Observational studyThe Annals of thoracic surgery2018
Association of Shunt Type With Arrhythmias After Norwood Procedure.
Observational study in The Annals of thoracic surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 19 citations in OpenAlex.
- Risk Factors and Outcomes for Post-operative Arrhythmias Following the Norwood Operation.Pediatric cardiology · 2026Article
- Type and Frequency of Arrhythmias Status Post Hybrid Procedure at 6 Years of Age.Pediatric cardiology · 2026Article
- Cumulative In-Hospital Costs Associated With Single-Ventricle Palliation.JACC. Advances · 2022Article
- Relation of Norwood Shunt Type and Frequency of Arrhythmias at 6 Years (from the Single Ventricle Reconstruction Trial).The American journal of cardiology · 2022Article
- Incidence and effect of early postoperative ventricular arrhythmias after congenital heart surgery.Heart rhythm · 2019Observational
- Single ventricle, many arrhythmias.Journal of thoracic disease · 2018Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundTransplant-free survival for single right ventricle (RV) lesions remains less than 70% at 3 years. Arrhythmia burden, influence of shunt type at Norwood procedure (RV-to-pulmonary artery shunt [RVPAS] versus Blalock-Taussig shunt [BTS]), and implications for mortality risk are not well defined.
methodsThe authors performed a single-center retrospective analysis of patients with single RV lesions enrolled in a prospective study of arrhythmias after congenital heart surgery.
resultsFifty-eight patients received a RVPAS and 62 received a BTS, with a median follow-up of 773 days. Overall arrhythmia incidence was 78%, two-thirds of which prompted intervention. Among all types of arrhythmias, only ventricular arrhythmias (VAs) differed by shunt type, which were more common in patients receiving an RVPAS (29% RVPAS versus 14% BTS; p = 0.049). The majority of VAs were transient (69% less than 1 minute), and typically occurred early post-Norwood procedure (median 12 days). No additional variables were associated with development of VAs. Shunt type did not influence transplant-free survival. Within the entire cohort, there was a trend toward increased mortality with prior history of VA (odds ratio, 2.90; 95% confidence interval, 0.99 to 8.90; p = 0.052). For interstage survivors to Glenn palliation, any VA associated with a 14-fold increased risk of death or transplant (hazard ratio, 14.00; 95% confidence interval, 3.66 to 53.40; p < .001). No other tachyarrhythmia or bradyarrhythmia was associated with mortality.
conclusionsIn this cohort with single RV lesions and prospective rhythm surveillance, patients receiving an RVPAS at Norwood surgery had an increased incidence of VAs compared with patients with a BTS. VAs correlated with late mortality in patients who survived the interstage period.
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