Pedro del Nido

Pedro del Nido
Harvard Medical School | HMS · Cardiac surgery

About

731
Publications
67,301
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26,287
Citations
Citations since 2017
171 Research Items
10831 Citations
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201720182019202020212022202305001,0001,5002,000
Introduction
Skills and Expertise

Publications

Publications (731)
Article
Full-text available
Reduced mitochondrial function increases myocardial susceptibility to ischemia–reperfusion injury (IRI) in diabetic hearts. Mitochondrial transplantation (MT) ameliorates IRI, however, the cardioprotective effects of MT may be limited using diabetic mitochondria. Zucker Diabetic Fatty (ZDF) rats were subjected to temporary myocardial RI and then re...
Article
Objective Restoration of biventricular circulation is an alternative management strategy in unbalanced atrioventricular canal defects (uAVCD), especially in patients with risk factors for single ventricle palliation (SVP) failure. When ventricular volume is inadequate for biventricular circulation, recruitment procedures may accommodate its growth....
Article
Objectives: The study objectives were to report on a growing experience of conduction system mapping during complex congenital heart surgery and create a predictive model of conduction anatomy. Methods: Patients undergoing complex cardiac repair with conduction mapping were studied. Intraoperative mapping used a multielectrode catheter to collec...
Article
Full-text available
This is the first description of active clinical manifestation of endocardial fibroelastosis (EFE) and remodeling of the endocardium via endothelial-to-mesenchymal transformation (EndMT) in an adolescent with Shone’s variant hypoplastic left heart complex (HLHC) and a genetic heterozygous ABL1 variant. While EFE has not been typically associated HL...
Article
Background: Ventricular fibromas frequently present with life-threatening ventricular tachycardia (VT) or ventricular fibrillation (VF) in children. The long-term risk of sustained ventricular arrhythmias following surgical resection is unknown. Objectives: To quantify the VT/VF risk following surgical resection and to examine the results of ear...
Article
Objective Aortic valve bicuspidization has been shown to be safe and effective in the short term in adults and children with unicuspid aortic valve. Outcomes of extending this technique to patients with other forms of aortic and truncal valve disease have not been reported. Methods We performed a retrospective review was performed of patients who...
Article
Background: While singular measures of socioeconomic status have been associated with outcomes after surgery for congenital heart disease, the multifaceted pathways through which a child's environment impacts similar outcomes remain incompletely characterized. We sought to evaluate the association between childhood opportunity level and adverse ou...
Article
Full-text available
Heterotaxy (HTX) is a rare condition of abnormal thoraco-abdominal organ arrangement across the left–right axis of the body. The pathogenesis of HTX includes a derangement of the complex signaling at the left–right organizer early in embryogenesis involving motile and non-motile cilia. It can be inherited as a single-gene disorder, a phenotypic fea...
Article
Single-stage ventricular septation for double-inlet left or right ventricle (DILV or DIRV) has historically been associated with poor outcomes. We hypothesize that staged ventricular septation may demonstrate favorable clinical outcomes to be an alternative to Fontan palliation. This single-center retrospective study reviewed patients with DILV or...
Article
This study reviews our early experience with the “reverse” double switch operation (R-DSO) for borderline left hearts. A retrospective review of children with borderline left hearts who underwent R-DSO between 2017 and 2021 was conducted. Patient characteristics and early hemodynamic and clinical outcomes were collected. R-DSO was performed in 8 pa...
Article
Background Data regarding the impact of intraoperative residual lesions on extracorporeal membrane oxygenation (ECMO) following the Norwood procedure are limited. Moreover, the significance of postoperative ECMO timing on in-hospital outcomes remains incompletely characterized. Methods This was a single-center, retrospective review of consecutive...
Preprint
Success of vascular progenitor cell transplantation for cardiac regeneration is partially limited by low retention/engraftment of the delivered cells. A clinically applicable method for improved cell retention would enable optimization of cell delivery. In this study, we used the myocardial infarction (MI) model by ligating the left anterior descen...
