Sitaram M. Emani’s research while affiliated with Boston Children's Hospital and other places

... And such heart block, should it be inadvertently induced nowadays, is usually the problem encountered during the closure of the channels that permit interventricular shunting. Those pointing to the need to avoid such iatrogenic block are now advocating the use of intraoperative mapping to identify with precision the site of the atrioventricular conduction axis [2,30,32]. Even with the use of their new technique, however, these investigators have yet to eradicate the problem of iatrogenic block [30,32]. ...

Reference:

Personalized Diagnoses for Those Born with Congenitally Malformed Hearts

... Fortunately, the current outcomes are excellent with low morbidity with a high rate of symptom resolution and freedom from reoperation. 3,21,26,[29][30][31] Regardless of the anatomy, the principle remains the same, relief of the compression, typically obtained through division of the ring (division of a ligamentum and division of a double aortic arch if present), ideally with resection of a Kommerell's diverticulum. In children, most are approached via left thoracotomy without cardiopulmonary bypass. ...

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Vascular rings - what has changed, and what do I need to know as a practitioner?

... And such heart block, should it be inadvertently induced nowadays, is usually the problem encountered during the closure of the channels that permit interventricular shunting. Those pointing to the need to avoid such iatrogenic block are now advocating the use of intraoperative mapping to identify with precision the site of the atrioventricular conduction axis [2,30,32]. Even with the use of their new technique, however, these investigators have yet to eradicate the problem of iatrogenic block [30,32]. ...

Reference:

Personalized Diagnoses for Those Born with Congenitally Malformed Hearts

... However, the anatomic features that define significant aortic arch hypoplasia (AAH) and the corresponding surgical methodology remain controversial [1][2][3][4][5][6]. Although several algorithms have been proposed to guide the surgical approach, the majority focus solely on the proximal transverse arch (PTA) dimension [5][6][7][8][9], and little attention has been given to the distal transverse arch (DTA). Following a thoracotomy, the DTA is largely incorporated within the extended end-to-end anastomosis (EEEA). ...

Reference:

Distal Transverse Arch Dimensions Dictate Long-Term Aortic Arch Gradients Following Coarctation of the Aorta Repair During Early Infancy

... From an ethical perspective, as management and treatment options for T13 and T18 evolve, we must consider whether any intervention we offer for a single-organ insufficiency, when considered in the context of multiple comorbidities associated with the genetic diagnosis, is reasonable for the child and their family. The prospect of performing surgical interventions and providing medical therapies for these children must be explored with a tailored view of the patient's care, while also considering the patient's QoL as well as his family's overall values, goals, and QoL [9,[34][35][36]. According to different organizations of healthcare systems around the world, some face varying access to care. ...

Reference:

Early assessment of clinical complexity and home care in patients affected by trisomy 13 and 18

... Once blood comes into contact with the artificial components of the ECMO circuit, activation of hemostatic and inflammatory systems ensues, promoting thrombin generation [86,87]. Systemic anticoagulation is typically initiated after ECMO cannulation in an effort to mitigate this response, however, it may also contribute to life-threatening bleeding in the patient, especially when combined with platelet and clotting factor consumption due to underlying critical illness and potentiated by exposure to the ECMO circuit [88]. Despite concerns about the increased risk of hemorrhagic complications, neither therapeutic nor excessive anticoagulation alone fully explains the increased prevalence of hemorrhagic events in ECMO patients [89][90][91]. ...

Reference:

Plasma brain-related biomarkers and potential therapeutic targets in pediatric ECMO

... Additionally, no strong guidelines were established in the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB) or The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) consensus conferences due to the lack of robust evidence [15,16]. The mostly homogeneous thresholds seen in minimal bleeding scenarios, along with the wide variability in resolved severe bleeding cases, highlight the absence of consensus on best practices. ...

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Platelet transfusion stated practices among neonatal and paediatric veno‐arterial extracorporeal membrane oxygenation providers: A survey

... Patients in the PCICU are in a hypercoagulable state following surgery, and the endothelial damage and stasis of blood flow that accompany the insertion of central venous catheters complete Virchow triad for thrombosis formation. 42 Indeed, pediatric patients undergoing surgery for congenital heart anomalies show a venous thromboembolism incidence of 2% to 18%. 43,44 Clinically, suspicion of thrombosis is aroused by clinical observations of edema, pain, tenderness, and phlebitis, and thrombosis is subsequently confirmed with ultrasound. ...

Reference:

Role of Artificial Intelligence in Congenital Heart Disease and Interventions

... In our study, the A172 cells were chosen as mitochondrial sources because it has been shown in vitro that astrocytes can naturally transfer their mitochondria to neurons under stress conditions [11,13]. In addition, the most relevant sources of mitochondria would be the same tissue as the targeted organ [20]. Therefore, the source of mitochondria to ensure the optimal effects of the transplantation is a relevant question, considering that their activity depends on their tissue origin [4]. ...

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Mitochondrial transplantation improves bioenergetics and neurite outgrowth in disease-associated P301Ltau-expressing neuronal cells

... Multiple devices have been used, including a fenestrated Amplatzer ASD occluder, a diabolo-shaped covered stent, and, most commonly, a fenestrated micro vascular plug device (Medtronic, Minneapolis, MN). The use of micro vascular plug devices as pulmonary flow restrictors has been found to be safe and effective [65][66][67], though cases of distal device migration, pulmonary over-circulation, pulmonary artery stenosis, and jailing of the branch pulmonary artery have been documented [68,69]. ...

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Updates in interventional cardiology in children with cardiac disease