Open Access

EDITORIAL

Editorial: Announcing the Renaming of Our Journal

Xuming Mo^1,*, Kisaburo Sakamoto^2,*, Vladimiro L. Vida^3,*

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.080525 - 31 March 2026
Abstract This article has no abstract. More >

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ARTICLE

Expert Consensus on Right Axillary Incision Approach for Open-Heart Surgery in Congenital Heart Disease

Xuming Mo^1,*, Taibing Fan^2,*, Zhongdong Hua^3,*, Christoph Haller⁴, Shinichiro Oda⁵, Shuhua Luo⁶, Weijie Liang², Yuzhong Yang¹, Huaipu Liu³, Nianguo Dong⁷, Shoujun Li⁸, Xinxin Chen⁹, Jimei Chen¹⁰, Hao Zhang¹¹, Qiang Shu¹², Haibo Zhang¹¹, Quansheng Xing¹³, Jinghao Zheng¹¹, Xiaofeng Li¹⁴, Teng Ming¹⁵, Qi An¹⁶, Ping Wen¹⁷, Qiang Wang¹⁸, Jirong Qi¹, Huiwen Chen¹¹, Shusheng Wen¹⁹, Rui Chen²⁰, Ming Ye²¹, Keming Yang⁸, Minhua Fang²², Caixia Liu²³, Ke Lin¹⁶, Zhongshi Wu²⁴, Xiangming Fan¹², Zhengxia Pan²⁵, Yiqun Ding²⁶, Ming’an Pi²⁷, Xin Li²⁸, Yong Zou²⁹, Shuguang Tao³⁰, Renwei Chen³¹, Li Ma⁹, Libing Zhang³², Tao You³³, Dongshan Liao³⁴, Cheng Zhou³⁵, Hongxin Li³⁶, Gengxu Zhou³⁷, Chunhu Gu³⁸, Zhiqiang Li³⁹, Yonggang Li²⁵, Hui Zhang⁴⁰, Xiaomin He¹¹, Yanan Lu¹¹, Haifa Hong⁴¹, Benqing Zhang⁸, Li Gong²⁷, Jiafeng Qi⁴², Song Bai³⁹, Yuhang Liu⁴³, Tianli Zhao²⁴, Cardiothoracic Surgery Group, Pediatric Surgery Branch of Chinese Medical Doctor Association, Cardiac Surgery Group, Pediatric Surgery Branch of Chinese Medical Association, the Asian Association for Pediatric and Congenital Heart Surgery

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.077974 - 31 March 2026
Abstract Congenital heart disease (CHD) is a common birth defect in children, and surgical intervention is the primary treatment. The traditional standard median sternotomy (MS) has drawbacks such as significant trauma and obvious scarring. The right axillary incision (RAI) has gradually become a conventional approach due to its advantages of preserving thoracic cage integrity, small incision size, rapid recovery, and hidden scarring. However, there is currently a lack of relevant guidelines and consensus for its application. This consensus adopts the international Delphi process, systematically searching domestic and foreign literature on CHD from 1982 to 2024. It… More >

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ARTICLE

Analysis of Relevant Factors Associated with Postoperative Recovery after Anomalous Origin of the Left Coronary Artery from Pulmonary Artery Surgery in Children

Jia Yuan^1,2,#, Yanxing Lv^2,#, Xinyuan Ding³, Yunyi Zeng¹, Li Ma⁴, Hang Yang¹, Lin Jiang¹, Kamil Bildebayev⁵, Boiko Yuliya Nikolaevna⁵, Na Zhou^1,*

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.076648 - 31 March 2026
Abstract Backgorund: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly of coronary artery anatomy, usually diagnosed in infancy, but adults may also be affected by this deformity. Objectives: The aim of this study is to examine long-term outcomes in patients with ALCAPA and analyze the relevant factors influencing postoperative outcomes. Methods: The records of patients with ALCAPA admitted from January 2015 to December 2024 were retrospectively reviewed. Clinical data of the patients were retrieved from the records. The follow-up data included mortality rates and complications. Kaplan-Meier survival curves were… More >

