{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T21:47:16Z","timestamp":1782078436110,"version":"3.54.5"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We sought to characterize the epidemiology, treatment patterns, and outcomes of neonatal Ebstein anomaly using a national database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this descriptive analysis, the pediatric health information system (PHIS) database was queried for the demographics, treatment, and outcomes of neonates with Ebstein anomaly using International Classification of Disease codes between 2004 and 2024. The surgical and nonoperative cohorts were each divided into two eras: era 1 = 2004-2014, era 2 = 2015-2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1323 neonates identified, 173 (13%) underwent surgical repair and 1150 (87%) received nonoperative management. Overall hospital mortality was 26.6% (46\/173) (operative) and 12.8% (147\/1150) (nonoperative). Nonoperative mortality significantly decreased over time (18.4% [34\/185] vs 11.7% [113\/965],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.01), while operative mortality did not improve (20.5% [9\/44] vs 28.7% [37\/129],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.38).\n                    <\/jats:p>\n                    <jats:p>\n                      In the operative cohort, 73% (126\/173) required mechanical ventilation (MV)\u2009&lt;\u200914 days and 27% (47\/173) required MV \u226514 days, with no mortality difference. In the nonoperative cohort, 60% (690\/1150) avoided intubation. In the nonoperative cohort, compared with nonintubated patients (mortality:8.4%), mortality odds increased significantly with MV for 7 to 13 days (21%; OR 8.5,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.01) and \u226514 days (26%; OR 7.8,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.01). High-volume centers (\u226575th percentile for Ebstein admissions) had significantly lower operative mortality compared with low-volume centers (19.6% vs 27.5%, OR 0.39,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.04) but equivalent nonoperative mortality. Only 26.6% (46\/173) of surgical patients were treated at high-volume centers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant mortality persists in neonatal Ebstein anomaly (27% [46\/173] surgical, 13% [147\/1150] nonsurgical), with improvement over time only in nonsurgical patients. Nonsurgical patients requiring intubation &gt;7 days have &gt;20% mortality, warranting strategy reconsideration. Higher-volume centers appear to demonstrate superior operative survival, perhaps supporting patient transfer for surgical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351261445890","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:26:01Z","timestamp":1781670361000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Substantial Operative and Nonoperative Mortality Persists in Neonatal Ebstein Anomaly: A 20-Year Multi-Institutional Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4641-989X","authenticated-orcid":false,"given":"Darren","family":"Turner","sequence":"first","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9980-0160","authenticated-orcid":false,"given":"Amir","family":"Mehdizadeh-Shrifi","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3834-1542","authenticated-orcid":false,"given":"Muhammad","family":"Faateh","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosam","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Carlisle","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lehenbauer","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ricci","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-9823","authenticated-orcid":false,"given":"Awais","family":"Ashfaq","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L. S.","family":"Morales","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2025.01.023"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.015839"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.016684"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-317756"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytad159"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.12.086"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.05.032"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.optechstcvs.2023.12.005"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjtc.2020.05.011"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.04.049"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2024.04.018"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.10.057"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.11.001"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.05.023"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114001747"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.04.037"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11050147"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12759"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.036214"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261445890","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501351261445890","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261445890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T20:48:36Z","timestamp":1782074916000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501351261445890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":19,"alternative-id":["10.1177\/21501351261445890"],"URL":"https:\/\/doi.org\/10.1177\/21501351261445890","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"article-number":"21501351261445890"}}