{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:34:04Z","timestamp":1783118044844,"version":"3.54.6"},"reference-count":10,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"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":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To analyze in-hospital mortality in children undergoing congenital heart interventions in the only public referral center in Amazonas, North Brazil, between 2014 and 2022.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This retrospective cohort study included 1041 patients undergoing cardiac interventions for congenital heart disease, of whom 135 died during hospitalization. Records were reviewed to obtain demographic, clinical, and surgical data. Descriptive statistics were applied for categorical and continuous variables.\n                    <jats:bold>Results:<\/jats:bold>\n                    In-hospital mortality was 12.96% (135\/1041). Most deaths occurred in infants (97\/135, 71.8%), and the median survival postsurgery was 1 day. The majority of patients were male (70\/135, 51.8%), mixed-race (119\/135, 88.2%), and born in Manaus (88\/135, 65%). Only 5\/135 (3.7%) underwent fetal echocardiography. Extracardiac malformations were present in 76\/135 (56.3%), and 123\/135 (91%) required mechanical ventilation postoperatively. Blalock-Taussig-Thomas shunt was the most frequent surgery among those who died. The RACHS-1 Category 3 concentrated 51.8% (70\/135) of deaths. Temporal trends showed increased mortality after 2016, coinciding with the rise in neonatal and infant surgeries. Surgical complications (81\/135, 60%) and hospital-acquired infections (34\/135, 25%) were the leading causes of death. Cardiopulmonary bypass was used in 92\/135 (68%) of cases, with a mean duration of 84\u2005min.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    In-hospital mortality following congenital heart surgery in the Brazilian Amazon remains elevated, particularly among infants and in intermediate-risk RACHS-1 categories. These findings suggest that factors beyond surgical complexity\u2014such as late diagnosis, referral delays, and resource limitations\u2014contribute to adverse outcomes. Strengthening early diagnosis, improving perioperative care, and expanding regional surgical capacity are essential to reducing disparities in pediatric cardiac care.\n                  <\/jats:p>","DOI":"10.1177\/21501351251364877","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T15:40:54Z","timestamp":1757518854000},"page":"196-202","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["In-Hospital Mortality in Children Undergoing Congenital Heart Surgery in North Brazil: A 9-Year Analysis From a Regional Referrel Center"],"prefix":"10.1177","volume":"17","author":[{"given":"Ana Luiza Menezes Teles","family":"Novelleto","sequence":"first","affiliation":[{"name":"Medical School, Federal University of Amazonas (UFAM)"},{"name":"University Hospital Get\u00falio Vargas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana Izabela Azevedo","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Medical School, Amazonas State University (UEA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa Tiemi Souza","family":"Tuda","sequence":"additional","affiliation":[{"name":"Medical School, Federal University of Amazonas (UFAM)"},{"name":"University Hospital Get\u00falio Vargas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Castro","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Medical School, Federal University of Amazonas (UFAM)"},{"name":"University Hospital Get\u00falio Vargas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thayla Lais","family":"Estevam","sequence":"additional","affiliation":[{"name":"University Hospital Get\u00falio Vargas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Araujo J\u00fanior","sequence":"additional","affiliation":[{"name":"Federal University of S\u00e3o Paulo (EPM-UNIFESP)"},{"name":"Discipline of Woman Health, Municipal University of S\u00e3o Caetano do Sul (USCS), S\u00e3o Caetano do Sul, S\u00e3o Paulo, Brazil"},{"name":"Discipline of Woman Health, Albert Einstein Israelite College of Health Sciences (FICSAE), Albert Einstein Israelite Hospital, S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciane Alves da","family":"Rocha Amorim","sequence":"additional","affiliation":[{"name":"Medical School, Federal University of Amazonas (UFAM)"},{"name":"University Hospital Get\u00falio Vargas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308996"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12013-015-0551-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.5935\/1678-9741.20120076"},{"key":"e_1_3_3_5_2","unstructured":"Brasil Minist\u00e9rio da Sa\u00fade. Portaria no 1.727 de 11 de julho de. 2017. Aprova o plano nacional de assist\u00eancia \u00e0 crian\u00e7a com cardiopatia cong\u00eanita. Available from: https:\/\/bvsms.saude.gov.br\/bvs\/saudelegis\/gm\/2017\/prt1727_12_07_2017.html#:\u223c:text=1%C2%BA%20Fica%20aprovado%20o%20Plano a%20redu%C3%A7%C3%A3o%20da%20morbimortalidade%20desse. Accessed 8\/29\/2025."},{"issue":"6","key":"e_1_3_3_6_2","first-page":"1164","article-title":"Inequalities in mortality rates from malformations of circulatory system between Brazilian macroregions in individuals younger than 20 years","volume":"115","author":"Salim TR","year":"2020","unstructured":"Salim TR, Andrade TM, Klein CH, Oliveira GMM. Inequalities in mortality rates from malformations of circulatory system between Brazilian macroregions in individuals younger than 20 years. Arq Bras Cardiol. 2020;115(6):1164-1173.","journal-title":"Arq Bras Cardiol"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.66.9.1252"},{"issue":"3","key":"e_1_3_3_8_2","first-page":"256","article-title":"Proposal of an integrated health care network system for patients with congenital heart defects","volume":"31","author":"J\u00fanior PV","year":"2016","unstructured":"J\u00fanior PV, Cavalcante RC, Branco KM, et al. Proposal of an integrated health care network system for patients with congenital heart defects. Braz J Cardiovasc Surg. 2016;31(3):256-260.","journal-title":"Braz J Cardiovasc Surg"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1590\/1413-812320242910.03462023en"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135118825151"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-015-0731-x"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351251364877","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501351251364877","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351251364877","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:27:52Z","timestamp":1777591672000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501351251364877"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,10]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/21501351251364877"],"URL":"https:\/\/doi.org\/10.1177\/21501351251364877","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,10]]}}}