{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T05:49:57Z","timestamp":1771652997987,"version":"3.50.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100008732","name":"The Uehara Memorial Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008732","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The present study was aiming to determine whether high mean pulmonary artery pressure before bidirectional cavopulmonary shunt is a risk factor for late adverse events in patients with low pulmonary artery pressure before total cavopulmonary connection (TCPC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We retrospectively reviewed the medical records of all patients undergoing both bidirectional cavopulmonary shunt and TCPC with available cardiac catheterization data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 316 patients were included in this study. The patients were divided into 4 groups according to mean pulmonary pressure: those with pre-Glenn &amp;lt;16 mmHg and pre-Fontan &amp;lt;10 mmHg (Group LL, n\u2009=\u2009124), those with pre-Glenn \u226516 mmHg and pre-Fontan &amp;lt;10 mmHg (Group HL, n\u2009=\u200961), those with pre-Glenn &amp;lt;16 mmHg and pre-Fontan \u226510 mmHg (Group LH, n\u2009=\u200966) and those with pre-Glenn \u226516 mmHg and pre-Fontan \u226510 mmHg (Group HH, n\u2009=\u200965). Group HL showed significantly higher rate of adverse events after TCPC than Group LL (P\u2009=\u20090.02). In univariate linear analysis, a history of atrial septectomy at stage 1 palliation was associated with low pre-Glenn mean pulmonary artery pressure (Coefficient B \u22121.38, 95% confidence interval \u22122.53 to \u22120.24; P\u2009=\u20090.02), while pulmonary artery banding was a significant risk factor for elevated pre-Fontan mean pulmonary artery pressure (Coefficient B 1.68, 95% confidence interval 0.81 to 2.56, P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>High mean pulmonary artery pressure before bidirectional cavopulmoary shunt (\u226516mmHg) remains a significant risk factor for adverse events after TCPC even though mean pulmonary artery pressure decreased below 10\u2009mmHg before TCPC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab079","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T06:29:08Z","timestamp":1612420148000},"page":"369-376","source":"Crossref","is-referenced-by-count":8,"title":["Impacts of stage 1 palliation and pre-Glenn pulmonary artery pressure on long-term outcomes after Fontan operation"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0570-8513","authenticated-orcid":false,"given":"Takashi","family":"Kido","sequence":"first","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Division of Congenital and Pediatric Heart Surgery, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8540-7090","authenticated-orcid":false,"given":"Melchior","family":"Burri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedikt","family":"Mayr","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Strbad","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Division of Congenital and Pediatric Heart Surgery, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1971-4375","authenticated-orcid":false,"given":"Julie","family":"Cleuziou","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Division of Congenital and Pediatric Heart Surgery, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2481-2017","authenticated-orcid":false,"given":"Alfred","family":"Hager","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"H\u00f6rer","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Division of Congenital and Pediatric Heart Surgery, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5699-6394","authenticated-orcid":false,"given":"Masamichi","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Division of Congenital and Pediatric Heart Surgery, Ludwig-Maximilians-Universit\u00e4t, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"key":"2021080208042786700_ezab079-B1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.jtcvs.2017.01.056","article-title":"Long-term survival after the Fontan operation: twenty years of experience at a single center","volume":"154","author":"Downing","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021080208042786700_ezab079-B2","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1093\/ejcts\/ezw091","article-title":"Clinical outcome following total cavopulmonary connection: a 20-year single-centre experience","volume":"50","author":"Ono","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021080208042786700_ezab079-B3","first-page":"S32","article-title":"Redefining expectations of long-term survival after the Fontan procedure: twenty-five years of follow-up from the entire population of Australia and New Zealand","volume":"130","author":"d'Udekem","year":"2014","journal-title":"Circulation"},{"key":"2021080208042786700_ezab079-B4","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/S0002-9149(99)80722-X","article-title":"Factors influencing survival in patients undergoing the bidirectional Glenn anastomosis","volume":"75","author":"Alejos","year":"1995","journal-title":"Am J Cardiol"},{"key":"2021080208042786700_ezab079-B5","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1007\/s00246-018-1932-6","article-title":"Elevated pulmonary artery pressure, not pulmonary vascular resistance, is an independent predictor of short-term morbidity following bidirectional cavopulmonary connection","volume":"39","author":"Tran","year":"2018","journal-title":"Pediatr Cardiol"},{"key":"2021080208042786700_ezab079-B6","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.ejcts.2006.11.043","article-title":"Factors influencing early and late outcome following the Fontan procedure in the current era. The \u2018Two