{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:55:44Z","timestamp":1787684144344,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pulmonary hypertension (PH) in congenital diaphragmatic hernia (CDH) is nearly universal yet incredibly complex. A patent ductus arteriosus (PDA) is increasingly utilized to both monitor echocardiographically and manage CDH\u2010PH. However, as pulmonary pressures are driven by both vascular resistance\n                    <jats:italic>and<\/jats:italic>\n                    blood flow, there is a risk that as the former improves, PH may in fact worsen from pathologic left\u2010to\u2010right (LtR) PDA shunting. Herein, we describe two cases of neonatal CDH whose PH was complicated by pathologic LtR PDA shunting and pulmonary overcirculation and improved following resolution of the transductal shunt, highlighting the underrecognized risk of pathologic PDA shunts in CDH.\n                  <\/jats:p>","DOI":"10.1111\/echo.70396","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T13:15:59Z","timestamp":1768828559000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Navigating the Unique Challenge of Pulmonary Hypertension From Left\u2010to\u2010Right PDA Shunts in Two Cases of Congenital Diaphragmatic Hernia"],"prefix":"10.1111","volume":"43","author":[{"suffix":"Jr","given":"John T.","family":"Wren","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics University of Iowa Healthcare  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhucha","family":"Joshi","sequence":"additional","affiliation":[{"name":"Division of Neonatology Children's Hospital of Orange County  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"McNamara","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics University of Iowa Healthcare  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","unstructured":"N.Patel A. C.Massolo U. S.Kraemer andF.Kipfmueller \u201cThe Heart in Congenital Diaphragmatic Hernia: Knowns Unknowns and Future Priorities \u201d10(2022):890422.","DOI":"10.3389\/fped.2022.890422"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","unstructured":"S.Hari Gopal N.Patel andC. J.Fernandes \u201cUse of Prostaglandin E1 in the Management of Congenital Diaphragmatic Hernia\u2010A Review \u201d10(2022):911588.","DOI":"10.3389\/fped.2022.911588"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2020.01.008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-025-02265-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/neo.24-11-e720"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2022.11.028"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7497"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.09.052"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40746-024-00296-3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.09.028"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.77.1.F36"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.189142"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15528"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.5385\/jksn.2011.18.2.365"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025784"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-020-0622-4"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.10.039"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.113564"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1272052"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.70396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:51:02Z","timestamp":1769601062000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.70396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/echo.70396"],"URL":"https:\/\/doi.org\/10.1111\/echo.70396","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-09-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70396"}}