{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:24:17Z","timestamp":1792211057435,"version":"4.4.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Surgical systemic\u2010to\u2010pulmonary artery shunts have been the standard approach to establish stable pulmonary blood flow in neonates with congenital heart disease with ductal\u2010dependent pulmonary blood flow. More recently, transcatheter ductal stents have been performed as an alternative, less invasive intervention. We aimed to characterize trends in the utilization of surgical shunts versus ductal stents and compare associated outcomes.<\/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              Using data from the Pediatric Health Information System, we retrospectively analyzed neonates with congenital heart disease with ductal\u2010dependent pulmonary blood flow who underwent surgical shunt or ductal stent placement between January 2016 and December 2021. Patients were identified by\n              <jats:italic>International Classification of Diseases, Tenth Revision<\/jats:italic>\n              (\n              <jats:italic>ICD\u201010<\/jats:italic>\n              ) diagnosis and procedure codes. The primary outcome was length of hospital stay. Secondary outcomes were reintervention risk and adjusted hospital costs. Of 936 patients included, 65.2% underwent a surgical shunt over the 6\u2010year period. The proportion who underwent ductal stenting increased from 19% to 53.4% from 2016 to 2021. The median adjusted difference in postintervention length of hospital stay was 11\u2009days greater for the surgical shunt cohort (95% CI, 7.2\u201314.8;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The adjusted reintervention risks within 3 (odds ratio [OR], 3.37 [95% CI, 1.91\u20135.95],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and 6\u2009months (OR, 2.43 [95% CI, 1.62\u20133.64],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) were significantly greater in the ductal stent group. Median adjusted index hospital costs were $198\u2009300 ($11\u20096400\u2013$340\u2009000) versus $120\u2009400 ($81\u2009800\u2013$192\u2009400) for the surgical shunt and ductal stent cohorts, respectively (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Ductal stenting has become an increasingly utilized palliative approach to secure pulmonary blood flow in neonates with congenital heart disease with ductal\u2010dependent pulmonary blood flow in the United States. Ductal stenting is associated with decreased length of hospital stay and reduced overall cost for the index hospitalization but with a greater reintervention risk than surgical shunting.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030528","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T09:08:50Z","timestamp":1692263330000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Transcatheter Ductal Stents Versus Surgical Systemic\u2010Pulmonary Artery Shunts in Neonates With Congenital Heart Disease With Ductal\u2010Dependent Pulmonary Blood Flow: Trends and Associated Outcomes From the Pediatric Health Information System Database"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4509-0444","authenticated-orcid":false,"given":"Eleonore","family":"Valencia","sequence":"first","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7588-7596","authenticated-orcid":false,"given":"Steven J.","family":"Staffa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0106-858X","authenticated-orcid":false,"given":"Michael T.","family":"Kuntz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Vanderbilt University Medical Center Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Zaleski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3450-4496","authenticated-orcid":false,"given":"Aditya K.","family":"Kaza","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Boston Children\u2019s Hospital, Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-3658","authenticated-orcid":false,"given":"Nicola","family":"Maschietto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2321-3987","authenticated-orcid":false,"given":"Viviane G.","family":"Nasr","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital, Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38389-8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.07.052"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028972"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029987"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-021-02699-7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.120.009520"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.118.007232"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25870"},{"key":"e_1_3_2_10_2","unstructured":"Leverage clinical and resource utilization data. Children's Hospital Association. 2020. Accessed February 21 2023. https:\/\/www.childrenshospitals.org\/content\/analytics\/product\u2010program\/pediatric\u2010health\u2010information\u2010system"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-14-199"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwad036"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac110"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25949"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951121001505"},{"key":"e_1_3_2_16_2","unstructured":"The STS Congenital Heart Surgery Database. The Society of Thoracic Surgeons.\u00a0Accessed July 7 2022. https:\/\/www.sts.org\/registries\u2010research\u2010center\/sts\u2010national\u2010database\/congenital\u2010heart\u2010surgery\u2010database"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.02.030"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.027"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.125227"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.04.040"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(03)00183-5"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0575"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.741579"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.06.032"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.12.012"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.05.019"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003711"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.123.030528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T13:02:05Z","timestamp":1715605325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.123.030528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,5]]},"references-count":26,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2023,9,5]]}},"alternative-id":["10.1161\/JAHA.123.030528"],"URL":"https:\/\/doi.org\/10.1161\/jaha.123.030528","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,5]]},"assertion":[{"value":"2023-04-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e030528"}}