the long-term outcome of congenital heart diseases. Therapeutic innovation requires establishing an animal model reproducing right ventricular dysfunction secondary to chronic pressure-volume overload.

Methods: Right ventricular tract enlargement by transvalvular patch and pulmonary artery banding were created in 2-month-old piglets (n = 6) to mimic repaired tetralogy of Fallot.

Robustness of end-systolic reconstructions in coronary dual-source CT angiography for high heart rate patients.

Objectives: Reconstruction of cardiac computed tomography (CT) images is challenging when the heart rate is higher than 65 beats per minute (bpm). The optimal reconstruction time is often found to be at the end-systolic phase, but image quality remains uncertain. Using dual-source (DS) CT and 83-ms temporal resolution, we evaluated the robustness of the temporal window with low motion during the end systole.