Abstract Background and Aims Adults with congenital heart disease tend to develop both cardiac and noncardiac age-related comorbidities earlier in life than the general population, suggesting accelerated biological ageing. Epigenetic clocks estimate biological age based on DNA methylation profiles. This study investigated whether adults with congenital heart disease display accelerated..
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Abstract Objectives To identify risk factors associated with inadequate heparin response in pediatric congenital heart surgery requiring cardiopulmonary bypass and to develop age-specific predictive scoring systems. Design Retrospective cohort study. Setting Tertiary medical center. Participants Pediatric patients (age <18 years) undergoing congenital heart surgery on cardiopulmonary bypass between December 2022..
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Abstract Congenital heart disease (CHD) is the most common congenital anomaly worldwide and is associated with substantial infant morbidity and mortality. This narrative review synthesizes evidence linking CHD to alterations in the gut microbiome across neonatal, perioperative, and chronic stages and highlights a gut–heart–immune framework in which microbial imbalance, intestinal..
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Abstract Importance Neurodevelopmental impairments are common in children with congenital heart disease. Objectives To compare neurodevelopmental outcomes by cardiac diagnosis and identify associations between medical and social factors and early neurodevelopmental outcomes among children with congenital heart disease. Design, Setting, and Participants This cross-sectional analysis used neurodevelopmental follow-up data obtained between May 1,..
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Abstract Background Discovered in 1938, haptoglobin is a liver-produced α2-glycoprotein that binds free hemoglobin, mitigating its toxic effects, and serves as a biomarker for hemolysis. The current study, under the HAPPI Kids initiative, aimed to define paediatric reference intervals for haptoglobin through the collection of samples from healthy children and..
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Abstract Background In 2019, the American Society of Extracorporeal Technology (AmSECT) approved the inaugural Standards and Guidelines for Pediatric and Congenital Perfusion Practice. These standards and guidelines were created with the intent of periodic revision to ensure continued alignment with evolving best practices. In 2023, an AmSECT subcommittee initiated this review..
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Abstract Effective perioperative hemostasis in pediatric cardiac surgery depends not only on accurate diagnostics and targeted transfusion strategies but also on a clear and consistent definition of postoperative bleeding. Despite the clinical importance of bleeding in neonates and children undergoing cardiopulmonary bypass, bleeding remains variably defined across institutions, registries, and..
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Abstract Aim Congenital heart disease still has significant morbidity and mortality despite advances in surgery. Inadequate tissue perfusion is thought to be the primary cause. Monitoring children with cerebral oxygenation with near infrared spectroscopy before and after surgery may predict pre- and post-operative mortality. This study evaluated the benefits of..
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Abstract Background: Pediatric cardiac surgery is still a high-risk procedure, with mortality being a significant concern. Lactate clearance has been demonstrated to enhance outcomes in critically ill adult populations; however, data regarding its significance in the context of pediatric cardiac surgery has been limited, particularly in resource-limited settings like Nepal. The..
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Abstract Background Congenital heart disease (CHD) remains a leading cause of pediatric morbidity and mortality worldwide. Cardiopulmonary bypass (CPB) is crucial for surgical repair but is associated with systemic inflammation and/or end-organ dysfunction. Ultrafiltration (UF) techniques, particularly zero-balance ultrafiltration (Z-BUF), have been developed to mitigate these effects by removing cytokines...
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