{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:33:58Z","timestamp":1770140038734,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Bi-ventricular (Bi-V) repair is viable in some patients with borderline left ventricular (LV) hypoplasia. We aimed to identify cardiovascular magnetic resonance (CMR) criteria predictive of successful primary Bi-V repair in neonates with borderline LV hypoplasia without significant mitral valve (MV) &amp; aortic valve (AV) stenosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Retrospective study (2003\u20132024) of patients with borderline LV hypoplasia with CMR for decision-making. Patients MV stenosis (mean Doppler gradient &amp;gt;5\u2009mmHg) and\/or AV stenosis (peak Doppler gradient &amp;gt;20\u2009mmHg) were excluded. Patients were divided into two groups: primary Bi-V repair and hybrid procedure. Outcomes were categorized as successful primary Bi-V repair, successful staged Bi-V repair and failure to achieve Bi-V repair.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>About 23\/37 patients (62%) underwent successful primary Bi-V repair, 8\/37 (22%) underwent staged Bi-V repair and 6\/37 (16%) failed to achieve Bi-V repair. The successful primary\/staged Bi-V repair group had higher LVEDVi (P\u2009&amp;lt;\u20090.002), higher blood flow volume through the ascending aorta (P\u2009&amp;lt;\u20090.012) and higher QAo\/superior vena cava (QSVC) flow ratio (P\u2009=\u20090.034) compared to the failure to achieve Bi-V repair group. CMR LVEDVi cut-off of 27\u2009ml\/m2 had 87% sensitivity and 79% specificity (AUC 87.6%), and QAo threshold of 1.9\u2009l\/min\/m2 had 65.2% sensitivity and 92.9% specificity (AUC 86.0%) for predicting successful primary Bi-V repair. About 7\/31(22%) patients with Bi-V repair underwent reinterventions for LVOT obstruction &amp; MV stenosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In patients with borderline LV hypoplasia without MV\/AV stenosis, CMR LVEDVi\u2009&amp;gt;\u200927\u2009ml\/m2 &amp; QAo\u2009&amp;gt;\u20091.99\u2009l\/min\/m2 were prognostic for successful primary biventricular repair.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf203","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T18:11:22Z","timestamp":1751047882000},"source":"Crossref","is-referenced-by-count":1,"title":["Borderline left ventricular hypoplasia without significant aortic or mitral stenosis: cardiac magnetic resonance criteria for biventricular repair"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8307-0597","authenticated-orcid":false,"given":"Aswathy","family":"Vaikom House","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aakansha","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankavipar","family":"Sapruangrang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar","family":"Jaeggi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3671-5337","authenticated-orcid":false,"given":"David J","family":"Barron","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4605-5600","authenticated-orcid":false,"given":"Christopher Z","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]},{"name":"Department of Diagnostic & Interventional Radiology, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9952-8504","authenticated-orcid":false,"given":"Shi-Joon","family":"Yoo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]},{"name":"Department of Diagnostic & Interventional Radiology, Hospital for Sick Children , Toronto, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"2025072618323220500_ezaf203-B1","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1093\/icvts\/ivw254","article-title":"Bailout shunt\/banding for backward left heart failure after adequate neonatal coarctectomy in borderline left hearts","volume":"23","author":"Brown","year":"2016","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2025072618323220500_ezaf203-B2","doi-asserted-by":"publisher","first-page":"1858","DOI":"10.1016\/j.jacc.2006.02.020","article-title":"Validation and re-evaluation of a discriminant model predicting anatomic suitability for biventricular repair in neonates with aortic stenosis","volume":"47","author":"Colan","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2025072618323220500_ezaf203-B3","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1016\/s0003-4975(98)00803-0","article-title":"Biventricular repair in neonates with hypoplastic left heart complex","volume":"66","author":"Tchervenkov","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"2025072618323220500_ezaf203-B4","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1177\/21501351221116016","article-title":"Hypoplastic left ventricle: hypoplastic left heart complex","volume":"13","author":"Tchervenkov","year":"2022","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2025072618323220500_ezaf203-B5","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1007\/s00246-017-1661-2","article-title":"The infant with aortic arch hypoplasia and small left heart structures: echocardiographic indices of mitral and aortic hypoplasia predicting successful biventricular repair","volume":"38","author":"Plymale","year":"2017","journal-title":"Pediatr Cardiol"},{"key":"2025072618323220500_ezaf203-B6","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1007\/s00246-014-1009-0","article-title":"Development of an echocardiographic scoring system to predict biventricular repair in neonatal hypoplastic left heart complex","volume":"35","author":"Mart","year":"2014","journal-title":"Pediatr Cardiol"},{"key":"2025072618323220500_ezaf203-B7","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.117.006979","article-title":"Relationship of echocardiographic Z scores adjusted for body surface area to age, sex, race, and ethnicity: the pediatric heart network normal echocardiogram database","volume":"10","author":"Lopez","year":"2017","journal-title":"Circ Cardiovasc Imaging"},{"key":"2025072618323220500_ezaf203-B8","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s00247-011-2219-8","article-title":"Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants","volume":"42","author":"Windram","year":"2012","journal-title":"Pediatr Radiol"},{"key":"2025072618323220500_ezaf203-B9","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s12968-014-0073-1","article-title":"Cardiovascular magnetic resonance parameters associated with early transplant-free survival in children with small left hearts following conversion from a univentricular to biventricular circulation","volume":"16","author":"Banka","year":"2014","journal-title":"J Cardiovasc Magn Reson"},{"key":"2025072618323220500_ezaf203-B10","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/HCO.0000000000000466","article-title":"Assessing the borderline ventricle in a term infant: combining imaging and physiology to establish the right course","volume":"33","author":"Cohen","year":"2018","journal-title":"Curr Opin Cardiol"},{"key":"2025072618323220500_ezaf203-B11","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1017\/S1047951115002267","article-title":"Characterising adequacy or inadequacy of the borderline left ventricle: what tools can we use?","volume":"25","author":"Kaplinski","year":"2015","journal-title":"Cardiol Young"},{"key":"2025072618323220500_ezaf203-B12","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1016\/j.jtcvs.2008.04.027","article-title":"Borderline hypoplasia of the left ventricle in neonates: insights for decision-making from functional assessment with magnetic resonance imaging","volume":"136","author":"Grosse-Wortmann","year":"2008","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025072618323220500_ezaf203-B13","doi-asserted-by":"publisher","first-page":"100066","DOI":"10.1016\/j.jacadv.2022.100066","article-title":"Biventricular repair in borderline left hearts: insights from cardiac magnetic resonance imaging","volume":"1","author":"Kang","year":"2022","journal-title":"JACC: Advances"},{"key":"2025072618323220500_ezaf203-B14","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.jtcvs.2017.02.070","article-title":"Hemodynamic parameters predict adverse outcomes following biventricular conversion with single-ventricle palliation takedown","volume":"154","author":"Herrin","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025072618323220500_ezaf203-B15","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1016\/j.jtcvs.2007.07.052","article-title":"Critical left ventricular outflow tract obstruction: the disproportionate impact of biventricular repair in borderline cases","volume":"134","author":"Hickey","year":"2007","journal-title":"J Thorac Cardiovasc 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\/ezaf203\/63529789\/ezaf203.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/67\/7\/ezaf203\/63529789\/ezaf203.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/67\/7\/ezaf203\/63529789\/ezaf203.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T22:32:39Z","timestamp":1753569159000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezaf203\/8169620"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,19]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezaf203","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,6,19]]},"article-number":"ezaf203"}}