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76

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ARTICLE

Impact of a Multifaceted Prevention Program on Ventilator-Associated Pneumonia in a Surgical Pediatric Cardiac ICU

Xiaofeng Wang^1,#, Da Huo^2,3,#, Shuo Li^4,#, Wenlong Wang¹, Qian Zhang¹, Ya Gao⁵, Xu Wang^1,*

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.077612 - 31 March 2026
Abstract Background: This study evaluated the impact of a comprehensive prevention program, which integrated eight evidence-based measures consistent with current clinical guidelines and practice standards, on ventilator-associated pneumonia (VAP) rates in a pediatric cardiac surgical intensive care unit (ICU). Methods: A quasi-experimental study was conducted from 2023 to 2024. We compared VAP rates across a 5-month pre-intervention period, a 12-month intervention period, and a 7-month post-intervention period in patients receiving mechanical ventilation for over 48 h. Additional outcomes, including postoperative length of stay were also assessed before and after the intervention. Results: Among 829 at-risk patients and 5677… More >

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CASE REPORT

Progressive Right Ventricular Outflow Tract Obstruction Following Perimembranous VSD Closure with Lifetech™ Konar-Multifunctional Occluder (MFO) Device: A Rare Case of Valve–Device Interaction

Mete Han Kizilkaya¹, Boran Cakan^2,3,*, Mehmet Bicer⁴, Ender Odemis^1,5

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.074189 - 31 March 2026
Abstract Background: Transcatheter closure of perimembranous ventricular septal defects (pmVSDs) with Lifetech™ Konar-Multifunctional Occluder (MFO) has demonstrated high procedural success and safety. However, long-term complications due to valve–device interaction are rarely reported. We describe a pediatric patient who developed progressive right ventricular outflow tract (RVOT) obstruction and severe tricuspid regurgitation 20 months after MFO closure, highlighting mechanisms, management, and outcomes. Case Description: A 13-year-old girl underwent successful MFO closure of a 6-mm pmVSD. Early follow-up showed trivial tricuspid regurgitation and mild subpulmonic stenosis. Pre-procedural imaging revealed right ventricular hypertrophy caused by long-standing jet-related turbulence from the pmVSD, with… More >

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67

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CASE REPORT

Late Embolization of a Ductal Stent in Pulmonary Atresia with Intact Ventricular Septum Successfully Managed by Urgent Central Shunt Reconstruction: A Case Report

Ricardo Garcia-Mora¹, Gunther Hernández-Morales², Miguel Ángel Chagolla-Santillán³, Iliana Acevedo-Bañuelos³, Jorge Luis Cervantes-Salazar⁴, Edel Rafael Rodea-Montero^5,*

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.071470 - 31 March 2026
Abstract We report a full-term newborn with pulmonary atresia with an intact ventricular septum who developed acute hypoxemia after ductal stent embolization. Emergency surgery was performed to remove the stent and create a central systemic-to-pulmonary shunt using a 3.5 mm GORE-TEX^® graft via a modified Gates, Laks, and Johnson technique. Postoperative recovery was favorable. At 24 months, the shunt remained patent with adequate pulmonary artery growth. This case underscores prompt surgical rescue and supports central shunting as an effective mid-term solution. More >

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REVIEW

Research Advances on the Mechanisms and Clinical Outcomes of Hyperglycemia in Pregnancy Leading to Congenital Heart Disease in Offspring

