{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:05:39Z","timestamp":1784729139512,"version":"3.55.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Pulmonary atresia with ventricular septal defect (PA-VSD) without major aortopulmonary collateral arteries (MAPCAs) is a rare congenital heart defect. Surgical management strategies include staged palliation or primary neonatal repair. We evaluated the midterm outcomes of neonatal primary repair in patients without MAPCAs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective single-centre analysis was performed of 31 neonates who underwent primary repair for PA-VSD without MAPCAs between 2005 and 2024. Primary outcomes included mortality, reintervention rates, and right ventricular (RV) function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen patients (41.9%) underwent urgent surgery, and 18 (58.1%) underwent emergent surgery. Median weight at repair was 2.8 kg (interquartile range [IQR] 2.6-3.2). Overall survival was 96.8% (n\u2009=\u200930), with one mortality (3.2%) related to multi-organ failure. Postoperative RV function was normal in 25 patients (80.7%). Median follow-up for hospital survivors was 5.4 years (IQR 1.2-7.6). Freedom from surgical reoperation was 56.7%; 13 patients (43.3%) required reoperation, most commonly for RV-to-pulmonary artery conduit revision (n\u2009=\u200911). Catheter-based reinterventions were performed in 24 patients (80.0%). Right ventricular function remained preserved in 29 patients (96.7%) at last follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neonatal primary repair of PA-VSD without major aortopulmonary collaterals can be performed with excellent midterm survival and preserved RV function. Reintervention, largely conduit-related, represents an anticipated component of longitudinal management rather than failure of the primary strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical registration number<\/jats:title>\n                    <jats:p>Pro00013608, approved on July 1, 2021.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag187","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:23:29Z","timestamp":1782923009000},"source":"Crossref","is-referenced-by-count":0,"title":["Neonatal Primary Repair of Pulmonary Atresia With Ventricular Septal Defect Without Major Aortopulmonary Collateral Arteries: Midterm Outcomes"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1968-1868","authenticated-orcid":false,"given":"Aybala","family":"Tongut","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]},{"name":"The George Washington University School of Medicine and Health Sciences , Washington, DC 20052,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irmak","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3611-7609","authenticated-orcid":false,"given":"Mitchell C","family":"Haverty","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alix","family":"Fetch","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]},{"name":"The George Washington University School of Medicine and Health Sciences , Washington, DC 20052,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Yerebakan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Nationwide Children\u2019s Hospital , Columbus, OH 43205,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bao N","family":"Puente","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]},{"name":"The George Washington University School of Medicine and Health Sciences , Washington, DC 20052,","place":["United States"]},{"name":"Division of Cardiac Critical Care, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua P","family":"Kanter","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]},{"name":"The George Washington University School of Medicine and Health Sciences , Washington, DC 20052,","place":["United States"]},{"name":"Division of Cardiology, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5114-8641","authenticated-orcid":false,"given":"Manan","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Children\u2019s National Hospital , Washington, DC 20010,","place":["United States"]},{"name":"The George Washington University School of Medicine and Health Sciences , Washington, DC 20052,","place":["United 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