Coronary Artery Dimensions on Computed Tomography Following the Neonatal Arterial Switch Operation for the Complete Transposition of the Great Arteries.

Coronary events are life-threatening long-term complications of the arterial switch operation for complete transposition of the great arteries. The aim of our study was to assess the dimensions of the reimplanted coronary arteries and their relationship with the various geometric characteristics to gain a better understanding of the involved mechanisms. Coronary computed tomography angiography (CCTA) scans of 78 asymptomatic pediatric patients were performed at the age of 10.

Striving for physiologic coaptation: An experimental and innovative approach towards designing and implanting aortic neo-leaflets.

Aortic valve repair has emerged as the treatment of choice for congenital aortic valvular disease, avoiding the need for a reoperation associated with stented prosthesis overgrowth. The introduction of a leaflet implant represents a recent advancement in a field that originated early techniques, such as simple commissurotomies. In our experimental approach, we assessed two established leaflet-sizing techniques by analysing their resultant coaptation areas.

Initial Clinical Trial of a Novel Pulmonary Valved Conduit.

Valved allografts and xenografts for reconstruction of the right ventricular outflow tract (RVOT) lack durability and do not grow. We report the first clinical use of a completely bioabsorbable valved conduit (Xeltis pulmonary valve - XPV) in children. Twelve children (six male), median age five (two to twelve) years and median weight 17 (10 to 43) kg, underwent RVOT reconstruction with the XPV.

A Novel Restorative Pulmonary Valve Conduit: Early Outcomes of Two Clinical Trials.

We report the first use of a biorestorative valved conduit (Xeltis pulmonary valve-XPV) in children. Based on early follow-up data the valve design was modified; we report on the comparative performance of the two designs at 12 months post-implantation. Twelve children (six male) median age 5 (2 to 12) years and weight 17 (10 to 43) kg, had implantation of the first XPV valve design (XPV-1, group 1; 16 mm ( = 5), and 18 mm ( = 7).

[Structure of the thymus at the beginning of the 21th century].

The classical histological features of the thymus are the cortex and medulla, the Hassall's bodies as well as the lobules. Anti-pan-cytokeratin immunocytochemistry shows that the keratin staining pattern of the cortical and medullary epithelial cells is different. The medulla is further compartmentalized: it consists of keratin-positive network and keratin-negative areas.

[Perioperative use of levosimendan in cardiac surgery. Hungarian recommendation].

Low output syndrome significantly increases morbidity and mortality of cardiac surgery and lengthens the durations of intensive care unit and hospital stays. Its treatment by catecholamines can lead to undesirable systemic and cardiac complications. Levosimendan is a calcium sensitiser and adenosine triphosphate (ATP)-sensitive potassium channel (I) opener agent.

Donor heart selection and outcomes: An analysis of over 2,000 cases.

Background: Decision-making when offered a donor heart for transplantation is complex, and supportive data describing outcomes according to acceptance or non-acceptance choices are sparse. Our aim was to analyze donor heart acceptance decisions and associated outcomes at a single center, and after subsequent acceptance elsewhere.

Methods: This investigation was a retrospective analysis of data obtained from the University of Vienna Medical Center and Eurotransplant centers for the period 2001 to 2015.

Chylothorax after pediatric cardiac surgery complicates short-term but not long-term outcomes-a propensity matched analysis.

Background: The occurrence of postoperative chylothorax in children with congenital heart disease is a rare and serious complication in cardiac intensive care units (ICUs). The aim of our study was to identify the perioperative characteristics, treatment options, resource utilization and long term complications of patients having chylothorax after a pediatric cardiac surgery.

Methods: Patients were retrospectively assessed for the presence of chylothorax between January 2002 and December 2012 in a tertiary national cardiac center.

Decline of FOXN1 gene expression in human thymus correlates with age: possible epigenetic regulation.

Background: Thymic involution is thought to be an important factor of age related immunodeficiency. Understanding the molecular mechanisms of human thymic senescence may lead to the discovery of novel therapeutic approaches aimed at the reestablishment of central and peripheral T cell repertoire.

Results: As an initial approach, here we report that the decline of human thymic FOXN1 transcription correlates with age, while other genes, DLL1, DLL4 and WNT4, essential for thymopoiesis, are constitutively transcribed.

Impact of the insulin and glucose content of the postoperative fluid on the outcome after pediatric cardiac surgery.

Introduction: The aim of this study was to investigate the role of the insulin and glucose content of the maintenance fluid in influencing the outcomes of pediatric patients undergoing heart surgery.

Methods: A total of 2063 consecutive pediatric patients undergoing cardiac surgery were screened between 2003 and 2008. A dextrose and an insulin propensity-matched group were constructed.

Down syndrome and postoperative complications after paediatric cardiac surgery: a propensity-matched analysis.

Objectives: The incidence of congenital heart disease is ~50%, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery.

Methods: Our perioperative data were analysed in paediatric patients with Down syndrome undergoing cardiac surgery.

Valve-sparing root replacement in children with aortic root aneurysm: mid-term results.