Jiafei He^1,2, Ailixiati Alifu², Haifan Wang², Renwei Chen^1,2,*

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.075858 - 31 March 2026
Abstract Hyperglycemia in pregnancy (HIP) is an important independent risk factor for congenital heart disease (CHD) in offspring. With an increasing number of women of childbearing age experiencing gestational hyperglycemia, the impact of an intrauterine hyperglycemic environment on fetal development has drawn significant attention. However, the teratogenic mechanisms underlying its effects on cardiac development remain incompletely understood. This review systematically analyzes relevant literature to summarize its underlying mechanisms and key findings: A hyperglycemic environment disrupts cardiac neural crest cell migration, differentiation, and the proliferation/apoptosis balance of cardiomyocytes by inducing oxidative stress, endoplasmic reticulum stress, and inflammatory… More >

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69

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ARTICLE

From Limited Samples to Mechanistic Insights: Exploring Ferroptosis-Related Genes in Hypoplastic Left Heart Syndrome

Yiheng Pang^1,#, Naixia Chao^2,#, Hongji Li³, Mingxi Xie³, Chunxia Wang^4,*, Ge Xu^1,*

Structural and Congenital Heart Disease, Vol.21, No.1, 2026, DOI:10.32604/schd.2026.072858 - 31 March 2026
Abstract Background: Hypoplastic left heart syndrome (HLHS) is a congenital heart disease (CHD), and accumulating evidence has implicated ferroptosis in the pathogenesis of HLHS. Therefore, exploring ferroptosis-related genes (FRGs) in HLHS is of clinical significance. Materials and Methods: Gene Expression Omnibus (GEO) was accessed to obtain analytical data. WGCNA was employed to screen relevant module genes, and the limma package was used to identify differentially expressed genes (DEGs). The rfe function in the R package caret and the glmnet package were utilized to conduct SVM-RFE and LASSO regression analyses, and the intersection of these two analyses was taken… More >

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119

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ARTICLE

2025 Chinese Expert Consensus on Clinical Applications of Biodegradable Patent Foramen Ovale Occluders

Caojin Zhang^1,#, Haibo Hu^2,#, Gangcheng Zhang^3,#, Qiguang Wang⁴, Xiaobin Chen⁵, Yingzhang Cheng⁶, Qunshan Shen⁷, Jie Yuan⁸, Wenqi Zhang⁹, Yuanshi Li¹⁰, Xuan Zheng³, Xiangbin Pan^2,*, Professional Committee of National Quality Management and Control Center for Structural Heart Diseases, Professional Committee of Structural Heart Diseases of the National Cardiovascular Disease Expert Committee

Congenital Heart Disease, Vol.20, No.4, pp. 403-420, 2025, DOI:10.32604/chd.2025.071050
Abstract Compared with traditional nickel-titanium alloy patent foramen ovale occluders, which are widely used in clinical practice, biodegradable patent foramen ovale occluders have obvious differences in material characteristics, interventional operation mode and postoperative management strategy. This article gives expert consensus on the selection of clinical indications and standardized operating procedures, so as to standardize the clinical application of biodegradable patent foramen ovale occluders. More >

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4007

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ARTICLE

Nationwide Trends in Congenital Heart Disease Surgery in Korea, 2002–2018: Volume, Age-Standardized Incidence, and Lesion-Based Case-Mix

Jae Sung Son¹, Soo-Jin Kim^2,*

Congenital Heart Disease, Vol.20, No.4, pp. 421-440, 2025, DOI:10.32604/chd.2025.070250
Abstract Background: Advancements in diagnostic tools, surgical techniques, and long-term management have significantly improved survival among individuals with congenital heart disease (CHD), leading to an evolving epidemiologic profile characterized by increasing procedural complexity and a growing adult CHD population. This study aimed to examine nationwide trends in CHD surgeries over a 17-year period, with a focus on temporal shifts in surgical volume, procedural complexity, and age-specific incidence. Methods: A total of 41,608 CHD surgeries and 85,417 surgical procedures performed between 2002 and 2018 were identified from a nationwide health insurance database. Temporal trends were evaluated using segmented… More >

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4044

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LETTER

Semilunar Valve Replacement with a Telescoping Arterial Trunk Valve

Edo Bedzra^1,2,*, Herra Javed^3,4, James E. O’Brien^1,2, Taufiek Konrad Rajab^3,4

