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Table of Contents
(Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - March 23, 2024 Category: Cardiovascular & Thoracic Surgery Source Type: research

Masthead
(Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - March 23, 2024 Category: Cardiovascular & Thoracic Surgery Source Type: research

Editors ’ Introduction
Pediatric Cardiac Surgery Annual has been dedicated to highlighting select invited presentations and discussions from the Congenital Program of The American Association for Thoracic Surgery Annual Meeting. This edition, reflecting the best of the 2023 103rd AATS meeting, continues the tradition. Herein, we have curated a collection of manuscripts introducing readers to novel procedures and presenting the latest strategies on existing complex surgical dilemmas. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 26, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Meena Nathan, Stephanie M. Fuller Source Type: research

Late pulmonary autograft dilation: Can we make a good operation great? The Supported Ross
The Ross procedure is an excellent option for aortic valve replacement resulting in outstanding hemodynamic performance and the ability to avoid systemic anticoagulation. The long-term durability of the autograft is generally good but concerns for later aortic root dilation with ensuing neoaortic insufficiency have prompted efforts to stabilize the autograft, root, sinuses and Sino-tubular junction in order to delay or entirely avoid late reinterventions on the neoaortic root. We have employed an inclusion technique, supporting the Auto-graft in a Terumo GelweaveTM Valsalva graft. (Source: Seminars in Thoracic and Cardiova...
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 24, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Michael E. Mitchell, Ronald K. Woods, Tracy Geoffrion, Mami Sow Tags: Invited Expert Technique Source Type: research

Reconstruction of Fibrous Skeleton of the Heart for Double-Valve Replacement in A Pediatric Patient - Modified Commando Procedure
We describe a modified technique of this reconstruction of the fibrous skeleton of the heart, combined with Konno procedure to further enlarge the aortic annulus. In modified commando procedure, following the reconstruction of aortomitral continuity with a bovine pericardium CardioCel patch (Admedus Regen Pty Ltd, Perth, WA, Australia), an aortic valved conduit that was made on the bench in order to have bottom skirt that enabled the suturing of the composite conduit far inside the left ventricle outflow tract. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Arif Selcuk, Yves d'Udekem, Sofia Hanabergh, Mahmut Ozturk, Aybala Tongut, Can Yerebakan, Manan Desai Tags: Invited Expert Technique Source Type: research

Partial Heart Transplantation - How to Change the System
Partial heart transplantation is the first clinically successful approach to deliver growing heart valve implants. To date, 13 clinical partial heart transplants have been performed. However, turning partial heart transplantation into a routine procedure that is available to all children who would benefit from growing heart valve implants poses formidable logistical challenges. Firstly, a supply for partial heart transplant donor grafts needs to be developed. This challenge is complicated by the scarcity of donor organs. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Douglas M. Overbey, Taufiek K. Rajab, Joseph W. Turek Tags: Invited Expert Review Source Type: research

Late pulmonary autograft dilation: Can we make a good operation great? The Tailored Approach
While it is the main viable option in the growing child and young adult, the Ross procedure has expanded its applicability to older patients, for whom long-term results are equivalent, if not superior, to prosthetic aortic valve replacement. Strategies aiming at mitigating long-term autograft failure from root enlargement and valve regurgitation have led some to advocate for root reinforcement with prosthetic graft material. On the contrary, we will discuss herein the rationale for a tailored approach to the Ross procedure; this strategy is aimed at maintaining the natural physiology and interplay between the various autog...
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Ismail El-Hamamsy, Luca A. Vricella Tags: Invited Expert Technique Source Type: research

Imaging of Double Inlet Left Ventricle
Double inlet left ventricle (DILV) is a form of single ventricle heart disease where both atrioventricular valves enter a single left ventricle. Surgical intervention may be needed in the neonatal period secondary to systemic outflow tract obstruction or less commonly pulmonary obstruction. Two-dimensional echocardiography can adequately assess newborn anatomy and define the need for surgery. Beyond the newborn period, there is a renewed interest in septation of DILV using intracardiac baffles in a staged approach. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Lindsay S. Rogers Tags: Invited Expert Review Source Type: research

En Bloc Rotation of the Outflow Tracts – Double Root Translocation
En bloc rotation of the outflow tracts or double root translocation offers an anatomic repair of transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction and closely related forms of double outlet right ventricle. The technical principle is to excise aortic and pulmonary root en bloc, rotate them as a whole by 180 °, and reimplant them. The left ventricular outflow tract is enlarged with the patch closing the ventricular septal defect. In our experience, two thirds of the pulmonary valves could be preserved (8,9, 15). (Source: Seminars in Thoracic and Cardiovascular Su...
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 23, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Rudolf Mair, Michaela Kreuzer, Eva Sames-Dolzer Source Type: research

