{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T21:59:02Z","timestamp":1759010342559,"version":"3.40.5"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"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":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951123000665_as1\"><jats:title>Background:<\/jats:title><jats:p>In single-ventricle patients undergoing staged-bidirectional Glenn, 36\u201359% have aorto-pulmonary collateral flow, but risk factors and clinical outcomes are unknown. We hypothesise that shunt type and catheter haemodynamics may predict pre-bidirectional Glenn aorto-pulmonary collateral burden, which may predict death\/transplantation, pulmonary artery or aorto-pulmonary collateral intervention.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000665_as2\"><jats:title>Methods:<\/jats:title><jats:p>Retrospective cohort study of patients undergoing a Norwood procedure for single-ventricle anatomy. Covariates included clinical and haemodynamic characteristics up to\/including pre-bidirectional Glenn catheterisation and aorto-pulmonary collateral burden at pre-bidirectional Glenn catheterisation. Multivariable models used to evaluate relationships between risk factors and outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000665_as3\"><jats:title>Results:<\/jats:title><jats:p>From January 2011 to March 2016, 104 patients underwent Norwood intervention. Male sex (odds ratio 3.36, 95% confidence interval 1.17\u201311.4), age at pre-bidirectional Glenn assessment (2.12, 1.33\u20133.39 per month), and pulmonary to systemic flow ratio (1.23, 1.08\u20131.41 per 0.1 unit) were associated with aorto-pulmonary collateral burden. Aorto-pulmonary collateral burden was not associated with death\/transplantation (hazard ratio 1.19, 95% confidence interval 0.37\u20133.85), pulmonary artery (sub-hazard ratio 1.38, 0.32\u20132.61), or aorto-pulmonary collateral interventions (sub-hazard ratio 1.11, 0.21\u20135.76). Longer post-Norwood length of stay was associated with greater risk of death\/transplantation (hazard ratio 1.22 per week, 95% confidence interval 1.08\u20131.38), but lower risk of aorto-pulmonary collateral intervention (sub-hazard ratio 0.86 per week, 95% confidence interval 0.75\u20130.98). Time to pre-bidirectional Glenn catheterisation was associated with lower risk of pulmonary artery (sub-hazard ratio 0.80 per month, 95% confidence interval 0.65\u20130.98) and aorto-pulmonary collateral intervention (sub-hazard ratio 0.79, 0.63\u20130.99). Probability of moderate\/severe aorto-pulmonary collateral burden increased with left-to-right shunt (22.5% at &lt;1.0, 57.6% at &gt;1.4) and the age at pre-bidirectional Glenn catheterisation (10.6% at &lt;2 months, 56.9% at &gt;5 months).<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000665_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Aorto-pulmonary collateral burden is common after Norwood procedure and increases as age at bidirectional Glenn increases. As expected, higher pulmonary to systemic flow ratio is a marker for greater aorto-pulmonary collateral burden pre-bi-directional Glenn; aorto-pulmonary collateral burden does not confer risk of death\/transplantation or pulmonary artery intervention.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951123000665","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T08:48:18Z","timestamp":1681721298000},"page":"2589-2596","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Pre-Glenn aorto-pulmonary collaterals in single-ventricle patients"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5008-4113","authenticated-orcid":false,"given":"Varun 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