{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:53:42Z","timestamp":1790812422797,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p\/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>There are no data on long-term outcomes beyond 30\u2009years after the Glenn procedure without the subsequent Fontan procedure in patients with single-ventricle physiology. Hence, this study aimed to clarify the very long-term outcomes of these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This single-centre, retrospective cohort study investigated the clinical outcomes of patients with single-ventricle physiology who underwent the Glenn procedure between 1970 and 1999. Those who underwent the subsequent Fontan procedure were excluded. The primary outcome was all-cause death. The secondary outcome was a composite of all-cause death, arrhythmic events, neurological events or infective endocarditis. The prognostic factors associated with the long-term outcomes were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In total, 36 patients were enrolled (median age at Glenn procedure: 6.2\u2009years, 56% male). During a median follow-up of 17.6\u2009years (interquartile range: 6.1\u201333.4), 21 patients died and 29 experienced the composite outcome. The 20-, 30- and 40-year overall survival after the Glenn procedure was 51.2%, 44.4% and 40.3%, respectively. The 20-, 30- and 40-year event-free survival was 36.0%, 25.5% and 14.5%, respectively. Patients with dominant left ventricular morphology had better overall survival than those with dominant right ventricular morphology (hazard ratio: 0.24, 95% confidence interval: 0.08\u20130.76, P\u2009=\u20090.014). None of the patients had liver cirrhosis but 1 had protein-losing enteropathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The 40-year overall survival after the Glenn procedure without the subsequent Fontan procedure in patients with single-ventricle physiology was 40.3%. Dominant left ventricular morphology may be associated with better long-term overall survival than dominant right ventricular morphology.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezac528","type":"journal-article","created":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T19:21:26Z","timestamp":1667416886000},"source":"Crossref","is-referenced-by-count":12,"title":["Forty-year survival after Glenn procedure without Fontan procedure in patients with single ventricle"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9519-6637","authenticated-orcid":false,"given":"Makoto","family":"Miyake","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tenri Hospital , Tenri, Japan"},{"name":"Congenital Heart Disease Center, Tenri Hospital , Tenri, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tenri Hospital , Tenri, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tenri Hospital , Tenri, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Iwakura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Tenri Hospital , Tenri, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiraku","family":"Doi","sequence":"additional","affiliation":[{"name":"Congenital Heart Disease Center, Tenri Hospital , Tenri, Japan"},{"name":"Department of Pediatric Cardiology, Tenri Hospital , Tenri, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tenri Hospital , Tenri, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,2]]},"reference":[{"key":"2023022120294129000_","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":"2023022120294129000_","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":"2023022120294129000_","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1016\/j.jacc.2015.07.065","article-title":"40-Year follow-up after the Fontan operation: long-term outcomes of 1,052 patients","volume":"66","author":"Pundi","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2023022120294129000_","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/S0022-5223(98)70406-4","article-title":"Protein-losing enteropathy after the Fontan operation: an international multicenter study. 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