{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T18:21:57Z","timestamp":1758478917559,"version":"3.41.2"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>We sought to investigate the impact of early postoperative low arterial oxygen saturation on mortality and morbidity after bidirectional cavopulmonary shunt (BCPS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>The medical records of all patients who underwent BCPS between 2013 and 2018 were reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 164 patients were included in this study. Forty-seven patients underwent reintervention during hospital stay at median 7\u2009days after BCPS. Before reintervention, 30 patients were intubated or had SpO2 of &amp;lt;75%. All re-interventions for Glenn pathway obstruction and 4 out of 5 venovenous coil embolization resulted in hospital discharge, while high mortality was observed after other re-interventions (atrioventricular valve surgery, thrombolysis, systemic ventricular outflow obstruction relief, extracorporeal membrane oxygenation implantation and diaphragmatic plication). Additional aortopulmonary shunt with pulmonary artery discontinuation was performed in 8 patients who showed severe cyanosis with median SpO2 of 59% under maximal ventilation support. In the univariable Cox regression analysis, the associated factors for mortality before total cavopulmonary connection were reduced ventricular function [hazard ratio (HR) 6.89, 95% confidence interval (CI) 1.76\u201326.9, P-value 0.006], greater than moderate atrioventricular valve regurgitation (HR 5.89, 95% CI 1.70\u201320.4, P-value 0.005), SpO2 1\u2009h after extubation (HR 0.87, 95% CI 0.80\u20130.96, P-value 0.004) and mean pulmonary artery pressure 1\u2009h after extubation (HR 1.14, 95% CI 1.02\u20131.26, P-value 0.016).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>After BCPS, unacceptable cyanosis persisted with various aetiologies. Low arterial oxygen saturation within 1\u2009h after extubation is significantly associated with high mortality after BCPS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac266","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T19:08:48Z","timestamp":1650308928000},"source":"Crossref","is-referenced-by-count":4,"title":["Impact of hypoxemia and re-interventions on clinical outcomes after bidirectional cavopulmonary shunt"],"prefix":"10.1093","volume":"62","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 , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-5777","authenticated-orcid":false,"given":"Caecilia","family":"Euringer","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, 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":"Janez","family":"Vodiskar","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , 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 , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, 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 , Munich, Germany"},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina","family":"Ruf","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich at the Technical University of Munich , Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart 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