{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:53:00Z","timestamp":1791039180728,"version":"4.1.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"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>Objectives<\/jats:title>\n                    <jats:p>The role of single-stage Fontan completion, performed without a preceding bidirectional Glenn, remains controversial in late-presenting patients and resource-limited settings. We compared early and midterm outcomes of single-stage and staged Fontan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective review of consecutive patients undergoing Fontan completion at a tertiary congenital cardiac center between January 2003 and December 2025. Cohorts were grouped by whether Fontan was direct (single-stage) or after prior bidirectional Glenn (staged). Primary endpoints were in-hospital mortality and 1-year survival; secondary endpoints included complications, intensive care unit (ICU) and hospital stay, and midterm survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 118 patients (single-stage n\u2009=\u200966; staged\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200952), single-stage patients were older (median age 11 vs 8 years;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002), with higher mean pulmonary artery pressure (14.9\u2009\u00b1\u20093.4 vs 12.1\u2009\u00b1\u20093.3\u2005mm\u2009Hg;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and lower ventricular ejection fraction (60% vs 67.5%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.01). Despite this, in-hospital mortality (9.1% vs 5.8%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.729), Kaplan-Meier 1-year survival (87.6% vs 94.2%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.59) and 5-year survival (87.6% vs 92.0%) did not differ. ICU stay (median 4 days), hospital stay (14 vs 15 days), and complications were comparable. Fontan-associated liver disease occurred in 17 of 109 patients (15.6%; 20.3% vs 10.0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =\u2009.138).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite less favorable baseline hemodynamics, early and midterm outcomes after single-stage Fontan were comparable to staged Fontan. Single-stage Fontan is a reasonable option for appropriately evaluated late-presenting patients in resource-constrained settings; multicenter studies are required to refine selection criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351261484590","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:57:36Z","timestamp":1790773056000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Outcomes of Single-Stage Fontan Procedure Versus Staged Fontan Following Glenn Procedure in Single-Ventricle Patients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6356-5545","authenticated-orcid":false,"given":"Panat","family":"Kittisit","sequence":"first","affiliation":[{"name":"Chulalongkorn University, King Chulalongkorn Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janewit","family":"Wanichwatphibun","sequence":"additional","affiliation":[{"name":"Chulalongkorn University, King Chulalongkorn Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mueanthep","family":"Chomvilailuk","sequence":"additional","affiliation":[{"name":"Chulalongkorn University, King Chulalongkorn Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayatat","family":"Sirinawin","sequence":"additional","affiliation":[{"name":"Chulalongkorn University, King Chulalongkorn Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jule","family":"Namchaisiri","sequence":"additional","affiliation":[{"name":"Chulalongkorn University, King Chulalongkorn Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vichai","family":"Benjacholamas","sequence":"additional","affiliation":[{"name":"Chulalongkorn University, King Chulalongkorn Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.26.3.240"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)35174-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000696"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307467"},{"issue":"2","key":"e_1_3_3_6_2","first-page":"114","article-title":"Fontan\u2019s procedure in two stages","volume":"56","author":"Norwood WI","year":"1993","unstructured":"Norwood WI, Jacobs ML. 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Outcome of late extracardiac Fontan completion in functional single ventricle patients. J Med Assoc Thai. 2019;102(4):414-422.","journal-title":"J Med Assoc Thai"},{"issue":"2","key":"e_1_3_3_14_2","first-page":"34","article-title":"Status of pediatric cardiac care in developing countries","volume":"6","author":"Saxena A.","year":"2019","unstructured":"Saxena A. Status of pediatric cardiac care in developing countries. Children (Basel). 2019;6(2):34.","journal-title":"Children (Basel)"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4103\/apc.apc_71_24"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.01.030"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac528"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.03.020"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.02.034"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.045"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.738559"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.065"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.11.043"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.08.025"},{"issue":"11","key":"e_1_3_3_25_2","article-title":"Redefining expectations of long-term survival after the Fontan procedure: Twenty-five years of follow-up from the entire population of Australia and New Zealand","volume":"130","author":"d\u2019Udekem Y","year":"2014","unstructured":"d\u2019Udekem Y, Iyengar AJ, Galati JC, et al. Redefining expectations of long-term survival after the Fontan procedure: Twenty-five years of follow-up from the entire population of Australia and New Zealand. Circulation. 2014;130(11 Suppl 1):S32-S38.","journal-title":"Circulation"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.1020984"},{"issue":"5","key":"e_1_3_3_27_2","article-title":"Defining the causes for Fontan circulatory failure in total cavopulmonary connection patients","volume":"39","author":"Van Puyvelde J","year":"2024","unstructured":"Van Puyvelde J, Rega F, Budts W, et al. Defining the causes for Fontan circulatory failure in total cavopulmonary connection patients. 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