Evidence map›Paper›PMID 38842558›Full record

ArticlePediatric cardiology2026

Comparison of Ductal Stent Versus Surgical Shunt as Initial Intervention for Neonates with Pulmonary Atresia with Intact Ventricular Septum.

Bao Nguyen Puente, Christopher W Mastropietro, Saul Flores, Eva W Cheung, Venugopal Amula, Monique Radman, David Kwiatkowski, Jason R Buckley, Kiona Allen, Rohit Loomba and 12 more

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Bao Nguyen PuenteDivision of Cardiac Critical Care, Children's National Health System, 111 Michigan Ave NW M4800, Washington, DC, 20010, USA. bpuente@childrensnational.org.ORCID http://orcid.org/0000-0001-8252-7559
Christopher W MastropietroDivision of Critical Care, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
Saul FloresDepartment of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Eva W CheungDivision of Critical Care & Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
Venugopal AmulaDivision of Critical Care, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA.
Monique RadmanDivision of Critical Care, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
David KwiatkowskiDivision of Cardiology, Department of Pediatrics, Lucille Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, USA.
Jason R BuckleyDivision of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
Kiona AllenDivision of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Rohit LoombaDepartment of Pediatrics, Chicago Medical School, Advocate Children's Hospital, Chicago, IL, USA.
Karan KarkiDivision of Cardiology, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Saurabh ChiwaneDivision of Critical Care, Department of Pediatrics, Cardinal Glennon Children's Hospital, Saint Louis University, Saint Louis, MO, USA.
Katherine CashenDivision of Critical Care Medicine, Duke Children's Hospital, Duke University, Durham, NC, USA.
Kurt PiggottDivision of Pediatrics, Nemours Children's Hospital, Orlando, FL, USA.
Yamini KapileshwarkarDepartment of Pediatrics, Children's Hospital of Illinois, Peoria, IL, USA.
Keshava Murthy Narayana GowdaDepartment of Pediatrics, Cleveland Clinic, Cleveland, OH, USA.
Aditya BadhekaDepartment of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA.
Rahul RamanDepartment of Pediatrics, Mercy Medical Center, Des Moines, IA, USA.
John M CostelloDivision of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
Huaiyu ZangCincinnati Children's Hospital Medical Center, Heart Institute, Cincinnati, OH, USA.
Ilias IliopoulosDepartment of Pediatrics, Inova Children's Hospital, Fairfax, VA, USA.
Collaborative Research from the Pediatric Cardiac Intensive Care Society (CoRe-PCICS) Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Data comparing surgical systemic-to-pulmonary artery shunt and patent ductus arteriosus (PDA) stent as the initial palliation procedure for patients with pulmonary atresia with intact ventricular septum (PA-IVS) are limited. We sought to compare characteristics and outcomes in a multicenter cohort of patients with PA-IVS undergoing surgical shunts versus PDA stents. We retrospectively reviewed neonates with PA-IVS from 2009 to 2019 in 19 United States centers. Bivariate comparisons and multivariable logistic regression analysis were performed to determine the relationship between initial palliation strategy and outcomes including major adverse cardiovascular events (MACE): stroke, mechanical circulatory support, cardiac arrest, or death. 187 patients were included: 38 PDA stents and 149 surgical shunts. Baseline characteristics did not differ statistically between groups. Post-procedural MACE occurred in 4 patients (11%) with PDA stents versus 38 (26%) with surgical shunts, p = 0.079. Overall, the initial palliation strategy was not significantly associated with MACE (aOR:0.37; 95% CI,0.13-1.02). In patients with moderate-to-severe right ventricle hypoplasia, PDA stents were significantly associated with decreased odds of MACE (aOR:0.36; 95% CI,0.13-0.99). PDA stents were associated with lower vasoactive inotrope scores (median 0 versus 5, p < 0.001), greater likelihood to be extubated at the end of their procedure (37% versus 4%, p < 0.001), and shorter duration of mechanical ventilation (median 24 versus 96 h, p < 0.001). PDA stents were associated with significantly more unplanned reinterventions for hypoxemia compared to surgical shunts (42% vs. 20%, p = 0.009). In this multicenter study, neonates with PA-IVS who underwent PDA stenting received less vasoactive and ventilatory support postoperatively compared to those who had surgical shunts. Furthermore, patients with the most severe morphology had decreased odds of MACE.

Indexed as

Cardiac Surgical ProceduresDuctus Arteriosus, PatentHeart Defects, CongenitalPulmonary AtresiaStentsFemaleHumansInfant, NewbornMalePalliative CareRetrospective StudiesTreatment OutcomeUnited StatesBTT shuntsCongenital heart defectsDuctal stentsPulmonary atresia intact ventricular septumSurgical shuntsSystemic-to-pulmonary artery shunt

Identifiers

PMID38842558

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.