{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:07:58Z","timestamp":1789553278974,"version":"build-2803163510"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Neonates with congenital univentricular conditions require staged palliation culminating in a Fontan circulation to support survival. The first\u2010stage Norwood procedure carries substantial risk of myocardial dysfunction, frequently necessitating extracorporeal membrane oxygenation (ECMO) support. The aim of this systematic review was to examine the incidence, risk factors, and outcomes of post\u2010Norwood ECMO use during the interstage period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We systematically searched MEDLINE, Embase, Cochrane Library, and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      for studies published between January 1990 and March 2026 reporting ECMO use following Norwood procedures. Studies evaluating ECMO as part of postoperative management strategies were included.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">From 1509 identified studies, 15 met inclusion criteria, encompassing 4030 patients. The pooled incidence of post\u2010Norwood ECMO was 18.1% (685\/3775 patients), ranging from 15.5% to 29.4% across studies. In\u2010hospital survival among ECMO\u2010supported patients ranged from 28.6% to 50%, with no clear temporal improvement. Risk factors for ECMO initiation included low birth weight (&lt;2.5 kg), prolonged cardiopulmonary bypass time, moderate\u2010to\u2010severe preoperative atrioventricular valve regurgitation, and complex cardiac anatomy (aortic atresia, diminutive ascending aorta). Factors associated with poor outcomes included prolonged ECMO duration and ECMO\u2010related complications, particularly neurological events, renal failure, and bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Despite increasing post\u2010Norwood ECMO use, survival outcomes remain poor. Identified risk factors may inform prospective risk stratification strategies, early identification of high\u2010risk patients, and evidence\u2010based decision\u2010making regarding ECMO initiation, continuation, or withdrawal in this vulnerable population. Significant heterogeneity across studies precluded meta\u2010analysis, highlighting the need for standardized reporting in future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047642","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:17:06Z","timestamp":1781525826000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal Membrane Oxygenation in the Interstage Period After Norwood and Related Stage I Palliations in Infants With Single Ventricle: A Systematic Review of Incidence, Risk Factors, and Outcomes"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6528-7131","authenticated-orcid":false,"given":"Dongzhe","family":"Li","sequence":"first","affiliation":[{"name":"Royal Children's Hospital Melbourne, University of 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