{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:46:40Z","timestamp":1790344000566,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>In infants with ductal-dependent pulmonary blood flow, initial palliation with patent ductus arteriosus (PDA) stent or modified Blalock-Taussig (BT) shunt have comparable mortality but discrepant length of stay, procedural complication rates and reintervention burdens, which may influence cost. The relative economic impact of these palliation strategies is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>\n              Retrospective study of infants with ductal-dependent pulmonary blood flow palliated with PDA stent (n=104) or BT shunt (n=251) from 2008 to 2015 at 4 centers of the Congenital Catheterization Research Collaborative. Inflation-adjusted inpatient hospital costs were calculated for first year of life using Pediatric Health Information System data. Costs derived from outpatient catheterizations not in Pediatric Health Information System were imputed. Costs were compared using propensity score-adjusted multivariable models, to account for baseline differences between groups. After propensity score adjustment, first year of life costs were significantly lower in PDA stent ($215\u2009825 [190\u2009644\u2013244\u2009333]) than BT shunt ($249\u2009855 [230\u2009693\u2013270\u2009609]) patients (\n              <jats:italic>P<\/jats:italic>\n              =0.05). After addition of imputed costs, first year of life costs were not significantly different between PDA stent ($226\u2009403 [200\u2009274\u2013255\u2009941]) and BT shunt ($252\u2009072 [232\u2009955\u2013272\u2009759]) groups (\n              <jats:italic>P<\/jats:italic>\n              =0.15). Patient characteristics associated with higher costs included: younger gestational age, genetic syndrome, noncardiac diagnoses, procedural complications, extracorporeal membrane oxygenation, duration of ventilation, intensive care unit and hospital length of stay and reintervention (\n              <jats:italic>P<\/jats:italic>\n              \u22640.02 for all).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In this first multicenter comparative cost study of PDA stent or BT shunt as palliation for infants with ductal-dependent pulmonary blood flow, adjusted for baseline differences, PDA stent was associated with lower to equivalent costs over the first year of life. Combined with previous evidence suggesting clinical noninferiority, these findings suggest that PDA stent provides competitive health care value.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.118.007232","type":"journal-article","created":{"date-parts":[[2019,4,8]],"date-time":"2019-04-08T09:00:36Z","timestamp":1554714036000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Differences in Cost of Care by Palliation Strategy for Infants With Ductal-Dependent Pulmonary Blood Flow"],"prefix":"10.1161","volume":"12","author":[{"given":"Bryan H.","family":"Goldstein","sequence":"first","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, OH (B.H.G., A.F., W.W., W.J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"O\u2019Byrne","sequence":"additional","affiliation":[{"name":"The Cardiac Center at the Children\u2019s Hospital of Philadelphia, University of Pennsylvania School of Medicine (M.L.O., D.D., H.M.G., C.E.M., A.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Petit","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University School of Medicine, GA (C.J.P., M.S.K., C.E.M., S.S., R.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athar M.","family":"Qureshi","sequence":"additional","affiliation":[{"name":"The Lillie Frank Abercrombie Section of Cardiology, Texas Children\u2019s Hospital, Baylor College of Medicine, Houston (A.M.Q., H.A., V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingwei","family":"Dai","sequence":"additional","affiliation":[{"name":"The Cardiac Center at the Children\u2019s Hospital of Philadelphia, University of Pennsylvania School of Medicine (M.L.O., D.D., H.M.G., C.E.M., A.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather M.","family":"Griffis","sequence":"additional","affiliation":[{"name":"The Cardiac Center at the Children\u2019s Hospital of Philadelphia, University of Pennsylvania School of Medicine (M.L.O., D.D., H.M.G., C.E.M., A.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashton","family":"France","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, OH (B.H.G., A.F., W.W., W.J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Kelleman","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University School of Medicine, GA (C.J.P., M.S.K., C.E.M., S.S., R.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney E.","family":"McCracken","sequence":"additional","affiliation":[{"name":"The Cardiac Center at the Children\u2019s Hospital of Philadelphia, University of Pennsylvania School of Medicine (M.L.O., D.D., H.M.G., C.E.M., A.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher E.","family":"Mascio","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University School of Medicine, GA (C.J.P., M.S.K., C.E.M., S.S., R.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subi","family":"Shashidharan","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University School of Medicine, GA (C.J.P., M.S.K., C.E.M., S.S., R.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Allen","family":"Ligon","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University School of Medicine, GA (C.J.P., M.S.K., C.E.M., S.S., R.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Whiteside","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, OH (B.H.G., A.F., W.W., W.J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Jack","family":"Wallen","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, OH (B.H.G., A.F., W.W., W.J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitesh","family":"Agrawal","sequence":"additional","affiliation":[{"name":"The Lillie Frank Abercrombie Section of Cardiology, Texas Children\u2019s Hospital, Baylor College of Medicine, Houston (A.M.Q., H.A., V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"The Lillie Frank Abercrombie Section of Cardiology, Texas Children\u2019s Hospital, Baylor College of Medicine, Houston (A.M.Q., H.A., V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C.","family":"Glatz","sequence":"additional","affiliation":[{"name":"The Cardiac Center at the Children\u2019s Hospital of Philadelphia, University of Pennsylvania School of Medicine (M.L.O., D.D., H.M.G., C.E.M., A.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03340400051025"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.10.033"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.02.030"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.67.3.240"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.03.066"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25949"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.123000"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028972"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029987"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.116.004428"},{"key":"e_1_3_3_12_2","article-title":"Comprehensive comparative outcomes in children with congenital heart disease: the rationale for the Congenital Catheterization Research Collaborative.","author":"Petit CJ","unstructured":"Petit, CJ, Qureshi, AM, Glatz, AC, McCracken, CE, Kelleman, M, Nicholson, GT, Meadows, JJ, Shahanavaz, S, Zampi, JD, Law, MA, Pettus, JA, Goldstein, BH. 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