Article
Background: Outcomes following TAPVC repair remain suboptimal due to recurrent pulmonary vein (PV) obstruction requiring reinterventions. We sought to develop a clinical prediction rule for PV reintervention following total anomalous pulmonary venous connection (TAPVC) repair. Methods: Data from consecutive patients who underwent TAPVC repair at...
Article
Full-text available
Double-chambered right ventricle (DCRV) is a progressive division of the right ventricular outflow tract (RVOT) often associated with a subaortic ventricular defect (VSD). The septation is caused by a mixture of hypertrophied muscle bundles and fibrous tissue, whereof the latter is of unclear pathogenesis. Our group has previously reported that flo...
Article
Ischemia-reperfusion injury can occur in a variety of organs resulting in deleterious effects that significantly compromise cellular function and viability. Mitochondria have been shown to play a major role in the consequential endpoints resulting from ischemia and reperfusion injury. In a series of studies, we have developed a novel therapeutic in...
Article
Background Unplanned catheter-based or surgical reinterventions after congenital heart operations are independently associated with operative mortality and increased postoperative length of stay. Objectives This study assessed the long-term outcomes of transplant-free survivors of hospital discharge requiring predischarge reinterventions after con...
Article
Mitochondrial transplantation involves the replacement or augmentation of native mitochondria damaged, by ischemia, with viable, respiration-competent mitochondria isolated from non-ischemic tissue obtained from the patient’s own body. The uptake and cellular functional integration of the transplanted mitochondria appears to occur in all cell types...
Article
(242/250 Words) Objective Outcomes following first-stage palliation of single-ventricle heart disease are influenced by many factors, including the presence of residual lesions requiring reintervention. However, there is a dearth of information regarding the optimal timing of reintervention. We assessed if earlier reintervention would be favorably...
Article
BACKGROUND The utility of the intraoperative TPS (IO-TPS) in predicting outcomes following congenital cardiac surgery remains unknown. METHODS Data from patients undergoing surgery for congenital heart disease from 01/2011-12/2019 at a single institution were retrospectively reviewed. Intraoperative echocardiograms were used to assign IO-TPS for e...
Article
Background While the pre-discharge technical performance score (DC-TPS) is significantly associated with outcomes following congenital cardiac surgery, the utility of the intraoperative TPS (IO-TPS) remains unknown. Methods This was a single-center retrospective review of consecutive patients who underwent congenital cardiac surgery from 01/2011-1...
Article
Objective To determine the contemporary outcomes of the double switch operation (DSO) (Mustard/Senning + arterial switch). Methods A single institution, retrospective review of all patients with ccTGA undergoing a DSO. Results Between 1999 and 2019, 103 patients had a DSO with a Mustard (n=93) or Senning (n=10) procedure. Segmental anatomy was [S...
Article
Background: Dextro transposition of the great arteries (d-TGA) is the most common critical congenital cardiac defect surgically treated in the neonatal period by arterial switch operation (ASO). Major aortopulmonary collaterals (MAPCAs) can be present in this population and may complicate the early postoperative period. Our aim was to review our in...
Article
OBJECTIVES Among patients with hypoplastic left heart syndrome (HLHS), tricuspid valve regurgitation (TR) portends a poor prognosis. Our goal was to describe the outcomes of tricuspid valve reconstruction (TVR) concomitant with the Norwood operation and using two-dimensional echocardiography and evaluate the structural factors associated with succe...
Article
Full-text available
Objective Postoperative heart block is a significant problem in congenital heart surgery because of the unpredictability and variability of conduction tissue location in complex congenital heart defects. A novel technique for intraoperative conduction system mapping during complex congenital heart surgery is described. Methods Intraoperative condu...
Article
Full-text available
Endocardial fibroelastosis (EFE) is defined by fibrotic tissue on the endocardium and forms partly through aberrant endothelial-to-mesenchymal transition. However, the pathologic triggers are still unknown. In this study, we showed that abnormal flow induces EFE partly through endothelial-to-mesenchymal transition in a rodent model, and that losart...