Improving Outcomes in Pulmonary Vein Stenosis: Novel Pursuits and Paradigm Shifts
Pulmonary veins stenosis (PVS) remains a clinical challenge, with progressive restenosis being common. In the past 5 years, we have seen an exponential increase in both clinical and scientific publication related to PVS. Central to progress in PVS clinical care is the paradigm shift towards collaborative, multidisciplinary care which utilizes a multimodality approach to treatment. This manuscript will discuss recent conceptual gains in PVS treatment and research while highlighting important outstanding questions and barriers. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 20, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Rachel D Vanderlaan Tags: Invited Expert Review Source Type: research

Staged Ventricular Septation of the Double-Inlet Ventricle: How-I-Do-It
Ventricular septation of the double-inlet ventricle is a largely abandoned operation due to poor historical outcomes. However, there has been renewed interest in septation as an alternative to Fontan palliation given its long-term sequelae. As one of the few centers to revisit septation in the early 1990s, our institution has long-term data on a series of patients with a double-inlet ventricle who underwent biventricular repair. This manuscript is a summary of our approach to staged septation of the double-inlet ventricle, with a focus on patient selection criteria, surgical techniques, perioperative considerations on timi...
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - January 19, 2024 Category: Cardiovascular & Thoracic Surgery Authors: Stephanie N. Nguyen, Jan M. Quaegebeur, Kanwal Farooqi, Emile A. Bacha, Andrew B. Goldstone Tags: Invited Expert Technique Source Type: research

How-I-Do-It: Aortic Annular Enlargement - Are the Nicks and Manouguian Obsolete?
The Y-incision aortic annular enlargement (AAE), first performed in Aug. 2020, offers a safe and more effective alternative for management of a small aortic annulus/root without need for violation of the left ventricular outflow tract, mitral valve geometry, or left/right atria in both first-time aortic valve replacement (AVR) and reoperative AVR.In the first consecutive 119 patients with Y-incision AAE, the median age was 65 (59, 71), 67% female, 28% had previous cardiac surgery, and two cases had endocarditis. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - December 22, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Kenneth R. Hassler, Katelyn Monaghan, China Green, Bo Yang Tags: Invited Expert Technique Source Type: research

Endocardial Fibroelastosis Resection: When it Works and When it Does Not
Endocardial fibroelastosis (EFE) is a thickening of the endocardial layer by accumulation of collagen and elastic fibers. Endothelial to mesenchymal transformation is proposed to be the underlying mechanism of formation. Although EFE can occur in both right and left ventricles, this article will focus on management of left ventricular EFE. Through its fibrous, nonelastic manifestation EFE restricts the myocardium leading to diastolic and systolic ventricular dysfunction and prevents ventricular growth in neonates and infants. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - December 21, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Gregor Gierlinger, Sitaram M. Emani Tags: Invited Expert Review Source Type: research

Endocardial fibroelastosis resection – When it works and when it does not
Endocardial fibroelastosis (EFE) is a thickening of the endocardial layer by accumulation of collagen and elastic fibers. Endothelial to mesenchymal transformation is proposed to be the underlying mechanism of formation. Although EFE can occur in both right and left ventricles, this article will focus on management of left ventricular EFE. Through its fibrous, nonelastic manifestation EFE restricts the myocardium leading to diastolic and systolic ventricular dysfunction and prevents ventricular growth in neonates and infants. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual)
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - December 21, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Gregor Gierlinger, Sitaram M. Emani Tags: Invited Expert Review Source Type: research

Left Ventricular Outflow Tract Obstruction in Congenital Heart Disease: The Role of Cardiovascular Computed Tomography in Surgical Decision Making
Patients with many forms of congenital heart disease (CHD) and hypertrophic cardiomyopathy undergo surgical intervention to relieve left ventricular outflow tract obstruction (LVOTO). CCT defines the complex pathway from the ventricle to the outflow tract and can be visualized in 2D, 3D and 4D (3D in motion) to help define the mechanism and physiologic significance of obstruction. Advanced cardiac visualization may aid in surgical planning to relieve obstruction in the left ventricular outflow tract, aortic or neo-aortic valve and the supravalvular space. (Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric ...
Source: Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual - December 16, 2023 Category: Cardiovascular & Thoracic Surgery Authors: B. Kelly Han, Binka Edem, Griffiths Eric, Hobbs Reilly, Eckhauser Aaron, Husain Adil, Overman David Tags: Invited Expert Technique Source Type: research