{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T18:31:42Z","timestamp":1765391502158,"version":"3.46.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Heart, Lung, and Blood Institute of the National Institutes of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patients with a single ventricle and systemic outflow obstruction undergo 1 of 3 stage 1 palliative operations: Norwood-Sano, Norwood-Modified Blalock-Taussig-Thomas shunt (mBTTs), or stage 1 hybrid palliation. We evaluated real-world outcomes for patients undergoing stage 1 palliation strategies in a national dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Kids\u2019 Inpatient Database (KID) was queried for patients undergoing Norwood and hybrid procedures for the years 2016, 2019, and 2019. Data were extracted using International Classification of Diseases (ICD-10) codes. Using survey weights, an estimated national cohort was derived. Multilevel, multivariable logistic regression models evaluated risk-adjusted mortality and post-operative extracorporeal membrane oxygenation (ECMO). Operations were plotted by hospital mortality for the entire sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1918 patients underwent stage 1 palliation with Norwood-Sano (1046, 54.5%), Norwood-mBTT shunt (770, 40.1%), or hybrid procedure (102, 5.3%). Unadjusted inpatient mortality was 9.0% for Norwood-Sano, 11.5% for Norwood-mBTT shunt, and 18.7% for the hybrid procedure. After risk adjustment, there was no significant difference in risk-adjusted inpatient mortality for Norwood-mBTTs (OR 1.25, P\u2009=\u2009.248) or hybrid procedures (OR 2.01, P\u2009=\u2009.057) compared to Norwood-Sano. There was no difference in need for ECMO for Norwood-mBTT shunt (OR 0.90, P\u2009=\u2009.78), or hybrid procedure (OR 0.50, P\u2009=\u2009.37). Finally, compared to Norwood-Sano, the use of mBTTs or hybrid procedures was higher in high-mortality hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared to historical data, outcomes for stage 1 palliative procedures are improving over historical norms. There was no difference in risk-adjusted inpatient mortality or ECMO comparing Norwood-Sano to Norwood-mBTTs. These data may aid the evolution of operative strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf423","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:23:08Z","timestamp":1763644988000},"source":"Crossref","is-referenced-by-count":0,"title":["Contemporary Real-world Outcomes of Stage 1 Palliation for Single-ventricle Patients: A Kids\u2019 Inpatient Database Analysis"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9566-8115","authenticated-orcid":false,"given":"Dhaval","family":"Chauhan","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University , Morgantown, WV, 26506,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Hunter","family":"Mehaffey","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University , Morgantown, WV, 26506,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J W Awori","family":"Hayanga","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University , Morgantown, WV, 26506,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gul","family":"Sher","sequence":"additional","affiliation":[{"name":"Division of Cardiac Intensive Care, Department of Pediatrics, West Virginia University , Morgantown, WV, 26506,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nita","family":"Ray-Chaudhury","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, West Virginia University , Morgantown, WV, 26506,","place":["United 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E","family":"Mascio","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, West Virginia University , Morgantown, WV, 26506,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"2025121013265007300_ezaf423-B1","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0022-5223(19)39288-8","article-title":"Experience with operations for hypoplastic left heart syndrome","volume":"82","author":"Norwood","year":"1981","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025121013265007300_ezaf423-B2","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1056\/NEJM198301063080106","article-title":"Physiologic repair of aortic atresia-hypoplastic left heart syndrome","volume":"308","author":"Norwood","year":"1983","journal-title":"N Engl J 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