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Research & Innovation

At the Complex Biventricular Repair Program, we are always looking for new and safe ways to improve patient outcomes. That’s why we are committed to research and innovation that offers insight on a wide range of biventricular repair procedures that aim to restore a child’s ventricular functions.

Advances in valve repair and replacement

Our team’s close alignment with the Congenital Heart Valve Program has led to the development of advanced valve repair and replacement techniques, including expandable valve technology. It all starts with better imaging. New techniques in three-dimensional echocardiography help us understand how valves work and how to improve their function. We can enlarge valve leaflets, replace chords, and reinforce support structures to help preserve native valve function.

Image of Autus Valve, which expands as a child grows

A heart valve that grows along with a child could reduce invasive surgeries

A prosthetic pulmonary valve replacement can expand over time in a child’s anatomy — potentially reducing the number of invasive replacement surgeries.

Read more

Computational and 3-D modeling of the heart

Over the past five years, major advances in technology have allowed us to improve surgical planning and show families, in great detail, how we manage treatment. We work closely with Benderson Family Heart Center engineers to create computational 3-D models that help us visualize patient anatomy before surgery so we can have an accurate understanding of how we can best approach biventricular repair in each child.

Stem cell therapy for single ventricle and borderline left ventricle

Sitaram Emani, MD, is the principal investigator of this clinical trial, which explores whether injecting mesenchymal precursor cells (MPCs) directly into the left ventricle can help promote growth of the ventricle.

The goal of the trial is to determine if injection of MPCs will improve the chances of those patients with a single ventricle or borderline left ventricle to being converted to biventricular circulation, which could improve their quality of life and longevity over palliation.

Electrical conduction mapping

During complex biventricular repairs, conduction tissue — the unseen electrical system of the heart — is at risk for injury by a surgical tool, which would prompt the need for a pacemaker. A novel technique, developed by Boston Children’s surgeons and electrophysiologists in our Surgical Electrophysiology Program, identifies conduction tissue during surgery to help us mark where it is and avoid injury.

Surgeon looks at screen showing data

Conduction tissue mapping is shown to significantly reduce heart block

An electrophysiology tool guides biventricular repair and other surgeries.

Learn how mapping makes a difference
Illustration with images of doctor, a heart

'Seeing' the unseen: A way to pinpoint elusive cardiac conduction tissue

How conduction tissue mapping is reducing heart block

Hear from our experts
Illustration of surgeon holding small tool near heart

A new lens on cardiac surgery could also prevent arrhythmias

Our cardiac surgeons also found that using confocal microscopy could help reduce arrhythmia in congenital heart defect operations.

