{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T22:36:50Z","timestamp":1773182210825,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T00:00:00Z","timestamp":1669939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"F\u00f6rderverein des Deutschen Herzzentrums M\u00fcnchen","award":["2021-2022"],"award-info":[{"award-number":["2021-2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Studies focused on infants with univentricular heart undergoing stage I palliation other than the Norwood procedure remain a topic of great interest. This study evaluated the outcome of infants who underwent systemic to pulmonary shunt (SPS) or pulmonary artery banding (PAB).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Infants who underwent SPS or PAB as stage I palliation between 1994 and 2019 were included. Survival and late systemic ventricular function were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Out of 242 patients, 188 underwent SPS (77.7%) and 54 PAB (22.3%). Main diagnosis included\u00a0tricuspid atresia, unbalanced atrioventricular septal defects, double inlet left ventricles and single ventricles with other morphology. Thirty-eight patients died before stage II palliation (15.7%). Stage II palliation was performed in 182 patients (75.2%), and mortality between stages II and III was 11 (5.6%). Stage III palliation was performed in 160 (66.1%) patients. Survival at 1, 5 and 15\u2009years after stage I procedure was 81.9, 77.1 and 76.2%, respectively, and similar between both procedures (P\u2009=\u20090.97). Premature birth [P\u2009=\u20090.03, hazard ratio (HR)\u2009=\u20092.1], heterotaxy (P\u2009=\u20090.006, HR\u2009=\u20092.4) and dominant right ventricle (P\u2009=\u20090.015, HR\u2009=\u20092.2) were factors associated to mortality. Unbalanced atrioventricular septal defect (P\u2009=\u20090.005, HR\u2009=\u20094.6) was a factor associated to systemic ventricular dysfunction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In patients with univentricular heart who underwent SPS and PAB as stage I palliation, survival at 15\u2009years was 76%, regardless of th chosen approach. Premature birth, heterotaxy and dominant right ventricle were\u00a0associated to mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad004","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T20:28:55Z","timestamp":1673382535000},"source":"Crossref","is-referenced-by-count":5,"title":["Outcome after stage 1 palliation in non-hypoplastic left heart syndrome patients as a univentricular palliation"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7427-1207","authenticated-orcid":false,"given":"Carina","family":"Schwarzbart","sequence":"first","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Department of Cardiac Surgery, 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":"Takashi","family":"Kido","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Department of Cardiac Surgery, 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\/0000-0003-2606-0557","authenticated-orcid":false,"given":"Paul Philipp","family":"Heinisch","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen , Munich, Germany"},{"name":"Department of Cardiac Surgery, Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , 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":"Department of Cardiac Surgery, 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":"Department of Cardiac Surgery, 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":"Department of Cardiac Surgery, 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\/0000-0002-2481-2017","authenticated-orcid":false,"given":"Alfred","family":"Hager","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-1190","authenticated-orcid":false,"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, 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 , Munich, Germany"},{"name":"Department of Cardiac Surgery, 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\/0000-0001-5699-6394","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 , Munich, Germany"},{"name":"Department of Cardiac Surgery, Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t , Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"2023011709472321800_ezad004-B1","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1093\/ejcts\/ezaa188","article-title":"Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: the European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Paediatric and Congenital Cardiology (AEPC) Hypoplastic Left Heart Syndrome Guidelines Task Force","volume":"58","author":"Alphonso","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023011709472321800_ezad004-B2","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1093\/ejcts\/ezab163","article-title":"Comparison of shunt types in the neonatal Norwood procedure for single ventricle","volume":"60","author":"Ono","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023011709472321800_ezad004-B3","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/ejcts\/ezab077","article-title":"Risk analysis for patients with a functionally univentricular heart after systemic-to-pulmonary shunt placement","volume":"60","author":"Ide","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023011709472321800_ezad004-B4","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jtcvs.2014.08.007","article-title":"Results of palliation with an initial pulmonary artery band in patients with single ventricle associated with unrestricted pulmonary blood flow","volume":"149","author":"Alsoufi","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023011709472321800_ezad004-B5","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.athoracsur.2021.11.003","article-title":"In-hospital morbidity and mortality following modified Blalock\u2013Taussig\u2013Thomas shunts","volume":"114","author":"Headrick","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"2023011709472321800_ezad004-B6","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1007\/s00246-015-1321-3","article-title":"Optimal timing of pulmonary banding for newborns with single ventricle physiology and unrestricted pulmonary blood flow","volume":"37","author":"Ramakrishnan","year":"2016","journal-title":"Pediatr Cardiol"},{"key":"2023011709472321800_ezad004-B7","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.hlc.2009.02.003","article-title":"Modification of Trusler\u2019s formula for the pulmonary artery banding","volume":"18","author":"Baslaim","year":"2009","journal-title":"Heart Lung Circ"},{"key":"2023011709472321800_ezad004-B8","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.athoracsur.2017.06.028","article-title":"Shunt failure\u2014risk factors and outcomes: an analysis of the society of thoracic surgeons congenital heart surgery database","volume":"105","author":"Do","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2023011709472321800_ezad004-B9","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.jtcvs.2016.03.075","article-title":"Extracorporeal membrane oxygenator support in infants with systemic-pulmonary