{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:59Z","timestamp":1787018099772,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,2,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Management of patients with hypoplastic left heart syndrome has benefited from advancements in medical and surgical care. Outcomes have improved, although survival and long\u2010term functional and cognitive deficits remain a concern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This is a cohort study of all consecutive patients with\n                      <jats:styled-content style=\"fixed-case\">hypoplastic left heart syndrome<\/jats:styled-content>\n                      undergoing surgical palliation at a single center. We aimed to examine demographic and perioperative factors from each surgical stage for their association with survival and neurocognitive outcomes. A total of 117 consecutive patients from 1996 to 2010 underwent surgical palliation. Seventy patients (60%) survived to the Fontan stage and 68 patients (58%) survived to undergo neurocognitive assessment at a mean (\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      ) age of 56.6 months (6.4 months). Full\u2010scale, performance, and verbal intelligence quotient, as well as visual\u2010motor integration mean (\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      ) scores were 86.7 (16.1), 86.3 (15.8), 88.8 (17.2), and 83.2 (14.8), respectively. On multivariable analysis, older age at Fontan, sepsis peri\u2010Norwood, lowest arterial partial pressure of oxygen postbidirectional cavopulmonary anastomosis, and presence of neuromotor disability pre\u2010Fontan were strongly associated with lower scores for all\n                      <jats:styled-content style=\"fixed-case\">intelligence quotient<\/jats:styled-content>\n                      domains. Older age at Fontan and sepsis peri\u2010Norwood remained associated with lower scores for all\n                      <jats:styled-content style=\"fixed-case\">intelligence quotient<\/jats:styled-content>\n                      domains in a subgroup analysis excluding patients with disability pre\u2010Fontan or with chromosomal abnormalities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Older age at Fontan and sepsis are among independent predictors of poor neurocognitive outcomes for patients with\n                      <jats:styled-content style=\"fixed-case\">hypoplastic left heart syndrome<\/jats:styled-content>\n                      . Further studies are required to identify the appropriate age range for Fontan completion,\u00a0balancing a lower risk of acute and long\u2010term hemodynamic complications while optimizing long\u2010term neurocognitive outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.013632","type":"journal-article","created":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T05:09:23Z","timestamp":1581397763000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Survival, Neurocognitive, and Functional Outcomes After Completion of Staged Surgical Palliation in a Cohort of Patients With Hypoplastic Left Heart Syndrome"],"prefix":"10.1161","volume":"9","author":[{"given":"Joseph","family":"Atallah","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Garcia Guerra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari R.","family":"Joffe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwen Y.","family":"Bond","sequence":"additional","affiliation":[{"name":"Glenrose Rehabilitation Hospital Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunjidatul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Florencia","family":"Ricci","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health University of Manitoba Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"AlAklabi","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan M.","family":"Rebeyka","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene M. 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