{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:55:13Z","timestamp":1790978113527,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"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":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older patients with severe cyanosis from unrepaired tetralogy of Fallot (TOF) face high perioperative morbidity despite technically straightforward surgical repair. Chronic hypoxemia leads to myocardial metabolic adaptation, polycythemia, and increased susceptibility to reperfusion injury. Preoperative optimization may improve outcomes in this high-risk group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether palliative balloon pulmonary valvotomy (BPV) before intracardiac repair (ICR) improves immediate postoperative outcomes in severely cyanotic patients with uncomplicated TOF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective observational study was conducted on 42 patients (age: 5 months-40 years) with severe cyanosis (oxygen saturation &lt;70%) undergoing BPV followed by elective ICR. Pre and postoperative parameters including oxygen saturation, hemoglobin, hematocrit, ventilation duration, vasoactive inotrope score, intensive care unit (ICU) stay, and hospital stay were recorded. Outcomes were compared with 49 matched controls undergoing direct ICR without BPV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Balloon pulmonary valvotomy led to a mean saturation increase of 15\u2009\u00b1\u20093% in 90% of patients, with reported improvement in functional capacity and cessation of cyanotic spells. Compared with the direct ICR group, BPV-ICR patients had significantly shorter ventilation time (13.3\u2009\u00b1\u200913.8 vs 29.1\u2009\u00b1\u200937.4\u2005h,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.011), inotrope duration (46.9\u2009\u00b1\u200915.5 vs 64.3\u2009\u00b1\u200930.8\u2005h,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001), ICU stay (62.9\u2009\u00b1\u200936.8 vs 94.9\u2009\u00b1\u200943.1\u2005h,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and hospital stay (6.6\u2009\u00b1\u20093.6 vs 10.6\u2009\u00b1\u20092.8 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001). No mortality occurred in the BPV-ICR group versus two deaths in the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Palliative BPV significantly improves preoperative condition and reduces immediate postoperative morbidity in severely cyanotic, anatomically suitable TOF patients. A staged BPV-ICR approach may be a safe, effective strategy in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351251403503","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:49:03Z","timestamp":1773402543000},"page":"813-820","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Palliative Balloon Pulmonary Valvotomy Enhances Immediate Postoperative Outcomes in Severely Cyanotic Patients With Tetralogy of Fallot"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4219-5067","authenticated-orcid":false,"given":"Sowmya","family":"Kasturi","sequence":"first","affiliation":[{"name":"Sri Padmavathi Children's Heart Centre \u2013 Sri Venkateswara Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinath Reddy","family":"Narahari","sequence":"additional","affiliation":[{"name":"Sri Padmavathi Children's Heart Centre \u2013 Sri Venkateswara Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipesh","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Sri Padmavathi Children's Heart Centre \u2013 Sri Venkateswara Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand Kumar","family":"Gowdhaman","sequence":"additional","affiliation":[{"name":"Sri Padmavathi Children's Heart Centre \u2013 Sri Venkateswara Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"issue":"21","key":"e_1_3_3_2_2","first-page":"33","article-title":"Incidence of congenital heart disease in a tertiary care hospital","volume":"6","author":"Shah GS","year":"2008","unstructured":"Shah GS, Singh MK, Pandey TR, Kalakheti BK, Bhandari GP. 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