{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:28:09Z","timestamp":1790908089949,"version":"4.1.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1995,11]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            We reviewed 212 consecutive patients who underwent stage I palliative surgery for hypoplastic left heart syndrome (HLHS) at our institution between January 1983 and June 1993.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            Six surgeons participated in the care of these patients. Follow-up is 97% complete. Preoperative anatomic and physiological factors and procedural features of the stage I operation were analyzed for impact on stage I mortality, survival to stage II palliation, and actuarial survival. Hospital mortality was not significantly lower during the second half of the study period (\n            <jats:italic>P<\/jats:italic>\n            =.242). Operative mortality was 46.2%. Multivariate analysis revealed improved stage I operative survival in patients with mitral stenosis (MS) and aortic stenosis (AS;\n            <jats:italic>P<\/jats:italic>\n            =.006). Additional risk factors for stage I mortality were a lower immediately pre\u2013stage I pH (\n            <jats:italic>P<\/jats:italic>\n            =.034) and weight &lt;3 kg (\n            <jats:italic>P<\/jats:italic>\n            =.015). Overall first-year actuarial survival for MS\/AS was 59%, and it was 33% for all others (\n            <jats:italic>P<\/jats:italic>\n            =.001). Among stage I survivors, patients with MS\/AS were more likely to survive to stage II palliation (\n            <jats:italic>P<\/jats:italic>\n            =.031). Analysis of actuarial survival of stage I survivors showed that a smaller ascending aorta (\n            <jats:italic>P<\/jats:italic>\n            &lt;.001), aortic atresia (\n            <jats:italic>P<\/jats:italic>\n            &lt;.001), and mitral atresia (\n            <jats:italic>P<\/jats:italic>\n            =.002) were all risk factors for intermediate death.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            Preoperative anatomic and physiological state are predictors of stage I mortality. HLHS anatomic subtype also influences intermediate outcome, most notably pre\u2013stage II attrition. These data may be useful in choosing initial management for patients with HLHS.\n          <\/jats:p>","DOI":"10.1161\/01.cir.92.9.262","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:34:42Z","timestamp":1339461282000},"page":"262-266","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":151,"title":["Ten-Year Institutional Experience With Palliative Surgery for Hypoplastic Left Heart Syndrome"],"prefix":"10.1161","volume":"92","author":[{"given":"Joseph M.","family":"Forbess","sequence":"first","affiliation":[{"name":"From the Departments of Cardiovascular Surgery (J.M.F., N.C., A.S., J.E.M., R.A.J.) and Cardiology (S.J.R.), Children\u2019s Hospital of Boston, and the Departments of Surgery and Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Cook","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Surgery (J.M.F., N.C., A.S., J.E.M., R.A.J.) and Cardiology (S.J.R.), Children\u2019s Hospital of Boston, and the Departments of Surgery and Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Roth","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Surgery (J.M.F., N.C., A.S., J.E.M., R.A.J.) and Cardiology (S.J.R.), Children\u2019s Hospital of Boston, and the Departments of Surgery and Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Serraf","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Surgery (J.M.F., N.C., A.S., J.E.M., R.A.J.) and Cardiology (S.J.R.), Children\u2019s Hospital of Boston, and the Departments of Surgery and Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"John E.","family":"Mayer","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Surgery (J.M.F., N.C., A.S., J.E.M., R.A.J.) and Cardiology (S.J.R.), Children\u2019s Hospital of Boston, and the Departments of Surgery and Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Jonas","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiovascular Surgery (J.M.F., N.C., A.S., J.E.M., R.A.J.) and Cardiology (S.J.R.), Children\u2019s Hospital of Boston, and the Departments of Surgery and Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(94)90562-2"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198301063080106"},{"key":"e_1_3_1_3_2","unstructured":"Murdison KA Baffa JM Farrell PE Chang AC Barber G Norwood WI Murphy JD. Hypoplastic left heart syndrome: outcome after initial reconstruction and before modified Fontan procedure. Circulation. 1990;82(suppl IV):IV-199-IV-207."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(91)90978-Y"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198610093151507"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34154-6"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510240056032"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91581-E"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.85.6.977"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(91)90980-5"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(94)70389-2"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(94)70352-3"},{"key":"e_1_3_1_13_2","unstructured":"Meliones JN Snider AR Bove EL Rosenthal A Rosen DA. Longitudinal results after first-stage palliation for hypoplastic left heart syndrome. Circulation. 1990;82(suppl IV):IV-151-IV-156."},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199310073291501"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.92.9.262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T15:56:28Z","timestamp":1715529388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.92.9.262"}},"subtitle":["Risk Factors Related to Stage I Mortality"],"short-title":[],"issued":{"date-parts":[[1995,11]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[1995,11]]}},"alternative-id":["10.1161\/01.CIR.92.9.262"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.92.9.262","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,11]]},"assertion":[{"value":"1995-11-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}