{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:45:03Z","timestamp":1792154703958,"version":"4.4.0"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"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":"\n Background<\/jats:title>\n Children with single ventricle (SV) physiology and total anomalous pulmonary venous connection (TAPVC) face high surgical risk. Despite advances in single ventricle care, survival in SV\/TAPVC patients has plateaued. We investigated multicenter outcomes, reintervention rates, and healthcare burden in this complex population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The Pediatric Health Information System was queried for TAPVC repairs (2015-2024). Infants were stratified by single-ventricle versus biventricular (BiV) anatomy.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 1258 infants undergoing TAPVC repair, 10% (N\u2009=\u2009120) had SV and 90% (N\u2009=\u20091138) had BiV anatomy. SV\/TAPVC patients showed higher prematurity (11% [13\/120] vs 8% [91\/1138],\n P<\/jats:italic>\n \u2009<\u2009.001), low birthweight (14% [17\/120] vs 9% [102\/1138],\n P<\/jats:italic>\n \u2009<\u2009.001), and neurologic abnormalities (13% [16\/120] vs 5% [60\/1138],\n P<\/jats:italic>\n \u2009<\u2009.001). Postoperatively, SV\/TAPVC had increased delayed sternal closure (11% [13\/120] vs 4% [45\/1138],\n P<\/jats:italic>\n \u2009<\u2009.001) and ECMO use (7% [8\/120] vs 3% [34\/1138],\n P<\/jats:italic>\n \u2009<\u2009.001). Healthcare burden was substantially higher in SV\/TAPVC children: 5-fold longer hospitalizations (102 vs 29 days,\n P<\/jats:italic>\n \u2009<\u2009.001), 6-fold more hospital visits (6 vs 1,\n P<\/jats:italic>\n \u2009<\u2009.001), and 5-fold higher costs ($1,019,390 vs $259,303,\n P<\/jats:italic>\n \u2009<\u2009.001). Survival at 1 year after repair was severely reduced (SV: 52% vs BiV: 88%,\n P<\/jats:italic>\n \u2009<\u2009.001). Pulmonary vein reinterventions were substantially higher (12-month cumulative incidence: 32% vs 5%,\n P<\/jats:italic>\n \u2009<\u2009.001). Single ventricle physiology was a strong mortality predictor (HR: 3.69,\n P<\/jats:italic>\n \u2009<\u2009.001), particularly pulmonary atresia with intact septum (HR: 6.62,\n P<\/jats:italic>\n \u2009<\u2009.001) and hypoplastic left heart syndrome (HR: 4.42,\n P<\/jats:italic>\n \u2009<\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Single ventricle physiology remains a powerful predictor of adverse outcome in children with TAPVC, with 1-year survival rates approaching 50%. Children with SV\/TAPVC face substantially longer hospitalizations, higher reintervention rates, higher hospital visits, and overall 5-fold greater healthcare costs.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/21501351261472486","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:42:49Z","timestamp":1791996169000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Single-Ventricle Physiology as a Dominant Determinant of Mortality, Resource Utilization, and Pulmonary Vein Reintervention in Total Anomalous Pulmonary Venous Connection: A Large Multicenter Study"],"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's 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's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blue","family":"Lee","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosam F.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7236-5402","authenticated-orcid":false,"given":"Grant","family":"Chappell","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8795-9526","authenticated-orcid":false,"given":"Sarosh","family":"Batlivala","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lehenbauer","sequence":"additional","affiliation":[{"name":"Cincinnati Children's 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's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.S.","family":"Morales","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ricci","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivy267"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.09.046"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135118771344"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-019-01141-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2022.07.021"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2023.08.006"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.958959"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.03.058"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2021.11.012"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951122004280"}],"container-title":["World Journal for Pediatric and Congenital Heart 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