{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:31:31Z","timestamp":1769272291805,"version":"3.49.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T00:00:00Z","timestamp":1592870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Alice Langdon Warner and Daniel M. Tabas Endowed Chairs in Pediatric Cardiac Surgery"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The objective of this study was to estimate hospital mortality and length of stay (LOS) for children with hypoplastic left heart syndrome undergoing superior cavopulmonary connection (SCPC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All hypoplastic left heart syndrome interstage survivors who underwent SCPC between 1 January 1988 and 31 December 2017 were included. The study period was divided into 4 eras based on changes in operative or medical management. Mortality rates were estimated using standard binomial proportions. Adjusted and unadjusted logistic regression models were used to identify risk factors for mortality and LOS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The most common procedures for the cohort (n\u2009=\u2009958) were Hemi-Fontan (57.3%) or Bidrectional Glenn shunt (35.7%). The mortality was 4.1% overall and decreased in all 3 later eras compared to era 1. Factors associated with mortality in a multiple covariate model included longer total support time, earlier gestational age, longer LOS at the Norwood Procedure and need for additional procedures. Overall, the median LOS was 7.0\u2009days with a decrease from eras 1 to 2 and plateaued in eras 3 and 4. Predictors of longer LOS included genetic anomaly, longer Norwood LOS, additional procedures, lower weight at surgery and longer total support time. The type of SCPC was not associated with mortality or LOS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In this large cohort of patients with hypoplastic left heart syndrome undergoing SCPC, hospital mortality has decreased significantly. LOS initially declined but plateaued in recent eras. The risk factors for mortality and longer LOS are related to patient and procedural complexity, especially the need for additional procedures at the time of SCPC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa117","type":"journal-article","created":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T20:22:16Z","timestamp":1584130936000},"page":"809-816","source":"Crossref","is-referenced-by-count":10,"title":["Outcomes for the superior cavopulmonary connection in children with hypoplastic left heart syndrome: a 30-year experience"],"prefix":"10.1093","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0095-7094","authenticated-orcid":false,"given":"Mallory L","family":"Hunt","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard F","family":"Ittenbach","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-2626","authenticated-orcid":false,"given":"Michelle","family":"Kaplinski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lucile Packard Children\u2019s Hospital Stanford, Palo Alto, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chitra","family":"Ravishankar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Rychik","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James M","family":"Steven","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Division of Cardiothoracic Anesthesia, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie M","family":"Fuller","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan C","family":"Nicolson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Division of Cardiothoracic Anesthesia, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas L","family":"Spray","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J William","family":"Gaynor","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher E","family":"Mascio","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,6,23]]},"reference":[{"key":"2020101419250187000_ezaa117-B1","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/S0031-3955(16)30727-1","article-title":"The hypoplastic left heart syndrome; an analysis of 101 cases","volume":"5","author":"Noonan","year":"1958","journal-title":"Pediatr Clin North Am"},{"key":"2020101419250187000_ezaa117-B2","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.jtcvs.2018.12.117","article-title":"Thirty years and 1663 consecutive Norwood procedures: has survival plateaued?","volume":"158","author":"Mascio","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2020101419250187000_ezaa117-B3","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/0003-4975(89)90384-6","article-title":"Bidirectional cavopulmonary shunts: clinical applications as staged or definitive palliation","volume":"47","author":"Mazzera","year":"1989","journal-title":"Ann Thorac Surg"},{"key":"2020101419250187000_ezaa117-B4","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0022-5223(19)38595-2","article-title":"Physiological rationale for a bidirectional cavopulmonary shunt. 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