Surgical resection is an effective adjunct to the management of an advanced metastatic osteosarcoma.

Cardiac involvement of metastatic osteosarcoma is exceedingly rare and carries a dismal prognosis. Documentation of the surgical management of cardiac metastatic osteosarcoma is limited. We describe the successful resection of a ∼ 3.

Outcomes of the lateral caval flap and conventional techniques for repair of right-sided partial anomalous pulmonary venous connection in adults.

Objective: In an effort to overcome limitations of conventional techniques for surgical repair of partial anomalous pulmonary venous connection (PAPVC), we developed the lateral caval flap (LCF) technique, which leverages a native endocardial surface to create unobstructed recruitment of the anomalous pulmonary veins to the left atrium. In this study, we report the long-term outcomes of the LCF and conventional techniques for repair of right-sided PAPVC.

Methods: In total, 109 adult patients (mean age 48 years; 57% male) who underwent right-sided PAPVC repair (53 LCF, 34 single-patch, 13 double-patch, 7 pericardial roll, and 2 Warden procedure) from 1997 to 2022 were retrospectively reviewed.

Long-Term Clinical Outcomes and Health-Related Quality of Life After the Ross Procedure.

Background: To evaluate long-term clinical outcomes and health-related quality of life (HR-QoL) in young adults following Ross procedures for aortic valve pathology.

Methods: From January 1990 to April 2021, 166 patients aged 14 to 63 years underwent the Ross procedure at Cleveland Clinic. Outcomes included postoperative events, longitudinal autograft valve function, reinterventions, and survival.

Aortic leaflet remodeling for the repair of congenitally malformed aortic valve.

Objective: Aortic valve repair techniques are still evolving with better understanding of aortic root and leaflet imaging. This study seeks to present the results of an additional new technique in aortic valve repair of patients with congenital heart disease. The technique entails remodeling of the leaflet by intentional peeling of the myxomatous tissue to remodel the thickened leaflets (from the ventricular side of the aortic valve along with thinning and plication of the central region of the leaflets).

Outcomes of Hypoattenuating Leaflet Thickening Post-Transcatheter Pulmonary Valve Replacement.

Background: Transcatheter pulmonary valve replacement (TPVR) is a mainstay of therapy for right ventricular outflow tract dysfunction, especially in adult congenital heart disease.

Objectives: This study aimed to assess the prevalence, characteristics, and clinical implications of hypoattenuating leaflet thickening (HALT) and hypoattenuation affecting motion (HAM) after TPVR.

Methods: This was a retrospective cohort study of TPVR performed from 2018 to 2024.

Neoaortic Dilation and Polyvalvar Dysfunction: The Coexistence of Marfan Syndrome with Hypoplastic Left Heart Syndrome.

We present a unique case of progressive neoaortic root and neoascending aortic dilatation, with poly-valvar regurgitation in a patient with Marfan syndrome and hypoplastic left heart syndrome palliated to Fontan procedure. This progressive dilation and valvar dysfunction necessitated a modified Bentall procedure and tricuspid valve repair. Our case highlights the impact of both a primary and secondary aortopathy complicating the Fontan procedure and the need for mechanical aortic valve replacement.

Cobrahead reimplantation of anomalous coronary arteries arising from the left coronary sinus.

Cobrahead reimplantation is a novel technique that we have implemented to address an anomalous right coronary artery arising from the left coronary sinus, particularly in patients with a short intramural course. This technique requires complete mobilization of the anomalous vessel, detachment of the right coronary artery from its origin at the aorta and creation of a splay incision or 'cobrahead' within the proximal vessel. This cobrahead apparatus is then utilized to create a wide anastomosis during reimplantation of the vessel in the aorta, minimizing the risk of kinking or stenosis at this site.

Arrhythmia burden in congenitally corrected transposition of the great arteries: Does treatment pathway matter?

Background: There are limited data comparing arrhythmia burden of patients with congenitally corrected transposition of the great arteries (cc-TGA) undergoing anatomic repair, physiologic repair, and nonsurgical management.

Objective: We aimed to examine the difference in rate of bradyarrhythmias and tachyarrhythmias in patients with cc-TGA stratified by treatment pathway.

Methods: A retrospective cohort study was conducted including all patients with cc-TGA observed at Cleveland Clinic Children's (1995-2021).

Outcomes for Children With Congenital Heart Disease Undergoing Ventricular Assist Device Implantation: An ACTION Registry Analysis.

Background: There are no contemporary reports that highlight the national outcomes for children with congenital heart disease (CHD) undergoing ventricular assist device (VAD) implantation.

Objectives: This study sought to evaluate differences in VAD outcomes for children with CHD to those with non-CHD as well as those with univentricular CHD to those with biventricular CHD.