Learn how the tool is used in surgery

Recent publications

  1. Deep survival analysis from adult and pediatric electrocardiograms: a multi-center benchmark study; Dec 18, 2025; pubmed:41408648. View on PubMed
  2. Outcomes in Children Requiring a Preoperative Extracorporeal Membrane Oxygenation Bridge to an Index Cardiac Operation; Nov 8, 2025; pubmed:41204982. View on PubMed
  3. Complex atrioventricular valve repair with single left-sided papillary muscle; Nov 7, 2025; pubmed:41203065. View on PubMed
  4. Annulus downsizing in valve-sparing aortic root replacement predicts aortic valve reoperation in children and young adults; Oct 31, 2025; pubmed:41169323. View on PubMed
  5. Surgical Management and Long-Term Outcomes of Patients With Superior-Inferior Ventricles; Oct 24, 2025; pubmed:41135385. View on PubMed
  6. Aortic valve repair using aortic wall as leaflet patch material in children; Oct 20, 2025; pubmed:41112473. View on PubMed
  7. Neonatal rapid 2-stage double-switch operation for congenitally corrected transposition of the great arteries with severe tricuspid regurgitation; Oct 20, 2025; pubmed:41112437. View on PubMed
  8. Automated phenotyping of congenital heart disease for dynamic patient aggregation and outcome reporting; Oct 3, 2025; pubmed:41041623. View on PubMed
  9. Long-Term Outcomes in Infants After Tetralogy of Fallot Repair: Does Repair Strategy Matter?; Sep 14, 2025; pubmed:40946886. View on PubMed
  10. Infant Electrocardiogram-Based Deep Learning Predicts Critical Congenital Heart Disease; Sep 12, 2025; pubmed:40938228. View on PubMed
  11. Timing of the Arterial Switch Operation in Premature Neonates < 2 kg With d-Loop Transposition of the Great Arteries and Intact Ventricular Septum-A Case Series; Sep 9, 2025; pubmed:40924650. View on PubMed
  12. Mitral annular disjunction distance is associated with adverse outcomes in children and young adults with connective tissue disorders; Sep 8, 2025; pubmed:40921252. View on PubMed
  13. Natural Language Processing to Build a Multicenter Computable Phenotype Library for Adults with Congenital Heart Disease; Sep 2, 2025; pubmed:40894160. View on PubMed
  14. Growth of the Fontan pathway and its association with long-term outcomes; Jul 31, 2025; pubmed:40744160. View on PubMed
  15. Preclinical Assessment of Atorvastatin for Treatment of Endocardial Fibroelastosis; Jul 31, 2025; pubmed:40742359. View on PubMed
  16. Outcomes following repair of truncus arteriosus with interrupted aortic arch; Jul 27, 2025; pubmed:40716727. View on PubMed
  17. Atrioventricular Inflow and Subsequent Ventricular Growth After Staged Ventricular Recruitment for Unbalanced Atrioventricular Canal Defect; Jul 19, 2025; pubmed:40683434. View on PubMed
  18. Long-Term Systolic and Diastolic Function in Patients with Repaired Anomalous Left Coronary Artery from the Pulmonary Artery; Jul 18, 2025; pubmed:40679595. View on PubMed
  19. Predicting Outcomes in Pediatric Intraluminal Pulmonary Vein Stenosis Using a Comprehensive Standardized Catheterization Assessment: A Prospective Study; Jul 14, 2025; pubmed:40654078. View on PubMed
  20. A modification of the reinforced Ross procedure: Root pressurization before implantation; Jul 11, 2025; pubmed:40641753. View on PubMed
  21. Revitalizing donor organs: The potential of mitochondrial transplantation in heart and lung transplantation; Jul 7, 2025; pubmed:40623615. View on PubMed
  22. Neo-aortic valve regurgitation and root dilation after arterial switch operation in patients with native left ventricular outflow tract obstruction; Jul 6, 2025; pubmed:40618993. View on PubMed
  23. Artificial Intelligence-Enabled Electrocardiograms: Do 15-Lead Studies Improve Model Performance?; Jun 26, 2025; pubmed:40570608. View on PubMed
  24. Eliminating left ventricular outlet stenosis lowers the risk for endocardial fibroelastosis recurrence†; Jun 26, 2025; pubmed:40569053. View on PubMed
  25. Artificial Intelligence-Enabled ECG to Detect Congenitally Corrected Transposition of the Great Arteries; Jun 16, 2025; pubmed:40523997. View on PubMed