Commandments\u2019?","volume":"31","author":"Hosein","year":"2007","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021080208042786700_ezab079-B7","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.jtcvs.2007.12.032","article-title":"Outcome of 200 patients after an extracardiac Fontan procedure","volume":"136","author":"Kim","year":"2008","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021080208042786700_ezab079-B8","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1007\/s00246-019-02172-6","article-title":"Impact of characteristics at stage-2-palliation on outcome following Fontan completion","volume":"40","author":"Vitanova","year":"2019","journal-title":"Pediatr Cardiol"},{"key":"2021080208042786700_ezab079-B9","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/S0022-5223(94)70049-4","article-title":"Central pulmonary artery growth patterns after the bidirectional Glenn procedure","volume":"107","author":"Mendelsohn","year":"1994","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021080208042786700_ezab079-B10","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1161\/01.CIR.73.4.758","article-title":"Subaortic stenosis, the univentricular heart, and banding of the pulmonary artery: an analysis of the courses of 43 patients with univentricular heart palliated by pulmonary artery banding","volume":"73","author":"Freedom","year":"1986","journal-title":"Circulation"},{"key":"2021080208042786700_ezab079-B11","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/S0022-5223(19)36666-8","article-title":"Double-inlet ventricle presenting in infancy. III. Outcome and potential for definitive repair","volume":"101","author":"Franklin","year":"1991","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021080208042786700_ezab079-B12","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.ejcts.2008.04.043","article-title":"Bidirectional cavopulmonary connection without additional pulmonary blood flow as an ideal staging for functional univentricular hearts","volume":"34","author":"Schreiber","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021080208042786700_ezab079-B13","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.athoracsur.2007.04.034","article-title":"Nonfenestrated extracardiac total cavopulmonary connection in 132 consecutive patients","volume":"84","author":"Schreiber","year":"2007","journal-title":"Ann Thorac Surg"},{"key":"2021080208042786700_ezab079-B14","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/0002-9149(93)90914-X","article-title":"Usefulness of the bidirectional Glenn procedure as staged reconstruction for the functional single ventricle","volume":"71","author":"Pridjian","year":"1993","journal-title":"Am J Cardiol"},{"key":"2021080208042786700_ezab079-B15","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jtcvs.2010.11.060","article-title":"Atrioventricular valve repair in patients with functional single-ventricle physiology: impact of ventricular and valve function and morphology on survival and reintervention","volume":"142","author":"Honjo","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021080208042786700_ezab079-B16","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1093\/ejcts\/ezs594","article-title":"Long-term results of treatments for functional single ventricle associated with extracardiac type total anomalous pulmonary venous connection","volume":"43","author":"Hoashi","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021080208042786700_ezab079-B17","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1093\/ejcts\/ezx019","article-title":"Impact of early Fontan completion on postoperative outcomes in patients with a functional single ventricle","volume":"51","author":"Ono","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021080208042786700_ezab079-B18","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1017\/S1047951115001262","article-title":"Restrictive atrial septum after the Fontan procedure","volume":"26","author":"Penford","year":"2016","journal-title":"Cardiol Young"},{"key":"2021080208042786700_ezab079-B19","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0022-5223(03)01296-0","article-title":"Pulmonary venous pathway obstruction from recurrent restriction at atrial septum late after Fontan procedure","volume":"127","author":"Padalino","year":"2004","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021080208042786700_ezab079-B20","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.athoracsur.2018.02.086","article-title":"Long-term outcome after pulmonary artery banding in children with atrioventricular septal defect","volume":"106","author":"Buratto","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2021080208042786700_ezab079-B21","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1016\/j.jtcvs.2019.09.019","article-title":"Pulmonary artery banding in complete atrioventricular septal defect","volume":"159","author":"Devlin","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021080208042786700_ezab079-B22","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1016\/j.jacc.2012.06.021","article-title":"Cardiac magnetic resonance and the need for routine cardiac catheterization in single ventricle patients prior to Fontan: a comparison of 3 groups: pre-Fontan CMR versus cath evaluation","volume":"60","author":"Fogel","year":"2012","journal-title":"J Am Coll Cardiol"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/60\/2\/369\/39502395\/ezab079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/60\/2\/369\/39502395\/ezab079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T08:05:24Z","timestamp":1627891524000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/60\/2\/369\/6186722"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,25]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,3,25]]},"published-print":{"date-parts":[[2021,7,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezab079","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,8,1]]},"published":{"date-parts":[[2021,3,25]]}}}