{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:04:15Z","timestamp":1761861855500,"version":"3.41.2"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,7,18]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Intensive monitoring has been associated with a lower death rate between the Norwood operation and superior cavopulmonary connection, possibly due to early identification and effective treatment of residual anatomic lesions like recoarctation before lasting harm occurs.<\/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              Neonates undergoing a Norwood operation and receiving interstage care at a single center between January 1, 2005, and September 18, 2020, were studied. In those with recoarctation, we evaluated association of era ([1] preinterstage monitoring, [2] a transitional phase, [3] current era) and likelihood of hemodynamic compromise (progression to moderate or greater ventricular dysfunction\/atrioventricular valve regurgitation, initiation\/escalation of vasoactive\/respiratory support, cardiac arrest preceding catheterization, or interstage death with recoarctation on autopsy). We also analyzed whether era was associated with technical success of transcatheter recoarctation interventions, major adverse events, and transplant\u2010free survival. A total of 483 subjects were studied, with 22% (n=106) treated for recoarctation during the interstage period. Number of catheterizations per Norwood increased (\n              <jats:italic>P<\/jats:italic>\n              =0.005) over the interstage eras, with no significant change in the proportion of subjects with recoarctation (\n              <jats:italic>P<\/jats:italic>\n              =0.36). In parallel, there was a lower likelihood of hemodynamic compromise in subjects with recoarctation that was not statistically significant (\n              <jats:italic>P<\/jats:italic>\n              =0.06), with a significant difference in the proportion with ventricular dysfunction at intervention (\n              <jats:italic>P<\/jats:italic>\n              =0.002). Rates of technical success, procedural major adverse events, and transplant\u2010free survival did not differ (\n              <jats:italic>P<\/jats:italic>\n              &gt;0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Periods with interstage monitoring were associated with increased referral for catheterization but also reduced likelihood of ventricular dysfunction (and a suggestion of lower likelihood of hemodynamic compromise) in subjects with recoarctation. Further study is needed to guide optimal interstage care of this vulnerable population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.029112","type":"journal-article","created":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T11:23:28Z","timestamp":1688815408000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Interstage Monitoring Era and Likelihood of Hemodynamic Compromise at Intervention for Recoarctation Following the Norwood Operation"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9509-2945","authenticated-orcid":false,"given":"Ari J.","family":"Gartenberg","sequence":"first","affiliation":[{"name":"Division of Cardiology, The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluwatimilehin","family":"Okunowo","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit The Children\u2019s Hospital of Philadelphia Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0531-8723","authenticated-orcid":false,"given":"Yoav","family":"Dori","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. William","family":"Gaynor","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery The Children\u2019s Hospital of Philadelphia and Department of Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher E.","family":"Mascio","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Department of Surgery West Virginia University Children\u2019s Hospital West Virginia University Medical School Morgantown WV"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7362-0935","authenticated-orcid":false,"given":"Jonathan J.","family":"Rome","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The Children\u2019s Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3791-8280","authenticated-orcid":false,"given":"Andrew C.","family":"Glatz","sequence":"additional","affiliation":[{"name":"Division of Cardiology St. Louis Children\u2019s Hospital St. Louis MO"},{"name":"Department of Pediatrics Washington University School of Medicine St. Louis MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-1634","authenticated-orcid":false,"given":"Michael L.","family":"O'Byrne","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The Children\u2019s Hospital of Philadelphia 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