{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:57:01Z","timestamp":1785776221892,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hybrid stage I palliation (HS1P) has developed as an alternative to the Norwood stage I palliation for neonates with hypoplastic left heart and related left\u2010sided obstructive lesions. HS1P is currently used in various clinical settings, such as single ventricle palliation, bridge to decision, bridge to biventricular repair, or destination therapy. The procedure comprises bilateral pulmonary artery banding and duct stenting, thus avoiding the need for cardiopulmonary bypass surgery, which may be particularly beneficial in high\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this multicenter retrospective observational study was to evaluate the feasibility, procedural safety, and clinical effectiveness of percutaneous deployment of the self\u2010expanding sinus\u2010SuperFlex\u2010DS (SSF\u2010DS) stent for duct stenting as part of HS1P in neonates weighing \u2264\u20092.5\u2009kg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All neonates weighing \u2264\u20092.5\u2009kg who underwent percutaneous SSF\u2010DS implantation as part of HS1P at five German centers between August 2011 and 2019 were included. Procedural characteristics, complications, reinterventions, and outcomes were analyzed until stent explantation or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010two patients with a median age of 11 days (range 2\u221237 days) and a median weight of 2200\u2009g (1600\u20132500\u2009g) at stent implantation were included. Of those, 50% were preterm and 25% had known chromosomal abnormalities. Percutaneous stent implantation was successful in all patients. It was performed exclusively via femoral access, with retrograde arterial access used in 62.5% of procedures, including infants with a minimal weight of 1900\u2009g. No procedure\u2010related deaths occurred. In 25% of patients, two SSF\u2010DS stents were implanted during the index procedure to achieve complete duct coverage. Twelve stent\u2010related reinterventions were performed in 10 patients (31%), with a median time to first reintervention of 42 days (18\u2013135 days). Implantation of more than one duct stent as part of the index procedure was associated with a higher reintervention rate (63% vs. 29%). The mean time to the subsequent surgical step did not differ between patients with and without stent\u2010related reintervention. The overall reintervention rate until stent removal was 63% (20\/32 patients). Twenty\u2010five patients (78%) were successfully bridged to surgery (72% univentricular surgery, 28% biventricular repair). Median time to stent removal was 127 days (25\u2013500 days), with a median weight of 4300\u2009g (2800\u20137000\u2009g) and a median weight gain of 2200\u2009g (500\u20135400\u2009g). In one patient, HS1P was the destination therapy. Six patients (19%) died before the subsequent surgical step. Mortality was related to severe comorbidities and the high\u2010risk nature of the cohort rather than the stenting procedure itself. Procedure\u2010related complications included atrial arrhythmias (6%) and stent migration\/embolization (6%), all managed successfully without conversion to open\u2010heart surgery. Occlusion of the primary access vessel occurred in two patients (6%; one femoral artery, one femoral vein).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Percutaneous deployment of the SSF\u2010DS stent as part of HS1P in neonates weighing \u2264\u20092.5\u2009kg is feasible and associated with acceptable procedural and access\u2010related complication rates. This strategy successfully bridges most patients to the next planned surgical stage despite the high\u2010risk characteristics of this population. Close clinical monitoring during the interstage period is warranted because of the substantial rate of reinterventions, including treatment of stent stenosis and restrictive atrial communications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70687","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:55:09Z","timestamp":1781495709000},"page":"644-652","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous Deployment of the Sinus\u2010SuperFlex\u2010DS Stent for Hybrid Stage I Palliation in Neonates Weighing \u2264\u20092.5\u2009kg: A Multicenter Study"],"prefix":"10.1002","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6995-0344","authenticated-orcid":false,"given":"Johanna","family":"Hummel","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Diseases\/Pediatric Cardiology Ruhr University Bochum, Heart and Diabetescenter NRW Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8583-6135","authenticated-orcid":false,"given":"Jochen","family":"Grohmann","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Diseases\/Pediatric Cardiology Ruhr University Bochum, Heart and Diabetescenter NRW Bad Oeynhausen Germany"},{"name":"Department of Congenital Heart Defects and Pediatric Cardiology University Heart Center Freiburg\u2010Bad Krozingen Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Gendera","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Defects and Paediatric Cardiology, TUM University Hospital German Heart Center Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6tz","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Children's Heart Clinic, University Heart &amp; Vascular Center Hamburg University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Bertram","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Critical Care Medizinische Hochschule Hannover (MHH) Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Sigler","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology University of M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Schranz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Goethe University Clinic Frankfurt Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Jux","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Pediatric Heart Center Justus\u2010Liebig University Giessen Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Khalil","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Pediatric Heart Center Justus\u2010Liebig University Giessen Giessen Germany"},{"name":"Department of Pediatric Cardiology University Hospital Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.69.6.551"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.20.2621"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.22.e178"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc0902.104709"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","unstructured":"M.Galantowicz J. P.Cheatham A.Phillips et al. \u201cHybrid Approach for Hypoplastic Left Heart Syndrome: Intermediate Results After the Learning Curve \u201d 85 no. 6 (2008): 2063\u20102071; Discussion 2070\u20101.","DOI":"10.1016\/j.athoracsur.2008.02.009"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022816"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2013.05.005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.6.645"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.5.5.893"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-004-0962-4"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acthis.2008.04.001"},{"key":"e_1_2_9_13_1","volume-title":"Mikroskopische Technik","author":"M. 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