Article
Background A novel polymeric pulmonary valved conduit, resistant to calcification and structural valve deterioration, may provide a more durable therapy option for the pediatric population by preventing loss of right ventricular function and increasing freedom from valve-related reintervention and mortality. Methods This was a prospective, multice...
Article
Endothelial-to-mesenchymal-transition (EndMT) plays a major role in cardiac fibrosis, including endocardial fibroelastosis but the stimuli are still unknown. We developed an endothelial cell (EC) culture and a whole heart model to test whether mechanical strain triggers TGF-β-mediated EndMT. Isolated ECs were exposed to 10% uniaxial static stretch...
Article
Evaluate outcomes of single leaflet aortic valve reconstruction using Ozaki sizer and template. Single institute retrospective analysis between August 2015 and August 2019. Thirty-three patients, median age 9.3 years and weight 29.2 kg underwent single leaflet Ozaki repair. Preoperative indications were: AR (n=17), AS (n=3) or AS/AR (n=13). Baselin...
Article
Background In this era of public scrutiny, there is an ongoing need for innovative methods for patient follow-up. Objectives As part of a quality initiative, we developed an automated post-operative follow-up system for patients following discharge after cardiac surgery at Boston Children’s Hospital. Methods Discharge Communication (DisCo) is a w...
Article
Full-text available
OBJECTIVES We have previously shown in experimental settings that a leaflet foldoplasty device reduces redundant leaflet area to re-establish mitral valve (MV) coaptation. The current study investigates the in vivo device retention and functional durability following foldoplasty. METHODS The prototype is of superelastic nitinol formed into a 3-dim...
Article
Full-text available
Purpose In clinical practice, many patients with right heart failure (RHF) have elevated pulmonary artery pressures and increased afterload on the right ventricle (RV). In this study, we evaluated the feasibility of RV augmentation using a soft robotic right ventricular assist device (SRVAD), in cases of increased RV afterload. Methods In nine Yor...
Article
Background Management of the congenitally corrected transposition of the great arteries (ccTGA) with intact ventricular septum (IVS) is controversial and includes either anatomic repair with systemic left ventricle (morphological left ventricle) or maintenance of a systemic right ventricle (morphological right ventricle). The purpose of this study...
Article
Background We sought to identify predictive factors for aortic valve (AoV) surgery after neonatal balloon aortic valvuloplasty (BAV) and characterize clinical outcomes of AoV surgery after neonatal BAV. Methods Time-to-event analysis identified predictors for AoV surgery after neonatal BAV. Clinical outcomes of AoV surgery following neonatal BAV w...
Article
IntroductionAmong patients with congenital heart disease, those born with only a single working ventricle represent a particularly complex sub-population, typically requiring multiple surgeries and suffering from high levels of mortality and morbidity. Their cardiac care is complex and has evolved considerably since surgical palliation was first in...
Article
Full-text available
Patients with repaired Tetralogy of Fallot (ToF), a congenital heart defect which includes a ventricular septal defect and severe right ventricular outflow obstruction, account for the majority of cases with late-onset right ventricle (RV) failure. Current surgery procedures, including pulmonary valve replacement (PVR) with right ventricle remodeli...
Article
Cone repair (CR) uses native tissue for tricuspid valve (TV) repair and provides potential for growth. Results after CR were investigated in different age groups including several surgical modifications. Single institution retrospective analysis of all CR excluding neonatal procedures. Endpoints included TV reoperation, late tricuspid regurgitation...
Article
Full-text available
The search for a source of endothelial cells (ECs) with translational therapeutic potential remains crucial in regenerative medicine. Human blood-derived endothelial colony-forming cells (ECFCs) represent a promising source of autologous ECs due to their robust capacity to form vascular networks in vivo and their easy accessibility from peripheral...
Article
Objective To assess the feasibility and outcomes of biventricular conversion following takedown of Fontan circulation. Methods Retrospective analysis of patients who had takedown of Fontan circulation and conversion to biventricular circulation at a single center from September 2007 to April 2020. Failing Fontan physiology was defined as Fontan ci...
