{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:22:51Z","timestamp":1789611771786,"version":"build-2803163510"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"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>Objective:<\/jats:title>\n                    <jats:p>To describe surgical outcomes, in-hospital mortality, and variables associated with mortality in pediatric patients with congenital heart disease (CHD) at a national referral center in M\u00e9xico over 14 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>\n                      Retrospective cross-sectional study of 4494 patients under 18 years of age with CHD undergoing cardiac surgery (2010-2024) at the Instituto Nacional de Cardiolog\u00eda \u201cIgnacio Ch\u00e1vez,\u201d using Registro Nacional de Cirug\u00eda Card\u00edaca Pedi\u00e1trica y Cardiopat\u00edas Cong\u00e9nitas (RENACCAPE) data. Comparisons used \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      , Fisher's exact, and Mann\u2013Whitney U tests (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). Analysis was univariate; RACHS-1\/STAT scores were incompletely recorded and excluded from risk adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 4494 patients (53.5% [2405\/4494] male), the predominant age groups were children 1 to 12 years (56.1% [2521\/4494]), infants 1 to 11 months (19.8% [888\/4494]), adolescents (17.4% [784\/4494]), and neonates (6.7% [301\/4494]). Down syndrome (6.2% [277\/4494]) and DiGeorge syndrome (1.2% [55\/4494]) were the most frequent genetic comorbidities; 85.5% (3844\/4494) underwent elective surgery. Leading procedures included ventricular septal defect closure (13.6%; [611\/4494] mortality 1.8% [11\/611]), modified Blalock\u2013Taussig-Thomas shunt (9.8% [440\/4494]; mortality 11.1% [49\/440]), total anomalous pulmonary venous connection repair (7.4% [334\/4494]; mortality 8.4% [28\/334]), atrial septal defect closure (6.7% [303\/4494]; mortality 0.0%), and tetralogy of Fallot repair (5.9% [267\/4494]; mortality 7.9% [21\/267]). Norwood had the highest procedure-specific mortality (71.4% [5\/7]), followed by Damus\u2013Kaye\u2013Stansel (60.0%) and Jatene (26.0% [32\/123]). Overall mortality was 9.4% (421\/4494), declining from 10.5% (2010) to 7.1% (2024), with a transient rise during COVID-19. Mortality-associated variables included neonatal\/infant age, low weight, cyanotic CHD, genetic syndromes, prolonged cardiopulmonary bypass (147 vs 89\u2005min), longer aortic cross-clamp time (83 vs 54\u2005min), and urgent surgery (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>To our knowledge this is this largest single-center Mexican pediatric CHD series, in-hospital mortality was 9.4% with a declining trend. Procedure-specific mortalities exceeded STS benchmarks, identifying targets for quality improvement. Expanding RENACCAPE and strengthening referral networks remain priorities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351261450531","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:24:09Z","timestamp":1782390249000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mortality and Risk Factors in Pediatric Cardiac Surgery for Congenital Heart Disease in Mexico"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1171-532X","authenticated-orcid":false,"given":"Yoana","family":"Leyva-L\u00f3pez","sequence":"first","affiliation":[{"name":"Universidad Contempor\u00e1nea de las Am\u00e9ricas"},{"name":"Office of Systematic Support for Advanced Research, National Institute of Cardiology Ignacio Ch\u00e1vez, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 L.","family":"Cerano-Fuentes","sequence":"additional","affiliation":[{"name":"Universidad Contempor\u00e1nea de las Am\u00e9ricas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Calder\u00f3n-Colmenero","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology Ignacio Ch\u00e1vez"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge L.","family":"Cervantes-Salazar","sequence":"additional","affiliation":[{"name":"National Institute of Cardiology Ignacio Ch\u00e1vez"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_3_4_2_2","first-page":"599","volume-title":"Cardiolog\u00eda","author":"De Jes\u00fas Mart\u00ednez Garc\u00eda A","year":"2022","unstructured":"De Jes\u00fas Mart\u00ednez Garc\u00eda A. Cardiopat\u00edas cong\u00e9nitas: cian\u00f3genas y acian\u00f3genas. En: Rosas EA, ed. Cardiolog\u00eda. Editorial Manual Moderno. 2022:599-619."},{"issue":"3","key":"e_1_3_4_3_2","first-page":"149","article-title":"Congenital heart disease, prenatal diagnosis and management","volume":"118","author":"Meller CH","year":"2020","unstructured":"Meller CH, Grinenco S, Aiello H, et al. Congenital heart disease, prenatal diagnosis and management. Arch Argent Pediatr. 