Congenital Heart Disease, Vol.20, No.4, pp. 441-446, 2025, DOI:10.32604/chd.2025.071035
（This article belongs to the Special Issue: Novel Methods and Techniques for the Management of Congenital Heart Disease)
Abstract A bicuspid aortic valve, from autologous tissue, with growth potential can be constructed using the simple, and reproducible telescoping arterial trunk technique. More >

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6649

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3869

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ARTICLE

Prognostic Value of the Perioperative Neutrophil–Lymphocyte Ratio for Adverse Outcomes in Pediatric Congenital Heart Surgery: A Retrospective Cohort Study

Hande İştar^1,#,*, Buğra Harmandar¹, Melike Korkmaz Toker², Fulden Cantaş Türkiş³

Congenital Heart Disease, Vol.20, No.4, pp. 503-517, 2025, DOI:10.32604/chd.2025.068540
（This article belongs to the Special Issue: Novel Insights into Congenital Heart Disease: Pathophysiology, Biomarkers, and Future Directions)
Abstract Background: The neutrophil–lymphocyte ratio (NLR) is a simple, cost-effective marker of systemic inflammation. This study aims to evaluate the association between perioperative NLR and postoperative outcomes in pediatric patients undergoing congenital heart surgery with cardiopulmonary bypass (CPB). Methods: We retrospectively reviewed 70 patients under 18 years of age who underwent surgery between 2018 and 2023. NLR was measured preoperatively and on postoperative days (POD) 0, 1, 2, 3, and 6. Receiver operating characteristic analysis identified optimal cutoffs, and associations with postoperative outcomes were assessed. Results: The preoperative NLR cutoff of 1.14 (AUC = 0.75) was associated with More >

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4104

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ARTICLE

Identification of Cardiac Risk Factors from ECG Signals Using Residual Neural Networks

Divya Arivalagan, Vignesh Ochathevan^*, Rubankumar Dhanasekaran

Congenital Heart Disease, Vol.20, No.4, pp. 477-501, 2025, DOI:10.32604/chd.2025.070372
Abstract Background: The accurate identification of cardiac abnormalities is essential for proper diagnosis and effective treatment of cardiovascular diseases. Method: This work introduces an advanced methodology for detecting cardiac abnormalities and estimating electrocardiographic age (ECG Age) using sophisticated signal processing and deep learning techniques. This study looks at six main heart conditions found in 12-lead electrocardiogram (ECG) data. It addresses important issues like class imbalances, missing lead scenarios, and model generalizations. A modified residual neural network (ResNet) architecture was developed to enhance the detection of cardiac abnormalities. Results: The proposed ResNet demonst rated superior performance when compared with… More >

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ARTICLE

Efficacy of Descending Aortic Retrograde Flow Area to Forward Flow Area Ratio on Echocardiography in Perioperative Management after Blalock-Thomas-Taussig Shunt

Kentaro Kogawa^1,2,*, Reiji Ito², Daishi Hirano², Kenji Hoshino^1,2

Congenital Heart Disease, Vol.20, No.4, pp. 451-461, 2025, DOI:10.32604/chd.2025.068006
（This article belongs to the Special Issue: Novel Methods and Techniques for the Management of Congenital Heart Disease)
Abstract Objective: To investigate the usefulness of the descending aortic retrograde flow area to forward flow area (dAO RF) ratio using echocardiography in managing pulmonary blood flow during the perioperative period following Blalock-Thomas-Taussig shunt (BTTS) surgery. Methods: This retrospective study analyzed patient characteristics, surgical procedures, and perioperative courses. The dAO RF ratio was measured upon admission to the pediatric intensive care unit (PICU) and 12, 24, 48, and 72 h post-surgery. Blood pressure, percutaneous oxygen saturation, arterial blood gas values, and lactate levels were measured at the same time as the dAO RF ratio. Results: Seventy-one cases were… More >

