Primary inferior vena cava synovial sarcoma treated with caval replacement during cardiopulmonary bypass and liver perfusion.

Primary inferior vena cava (IVC) tumors are rare. Most are leiomyosarcomas. The prognosis is poor with those involving and superior to the hepatic veins faring worse than those isolated within the retrohepatic cava.

Standardized Temporary Atrial Epicardial Wire Locations Lead to Enhanced Atrial Signal Identification.

Arrhythmias, common after pediatric cardiac surgery, are associated with increased morbidity and mortality. Atrial epicardial wires (AEW) improve diagnostic accuracy but have variable pacing and sensing properties based on their location. Even so, there are no longitudinal prospective pediatric studies examining ideal placement of AEW.

Surgically induced aortic coarctation in a neonatal porcine model allows for longitudinal assessment of cardiovascular changes.

Noncritical aortic coarctation (COA) typically presents beyond early childhood with hypertension. Correction of COA does not ensure a return to normal cardiovascular health, but the mechanisms are poorly understood. Therefore, we developed a porcine COA model to study the secondary cardiovascular changes.

Association of Size Matching Using Predicted Heart Mass With Mortality in Heart Transplant Recipients With Obesity or High Pulmonary Vascular Resistance.

Importance: Pretransplant obesity and higher pulmonary vascular resistance (PVR) are risk factors for death after heart transplant. However, it remains unclear whether appropriate donor-to-recipient size matching using predicted heart mass (PHM) is associated with lower risk.

Objective: To investigate the association of size matching using PHM with risk of death posttransplant among patients with obesity and/or higher PVR.

Systems of Care Factors Should Be Considered in Regionalization of Congenital Cardiac Surgery.

Background: Regionalization of care has been proposed to optimize outcomes in congenital cardiac surgery (CCS). We hypothesized that hospital infrastructure and systems of care factors could also be considered in regionalization efforts.

Methods: Observed-to-expected (O/E) mortality ratio and hospital volumes were obtained between 2015 and 2018 from public reporting data.

Nicardipine Is a Safe, Efficacious, and Cost-Effective Antihypertensive for Neonates and Young Infants Undergoing Cardiac Surgery.

Objective: The use of nicardipine in congenital cardiac surgery has been guarded given the calcium sensitivity of immature myocardium and paucity of clinical data. Reports of nicardipine use have excluded neonates with single ventricles. The goal of this study was to compare the use of nicardipine and sodium nitroprusside for postoperative blood pressure control in young patients recovering from cardiac surgery.

Is Porcine Small Intestinal Submucosal Extracellular Matrix (ECM) a Suitable Material for Right Ventricular Outflow Tract Reconstruction in Association With Pulmonary Valve Replacement?

Pulmonary valve replacement (PVR) with right ventricular outflow tract (RVOT) reconstruction is a common congenital cardiac operation. Porcine submucosal intestinal-derived extracellular matrix (ECM) patches have been used for RVOT reconstruction. We present 2 adult patients with Tetralogy of Fallot who underwent PVR with RVOT reconstruction utilizing ECM.

Unconventional use of total artificial heart in a patient with severe, destructive prosthetic valve endocarditis.

Here, we report the case of a patient who presented to our institution with severe, destructive, and unreconstructable prosthetic valve endocarditis which required the planned implantation of a total artificial heart (TAH) to function as a bridge to cardiac transplantation. The use of TAH in this fashion has been infrequently reported in the literature. This case highlights the importance of a thoughtful, preoperative multidisciplinary approach to these complex patients to provide the most appropriate and life-saving care.

National Trends in Heart Donor Usage Rates: Are We Efficiently Transplanting More Hearts?

Background It is unclear whether the recent increase in the number of heart transplants performed annually in the United States is only because of higher availability of donors and if it affected recipients' survival. Methods and Results We examined characteristics of donors and recipients from 2008 to 2012 (n=11 654) and 2013 to 2017 (n=14 556) and compared them with 2003 to 2007 (n=10 869). Cox models examined 30-day and 1-year risk of recipients' death post transplant.

The Use of STS Public Reporting to Guide Referrals in Congenital Heart Surgery: Results of a Survey.

Background: The Society of Thoracic Surgeons (STS) public reporting in congenital heart surgery has received considerable attention; however, it is unclear how pediatric cardiac providers use these data to guide surgical referrals.

Methods: We surveyed members of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and PediHeartNet members regarding use of STS public reporting.

Results: There were 155 respondents (90% cardiologist, 7% surgeons) from approximately 800 solicitations (∼19% response rate).

Survival after orthotopic heart transplantation in patients with BMI > = 35 with and without diabetes.

Background: Orthotopic heart transplant (OHT) recipients with a body mass index (BMI) > = 35 have worse survival than those with a BMI < 35. Diabetes is a risk factor for mortality. We evaluated the impact of diabetes on mortality rates after OHT in patients with a BMI > 35.

Multi-institutional collaborative mock oral (mICMO) examination for cardiothoracic surgery trainees: Results from the pilot experience.

Objective: The American Board of Thoracic Surgery-certifying examination is challenging for applicants. Single institutions have reported good results with a mock oral examination (MOE) for trainees. General surgery literature has demonstrated success with in-person multi-institutional MOE examinations.

Case report: a step-wise management of concurrent presentation of congenital single lung and aberrant right subclavian artery in an infant girl.

Introduction: Congenital single lung (CSL) is a rare condition, and symptomatic patients often present with respiratory distress or recurrent respiratory infection due to mediastinal shift causing vascular or airway compression. Aberrant right subclavian artery (ARSA) is another rare congenital anomality that can lead to tracheal or esophageal compressions. There is only one other case of concurrent presentation of CSL and ARSA reported, which presented unique challenge in surgical management of our patient.

Pulmonary artery and lung parenchymal growth following early versus delayed stent interventions in a swine pulmonary artery stenosis model.

Objectives: Compare lung parenchymal and pulmonary artery (PA) growth and hemodynamics following early and delayed PA stent interventions for treatment of unilateral branch PA stenosis (PAS) in swine.

Background: How the pulmonary circulation remodels in response to different durations of hypoperfusion and how much growth and function can be recovered with catheter directed interventions at differing time periods of lung development is not understood.

Methods: A total of 18 swine were assigned to four groups: Sham (n = 4), untreated left PAS (LPAS) (n = 4), early intervention (EI) (n = 5), and delayed intervention (DI) (n = 5).

Multimodal Cardiopulmonary Bypass Skills Assessment Within a High-Fidelity Simulation Environment.

Background: A high-fidelity simulator that uses a perfused porcine heart, cannulae, and tubing has been demonstrated to be a useful training adjunct. We hypothesized that multimodal assessment of cardiopulmonary bypass (CPB) skills within this high-fidelity simulated environment could discern expert from trainee performance.

Methods: Three traditional fellows (postgraduate year 6-8) and 3 attending surgeons each performed 3 aortic cannulations.

Distinct hypertrophic cardiomyopathy genotypes result in convergent sarcomeric proteoform profiles revealed by top-down proteomics.

Hypertrophic cardiomyopathy (HCM) is the most common heritable heart disease. Although the genetic cause of HCM has been linked to mutations in genes encoding sarcomeric proteins, the ability to predict clinical outcomes based on specific mutations in HCM patients is limited. Moreover, how mutations in different sarcomeric proteins can result in highly similar clinical phenotypes remains unknown.