shunts","volume":"152","author":"Botha","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023011709472321800_ezad004-B10","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1177\/2150135118755985","article-title":"Cardiopulmonary bypass reduces early thrombosis of systemic-to-pulmonary artery shunts","volume":"9","author":"Patregnani","year":"2018","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2023011709472321800_ezad004-B11","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1007\/s00246-021-02548-7","article-title":"Univentricular pulmonary artery banding: how tight is tight enough for successful progress?","volume":"42","author":"Erg\u00fcn","year":"2021","journal-title":"Pediatr Cardiol"},{"key":"2023011709472321800_ezad004-B12","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1055\/s-0037-1621706","article-title":"Reasons for failure of systemic-to-pulmonary artery shunts in neonates","volume":"67","author":"Vitanova","year":"2019","journal-title":"Thorac Cardiovasc Surg"},{"key":"2023011709472321800_ezad004-B13","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.athoracsur.2021.05.022","article-title":"Improved long-term outcome of Damus\u2013Kaye\u2013Stansel procedure without previous pulmonary artery banding","volume":"114","author":"Kido","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"2023011709472321800_ezad004-B14","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.athoracsur.2020.06.030","article-title":"Risk factors for failed Fontan procedure after stage 2 palliation","volume":"112","author":"Ono","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2023011709472321800_ezad004-B15","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":"2023011709472321800_ezad004-B16","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":"2023011709472321800_ezad004-B17","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1001\/jama.1984.03340400051025","article-title":"Landmark article May 19, 1945: the surgical treatment of malformations of the heart in which there is pulmonary stenosis or pulmonary atresia. By Alfred Blalock and Helen B Taussig","volume":"251","author":"Blalock","year":"1984","journal-title":"JAMA"},{"key":"2023011709472321800_ezad004-B18","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S0022-5223(19)37668-8","article-title":"Modified Blalock\u2013Taussig shunt. Use of subclavian artery orifice as flow regulator in prosthetic systemic-pulmonary artery shunts","volume":"81","author":"de Leval","year":"1981","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023011709472321800_ezad004-B19","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.ejcts.2005.03.005","article-title":"Comparison of hemodynamics between Norwood procedure and systemic-to-pulmonary artery shunt for single right ventricle patients","volume":"27","author":"Takabayashi","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023011709472321800_ezad004-B20","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1093\/ejcts\/ezv435","article-title":"Indications and results of systemic to pulmonary shunts: results from a national database","volume":"49","author":"Dorobantu","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023011709472321800_ezad004-B21","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.ejcts.2008.06.001","article-title":"Could we still improve early and interim outcome after prosthetic systemic-pulmonary shunt? A risk factors analysis","volume":"34","author":"Mohammadi","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023011709472321800_ezad004-B22","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1161\/CIRCULATIONAHA.117.029987","article-title":"Comparison between patent ductus arteriosus stent and modified Blalock\u2013Taussig shunt as palliation for infants with ductal-dependent pulmonary blood flow: insights from the congenital catheterization research collaborative","volume":"137","author":"Glatz","year":"2018","journal-title":"Circulation"},{"key":"2023011709472321800_ezad004-B23","first-page":"213","article-title":"Jr. The treatment of certain congenital malformation of the heart by the creation of pulmonic stenosis to reduce pulmonary hypetension and excessive pulmonary blood flow","volume":"95","author":"Muller","year":"1952","journal-title":"Surg Gynec Obstet"},{"key":"2023011709472321800_ezad004-B24","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/S0003-4975(10)64866-7","article-title":"A method of banding the pulmonary artery for large isolated ventricular septal defect with and without transposition of the great arteries","volume":"13","author":"Trusler","year":"1972","journal-title":"Ann Thorac Surg"},{"key":"2023011709472321800_ezad004-B25","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.ejcts.2005.01.066","article-title":"Staged surgical repair of functional single ventricle in infants with unobstructed pulmonary blood flow","volume":"27","author":"Rodefeld","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023011709472321800_ezad004-B26","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/S0003-4975(10)62150-9","article-title":"Pulmonary artery banding: results and current indications in pediatric cardiac surgery","volume":"44","author":"LeBlanc","year":"1987","journal-title":"Ann Thorac Surg"},{"key":"2023011709472321800_ezad004-B27","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/S0003-4975(02)03836-5","article-title":"The infant with single ventricle and excessive pulmonary blood flow: results of a strategy of pulmonary artery division and shunt","volume":"74","author":"Bradley","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"2023011709472321800_ezad004-B28","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1017\/S1047951117001299","article-title":"Influence of weight at the time of first palliation on survival in patients with a single ventricle","volume":"27","author":"Surendran","year":"2017","journal-title":"Cardiol Young"},{"key":"2023011709472321800_ezad004-B29","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1053\/j.semtcvs.2018.09.019","article-title":"Simultaneous systemic to pulmonary shunt and pulmonary artery banding is a viable option for neonatal palliation of single ventricle physiology","volume":"31","author":"Wiggins","year":"2019","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"2023011709472321800_ezad004-B30","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1016\/j.jacc.2011.11.049","article-title":"Predictors of survival after single-ventricle palliation: the impact of right ventricular dominance","volume":"59","author":"d\u2019Udekem","year":"2012","journal-title":"J Am Coll Cardiol"}],"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\/ezad004\/48614791\/ezad004.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezad004\/48732113\/ezad004.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezad004\/48732113\/ezad004.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T09:49:09Z","timestamp":1673948949000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezad004\/6984720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,2]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezad004","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,1,1]]},"published":{"date-parts":[[2022,12,2]]},"article-number":"ezad004"}}