{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:32:37Z","timestamp":1787499157371,"version":"build-2736575974"},"reference-count":8,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"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":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951121000640_as1\">\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Many newborns with pulmonary atresia\/intact ventricular septum require intervention to establish pulmonary flow and sufficient cardiac output. The resulting haemodynamic changes are not well characterised and may have unintended consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951121000640_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a 30-year (1988\u20132018) retrospective study of patients with pulmonary atresia intact ventricular septum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951121000640_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighty-nine patients were included, and median follow-up was 8 years. Fifty-five per cent had coronary sinusoids and 27% had right ventricular-dependent coronary circulation. Most patients were managed with surgical aortopulmonary or modified Blalock\u2013Taussig shunt (73%), and 12 patients underwent balloon atrial septostomy before surgical intervention. The remaining patients (27%) underwent only transcatheter interventions; 7 required an atrial septostomy and 17 required ductal stentings. All-cause mortality was 10%, most deaths (89%) occurred before 18 months of age. Of these early deaths, 87% required a balloon atrial septostomy and 85% had right ventricular-dependent coronary sinusoids. Eighteen-month mortality was significantly higher for patients who required a balloon atrial septostomy compared to those who did not (36% versus 1.4% p &lt; 0.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951121000640_as4\">\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Patients with pulmonary atresia\/intact ventricular septum who require balloon atrial septostomy in the newborn period have significantly higher 18-month mortality. Quantifying the mortality difference may help guide prognostication and expectation setting. Infants who had septostomy and a surgical shunt in the newborn period fared better than those who only underwent septostomy (even when accompanied by ductal stenting). For infants with right ventricular-dependent circulation, atrial septostomy should only be performed on an urgent or emergent basis and these patients should be considered for early surgical intervention and neonatal transplant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951121000640","type":"journal-article","created":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T21:14:52Z","timestamp":1614546892000},"page":"1613-1618","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Infants with pulmonary atresia intact ventricular septum who require balloon atrial septostomy have significantly higher 18-month mortality"],"prefix":"10.1017","volume":"31","author":[{"given":"Nicole L","family":"Herrick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asimina","family":"Courelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse W","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanishka","family":"Ratnayaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laith I","family":"Alshawabkeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3447-7398","authenticated-orcid":false,"given":"Howaida G","family":"El-Said","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"key":"S1047951121000640_ref5","doi-asserted-by":"publisher","DOI":"10.1177\/2150135117701407"},{"key":"S1047951121000640_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.05.085"},{"key":"S1047951121000640_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2003.11.057"},{"key":"S1047951121000640_ref4","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1250101"},{"key":"S1047951121000640_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25870"},{"key":"S1047951121000640_ref8","doi-asserted-by":"publisher","DOI":"10.1177\/1089253218756757"},{"key":"S1047951121000640_ref3","first-page":"1406","article-title":"Changing trends in the management of pulmonary atresia with intact ventricular septum: the Melbourne experience","volume":"40","author":"Liava\u2019a","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"S1047951121000640_ref6","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1706-6"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951121000640","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T09:19:16Z","timestamp":1647335956000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951121000640\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,1]]},"references-count":8,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["S1047951121000640"],"URL":"https:\/\/doi.org\/10.1017\/s1047951121000640","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,1]]},"assertion":[{"value":"\u00a9 The Author(s), 2021. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}