{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:27:08Z","timestamp":1785414428610,"version":"3.56.0"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S104795112611316X_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with hypoplastic left heart syndrome who develop a restrictive atrial septum prenatally have higher rates of postnatal mortality compared to those without atrial restriction. It is not understood whether the gestational age at which restriction becomes apparent echocardiographically impacts clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112611316X_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A single-centre, retrospective cohort study was performed, including 196 patients with hypoplastic left heart syndrome from 2008 to 2022. A restrictive atrial septum was diagnosed based on fetal echocardiographic findings of an intact atrial septum, antegrade:retrograde pulmonary vein Doppler velocity time integral ratio &lt;3, and\/or the presence of a decompressing vein. Patients were grouped as follows: 1. Without Restriction, 2. Early Restriction (&lt;30 weeks\u2019 gestation), and 3. Late Restriction (\u226530 weeks\u2019 gestation), based on the gestational age at which diagnostic criteria for restriction were met. Comparative postnatal overall survival and transplant-free survival analyses were performed using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112611316X_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall mortality rates were higher in the Early group (62%,\n                      <jats:italic>n<\/jats:italic>\n                      = 13) compared to the Late group (29%,\n                      <jats:italic>n<\/jats:italic>\n                      = 7) and the group without atrial restriction (40%). Similarly, transplant rates were higher in the Early group (23%) compared to the Late group (14%) and those without restriction (14%). Overall survival and transplant-free survival were not statistically different among the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112611316X_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>While not statistically significant in this cohort with a small number of patients with atrial restriction, our data suggest that patients with hypoplastic left heart syndrome who meet diagnostic criteria for atrial restriction later in gestation may have outcomes more similar to those without atrial restriction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s104795112611316x","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T06:12:35Z","timestamp":1779343955000},"page":"982-989","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Impact of gestational age of onset of fetal atrial restriction on postnatal outcomes in hypoplastic left heart syndrome"],"prefix":"10.1017","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4274-481X","authenticated-orcid":false,"given":"Sandra","family":"Kikano","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03njmea73","id-type":"ROR","asserted-by":"publisher"}],"name":"Duke University School of Medicine"},{"id":[{"id":"https:\/\/ror.org\/05dq2gs74","id-type":"ROR","asserted-by":"publisher"}],"name":"Vanderbilt University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Contreras Vega","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05dq2gs74","id-type":"ROR","asserted-by":"publisher"}],"name":"Vanderbilt University Medical 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2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}