  26. Corrigendum to "Cardiac manifestations and outcomes of COVID-19 vaccine-associated myocarditis in the young in the USA: longitudinal results from the Myocarditis After COVID Vaccination (MACiV) multicenter study"; Jun 11, 2025; pubmed:40496878. View on PubMed
  27. Report of Facing Heterotaxy Together 2024: A Virtual, Multidisciplinary Scientific Conference; Jun 9, 2025; pubmed:40485340. View on PubMed
  28. Risk of Recurrence and Long-Term Outcomes of Ectopic Atrial Tachycardia After Surgery for Congenital Heart Disease; Jun 3, 2025; pubmed:40457882. View on PubMed
  29. Don't Give up on the Left Ventricle! Surgical Strategies for Recruitment of the Borderline Left Heart; May 17, 2025; pubmed:40382117. View on PubMed
  30. Myocardial Infarction in Kawasaki Disease; May 14, 2025; pubmed:40368243. View on PubMed
  31. Design and characterization of metallic microfasteners for mechanical adhesion to soft tissues; May 12, 2025; pubmed:40355017. View on PubMed
  32. Contemporary trends in utilization of pediatric cardiac imaging in children's hospitals; May 7, 2025; pubmed:40335336. View on PubMed
  33. Electrocardiogram-based deep learning to predict left ventricular systolic dysfunction in paediatric and adult congenital heart disease in the USA: a multicentre modelling study; Mar 27, 2025; pubmed:40148010. View on PubMed
  34. Indications and Practical Considerations for Partial Heart Transplantation; Mar 19, 2025; pubmed:40107593. View on PubMed
  35. Primary repair versus pulmonary artery banding in complete atrioventricular canal defects in the modern surgical era; Mar 7, 2025; pubmed:40054839. View on PubMed
  36. Rapid growth of CT utilization compared to MRI and echocardiography in imaging for congenital heart disease: A multicenter analysis; Feb 28, 2025; pubmed:40021402. View on PubMed
  37. Acute Effects of Enhanced External Counterpulsation in Adults With Fontan Circulation; Feb 21, 2025; pubmed:39983607. View on PubMed
  38. Comparison of cine cardiac CT and echocardiography for assessment of ventricular function late after the Fontan operation; Feb 5, 2025; pubmed:39909763. View on PubMed
  39. Proposed resources required for a comprehensive program for CCT CHD imaging; Jan 19, 2025; pubmed:39828491. View on PubMed
  40. Impact of Anticoagulation Therapy After Bioprosthetic and Homograft Pulmonary Valve Replacement; Jan 19, 2025; pubmed:39828075. View on PubMed
  41. Biventricular Repair of Univentricular Heart Lowers Risk of Liver Disease Compared With the Fontan Operation; Jan 13, 2025; pubmed:39801815. View on PubMed
  42. Sternotomy or thoracotomy for neonatal repair of coarctation of the aorta with aortic arch hypoplasia; Jan 9, 2025; pubmed:39780815. View on PubMed
  43. Mitochondrial transplantation normalizes transcriptomic and proteomic shift associated with ischemia reperfusion injury in neonatal hearts donated after circulatory death; Dec 29, 2024; pubmed:39732955. View on PubMed
  44. Biomechanical modeling combined with pressure-volume loop analysis to aid surgical planning in patients with complex congenital heart disease; Dec 22, 2024; pubmed:39709691. View on PubMed
  45. Challenges in the Development and Evaluation of Pediatric Heart Valve Technologies; Dec 14, 2024; pubmed:39674526. View on PubMed
  46. Wide variation in shape of hypoplastic left ventricles undergoing recruitment and biventricular repair: A statistical shape modeling study; Dec 8, 2024; pubmed:39647766. View on PubMed
  47. Intraoperative Conduction Mapping to Reduce Postoperative Atrioventricular Block in Complex Congenital Heart Disease; Nov 13, 2024; pubmed:39537250. View on PubMed
  48. Intraoperative conduction system mapping during reoperative mitral valve replacement; Oct 31, 2024; pubmed:39478916. View on PubMed
  49. Electrocardiogram-based deep learning to predict mortality in paediatric and adult congenital heart disease; Oct 10, 2024; pubmed:39387652. View on PubMed