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4494

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CASE REPORT

Case Report: A Third Patch as a Saviour in an Unsuccessful Complete Atrioventricular Septal Defect Repair

Emrah Şişli^1,*, Pelin Köşger²

Congenital Heart Disease, Vol.20, No.4, pp. 531-537, 2025, DOI:10.32604/chd.2025.067271
（This article belongs to the Special Issue: Novel Methods and Techniques for the Management of Congenital Heart Disease)
Abstract Residual atrioventricular valve regurgitation after correction of complete atrioventricular septal defect (cAVSD) is still not ideal. As a modification of the double-patch method, our technique comprises a suture-bite-wide strip of a third patch that is incorporated to the upper margin of the left side of the ventricular septal defect (VSD) patch. This third patch counteracts not only the valvular tissue loss caused by the suture bites but also the rightward displacement of the VSD patch in a bulged fashion that occurs with increased left ventricular pressure after weaning from cardiopulmonary bypass. This unfavorable outcome was More >

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3973

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ARTICLE

Preoperative ECMO Bridging in Pediatric Heart Transplantation: A Cohort Study on Graft Remodeling, Inflammatory Biomarkers and Survival

Hui Yi^1,2,#, Hongjian Shi^2,3,#, Fuquan Kan^2,4,#, Fan Han², Lei Wan⁵, Xiaoyang Hong¹, Zhe Zhao¹, Junjie Shao², Gang Wang¹, Hui Wang¹, Hua Yan⁵, Xiujuan Shi¹, Ran Zhang^2,6,*, Gengxu Zhou^1,*

Congenital Heart Disease, Vol.20, No.4, pp. 519-530, 2025, DOI:10.32604/chd.2025.067164
Abstract Background: To investigate the impact of preoperative extracorporeal membrane oxygenation (ECMO) on clinical outcomes in pediatric heart transplantation (PHT). Methods: This retrospective cohort analysis was conducted on 19 pediatric heart transplant recipients, divided into two groups: ECMO and non-ECMO, based on whether preoperative ECMO was utilized. We evaluated the patients’ surgical conditions, postoperative complications, and survival rates. Additionally, the analysis focused on the differences and correlations in clinical characteristics, inflammatory markers, and long-term survival outcomes. Results: There was no statistically significant difference in perioperative survival rates between the ECMO group (85.7%) and the non-ECMO group (83.3%). However,… More >

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1375

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COMMENTARY

Asymptomatic Ebstein’s Anomaly in Children and Adults: Intervene or Observe?

Runzhang Liang^1,2, Haiyun Yuan^1,2, Shusheng Wen^1,2,*

Congenital Heart Disease, Vol.20, No.4, pp. 447-449, 2025, DOI:10.32604/chd.2025.067838
Abstract This article has no abstract. More >

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4417

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3907

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ARTICLE

Long-Term Follow-Up of Percutaneous Stent Implantation for Residual Pulmonary Artery Stenosis in Pediatric Patients after Surgical Repair of Complicated Congenital Heart Diseases

Yifan Li^1,#, Xu Huang^2,#, Bingyu Ma³, Ling Sun¹, Shushui Wang¹, Zhiwei Zhang¹, Yumei Xie^1,*

Congenital Heart Disease, Vol.20, No.4, pp. 463-475, 2025, DOI:10.32604/chd.2025.068286
Abstract Objective: The aim of the present study was to investigate long-term efficacy and safety of percutaneous stent implantation for residual pulmonary artery stenosis (PAS) in pediatric patients after surgical repair of complicated congenital heart diseases (CHDs). Methods: All pediatric patients diagnosed with residual PAS after surgical repair of complicated CHDs between 1996 and 2020 were retrospectively enrolled in the study. Results: A total of 41 patients (30 males, 11 females; median age 5.0 years, median weight 17 kg) were followed-up for a median of 7.1 years. Follow-up echocardiography results demonstrated that the target vessel diameter increased from… More >

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