{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:07:49Z","timestamp":1773162469353,"version":"3.50.1"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S104795112200261X_as1\"><jats:title>Objectives:<\/jats:title><jats:p>To determine potentially modifiable risk factors for a complicated Glenn procedure (cGP) and whether a cGP predicted adverse neurodevelopmental and functional outcomes. A cGP was defined as post-operative death, heart transplant, extracorporeal life support, Glenn takedown, or prolonged ventilation.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112200261X_as2\"><jats:title>Methods:<\/jats:title><jats:p>All 169 patients having a Glenn procedure from 2012 to 2017 were included. Neurodevelopmental assessments were performed at age 2 years in consenting survivors (n = 156\/159 survivors). The Bayley Scales of Infant and Toddler Development-3<jats:sup>rd<\/jats:sup> Edition (Bayley-III) and the Adaptive Behavior Assessment System-2<jats:sup>nd<\/jats:sup> Edition (ABAS-II) were administered. Adaptive functional outcomes were determined by the General Adaptive Composite (GAC) score from the ABAS-II. Predictors of outcomes were determined using univariate and multiple variable linear or Cox regressions.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112200261X_as3\"><jats:title>Results:<\/jats:title><jats:p>Of patients who had a Glenn procedure, 10\/169 (6%) died by 2 years of age and 27\/169 (16%) had a cGP. Variables statistically significantly associated with a cGP were the inotrope score on post-operative day 1 (HR 1.04, 95%CI 1.01, 1.06; p = 0.010) and use of inhaled nitric oxide post-operatively (HR 7.31, 95%CI 3.19, 16.76; p &lt; 0.001). A cGP was independently statistically significantly associated with adverse Bayley-III Cognitive (ES \u221210.60, 95%CI \u221217.09, \u22124.11; p = 0.002) and Language (ES \u221211.43, 95%CI \u221219.25, \u22123.60; p = 0.004) scores and adverse GAC score (ES \u221214.89, 95%CI \u221222.86, \u22126.92; p &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec id=\"S104795112200261X_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Higher inotrope score and inhaled nitric oxide used post-operatively were associated with a cGP. A cGP was independently associated with adverse 2-year neurodevelopmental and functional outcomes. Whether early recognition and intervention for risk of a cGP can prevent adverse outcomes warrants study.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s104795112200261x","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T08:11:18Z","timestamp":1661328678000},"page":"1536-1543","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["A complicated Glenn procedure: risk factors and association with adverse long-term neurodevelopmental and functional outcomes"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-9308","authenticated-orcid":false,"given":"Gurpreet K.","family":"Khaira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ari R.","family":"Joffe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo G.","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany A.","family":"Matenchuk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Dinu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9700-0562","authenticated-orcid":false,"given":"Gwen","family":"Bond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Alaklabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlene M.T.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. Ben","family":"Sivarajan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Complex Pediatric Therapies Follow-up Program","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"S104795112200261X_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38595-2"},{"key":"S104795112200261X_ref28","doi-asserted-by":"publisher","DOI":"10.1017\/S104795110800200X"},{"key":"S104795112200261X_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2003.10.035"},{"key":"S104795112200261X_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.05.017"},{"key":"S104795112200261X_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00068-5"},{"key":"S104795112200261X_ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1598-5"},{"key":"S104795112200261X_ref31","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000800"},{"key":"S104795112200261X_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-618X.1987.tb00639.x"},{"key":"S104795112200261X_ref17","volume-title":"Manual 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2022. 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