Base by Base

103: Genome Sequencing Forecasts Outcomes After Congenital Cardiac Surgery


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️ Episode 103: Genome Sequencing Forecasts Outcomes After Congenital Cardiac Surgery

In this episode of PaperCast Base by Base, we explore how large-scale exome sequencing combined with explainable AI can predict adverse outcomes after surgery for congenital heart defects. Using a prospective cohort from the Pediatric Cardiac Genomics Consortium, the study links specific genetic pathways to real-world postoperative risks and shows how genomics sharpens clinical risk stratification.

Study Highlights:
A prospective observational cohort of 2,253 patients underwent whole-exome sequencing; variants were prioritized with an AI genome-interpretation tool, cardiac phenotypes were auto-classified, and Bayesian networks quantified risk. Damaging de novo variants in chromatin-modifying genes and recessive/biallelic genotypes in cilia-related genes were associated with higher probabilities of mortality, cardiac arrest, and prolonged ventilation, whereas their absence lowered risk. Effects were strongest in high-complexity surgeries and specific phenotypes—such as left-ventricular outflow tract obstruction/hypoplastic left heart for chromatin genes and heterotaxy for cilia genes—and were amplified by extra-cardiac anomalies. The framework delivers personalized, clinically relevant risk estimates that can inform pre-operative planning, including proactive respiratory strategies for patients with ciliary dysfunction.

Conclusion: Genomic profiling at or before surgery can meaningfully refine outcome forecasts for children with complex CHD, supporting earlier, targeted interventions and more precise peri-operative care.

Reference:
Watkins WS, Hernandez EJ, Miller TA, et al. Genome sequencing is critical for forecasting outcomes following congenital cardiac surgery. Nature Communications. 2025;16:6365. https://doi.org/10.1038/s41467-025-61625-0  

License:
This episode is based on an open-access article published under the Creative Commons Attribution 4.0 International License (CC BY 4.0) – https://creativecommons.org/licenses/by/4.0/

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On PaperCast Base by Base you’ll discover the latest in genomics, functional genomics, structural genomics, and proteomics.

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Base by BaseBy Gustavo Barra