Implantation of atrial flow regulator devices in patients with congenital heart disease and children with severe pulmonary hypertension or cardiomyopathy-an international multicenter case series.

Background: The Occlutech Atrial Flow Regulator (AFR) is a self-expandable double-disc nitinol device with a central fenestration. Its use has been approved in the adult population with heart failure and described for pulmonary hypertension (PH). Only case reports and small series have been published about its use in the paediatric population and for congenital heart disease (CHD).

Retrograde Pulmonary Vein Recanalization Using Transcatheter Electrosurgery.

Transcatheter electrosurgery is a wire-based technique used to traverse or cut tissue within blood-filled spaces using alternating current delivered by guidewires or catheters. The use of transcatheter electrosurgical techniques in the pediatric population has been limited. We are reporting the first case of retrograde pulmonary vein recanalization using transcatheter electrosurgery.

Pulmonary Vein Stenosis in Children: A Programmatic Approach Employing Primary and Anatomic Therapy.

Pulmonary vein stenosis (PVS) is a difficult condition to treat due to recurrence and progression. In 2017, we developed a comprehensive PVS Program at our center to address the multidisciplinary needs of these patients. We discuss the components of our program and our approach to these patients, using a combination of primary (medical) therapy in addition to anatomic therapy to preserve vessel patency.

Aortic Root Distortion During Balloon Angioplasty of Right Ventricular Outflow Tract Prior to Transcatheter Pulmonary Valve Implantation.

We describe our experience with aortic root distortion in transcatheter pulmonary valve implantation (TPVI). Aortic root distortion (AD) can be observed with balloon angioplasty of the right ventricular outflow tract (RVOT), but its long-term significance is unknown. This has been a common finding in our institution, though not fully appreciated in our early experience.

Midterm outcomes of right ventricular outflow tract reconstruction using the Freestyle xenograft.

Objective: Various options exist for right ventricular outflow tract (RVOT) reconstruction in congenital heart disease. The Freestyle porcine aortic root may be used but its longevity is not well defined.

Design: We performed a retrospective review of all non-Ross RVOT reconstructions using the Freestyle root in our institution.

Outcomes of Transcatheter Tricuspid Valve-in-Valve Implantation in Patients With Ebstein Anomaly.

We sought to describe the acute results and short- to medium-term durability of transcatheter tricuspid valve-in-valve (TVIV) implantation within surgical bioprostheses among patients with Ebstein anomaly (EA). Cases were identified from a voluntary, multicenter, international registry of 29 institutions that perform TVIV. Demographic, clinical, procedural, and follow-up data were analyzed.

Melody valve implantation within freestyle stentless porcine aortic heterograft.

Background: The Melody transcatheter pulmonary valve has been implanted successfully worldwide since its first implant in 2000. The vast majority of these valves have been implanted in pulmonary homografts. In our institution, the most common valve used for pulmonary valve replacement is the Medtronic Freestyle stentless porcine aortic heterograft.

Percutaneous device occlusion of hepatocardiac venous collateral via left transhepatic access in a patient with heterotaxy syndrome following Fontan procedure.

Venovenous collateral vessels are a common cause for desaturation in patients who have undergone a Fontan procedure. We describe a patient with heterotaxy syndrome (leftward pointing apex) and complex single ventricle with Fontan physiology that was desaturated due to a hepatocardiac vein. The vessel was entered via a left transhepatic access and was successfully occluded using an Amplatzer Vascular Plug.

Red blood cell transfusion for infants with single-ventricle physiology.

The purpose of this study was to assess how red blood cell (RBC) transfusions impact hemodynamic parameters in infants with single-ventricle lesions. This was a retrospective chart review. The setting was a pediatric cardiac intensive care unit at a tertiary care children's hospital.

Catheter-based therapy for small preterm infants with pulmonary atresia/intact ventricular septum.

Catheter-based therapy is the preferred treatment for term infants with pulmonary atresia and intact ventricular septum without right ventricular-dependent coronaries, membranous atresia with patent infundibulum, and acceptable-sized tricuspid valve. However, in smaller preterm infants, it is more difficult to determine the adequacy of the tricuspid valve and right ventricle for two-ventricle repair and there are increased procedural risks. An excellent result in a small preterm infant with pulmonary atresia and intact ventricular septum is described using the following algorithm: determination of the tricuspid/mitral annular ratio, right-sided catheter-based intervention, and a combination of transthoracic echocardiography and angiography.

Ankyrin binding mediates L1CAM interactions with static components of the cytoskeleton and inhibits retrograde movement of L1CAM on the cell surface.

The function of adhesion receptors in both cell adhesion and migration depends critically on interactions with the cytoskeleton. During cell adhesion, cytoskeletal interactions stabilize receptors to strengthen adhesive contacts. In contrast, during cell migration, adhesion proteins are believed to interact with dynamic components of the cytoskeleton, permitting the transmission of traction forces through the receptor to the extracellular environment.