{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:21:17Z","timestamp":1790788877716,"version":"4.1.0"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T00:00:00Z","timestamp":1603670400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951120003376_as1\"><jats:title>Introduction:<\/jats:title><jats:p>Treatment of hypoplastic left heart syndrome varies across institutions. This study examined the impact of introducing a standardised programme.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951120003376_as2\"><jats:title>Methods:<\/jats:title><jats:p>This retrospective cohort study evaluated the effects of a comprehensive strategy on 1-year transplant-free survival with preserved ventricular and atrioventricular valve (AVV) function following a Norwood operation. This strategy included standardised operative and perioperative management and dedicated interstage monitoring. The post-implementation cohort (C2) was compared to historic controls (C1). Outcomes were assessed using logistic regression and Kaplan\u2013Meier analysis.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951120003376_as3\"><jats:title>Results:<\/jats:title><jats:p>The study included 105 patients, 76 in C1 and 29 in C2. Groups had similar baseline characteristics, including percentage with preserved ventricular (96% C1 versus 100% C2, p = 0.28) and AVV function (97% C1 versus 93% C2, p = 0.31). Perioperatively, C2 had higher indexed oxygen delivery (348 \u00b1 67 ml\/minute\/m<jats:sup>2<\/jats:sup> C1 versus 402 \u00b1 102ml\/minute\/m<jats:sup>2<\/jats:sup> C2, p = 0.015) and lower renal injury (47% C1 versus 3% C2, p = 0.004). The primary outcome was similar in both groups (49% C1 and 52% C2, p = 0.78), with comparable rates of death and transplantation (36% C1 versus 38% C2, p = 0.89) and ventricular (2% C1 versus 0% C2, p = 0.53) and AVV dysfunction (11% C1 versus 11% C2, p = 0.96) at 1-year. When accounting for cohort and 100-day freedom from hospitalisation, female gender (OR 3.7, p = 0.01) increased and ventricular dysfunction (OR 0.21, p = 0.02) and CPR (OR 0.11, p = 0.002) or ECMO use (OR 0.15, p = 001) decreased the likelihood of 1-year transplant-free survival.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951120003376_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Standardised perioperative management was not associated with improved 1-year transplant-free survival. Post-operative ventricular or AVV dysfunction was the strongest predictor of 1-year mortality.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951120003376","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T09:12:57Z","timestamp":1603703577000},"page":"105-113","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Standardisation of management after Norwood operation has not improved 1-year 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