{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:53:20Z","timestamp":1792205600725,"version":"4.4.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2014,5,20]]},"abstract":"\n Background\u2014<\/jats:title>\n In the Single Ventricle Reconstruction (SVR) trial, 1-year transplantation-free survival was better for the Norwood procedure with right ventricle\u2013to\u2013pulmonary artery shunt (RVPAS) compared with a modified Blalock-Taussig shunt (MBTS). At 3 years, we compared transplantation-free survival, echocardiographic right ventricular ejection fraction, and unplanned interventions in the treatment groups.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results\u2014<\/jats:title>\n \n Vital status and medical history were ascertained from annual medical records, death indexes, and phone interviews. The cohort included 549 patients randomized and treated in the SVR trial. Transplantation-free survival for the RVPAS versus MBTS groups did not differ at 3 years (67% versus 61%;\n P<\/jats:italic>\n =0.15) or with all available follow-up of 4.8\u00b11.1 years (log-rank\n P<\/jats:italic>\n =0.14). Pre-Fontan right ventricular ejection fraction was lower in the RVPAS group than in the MBTS group (41.7\n \u00b1<\/jats:italic>\n 5.1% versus 44.7\n \u00b1<\/jats:italic>\n 6.0%;\n P<\/jats:italic>\n =0.007), and right ventricular ejection fraction deteriorated in RVPAS (\n P<\/jats:italic>\n =0.004) but not MBTS (\n P<\/jats:italic>\n =0.40) subjects (pre-Fontan minus 14-month mean, \u22123.25\u00b18.24% versus 0.99\u00b18.80%;\n P<\/jats:italic>\n =0.009). The RVPAS versus MBTS treatment effect had nonproportional hazards (\n P<\/jats:italic>\n =0.004); the hazard ratio favored the RVPAS before 5 months (hazard ratio=0.63; 95% confidence interval, 0.45\u20130.88) but the MBTS beyond 1 year (hazard ratio=2.22; 95% confidence interval, 1.07\u20134.62). By 3 years, RVPAS subjects had a higher incidence of catheter interventions (\n P<\/jats:italic>\n <0.001) with an increasing HR over time (\n P<\/jats:italic>\n =0.005): <5 months, 1.14 (95% confidence interval, 0.81\u20131.60); from 5 months to 1 year, 1.94 (95% confidence interval, 1.02\u20133.69); and >1 year, 2.48 (95% confidence interval, 1.28\u20134.80).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions\u2014<\/jats:title>\n By 3 years, the Norwood procedure with RVPAS compared with MBTS was no longer associated with superior transplantation-free survival. Moreover, RVPAS subjects had slightly worse right ventricular ejection fraction and underwent more catheter interventions with increasing hazard ratio over time.<\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration\u2014<\/jats:title>\n \n URL:\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier: NCT00115934.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/circulationaha.113.006191","type":"journal-article","created":{"date-parts":[[2014,4,5]],"date-time":"2014-04-05T02:13:05Z","timestamp":1396663985000},"page":"2013-2020","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":194,"title":["Transplantation-Free Survival and Interventions at 3 Years in the Single Ventricle Reconstruction Trial"],"prefix":"10.1161","volume":"129","author":[{"given":"Jane W.","family":"Newburger","sequence":"first","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn A.","family":"Sleeper","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Frommelt","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail D.","family":"Pearson","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Mahle","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Dunbar-Masterson","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Mital","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismee A.","family":"Williams","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy S.","family":"Ghanayem","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caren S.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine D.","family":"Krawczeski","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan B.","family":"Lewis","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara K.","family":"Pasquali","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Pizarro","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Gruber","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Atz","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Khaikin","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. William","family":"Gaynor","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Ohye","sequence":"additional","affiliation":[{"name":"From the Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA (J.W.N., C.D.-M.); New England Research Institutes, Watertown, MA (L.A.S., S.C.); Children\u2019s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (P.C.F.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.D.P.); Emory University, Atlanta, GA (W.T.M.); Hospital for Sick Children, Toronto, ON, Canada (S.M., S.K.); Morgan Stanley Children\u2019s Hospital of New York\u2013Presbyterian,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"25","article-title":"Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects---United States, 2003.","volume":"562","year":"2007","unstructured":"Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects---United States, 2003. 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