2020;118(3):149-161.","journal-title":"Arch Argent Pediatr"},{"issue":"4","key":"e_1_3_4_4_2","first-page":"182","article-title":"Epidemiolog\u00eda de pacientes con cardiopat\u00edas cong\u00e9nitas sometidos a cirug\u00eda en un hospital privado de tercer nivel en M\u00e9xico","volume":"22","author":"Varela-Ortiz J","year":"2015","unstructured":"Varela-Ortiz J, Contreras-Santiago E, Calder\u00f3n-Colmenero J, et al. Epidemiolog\u00eda de pacientes con cardiopat\u00edas cong\u00e9nitas sometidos a cirug\u00eda en un hospital privado de tercer nivel en M\u00e9xico. Med Sur. 2015;22(4):182-188.","journal-title":"Med Sur"},{"key":"e_1_3_4_5_2","unstructured":"Organizaci\u00f3n Mundial de la Salud: Observatorio Mundial de la Salud. Iccrom.org. [citado el 12 de septiembre de 2025]. https:\/\/ocm.iccrom.org\/es\/documents\/organizacion-mundial-de-la-salud-observatorio-mundial-de-la-salud. Accessed 6\/8\/2026."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.26633\/rpsp.2019.44"},{"key":"e_1_3_4_7_2","unstructured":"Argentina. Ministerio de Salud. Programa Nacional de Cardiopat\u00edas Cong\u00e9nitas (PNCC). Buenos Aires: Presidencia de la Naci\u00f3n; [citado el 12 sep 2025]. https:\/\/www.argentina.gob.ar\/salud\/cardiopatiascongenitas. Accessed 6\/8\/2026."},{"issue":"5","key":"e_1_3_4_8_2","first-page":"286","article-title":"Mexican Registry of Pediatric Cardiac Surgery","volume":"71","author":"Cervantes-Salazar JL","year":"2014","unstructured":"Cervantes-Salazar JL, Calder\u00f3n-Colmenero J, Mart\u00ednez-Soto T, et al. Mexican Registry of Pediatric Cardiac Surgery. Bol Med Hosp Infant Mex. 2014;71(5):286-291.","journal-title":"Bol Med Hosp Infant Mex"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1522644"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anpedi.2017.12.009"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2022-321208"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2024-003054"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.circv.2023.04.002"},{"issue":"1","key":"e_1_3_4_14_2","first-page":"66","article-title":"Cardiopat\u00edas cong\u00e9nitas m\u00e1s frecuentes en ni\u00f1os con s\u00edndrome de Down","volume":"24","author":"Ruz-Montes MA","year":"2017","unstructured":"Ruz-Montes MA, Ca\u00f1as-Arenas EM, Lugo-Posada MA, et al. Cardiopat\u00edas cong\u00e9nitas m\u00e1s frecuentes en ni\u00f1os con s\u00edndrome de Down. Rev Colomb Cardiol. 2017;24(1):66-70.","journal-title":"Rev Colomb Cardiol"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-024-07759-w"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.5935\/abc.20180175"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.10.145"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.24875\/acm.20000166"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13137"},{"issue":"2","key":"e_1_3_4_20_2","first-page":"149","article-title":"Paro card\u00edaco posoperatorio en cirug\u00eda card\u00edaca: \u00bfc\u00f3mo mejorar el resultado?","volume":"75","author":"Ashraf Khasawneh M","year":"2021","unstructured":"Ashraf Khasawneh M, Odwan H, Alghoul Y, Makahleh Z, Altarabsheh S. Paro card\u00edaco posoperatorio en cirug\u00eda card\u00edaca: \u00bfc\u00f3mo mejorar el resultado? Arch Med (Sarajevo). 2021;75(2):149-153.","journal-title":"Arch Med (Sarajevo)"},{"issue":"4","key":"e_1_3_4_21_2","article-title":"Caracter\u00edsticas cl\u00ednico-epidemiol\u00f3gicas de las cardiopat\u00edas cong\u00e9nitas en menores de un a\u00f1o","volume":"93","author":"Aguilera S\u00e1nchez Y","year":"2021","unstructured":"Aguilera S\u00e1nchez Y, Angulo Palma HJ. Caracter\u00edsticas cl\u00ednico-epidemiol\u00f3gicas de las cardiopat\u00edas cong\u00e9nitas en menores de un a\u00f1o. Rev Cub Pediatr. 2021;93(4):e1285.","journal-title":"Rev Cub Pediatr"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/21501351211037624"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135118818370"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.24875\/acm.m19000027"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261450531","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501351261450531","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261450531","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T11:49:46Z","timestamp":1782560986000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501351261450531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":23,"alternative-id":["10.1177\/21501351261450531"],"URL":"https:\/\/doi.org\/10.1177\/21501351261450531","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"article-number":"21501351261450531"}}