Article
Patients with borderline hypoplastic right or left ventricle and VSDs may be candidates for either single ventricle palliation or staged ventricular recruitment (SVR) followed by eventual biventricular conversion. Components of SVR include restriction of atrial septal defects (ASD) without ventricular septal defects (VSD) closure and addition of ac...
Article
Background Despite the improvement of surgical techniques for mitral valve (MV) repair in children, mitral valve replacement (MVR) is sometimes still necessary. MVR and redo-MVR continue to be burdened by early postoperative mortality and long-term morbidity with only about 75% of these patients being alive or transplant-free 10 years after the ini...
Article
Objectives The Super Glenn procedure involves targeted increased in blood flow to left sided heart structures with fenestrated atrial septation. The objective of this study was to examine the outcomes of patients who had this procedure as a part of biventricular staging and specifically evaluate the effect on dimensions of left heart structures. M...
Article
Background Surgical resection of cardiac fibromas in children reduces hemodynamic and arrhythmia burden; however, little is known about postoperative left ventricular (LV) function. We aimed to evaluate factors associated with postoperative LV dysfunction. Methods In this retrospective observational cohort study, imaging data were reviewed from 41...
Article
Objective In this study, we sought to identify independent risk factors for mortality and reintervention after early surgical correction of truncus arteriosus (TA) using a novel statistical method. Methods Patients undergoing neonatal/infant TA repair between January 1984 and December 2018 were reviewed retrospectively. An innovative statistical s...
Article
Full-text available
Ex situ heart perfusion (ESHP) has proven to be an important and valuable step toward better preservation of donor hearts for heart transplantation. Currently, few ESHP systems allow for a convenient functional and physiological evaluation of the heart. We sought to establish a simple system that provides functional and physiological assessment of...
Article
Objectives To report outcomes in a pilot study of autologous mitochondrial transplantation (MT) in pediatric patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) for severe refractory cardiogenic shock after ischemia-reperfusion injury (IRI). Methods A single-center retrospective study of patients requiring ECMO for postcar...
Article
Introduction: This prospective, multicenter, single-arm, early feasibility study evaluates the safety and performance of an investigational ePTFE-based valve for replacement of the pulmonary valve and reconstruction of the Right Ventricular Outflow Tract. A novel polymeric pulmonary valved conduit, resistant to calcification and structural valve de...
Article
Introduction: Despite the improvement of surgical techniques for mitral valve (MV) repair in children, mitral valve replacement (MVR) is sometimes still necessary. MVR and redo-MVR continue to be burdened by early postoperative mortality and long-term morbidity with only about 75% of these patients being alive or transplant-free 10 years after the...
Article
Introduction: Acute kidney injury (AKI) is a common clinical disorder and one of the major causes of morbidity and mortality during the postoperative period. In this study, we investigated the safety and efficacy of autologous mitochondrial transplantation by intra-arterial injection for renal protection in a swine model of bilateral renal ischemia...
Article
Introduction: Endocardial Fibroelastosis (EFE) is a condition defined by the formation of fibrotic tissue on the endocardium, stunting cardiac development. The presence of EFE restricts diastolic compliance, leading to systolic and diastolic heart failure, and contributing to higher morbidity and mortality, particularly in Hypoplastic Left Heart Sy...
Article
Hypothesis: Biventricular conversion (BiVC) following takedown of Fontan circulation is feasible and results in improved hemodynamics. Methods: Retrospective analysis of patients who had takedown of Fontan circulation and conversion to BiV circulation at a single center from September 2007 to April 2020. Failing Fontan physiology was defined as Fon...
Article
Objective The present study examined the feasibility and efficacy of continuous bilateral erector spinae blocks for post-sternotomy pain in pediatric cardiac surgery. Design Prospective cohort study; patients were retrospectively matched 1:2 to control patients. Conditional logistic regression was used to compare dichotomous outcomes, and generali...
