The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
The Circulatory Arrest Recovery Ammonia Problem (CARAP) Hypothesis: a 1H-MRS study of brain metabolism during neonatal cardiopulmonary bypass surgery.
Congenital heart disease affects 1% of US births, with many babies requiring major cardiothoracic surgery under cardiopulmonary bypass (CPB), exposing the more critical patients to neurodevelopmental impairment. Optimal surgical parameters to minimize neuronal injury are unknown. We used proton magnetic resonance spectroscopy (1H MRS) and blood ammonia assays in a neonatal pig model of CPB to compare 2 approaches, complete circulatory arrest (CA) versus antegrade cerebral perfusion. ⋯ Serial 1H-MRS and blood ammonia assays in this preclinical CPB model identified a previously unreported build-up of ammonia, hypothesized to arise from gut bacterial production, after reperfusion, that may contribute to brain injury in these pediatric surgeries.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Comparing innovative AI algorithms to assess echocardiographic videos for clinical modelling.
We conduct a comparative study that employs the use of multiple dynamic deep learning algorithms to develop predictive models with video-based echocardiographic images using sample size determination as a key variable to assess optimal performance metrics. ⋯ Because semi-supervised models use both labelled and unlabelled data sets, our findings are significant in showing that performance of certain predictive models using mixtures of unlabelled and labelled data is comparable to those using only labelled data with similar sample sizes, thus obviating the need for large sample sizes of labelled data.