{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:32:09Z","timestamp":1787596329378,"version":"build-2736575974"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asian Cardiovasc Thorac Ann"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Norwood surgery is the first stage in the surgical palliation of hypoplastic left heart syndrome (HLHS) and its variants. Postcardiotomy extracorporeal membrane oxygenation (ECMO) may be required in some patients undergoing the Norwood procedure given its complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Kids Inpatient Database (2000\u20132022) and National Inpatient Sample (2016\u20132022) datasets were used. 2284 patients underwent a Norwood procedure. The cohort was dichotomized into ECMO (EG,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009147) and Non-ECMO (NEG,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092137) groups; Survivor and Nonsurvivor. Demographic and clinical characteristics were extracted. Overlap weights were used to attain covariate balance and perform overlap-weighted analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Postcardiotomy ECMO utilization was 6% (147\/2284). The EG was more likely to have HLHS as compared to its variants, total anomalous pulmonary venous return, small for gestational age, congestive heart failure, and arrhythmias. Overall discharge mortality for the entire cohort is 10%. The EG experienced higher mortality compared to NEG \u201c44% versus 8%\u201d and higher morbidity such as cardiac arrest, pericardial complication, cardiogenic shock, respiratory complications, acute kidney injury (AKI), postoperative bleeding, sepsis and reoperation, longer length-of-stay, and higher hospital charges than NEG. ECMO utilization rose over time, peaking after 2015, while mortality progressively declined. The Midwest had the highest ECMO use (8.93%). In multivariate analysis, ECMO use and AKI were independent predictors of mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Postcardiotomy ECMO utilization for the Norwood procedure remains rare, but utilization is increasing with regional variation. Postoperative AKI and ECMO utilization were independent predictors of mortality among Norwood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02184923261478983","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:07:26Z","timestamp":1787238446000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of postcardiotomy ECMO utilization after the Norwood procedure in the United States"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4876-9620","authenticated-orcid":false,"given":"Rohit","family":"Ganduboina","sequence":"first","affiliation":[{"name":"Northwell Health Cardiovascular Institute"},{"name":"NRI Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Karamichalis","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1895-0819","authenticated-orcid":false,"given":"Keerthi","family":"Palagati","sequence":"additional","affiliation":[{"name":"University of Miami"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Sainathan","sequence":"additional","affiliation":[{"name":"Corewell Health, Helen Devos Children's Hospital"},{"name":"Department of Pediatrics, Michigan State University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028481"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.04.028"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac129"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2024.07.020"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951124026568"},{"key":"e_1_3_3_7_2","unstructured":"Introduction to the HCUP Kids\u2019 Inpatient Database (KID) 2022 [Internet]. Ahrq.gov. [cited 2025 Oct 10]. https:\/\/www.hcup-us.ahrq.gov\/db\/nation\/kid\/KIDIntroduction2022.pdf"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.10.015"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.03.035"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.06.028"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.07.070"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.10.011"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.03.086"},{"key":"e_1_3_3_14_2","article-title":"Survival of children with hypoplastic left heart syndrome","volume":"136","author":"Siffel C","year":"2015","unstructured":"Siffel C, Riehle-Colarusso T, Oster ME, et al. Survival of children with hypoplastic left heart syndrome. Pediatrics [Internet] 2015; 136: e864\u2013e870.","journal-title":"Pediatrics [Internet]"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.065192"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivaf132"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-023-06235-y"}],"container-title":["Asian Cardiovascular and Thoracic Annals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02184923261478983","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02184923261478983","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02184923261478983","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:57:44Z","timestamp":1787594264000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02184923261478983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":16,"alternative-id":["10.1177\/02184923261478983"],"URL":"https:\/\/doi.org\/10.1177\/02184923261478983","relation":{},"ISSN":["0218-4923","1816-5370"],"issn-type":[{"value":"0218-4923","type":"print"},{"value":"1816-5370","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"article-number":"02184923261478983"}}