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Background Study Design and Methods Results Conclusions Low titer group O whole blood (LTOWB) is commonly used for severe bleeding in trauma patients. LTOWB may also benefit young children requiring cardiac surgery with cardiopulmonary bypass (CPB) at risk of severe bleeding.In this retrospective study, children <2 years old who underwent cardiac surgery with CPB were included. Comparisons were performed between those receiving component therapy (CT) versus those receiving LTOWB plus CT (LTOWB+CT). Outcomes included drainage tube (DT) output and total transfusion volumes. Optimization‐based weighting was used for adjusted analyses between groups.There were 117 patients transfused with only CT and 127 patients transfused with LTOWB+CT. In the LTOWB+CT group, 66 were Group non‐O and 61 were Group O. Total transfusion volumes given from the start of the operation until the first 24 h in the cardiac intensive care unit was a median (IQR) 41 (10, 93) mL/kg in the CT group and 48 (28, 77) mL/kg in the LTOWB+CT group, (p = .28). Median (IQR) DT output was 22 (15–32) in CT versus 22 (16–28) in LTOWB+CT groups, (p = .27). There were no differences in death, renal failure and a composite of death and renal failure between the two groups, but there were statistically fewer re‐explorations for bleeding in the LTOWB+CT group (p < .001).The use of LTOWB appears to be safe in <2 years old undergoing cardiac surgery and may reduce re‐explorations for severe bleeding. Large trials are needed to determine the efficacy and safety of LTOWB in this population with severe bleeding. [ABSTRACT FROM AUTHOR]

Minimally invasive approaches for cardiac surgery in children have been lagging in comparison to the adult world. A wide range of the most common congenital heart defects in infants and children can be repaired successfully through a variety of non-sternotomy incisions. This has been shown to be associated with superior cosmetic results, shorter hospital stays, and rapid return to full activity compared to sternotomy. These approaches have been around for decades, but they have not been widely adopted for a variety of reasons. Right axillary thoracotomy is one of these approaches that we believe should be the new standard for the repair of a wide variety of heart defects in children and will be the focus of our current review. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy is a prevalent cause of sudden cardiac death among young people. This distinctive genetic condition can manifest at any age from infancy to adulthood. The primary features include unexplained left ventricular hypertrophy coupled with dynamic left ventricular outflow tract (LVOT) obstruction and a variable degree of mitral valve regurgitation. In certain cases, patients may also experience biventricular outflow tract obstruction. Surgical septal myectomy is the gold standard treatment for symptomatic children experiencing severe LVOT obstruction. This review focuses on surgical techniques for septal myectomy in pediatric patients and other adjunct procedures and summarizes the current outcomes. Keywords:Hypertrophic cardiomyopathy, sudden cardiac death, left ventricular outflow tract obstruction, asymmetrical septal hypertrophy, left ventricular myectomy: [ABSTRACT FROM AUTHOR]

The extracardiac Fontan procedure is the final common pathway for palliation of patients with univentricular physiology. The procedure is typically performed on cardiopulmonary bypass with or without fenestration using an adequate-sized polytetrafluoroethylene graft as the extracardiac conduit. On a few occasions, some patients may develop narrowing of their conduit with or without calcifications, which is often managed by various transcatheter techniques. Rarely, some of these conduits must be replaced surgically. In the current report, we present an alternative to standard surgical replacement of the calcified Fontan conduit in a patient with dextrocardia. [ABSTRACT FROM AUTHOR]

Valve surgery is common in cardiac procedures, with fasteners like COR-KNOT® and hand-tied knots used for knot securing. This study compares their efficacy in valve surgery patients. We searched PubMed, SCOPUS, and Cochrane Central until August 2023. Outcomes assessed included aortic cross-clamp time (AXT), cardiopulmonary bypass (CPB) time, valvular regurgitation, mortality, prolonged ventilatory support, atrial fibrillation, postoperative left ventricular ejection fraction (LVEF), and renal failure. Subgroup analysis was performed for minimally invasive and open cardiac surgery. We used a random effects model for analysis. We included eight observational studies and two randomized controlled trials (RCTs) with a total of 1.411 participants. COR-KNOT significantly reduced AXT [MD -15.14, 95 % CI (-18.57, -11.70), P<0.00001] and CPB time [MD -12.38, 95 % CI (-14.99, -9.77), P<0.00001]. Valvular regurgitation [RR 0.40, 95 % CI (0.26, 0.61), P<0.0001] and need for prolonged ventilatory support [RR 0.29, 95 % CI (0.13, 0.65), P=0.003] were significantly lower with COR-KNOT. There were no significant differences in mortality [RR 0.39, 95 % CI (0.09, 1.69), P=0.44], atrial fibrillation [RR 1.03, 95 % CI (0.83, 1.27), P=0.81], LVEF changes [MD 0.05, 95 % CI (-1.37, 1.47), P = 0.95], or renal failure [RR 0.87, 95 % CI (0.16, 4.80), P = 0.87]. COR-KNOT devices reduce operative time and valvular regurgitation without increasing mortality or adverse outcomes. This supports their use in enhancing surgical efficiency and patient outcomes. However, ongoing discussions about suturing techniques, especially in minimally invasive procedures, highlight the need for further research and consensus among practitioners. [ABSTRACT FROM AUTHOR]