Mechanical support and transplantation

Filmed at the 2017 Annual STS Meeting in Houston, Texas, Dr Robert Sade moderates a debate on the appropriate course of care in the fictional case of a child who cannot be weaned from bypass following heart surgery.

This video demonstrates a “split-graft technique” for heart transplant following a hybrid bridge to transplantation approach in a neonate with an underlying diagnosis of aortic atresia and hypoplastic arch.

Changes in risk profile and outcomes over 40 years were assessed from the Stanford experience with heart transplant in children.  Age at transplant decreased in the most recent time period from about 10 to 5.6 years.  The use of mechnical support as bridge increased dramatically over the time of the study.  Long-term survival increased dramatically,

This single institution study evaluated the effects of 24-hr in hospital congenital cardiac surgery coverage on outcomes for perioperative congenital heart surgery ECMO.  Institution of 24-hr coverage reduced hospital mortality from 68% to 43% as well as rates of cardiac arrhythmias and pneumonia.  24-hr coverage was independently associated with a r