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Overall, by the long-term follow-up of 77 children with prenatal SVES we could show that prenatal SVES has a good prognosis. However, 30% of children develop arrhythmia postpartum and 31% of children present with cardiac anomalies. These children still have a worse prognosis than children with isolated prenatal SVES.

A 58-year-old man with recently diagnosed diabetes mellitus presented to the emergency department after a syncopal event with a prodrome of lightheadedness. According to witnesses, he woke up quickly and complained of left-sided chest pain immediately after the fall. He had no chest pain prior to the event and denied shortness of breath, diaphoresis, palpitations, or dizziness at the time of evaluation. He was in no respiratory distress and was alert and oriented to person, place, and time. His vital signs were temperature 97.8°F, heart rate 115 beats ⁄ min, respiratory rate 18 breaths ⁄ min, blood pressure 90 ⁄ 61 mm Hg, and oxygen saturation 99% while breathing room air. His physical exam was otherwise unremarkable.While awaiting portable chest radiography, a bedside cardiac ultrasound (US) was performed by the emergency physician using a 5-1 MHz phased array transducer (SonoSite MTurbo, Bothell, WA). Although the subcostal view was unremarkable, upon imaging the parasternal region, the pro-

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Background: Right ventricular failure (RVF) remains one of the major causes of morbidity and mortality after left ventricular assist device (LVAD) implantation. We sought to compare immediate postoperative invasive hemodynamics and the risk of RVF following two different surgical approaches: less invasive surgery (LIS) versus full sternotomy (FS). Methods:The study population comprised all 231 patients who underwent implantation of a HeartMate 3 (Abbott) LVAD at our institution from 2015 to 2020, utilizing an LIS (n = 161; 70%) versus FS (n = 70; 30%) surgical approach.Outcomes included postoperative invasive hemodynamic parameters, vasoactiveinotropic score (VIS), RVF during index hospitalization, and 6-month mortality.Results: Baseline clinical characteristics of the two groups were similar. Multivariate analysis showed that LIS, compared with FS, was associated with the improved cardiac index (CI) at the sixth postoperative hour (p = .036) and similar CI at 24 h, maintained by lower VIS at both timepoints (p = .002). The LIS versus FS approach was also associated with a three-fold lower incidence of in-hospital severe RVF (8.7% vs. 28.6%, p < .001) and need for RVAD support (5.0% vs. 17.1%, p = .003), and with 68% reduction in the risk of 6-month mortality after LVAD implantation (Hazard ratio, 0.32; CI, 0.13-0.78; p = .012). Conclusion:Our findings suggest that LIS, compared with FS, is associated with a more favorable hemodynamic profile, as indicated by similar hemodynamic parameters maintained by lower vasoactive-inotropic support during the acute postoperative period. These findings were followed by a reduction in the risk of severe RVF and 6-month mortality in the LIS group.