Article
Background: Technical Performance Score (TPS) can predict outcomes after congenital cardiac surgery. We sought to validate TPS as a predictor of both short- and long-term outcomes of the Norwood procedure. Methods: We conducted a retrospective review of patients who underwent the Norwood procedure from 1997-2017. We assigned TPS (Class 1, no res...
Article
Background: The risks of ascending aortic dilation and the indications for intervention in pediatric patients is unclear. Given the concern for aortic size mismatch with growth, larger ascending aortic diameters have been accepted in pediatric patients. The purpose of this study was to evaluate the effectiveness of ascending aortic reduction at th...
Article
Background Right ventricular hypertrophy (RVH) and failure (RVF) are major causes of cardiac morbidity and mortality. A key event in the progression to RVF is cardiomyocyte apoptosis due to mitochondrial dysfunction. We sought to determine whether localized intramyocardial injection of autologous mitochondria from healthy muscle treats heart failur...
Article
Full-text available
Acute kidney injury (AKI) is a common clinical disorder and one of the major causes of morbidity and mortality in the postoperative period. In this study, the safety and efficacy of autologous mitochondrial transplantation by intra-arterial injection for renal protection in a swine model of bilateral renal ischemia-reperfusion injury (IRI) was inve...
Article
Background Several factors predict reintervention for subaortic stenosis (SubAS): age, pre-operative left ventricular outflow tract (LVOT) gradient, distance from obstructive subaortic ridge to aortic valve (AoV), and peeling of membrane from the aortic/mitral valves. We sought to develop a prediction rule to categorize risk of reintervention for r...
Article
Background Outcomes after the arterial switch operation (ASO) for d-transposition of the great arteries (d-TGA) have improved significantly since its inception in the 1980’s. This study reviews contemporaneous outcomes and predictors for late reinterventions following ASO. Methods We retrospectively reviewed patients who underwent ASO for d-TGA fr...
Article
Background Multiple congenital cardiac malformations require pulmonary valve replacement (PVR) and/or right ventricular outflow (RVOT) reconstruction. PVR remains challenging in children due to limited growth potential of prosthetic valves. We evaluated our outcomes in patients undergoing surgical implantation of a Melody valve in the RVOT. Method...
Article
Background Donation after circulatory death (DCD) offers an additional source of cardiac allografts, potentially allowing expansion of the donor pool, but is limited due to the effects of ischemia. In this study, we investigated the efficacy of mitochondrial transplantation to enhance myocardial function of DCD hearts. Methods Circulatory death wa...
Article
Background Aortic valve neo-cuspidization (AVNeo, Ozaki procedure) has excellent mid-term results in adults. Outcomes in patients with a small native aortic annulus are unknown. We report early outcomes in young patients with small native aortic valve annuli. Methods Retrospective review of patients undergoing AVNeo between 2015-2019 were reviewed...
Article
Soft robotic devices have been proposed as an alternative solution for ventricular assistance. Unlike conventional ventricular assist devices (VADs) that pump blood through an artificial lumen, soft robotic VADs (SRVADs) use pneumatic artificial muscles (PAM) to assist native contraction and relaxation of the ventricle. Synchronization of SRVADs is...
Article
Purpose Donation after circulatory death (DCD) offers an additional source of cardiac allografts, potentially allowing expansion of the donor pool. In this study, we investigated the efficacy of mitochondrial transplantation to improve myocardial function in DCD hearts. Methods Cardiocirculatory death was induced in Yorkshire pigs (40-50 kg, n=22)...
Article
Full-text available
IntroductionRight ventricle (RV) failure is one of the most common symptoms among patients with repaired tetralogy of Fallot (TOF). The current surgery treatment approach including pulmonary valve replacement (PVR) showed mixed post-surgery outcomes. A novel PVR surgical strategy using active contracting bands is proposed to improve the post-PVR ou...
Article
Full-text available
Objective Technical performance score (TPS) has been associated with both early and late outcomes across a wide range of congenital cardiac procedures. A previous study has shown that the presence of residual lesions before discharge, as measured by TPS, is accurately able to identify patients who required postdischarge reinterventions after comple...