{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:24:42Z","timestamp":1787840682644,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"\n Background:<\/jats:title>\n Despite improvement in the outcome of the Norwood procedure, the prognosis of hypoplastic left heart syndrome\u00a0(HLHS) remains problematic. The aim of this study was to assess the impact of pre-\u00a0and perioperative factors and catheterization data on outcomes after the Norwood procedure.<\/jats:p>\n <\/jats:sec>\n \n Subjects and Methods:<\/jats:title>\n \n This case\u2013control study included all patients who underwent the Norwood procedure for HLHS at Fukuoka Children\u2019s Hospital between January 2000 and October 2011. Subjects\u00a0(\n n<\/jats:italic>\n \u00a0=\u00a066) were divided into two outcome groups: survivors\u00a0(\n n<\/jats:italic>\n \u00a0=\u00a041) and nonsurvivors\u00a0(\n n<\/jats:italic>\n \u00a0=\u00a025). First, we compared the pre-\u00a0and perioperative data. Second, we compared the catheterization data after the Norwood procedure.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The mean follow-up period was 40\u00a0months\u00a0(range: 1.4\u2013141). Overall, there was a 38% mortality, including early death. The pre-\u00a0and perioperative data, as well as PaO\n 2<\/jats:sub>\n in room air at catheterization, were not significantly different. However, univariate analysis revealed that the incidence of home oxygen therapy to maintain oxygen saturation\u00a0>80% was significantly higher in the survivors\u00a0(\n P<\/jats:italic>\n \u00a0<\u00a00.001). The right ventricular ejection fraction was higher in the survivors\u00a0(48.7% \u00b1 1.9%, mean\u00a0\u00b1\u00a0standard error) than in the nonsurvivors\u00a0(41.4% \u00b1 2.8%,\n P\u00a0<\/jats:italic>\n =\u00a00.041). The severity of tricuspid regurgitation\u00a0(TR) and the pulmonary blood flow\/systemic blood flow ratio were lower in the survivors than in the nonsurvivors. Multivariate logistic regression analysis identified severe TR as the only significant prognostic marker of mortality\u00a0(\n P<\/jats:italic>\n \u00a0=\u00a00.041).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The severity of TR was associated with the prognosis of HLHS after the Norwood procedure.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/apc.apc_57_25","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T18:00:28Z","timestamp":1756490428000},"page":"100-104","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["An 11-year single-center experience of Norwood procedures in the neonates with hypoplastic left heart syndrome and variants"],"prefix":"10.4103","volume":"18","author":[{"given":"Akihiro","family":"Nakamura","sequence":"first","affiliation":[{"name":"Fukuoka Children\u2019s Hospital, Fukuoka, Japan"},{"name":"NYS Medical Inc., Shibuya, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Fukuoka Children\u2019s Hospital, Fukuoka, Japan"},{"name":"Medical Corporation Minatomirai Chigasaki Clinic, Chigasaki, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/S0031-3955(16)30727-1","article-title":"The hypoplastic left heart syndrome; an analysis of 101 cases","volume":"5","author":"Noonan","year":"1958","journal-title":"Pediatr Clin North Am"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1016\/0003-4975(92)90065-C","article-title":"Fontan procedure for hypoplastic left heart syndrome","volume":"54","author":"Norwood","year":"1992","journal-title":"Ann Thorac Surg"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s002469900314","article-title":"Current status of staged reconstruction for hypoplastic left heart syndrome","volume":"19","author":"Bove","year":"1998","journal-title":"Pediatr Cardiol"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.jtcvs.2011.01.030","article-title":"Interstage attrition between bidirectional Glenn and Fontan palliation in children with hypoplastic left heart syndrome","volume":"142","author":"Carlo","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"S205","DOI":"10.1161\/CIRCULATIONAHA.112.000380","article-title":"Surgical palliation strategy does not affect interstage ventricular dysfunction or atrioventricular valve regurgitation in children with hypoplastic left heart syndrome and 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cases","volume":"14","author":"Sellers","year":"1964","journal-title":"Am J Cardiol"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1056\/NEJMoa0912461","article-title":"Comparison of shunt types in the Norwood procedure for single-ventricle lesions","volume":"362","author":"Ohye","year":"2010","journal-title":"N Engl J Med"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.athoracsur.2008.08.027","article-title":"Risk factors for mortality after the Norwood procedure using right ventricle to pulmonary artery shunt","volume":"87","author":"Sano","year":"2009","journal-title":"Ann Thorac Surg"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jtcvs.2005.09.030","article-title":"Current outcomes and risk factors for the Norwood procedure","volume":"131","author":"Stasik","year":"2006","journal-title":"J Thorac Cardiovasc 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levels","volume":"124","author":"Mahajan","year":"2011","journal-title":"Circulation"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"56","DOI":"10.4103\/apc.APC_113_17","article-title":"Prognostic value of troponin in infants with hypoplastic left heart syndrome between stage I and II of palliation","volume":"11","author":"Christmann","year":"2018","journal-title":"Ann Pediatr Cardiol"}],"container-title":["Annals of Pediatric 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