Are outcomes in congenital cardiac surgery better than ever?

Holcomb, Ryan M.; Ündar, Akif

doi:10.1111/jocs.16225

Cited by 7 publications

(3 citation statements)

References 71 publications

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“…About one of four infants is diagnosed with a critical defect and will need surgery within the first year of life ( 1 ). Pediatric cardiac surgery has achieved numerous significant advancements in the last few decades ( 2 ). Some improvements are due to the implementation of new materials that make it possible to correct even anatomically complex cases ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…With regard to this issue, one of the most critical problems is the limited availability of high-performing devices and materials for this category of patients. As a result, currently used materials may help save lives, but they do not offer unrestricted lifespans ( 2 , 3 ). In addition to already known phenomena of tissue degeneration, there are additional concerns with foreign materials in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

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Biogenic polymer-based patches for congenital cardiac surgery: a feasibility study

Richert,

Nienhaus,

Ekroll Jahren

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveCurrently used patch materials in congenital cardiac surgery do not grow, renew, or remodel. Patch calcification occurs more rapidly in pediatric patients eventually leading to reoperations. Bacterial cellulose (BC) as a biogenic polymer offers high tensile strength, biocompatibility, and hemocompatibility. Thus, we further investigated the biomechanical properties of BC for use as patch material.MethodsThe BC-producing bacteria Acetobacter xylinum were cultured in different environments to investigate optimal culturing conditions. For mechanical characterization, an established method of inflation for biaxial testing was used. The applied static pressure and deflection height of the BC patch were measured. Furthermore, a displacement and strain distribution analysis was performed and compared to a standard xenograft pericardial patch.ResultsThe examination of the culturing conditions revealed that the BC became homogenous and stable when cultivated at 29°C, 60% oxygen concentration, and culturing medium exchange every third day for a total culturing period of 12 days. The estimated elastic modulus of the BC patches ranged from 200 to 530 MPa compared to 230 MPa for the pericardial patch. The strain distributions, calculated from preloaded (2 mmHg) to 80 mmHg inflation, show BC patch strains ranging between 0.6% and 4%, which was comparable to the pericardial patch. However, the pressure at rupture and peak deflection height varied greatly, ranging from 67 to around 200 mmHg and 0.96 to 5.28 mm, respectively. The same patch thickness does not automatically result in the same material properties indicating that the manufacturing conditions have a significant impact on durabilityConclusionsBC patches can achieve comparable results to pericardial patches in terms of strain behavior as well as in the maximum applied pressure that can be withstood without rupture. Bacterial cellulose patches could be a promising material worth further research.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biogenic polymer-based patches for congenital cardiac surgery: a feasibility study

Richert,

Nienhaus,

Ekroll Jahren

et al. 2023

Front. Cardiovasc. Med.

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“…1 With surgical intervention, the mortality for children with CHD can be reduced to as low as 3%. 2 Therefore, early detection of CHD is very important.…”

Section: Introductionmentioning

confidence: 99%

A deep learning-based method for pediatric congenital heart disease detection with seven standard views in echocardiography

Jiang

Jin

et al. 2023

World Jnl Ped Surgery

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BackgroundWith the aggregation of clinical data and the evolution of computational resources, artificial intelligence-based methods have become possible to facilitate clinical diagnosis. For congenital heart disease (CHD) detection, recent deep learning-based methods tend to achieve classification with few views or even a single view. Due to the complexity of CHD, the input images for the deep learning model should cover as many anatomical structures of the heart as possible to enhance the accuracy and robustness of the algorithm. In this paper, we first propose a deep learning method based on seven views for CHD classification and then validate it with clinical data, the results of which show the competitiveness of our approach.MethodsA total of 1411 children admitted to the Children’s Hospital of Zhejiang University School of Medicine were selected, and their echocardiographic videos were obtained. Then, seven standard views were selected from each video, which were used as the input to the deep learning model to obtain the final result after training, validation and testing.ResultsIn the test set, when a reasonable type of image was input, the area under the curve (AUC) value could reach 0.91, and the accuracy could reach 92.3%. During the experiment, shear transformation was used as interference to test the infection resistance of our method. As long as appropriate data were input, the above experimental results would not fluctuate obviously even if artificial interference was applied.ConclusionsThese results indicate that the deep learning model based on the seven standard echocardiographic views can effectively detect CHD in children, and this approach has considerable value in practical application.

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Statistical process monitoring creates a hemodynamic trajectory map after pediatric cardiac surgery: A case study of the arterial switch operation

Howsmon,

Mikulski,

Kabra

et al. 2024

Bioengineering & Transla Med

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Postoperative critical care management of congenital heart disease patients requires prompt intervention when the patient deviates significantly from clinician‐determined vital sign and hemodynamic goals. Current monitoring systems only allow for static thresholds to be set on individual variables, despite the expectations that these signals change as the patient recovers and that variables interact. To address this incongruency, we have employed statistical process monitoring (SPM) techniques originally developed to monitor batch industrial processes to monitor high‐frequency vital sign and hemodynamic data to establish multivariate trajectory maps for patients with d‐transposition of the great arteries following the arterial switch operation. In addition to providing multivariate trajectory maps, the multivariate control charts produced by the SPM framework allow for assessment of adherence to the desired trajectory at each time point as the data is collected. Control charts based on slow feature analysis were compared with those based on principal component analysis. Alarms generated by the multivariate control charts are discussed in the context of the available clinical documentation.

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Are outcomes in congenital cardiac surgery better than ever?

Cited by 7 publications

References 71 publications

Biogenic polymer-based patches for congenital cardiac surgery: a feasibility study

Biogenic polymer-based patches for congenital cardiac surgery: a feasibility study

A deep learning-based method for pediatric congenital heart disease detection with seven standard views in echocardiography

Statistical process monitoring creates a hemodynamic trajectory map after pediatric cardiac surgery: A case study of the arterial switch operation

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