Autograft Reoperation Following the Ross Procedure: Evolving Strategies and Future Perspectives.

Pulmonary autograft failure remains a cause of reoperation following the Ross procedure. The aim of this study is to describe our evolving approach to autograft reoperations. Retrospective study of all patients who underwent a pulmonary autograft reoperation following a Ross procedure between June 1997 and July 2022.

Total Aortic Arch and Neoaortic Root Replacement Following Stage III Palliation for Hypoplastic Left Heart Syndrome.

Progressive dilatation of the neoaortic root and reconstructed aortic arch is a serious complication after the Norwood procedure. There are no clear guidelines on the management of this complex anatomy in the setting of single ventricle physiology, and the surgical treatment of such an entity remains anecdotal. We describe a successful surgical repair in a 15-year-old girl presenting with a severely dilated neoaortic root and aortic arch causing compression and narrowing of the left pulmonary artery after successful three-stage palliation for hypoplastic left heart syndrome.

Outcomes of the Ross procedure in young adults with previous aortic valve interventions.

Objectives: Contemporarily modified Ross procedure continues to deliver excellent outcomes and remains part of the treatment strategy for aortic valve disease in the young adult population. The aim of this study was to assess whether Ross procedure carried out as a second or subsequent intervention for aortic valve disease carries similar risk and long-term benefit, when compared to Ross procedure for the first-time aortic valve replacement.

Methods: A total of 158 patients aged 16-60 years from a single congenital cardiac centre between 1997 and 2020 were included.

Aortic root translocation and en bloc rotation of the outflow tracts surgery for complex forms of transposition of the great arteries and double outlet right ventricle: A multicenter study.

Objective: There are several choices for the correction of complex transposition of the great arteries and double outlet right ventricle not amenable to the Rastelli-type surgery, but outcome data are limited to small series. This study aims to report results after the aortic root translocation and en bloc rotation of the outflow tract procedures.

Methods: This is a retrospective, multicentric, observational study.

Evolving Approach in Hypoplastic Left Heart Syndrome With Restrictive and Intact Septum.

Hypoplastic left heart syndrome (HLHS) with either intact atrial septum (IS) or highly restrictive interatrial communication (HRIC) is associated with poor survival. Immediate postpartum access to cardiac therapy and timely left atrial decompression (LAD) are paramount to a successful outcome. We describe herein our evolving approach to LAD and report interstage and longer-term results.

Contemporary Ross procedure outcomes: medium- to long-term results in 214 patients.

Objective: Our goal was to present 2 decades of our experience with the Ross procedure and its sequential modifications, adopted since 2010, to improve the reoperation rate.

Methods: We performed a single-centre, retrospective review of database information and medical notes about the implantation technique: the freestanding root. We compared era 1 (1997-2009) and era 2 (2010-2019).

HeartWare Explant After Recovery 6 Years After Implant in a 3-Year-Old Child: Has the Game Changed?

The use of continuous-flow mechanical circulatory support in preschool children remains anecdotal. This case report describes the sequel to the implantation with a HeartWare HVAD system (Medtronic, Minneapolis, MN) in a 3-year old child. A 3-year-old boy with myocarditis-related cardiomyopathy underwent implantation with a HeartWare device.

Extracorporeal life support in the multidisciplinary management of cardiogenic shock complicating acute myocardial infarction.

Objectives: To analyze the results of extracorporeal life support (ECLS) for cardiogenic shock complicating acute myocardial infarction (AMI) in a single-center experience.

Background: Cardiogenic shock is still a leading cause of death for AMI. Conventional management carries mortality rates exceeding 50%.

Reoperation for left atrioventricular valve failure in repaired atrioventricular septal defect: Can more valves be preserved in the current era?

Objective: Left atrio-ventricular valve (LAVV) regurgitation after repair of an atrio-ventricular septal defect (AVSD) may necessitate further surgery. However, redo-LAVV repair remains challenging. We sought to determine if more LAVV valves are preserved in the current era, and analyze early and longer-term results.

Surgical rescue after transcatheter interventional procedures in congenital heart disease patients: an existing problem.