Methods: Data for CHD and non-CHD patients from the multicenter ACTION (Advanced Cardiac Therapies Improving Outcomes Network) undergoing VAD implantation from April 2018 to February 2023 were included.

Implantable continuous-flow total artificial heart for newborns and small pediatric patients: First report of working model.

Objective: The need for safe and reliable mechanical circulatory support (MCS) for smaller children with severe heart failure (HF) is well defined. More specifically, in pediatric patients with advanced congenital HF, there is no implantable total artificial heart (TAH) device available for small patients. Herein, we report the development of the infant continuous-flow total artificial heart (I-CFTAH), a fully implantable in infants and newborns.

Mitral Valve Intervention, Pulmonary Hypertension, and Survival in 219 Shone's Syndrome Patients.

Background: Relationships between pulmonary hypertension (PHTN), mitral valve intervention (MVI), and death among patients with Shone's syndrome (SS) are unclear. Our recent data suggested temporal progression of MV disease and early survival benefit with MVI at initial operation. In this expanded cohort, we characterized trajectory and impact of PHTN on survival, and its relationship to MVI(s).

Lifetime Management of Adolescents and Young Adults with Congenital Aortic Valve Disease.

In this invited expert review, we focus on evolving lifetime management strategies for adolescents and young adults with congenital aortic valve disease, acknowledging that these patients often require multiple interventions during their lifetime. Our goal is to preserve the native aortic valve when feasible. Leveraging advanced multimodality imaging, a detailed assessment of the aortic valve and root complex can be obtained, and a surgically approach tailored to an individual patient's anatomy and pathology can be used.

Perioperative Assessment of the Hemodynamic Ventriculoarterial Junction of the Aortic Root by Three-Dimensional Echocardiography.

Improved strategies in aortic valve-preserving operations appreciate the dynamic, three-dimensional complexity of the aortic root and its valve. This depends not only on detailed four-dimensional imaging of the planar dimensions of the aortic root but also on quantitative assessment of the valvar leaflets and their competency. The zones of apposition and resulting hemodynamic ventriculoarterial junction formed in diastole determine valvar competency.

The Ozaki Procedure: Standardized Protocol Adoption of a Complex Innovative Procedure.

Background: The Ozaki procedure using autologous pericardium is an interesting but complex alternative for aortic valve replacement. We present a standardized approach to minimize the learning curve and confirm reproducibility.

Methods: After careful preparation, from May 2015 to February 2021, an Ozaki procedure was performed on 46 patients age 51 ± 14 years.

Multifocal disease progression and subsequent intervention in patients with actin alpha-2 variants: A single-center experience.

Objectives: To describe patient characteristics and indications for surgical intervention, reoperation, and outcomes in patients with actin alpha-2 (ACTA2) variants.

Methods: A single-center retrospective cohort study with prospective follow-up was performed for 38 patients with an ACTA2 variant.

Results: From 1999 to 2020, 26 (70%) patients underwent surgery; 11 remain under surveillance (mean follow-up, 7.

Can perioperative electroencephalogram and adverse hemodynamic events predict neurodevelopmental outcomes in infants with congenital heart disease?

Objective: The study objective was to characterize preoperative and postoperative continuous electroencephalogram metrics and hemodynamic adverse events as predictors of neurodevelopment in congenital heart disease infants undergoing cardiac surgery.

Methods: From 2010 to 2021, 320 infants underwent congenital heart disease surgery at our institution, of whom 217 had perioperative continuous electroencephalogram monitoring and were included in our study. Neurodevelopment was assessed in 76 patients by the Bayley Scales of Infant and Toddler Development, 3rd edition, consisting of cognitive, communication, and motor scaled scores.

Blood Speckle Imaging: An Emerging Method for Perioperative Evaluation of Subaortic and Aortic Valvar Repair.

Background: This article presents the use of blood speckle Imaging (BSI) as an echocardiographic approach for the pre- and post-operative evaluation of subaortic membrane resection and aortic valve repair.

Method: BSI, employing block-matching algorithms, provided detailed visualization of flow patterns and quantification of parameters from ultrasound data. The 9-year-old patient underwent subaortic membrane resection and peeling extensions of the membrane from under the ventricular-facing surface of all three aortic valve leaflets.

The Academic Impact of Congenital Heart Surgeons' Society (CHSS) Studies.

Purpose: We reviewed all 64 articles ever published by The Congenital Heart Surgeons' Society (CHSS) Data Center to estimate the academic impact of these peer-reviewed articles.

Materials And Methods: The Congenital Heart Surgeons' Society has performed research based on 12 Diagnostic Inception Cohorts. The first cohort (Transposition) began enrolling patients on January 1, 1985.