  50. Ventricular septation for double inlet ventricle: Avoiding conduction injury; Sep 28, 2024; pubmed:39341552. View on PubMed
  51. Outcomes of Patients Undergoing Surgery for Complete Vascular Rings; Sep 25, 2024; pubmed:39322321. View on PubMed
  52. Electrocardiogram-Based Deep Learning to Predict Mortality in Repaired Tetralogy of Fallot; Sep 19, 2024; pubmed:39297841. View on PubMed
  53. Operative and nonoperative outcomes in patients with trisomy 13 and 18 with congenital heart disease; Sep 19, 2024; pubmed:39296445. View on PubMed
  54. Cardiac manifestations and outcomes of COVID-19 vaccine-associated myocarditis in the young in the USA: longitudinal results from the Myocarditis After COVID Vaccination (MACiV) multicenter study; Sep 18, 2024; pubmed:39290640. View on PubMed
  55. Thromboelastography-guided Intraoperative Platelet Transfusion in Pediatric Heart Surgery; Sep 14, 2024; pubmed:39277157. View on PubMed
  56. Impact of surgical strategy and postrepair transverse aortic arch size on late hypertension after coarctation repair during infancy; Sep 8, 2024; pubmed:39245406. View on PubMed
  57. Efficacy and safety of early postoperative ablation in patients with congenital heart disease; Sep 8, 2024; pubmed:39245252. View on PubMed
  58. Reverse double switch operation for the borderline left ventricle; Sep 1, 2024; pubmed:39218145. View on PubMed
  59. Predictive modeling of endocardial fibroelastosis recurrence in patients with congenital heart disease; Aug 29, 2024; pubmed:39208926. View on PubMed
  60. Impact of permanent pacemaker for iatrogenic atrioventricular block on outcomes after congenital heart surgery; Aug 25, 2024; pubmed:39182903. View on PubMed
  61. Society for Cardiovascular Magnetic Resonance 2023 Cases of SCMR case series; Aug 24, 2024; pubmed:39181403. View on PubMed
  62. Coronary Events Following Dobutamine Stress Cardiac Magnetic Resonance Imaging in Pediatric Patients; Aug 22, 2024; pubmed:39172254. View on PubMed
  63. Deep Learning-Based Electrocardiogram Analysis Predicts Biventricular Dysfunction and Dilation in Congenital Heart Disease; Aug 21, 2024; pubmed:39168568. View on PubMed
  64. Clinical and 2D/3D-Echo Cardiography Determinants of Mitral Valve Reoperation in Children With Congenital Mitral Valve Disease; Aug 8, 2024; pubmed:39113914. View on PubMed
  65. Experience Curve With the Cone Procedure for Ebstein's Anomaly: Effect on Cost and Resource Utilization; Aug 6, 2024; pubmed:39105113. View on PubMed
  66. Preoperative Echocardiographically Derived Mean dP/dTic Predicts Early Post-operative Dysfunction in Children Undergoing Mitral Valve Surgery; Jul 24, 2024; pubmed:39046479. View on PubMed
  67. Identifying high-risk Fontan phenotypes using K-means clustering of cardiac magnetic resonance-based dyssynchrony metrics; Jul 14, 2024; pubmed:39004418. View on PubMed
  68. Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference; Jul 3, 2024; pubmed:38959362. View on PubMed
  69. Management of Bleeding and Thrombotic Complications During Pediatric Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference; Jul 3, 2024; pubmed:38959361. View on PubMed
  70. Management of Extracorporeal Membrane Oxygenation Anticoagulation in the Perioperative Period: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference; Jul 3, 2024; pubmed:38959360. View on PubMed
  71. Anticoagulation Monitoring and Targets: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference; Jul 3, 2024; pubmed:38959356. View on PubMed
  72. Anticoagulant Medications: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference; Jul 3, 2024; pubmed:38959355. View on PubMed
  73. The Influence of the Extracorporeal Membrane Oxygenation Circuit and Components on Anticoagulation Management: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference; Jul 3, 2024; pubmed:38959354. View on PubMed
  74. Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference; Jul 3, 2024; pubmed:38959353. View on PubMed