Aims: Nowadays, transcatheter approaches are the treatment of choice for several congenital heart defects. However, adverse events may occur during interventional procedures. Even if the complication rate has been reduced remarkably because of learning curve and technological improvements, catastrophic events are still possible.

Could anterior papillary muscle partial necrosis explain early mitral valve repair failure?

Standardized techniques of mitral valve repair (MVR) have recently witnessed the introduction of a 'respect rather than resect' concept, the strategy of which involves the use of artificial chordae. MVR displays several advantages over mitral valve replacement in degenerative mitral regurgitation (MR), but the risk of reoperation for MVR failure must be taken into account. Different mechanisms could be advocated as the leading cause of MVR failure; procedure-related mechanisms are usually involved in early MVR failure, while valve-related mechanisms are common in late failure.

Long-term results of sequential vein coronary artery bypass grafting compared with totally arterial myocardial revascularization: a propensity score-matched follow-up study†.

Objectives: The aim of the study was to analyse the early and long-term outcomes of a consecutive series of patients who underwent sequential coronary artery bypass grafting (CABG) and to compare them with a matched population of totally arterial revascularized patients.

Methods: From January 1994 to December 1996, 209 patients underwent total arterial myocardial revascularization at our institution [arterial (ART) group]. In the same period, 2097 patients underwent CABG with left internal thoracic artery on left anterior descending and great saphenous vein on the right and circumflex branches sequentially [sequential vein (SV) group].

Uncertainty estimation in the analysis of pesticide residues in olive oil using data from proficiency tests.

In this work we report the results for estimating the measurement uncertainty (MU) following up the application of two different approaches, relatively the top-down procedure, by using proficiency test data. We have focused the estimation on the olive oil matrix. We used the analytical data obtained from five selected editions of the Proficiency Tests (PTs, from 2007 to 2011) on pesticide residues in olive oil to estimate the MU.

Quadricuspid aortic valve plasty: is it worth it to repair as an alternative to substitution?

We present the case of a 49-year-old man with an abnormal aortic valve formed by four cusps (three equal large cusps and one smaller cusp; type 1 according to Hurwits and Roberts classification) with a marked lack of coaptation that caused a severe aortic valve insufficiency. The patient underwent a repair of the defect with a tricuspidalization of the aortic valve, restoring the normal coaptation of the cusps and the normal function of the aortic valve. Postoperative course was unremarkable.

Aorta to right atrial shunt due to the rupture of a degenerative aneurysm of the noncoronary sinus of Valsalva.

Aneurysms of the sinus of Valsalva are a rare aortic pathology. Congenital aneurysms caused by weakness at the junction of the aortic media and the annulus fibrosus occur more commonly than acquired aneurysms, which are typically secondary to disease processes that involve the aortic root. The both can remain clinically silent for many years.

Pulmonary valve papillary fibroelastoma: management of an unusual, tricky pathology.

Papillary fibroelastomas are rare benign tumours of the endocardium, accounting for the most common primary valvular tumours of the heart. They typically originate from left-sided heart valves, whereas pulmonary valve involvement is anecdotal. They rarely cause valvular dysfunction, but they can cause turbulent flow and thrombus formation with consequent cerebral, retinal, coronary and pulmonary embolic disease and obstruction.

Tracheostomy after cardiac operations: in-hospital and long-term survival.

Background: Patients with ventilator dependency after cardiac operations may require a tracheostomy. This study determined the hospital and postdischarge outcome in a series of patients who underwent a tracheostomy due to ventilator dependency after cardiac operations.

Methods: Medical records of cardiac surgical patients were retrospectively reviewed for preoperative, intraoperative, and postoperative variables, and also prospective follow-up for all-cause mortality.

Right mesothelial pericardial cyst determining intractable atrial arrhythmias.

Pericardial cysts are intrathoracic lesions usually considered to be congenital and less frequently to be acquired. They are normally found incidentally upon chest radiography, computed tomography (CT)-scan or echocardiography. They are usually asymptomatic and have a benign behavior although sometimes they can cause clinical symptoms and diagnosis can be uncertain.