{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:06:33Z","timestamp":1787241993357,"version":"build-2736575974"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T00:00:00Z","timestamp":1653696000000},"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":[[2022,7,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>There is increasing evidence that performing superior cavopulmonary connection (SCPC) at 3\u2009months reduces mortality: reducing the risky \u2018interstage\u2019 period, volume off-loading the ventricle and reducing coronary steal, hopefully preserving ventricular function. Our objective was to describe our experience of early SCPC with preoperative computer tomography (CT) assessment compared to later connection at 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients undergoing Norwood procedure from 2005 to 2020 were divided into 2 eras were described and compared. Era 1 from 2005 to 2016 when SCPC was undertaken at 6\u2009months: and era 2 (2017\u20132020) when an earlier operation was performed. Demographics, mortality (interstage, early and late following SCPC) and data on postoperative course and complications were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In era 1, 191 patients underwent Norwood (120 survivors to SCPC) and 28 patients (23 survivors) in era 2. There were no significant differences in the demographics. Interstage mortality was 17.8% in era 1 and 8.0% in era 2 but not significantly significant (P\u2009=\u20090.22). The median (interquartile range) age at pre-imaging and SCPC was significantly lower: 99 (81\u2013120) vs 77 (47\u2013102) days and 175 (117\u2013208) vs 106 (102\u2013122) days in era 1 vs era 2 (P\u2009&amp;lt;\u20090.005). Weight was lower at SCPC in era 2 [mean (standard deviation) 6.2\u2009kg (1.2) vs 5.1\u2009kg (0.8), P\u2009&amp;lt;\u20090.05]. Intubation time and total length of stay were not statistically different. Median intensive care unit stay was statistically significantly longer, but not clinically significant: 2.5 (2\u20134) vs 3 (3\u20135) days, respectively (P\u2009&amp;lt;\u20090.05). There was no significant difference in early or late mortality, rates of diagnostic or interventional catheter, postoperative magnetic resonance imaging\/CT or stroke. Logistic regression analysis demonstrates increasing age at SCPC was associated with increased chance of stroke or early death (P\u2009=\u20090.043).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Early SCPC with CT assessment is feasible and although intensive care unit length of stay was slightly longer there was no change in the overall length of stay and no change in postoperative mortality or complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac324","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T16:28:01Z","timestamp":1654014481000},"source":"Crossref","is-referenced-by-count":2,"title":["Early superior cavopulmonary connection with preoperative computer tomography shows comparable outcomes for infants following Norwood palliation"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0360-944X","authenticated-orcid":false,"given":"Hannah R","family":"Bellsham-Revell","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulla","family":"Tarmahomed","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catie","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujeev","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4084-4203","authenticated-orcid":false,"given":"Trisha","family":"Vigneswaran","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caner","family":"Salih","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease, Evelina London Children\u2019s Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,28]]},"reference":[{"key":"2022071210362229000_ezac324-B1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/0002-9149(80)90224-6","article-title":"Hypoplastic left heart syndrome: experience with palliative surgery","volume":"45","author":"Norwood","year":"1980","journal-title":"Am J Cardiol"},{"key":"2022071210362229000_ezac324-B2","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S0022-5223(19)37500-2","article-title":"The role of the Glenn shunt in patients undergoing the Fontan operation","volume":"85","author":"DeLeon","year":"1983","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022071210362229000_ezac324-B3","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1136\/hrt.2004.051789","article-title":"The Fontan circulation","volume":"91","author":"Gewillig","year":"2005","journal-title":"Heart"},{"key":"2022071210362229000_ezac324-B4","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1056\/NEJMoa0912461","article-title":"Comparison of shunt types in the Norwood procedure for single-ventricle lesions","volume":"362","author":"Ohye","year":"2010","journal-title":"N Engl J Med"},{"key":"2022071210362229000_ezac324-B5","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.athoracsur.2012.05.043","article-title":"Is indexed preoperative superior vena cava blood flow a risk factor in patients undergoing bidirectional cavopulmonary shunt?","volume":"94","author":"Kotani","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2022071210362229000_ezac324-B6","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/S0140-6736(09)60563-8","article-title":"Hypoplastic left heart syndrome","volume":"374","author":"Barron","year":"2009","journal-title":"Lancet"},{"key":"2022071210362229000_ezac324-B7","doi-asserted-by":"crossref","first-page":"3256","DOI":"10.1161\/CIRCULATIONAHA.105.543686","article-title":"Cardiac magnetic resonance imaging after stage I Norwood operation for hypoplastic left heart syndrome","volume":"112","author":"Muthurangu","year":"2005","journal-title":"Circulation"},{"key":"2022071210362229000_ezac324-B8","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.acvd.2018.04.006","article-title":"Accuracy of computed tomography in detection of great vessel stenosis or hypoplasia before superior bidirectional cavopulmonary connection: comparison with cardiac catheterization and surgical findings","volume":"112","author":"Krupickova","year":"2019","journal-title":"Arch Cardiovasc Dis"},{"key":"2022071210362229000_ezac324-B9","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13019-018-0729-2","article-title":"Diagnostic accuracy of low-dose dual-source cardiac computed tomography as compared to surgery in univentricular heart patients","volume":"13","author":"Chaosuwannakit","year":"2018","journal-title":"J Cardiothorac Surg"},{"key":"2022071210362229000_ezac324-B10","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.athoracsur.2020.03.080","article-title":"Bidirectional Glenn procedure in patients less than 3 months of age: a 14-year experience","volume":"110","author":"Viegas","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2022071210362229000_ezac324-B11","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.jtcvs.2009.08.025","article-title":"Outcomes of the bidirectional Glenn procedure in patients less than 3 months of age","volume":"139","author":"Petrucci","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022071210362229000_ezac324-B12","doi-asserted-by":"crossref","first-page":"3326","DOI":"10.1111\/jocs.15055","article-title":"The outcomes of bidirectional Glenn before and after 4 months of age: a comparative study","volume":"35","author":"Dohain","year":"2020","journal-title":"J Card Surg"},{"key":"2022071210362229000_ezac324-B13","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1007\/s00246-013-0780-7","article-title":"Fate of ventricular and valve performance following early bidirectional Glenn procedure after norwood operation controlled for hypoplastic left heart syndome anatomic subtype","volume":"35","author":"Polimenakos","year":"2014","journal-title":"Pediatr Cardiol"},{"key":"2022071210362229000_ezac324-B14","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1007\/s00246-017-1632-7","article-title":"An early Glenn operation may be associated with the later occurrence of protein-losing enteropathy in Fontan patients","volume":"38","author":"Unseld","year":"2017","journal-title":"Pediatr Cardiol"},{"key":"2022071210362229000_ezac324-B15","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1510\/icvts.2009.218586","article-title":"Volume load paradox while preparing for the Fontan: not too much for the ventricle, not too little for the lungs","volume":"10","author":"Gewillig","year":"2010","journal-title":"Interact CardioVasc Thorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezac324\/43923458\/ezac324.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/2\/ezac324\/44830172\/ezac324.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/2\/ezac324\/44830172\/ezac324.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T06:37:14Z","timestamp":1657607834000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezac324\/6594490"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,28]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,7,11]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac324","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8,1]]},"published":{"date-parts":[[2022,5,28]]},"article-number":"ezac324"}}