  75. HVSMR-2.0: A 3D cardiovascular MR dataset for whole-heart segmentation in congenital heart disease; Jul 2, 2024; pubmed:38956063. View on PubMed
  76. Pediatric Electrocardiogram-Based Deep Learning to Predict Secundum Atrial Septal Defects; Jul 2, 2024; pubmed:38953953. View on PubMed
  77. Single Ventricular Torsional Mechanics After Fontan Palliation and Their Impact on Outcomes; Jun 28, 2024; pubmed:38938250. View on PubMed
  78. Thoracic duct drainage patterns in heterotaxy; Jun 23, 2024; pubmed:38909657. View on PubMed
  79. The Society of Thoracic Surgeons Clinical Practice Guidelines on the Management of Neonates and Infants With Coarctation; Jun 21, 2024; pubmed:38904587. View on PubMed
  80. Perioperative Hyper-coagulation and Thrombosis: Cost Analysis After Congenital Heart Surgery; Jun 20, 2024; pubmed:38902366. View on PubMed
  81. Off-center staggered leaflet plication technique to prevent residual central regurgitation in aortic valve repair; Jun 20, 2024; pubmed:38899070. View on PubMed
  82. Why partial heart transplantation could be regulated as organ transplantation; Jun 14, 2024; pubmed:38876367. View on PubMed
  83. Surgical debulking of large ventricular fibromas in children; May 27, 2024; pubmed:38802044. View on PubMed
  84. Early and long-term outcomes following cardiac surgery for patients with heterotaxy syndrome; May 1, 2024; pubmed:38690436. View on PubMed
  85. Repeat Repair After Translocation of an Anomalous Left Coronary Artery; Apr 15, 2024; pubmed:38621655. View on PubMed
  86. The impact of audiovisual breathing guidance on respiratory-triggered cardiac magnetic resonance cine imaging; Apr 5, 2024; pubmed:38579974. View on PubMed
  87. Rare cardiac inflammatory pseudotumor in a toddler: Complementary roles of cardiac magnetic resonance and positron emission tomography; Apr 3, 2024; pubmed:38570104. View on PubMed
  88. Impact of Age-Related Change in Caval Flow Ratio on Hepatic Flow Distribution in the Fontan Circulation; Apr 3, 2024; pubmed:38567518. View on PubMed
  89. Cleft closure and other predictors of contemporary outcomes after atrioventricular canal repair in patients with parachute left atrioventricular valve; Mar 28, 2024; pubmed:38539038. View on PubMed
  90. Design and implementation of multicenter pediatric and congenital studies with cardiovascular magnetic resonance: Big data in smaller bodies; Mar 25, 2024; pubmed:38527706. View on PubMed
  91. Endocardial Fibroelastosis Resection: When it Works and When it Does Not; Mar 24, 2024; pubmed:38522867. View on PubMed
  92. Morphology, Clinical Associations, and Pathologic Follow-up of Quadricuspid Aortic Valves in Children; Mar 13, 2024; pubmed:38478047. View on PubMed
  93. Mitral valve orifice area predicts outcome after biventricular repair in patients with hypoplastic left ventricles; Feb 25, 2024; pubmed:38403073. View on PubMed
  94. Pediatric ECG-Based Deep Learning to Predict Left Ventricular Dysfunction and Remodeling; Feb 5, 2024; pubmed:38314583. View on PubMed
  95. Association of tetralogy of Fallot and complete atrioventricular canal: a single-centre 40-year experience; Feb 4, 2024; pubmed:38310341. View on PubMed
  96. Prospective randomized controlled trial of the safety and feasibility of a novel mesenchymal precursor cell therapy in hypoplastic left heart syndrome; Jan 11, 2024; pubmed:38204673. View on PubMed
  97. Trends in surgical management of anomalous aortic origin of the coronary artery over 2 decades; Jan 11, 2024; pubmed:38204671. View on PubMed
  98. A Deep Learning Pipeline for Assessing Ventricular Volumes from a Cardiac MRI Registry of Patients with Single Ventricle Physiology; Jan 2, 2024; pubmed:38166332. View on PubMed
  99. Mitochondrial transplantation: the advance to therapeutic application and molecular modulation; Jan 1, 2024; pubmed:38162128. View on PubMed
  100. Transcatheter Palliation With Pulmonary Artery Flow Restrictors in Neonates With Congenital Heart Disease: Feasibility, Outcomes, and Comparison With a Historical Hybrid Stage 1 Cohort; Dec 19, 2023; pubmed:38113289. View on PubMed