{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:34:51Z","timestamp":1792035291438,"version":"4.4.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2016,10,25]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>We have previously shown that neonates in profound cardiogenic shock caused by a severe Ebstein anomaly can be successfully salvaged with fenestrated right ventricular exclusion and systemic to pulmonary shunt (modified Starnes procedure). The long-term outcome of single-ventricle management in these patients is not known.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We retrospectively reviewed the records of patients who underwent neonatal Starnes procedure between 1989 and 2015. Patient demographics, clinical variables, and outcome data were collected.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Twenty-seven patients (13, 48% boys) underwent the Starnes procedure at 7 (5\u20139) days of life. All were intubated and on prostaglandin, 24 (89%) were inotrope dependent, and 22 (81%) had no antegrade flow from the right ventricle. Three patients underwent nonfenestrated right ventricular exclusion, 2 (67%) of whom died. Of the remaining 24, 3 (13%) died during the same hospitalization. The 22 neonatal survivors have been followed for 7 (6\u20138) years: 1 patient is awaiting a Glenn procedure; 1 died after undergoing a Glenn procedure; and the remaining 20 patients have successfully undergone Fontan completion. Their indexed pulmonary vascular resistance was 1.8 (1.2\u20132.3) W\/m\n              <jats:sup>2<\/jats:sup>\n              , and mean pulmonary pressure was 12 (9\u201318) mm\u2009Hg. At last follow-up, 1 patient had died, and the remaining patients had normal left ventricular function, and all but 1 have New York Heart Association class I symptoms. Two patients have required pacemaker implantation, whereas the rest are in sinus rhythm. Survival for the entire cohort at 1, 5, and 10 years is 81\u00b14%, 81\u00b15%, and 76\u00b13%, respectively, whereas for those with fenestrated right ventricular exclusion, survival at 1, 5, and 10 years is 87\u00b12%, 87\u00b12%, and 81\u00b14%, respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Long-term single-ventricle outcomes among neonatal survivors of the modified Starnes procedure are excellent. There is reliable remodeling of the excluded right ventricle and good function of the left ventricle.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.115.021241","type":"journal-article","created":{"date-parts":[[2016,10,24]],"date-time":"2016-10-24T20:42:27Z","timestamp":1477341747000},"page":"1257-1264","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Single-Ventricle Outcomes After Neonatal Palliation of Severe Ebstein Anomaly With Modified Starnes Procedure"],"prefix":"10.1161","volume":"134","author":[{"given":"S. Ram","family":"Kumar","sequence":"first","affiliation":[{"name":"From Heart Institute, Children\u2019s Hospital Los Angeles, CA (S.R.K., G.K., N.N., N.C., B.F., W.J.W., V.A.S.); and Departments of Surgery (S.R.K., W.J.W., V.A.S.) and Pediatrics (S.R.K., G.K.), Keck School of Medicine of the University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Kung","sequence":"additional","affiliation":[{"name":"From Heart Institute, Children\u2019s Hospital Los Angeles, CA (S.R.K., G.K., N.N., N.C., B.F., W.J.W., V.A.S.); and Departments of Surgery (S.R.K., W.J.W., V.A.S.) and Pediatrics (S.R.K., G.K.), Keck School of Medicine of the University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Noh","sequence":"additional","affiliation":[{"name":"From Heart Institute, Children\u2019s Hospital Los Angeles, CA (S.R.K., G.K., N.N., N.C., B.F., W.J.W., V.A.S.); and Departments of Surgery (S.R.K., W.J.W., V.A.S.) and Pediatrics (S.R.K., G.K.), Keck School of Medicine of the University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Novel","family":"Castillo","sequence":"additional","affiliation":[{"name":"From Heart Institute, Children\u2019s Hospital Los Angeles, CA (S.R.K., G.K., N.N., N.C., B.F., W.J.W., V.A.S.); and Departments of Surgery (S.R.K., W.J.W., V.A.S.) and Pediatrics (S.R.K., G.K.), Keck School of Medicine of the University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Fagan","sequence":"additional","affiliation":[{"name":"From Heart Institute, Children\u2019s Hospital Los Angeles, CA (S.R.K., G.K., N.N., N.C., B.F., W.J.W., V.A.S.); and Departments of Surgery (S.R.K., W.J.W., V.A.S.) and Pediatrics (S.R.K., G.K.), Keck School of Medicine of the University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfield J.","family":"Wells","sequence":"additional","affiliation":[{"name":"From Heart Institute, Children\u2019s Hospital Los Angeles, CA (S.R.K., G.K., N.N., N.C., B.F., W.J.W., V.A.S.); and Departments of Surgery (S.R.K., W.J.W., V.A.S.) and Pediatrics (S.R.K., G.K.), Keck School of Medicine of the University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaughn A.","family":"Starnes","sequence":"additional","affiliation":[{"name":"From Heart Institute, Children\u2019s Hospital Los Angeles, CA (S.R.K., G.K., N.N., N.C., B.F., W.J.W., V.A.S.); and Departments of Surgery (S.R.K., W.J.W., V.A.S.) and Pediatrics (S.R.K., G.K.), Keck School of Medicine of the University of Southern California, Los Angeles."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36627-9"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.08.044"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.07.047"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90291-T"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.68.3.545"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.09.018"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.04.146"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12155"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.pcsu.2009.01.023"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135111425933"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.01.029"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.07.062"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.115.021241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:01:34Z","timestamp":1715583694000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.115.021241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,25]]},"references-count":12,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2016,10,25]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.115.021241"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.115.021241","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,25]]},"assertion":[{"value":"2015-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}