Objectives: We aimed at evaluating the results of aortic valve-sparing root replacement (AVSRR) in children with aortic root aneurysm (ARA) due to genetic disorders in terms of mortality, reoperation and recurrent aortic valve regurgitation (AVR).

Methods: Thirteen patients (mean age 9.7 ± 6.

Aortic atresia combined with right aortic arch.

We present a case of an aortic atresia and a persistent right aortic arch with a retro-aortic brachiocephalic vein. A left neo-aortic arch was constructed using a reversed subclavian flap and a standard Norwood-type patch enlargement to provide systemic outflow. The intercarotid section of the aortic arch was hypoplastic.

Pulmonary stenosis is a predictor of unfavorable outcome after surgery for supravalvular aortic stenosis.

We sought to evaluate whether the presence of pulmonary stenosis (PS), amongst other factors, influences the mortality and the rate of reoperations in the long-term follow-up of patients with supravalvular aortic stenosis (SVAS). We identified all patients with SVAS from our surgical database. The patients with multi-level aortic stenosis or concomitant cardiac procedures were excluded from this study.

Primary resection of Kommerell's diverticulum in a 37-year-old patient.

A previously non-operated 37-year-old patient presented with esophageal dysphagia for solid food and stridorous breathing. Computed tomography and magnetic resonance showed a 33-mm wide Kommerell's diverticulum. The diverticulum and the obliterated ductus arteriosus arising from it towards the pulmonary artery were resected.

Ring-enforced right ventricle-to-pulmonary artery conduit in Norwood stage I reduces proximal conduit stenosis.

Background: An increasing number of surgeons prefer to place a conduit from the right ventricle to the pulmonary artery at the time of the Norwood stage I procedure. Proximal conduit stenoses have led us to modify this technique by using ring-enforced polytetrafluoroethylene conduits.

Methods: Angiograms of 24 patients with conventional conduits (CC) and 28 patients with ring-enforced conduits (RC) before partial bidirectional cavopulmonary anastomosis were analyzed.

A comparative study of mechanical and homograft prostheses in the pulmonary position.

Background: Homografts (HGs) are considered the gold standard for pulmonary valve replacement. However, to avoid further operations, the use of mechanical valves (MVs) might be considered, especially in patients who had had multiple prior operations or require an additional MV in another position.

Methods: Data of 19 patients with MVs were compared with 19 patients with HGs, matched for age, sex, and follow-up time.

[Surgical management of congenital heart defects in adolescent and adult patients, between years 2001-2008].

Unlabelled: The leading interventions due to congenital heart defects performed in adults are: (I) reconstructive operations, including: (a) newly diagnosed malformations, (b) previously adjudged to be inoperable defects, (c) so called "tardive" interventions due to pulmonary hypertension or right ventricle insufficiency. There is a growing number of (II) REDO operations, including: (a) correction of residual defects, (b) replacement of damaged or outgrown homografts, (c) recoarctation (aneurysm, dissection) of the aorta after surgical or catheter interventions, (d) Ross procedure, valve replacements due to previously performed aortic valvulotomy/valvuloplasty or corrections of different malformations (e.g.

Improvement in long-term survival after hospital discharge but not in freedom from reoperation after the change from atrial to arterial switch for transposition of the great arteries.

Objective: To compare survival, freedom from reoperation, and functional status between atrial switch and arterial switch operations for transposition of the great arteries.

Methods: Data from 88, 329, and 512 patients who underwent Mustard, Senning, and arterial switch operations between 1974 and 2006 were analyzed.

Results: In-hospital mortalities were 8.

Outcome after surgical repair/palliation of congenitally corrected transposition of the great arteries.

Background: The surgical concepts for patients with congenitally corrected transposition of the great arteries (CCTGA) address discordant connections and associated lesions. The outcomes after biventricular repair without correction of discordant connections ("classic repair", or with its correction "anatomic repair") and after "univentricular palliation" were investigated.

Methods: All patients with CCTGA who underwent "classic repair" (n = 39), "anatomic repair" (n = 6), or "univentricular palliation" (n = 11) between 1978 and 2006 were analyzed.

Incidence and results of reoperations following the Senning operation: 27 years of follow-up in 314 patients at a single center.

Objectives: Atrial switch procedures for transposition of the great arteries are associated with reoperations mainly for systemic ventricular dysfunction and baffle complications. This study aims at identifying the results of reoperations following the Senning operation.

Methods: Records of 314 hospital survivors who had undergone the Senning operation were reviewed for details concerning cardiac reoperations.

How well are patients doing up to 30 years after a mustard operation?

Background: Right heart failure and baffle complications may affect the health status of patients with transposition of the great arteries after an atrial switch operation.

Methods: This study aims to identify risk factors for late death, the incidence of reoperations, and the functional status of 88 patients who underwent a Mustard operation with a mean follow-up of 20.9 +/- 10.

Nonfenestrated extracardiac total cavopulmonary connection in 132 consecutive patients.

Background: The study was conducted to assess the need for fenestration for completion of a total cavopulmonary connection (TCPC) with the most recent modification of an extracardiac conduit.

Methods: The extracardiac approach was introduced to our institution in January 1999. Between June 2000 and June 2006, 132 consecutive patients were treated without a fenestration.