Clinical trial NCT00115934: Comparison of Two Types of Shunts in Infants With Single Ventricle Defect Undergoing Staged Reconstruction--Pediatric Heart Network
Official title: Trial of Right Ventricular Versus Modified Blalock-Taussig Shunt in Infants With Single Ventricle Defect Undergoing Staged Reconstruction (A Trial Conducted by the Pediatric Heart Network)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Heart Defects, Congenital
Lead sponsor: Carelon Research
Sponsor class: OTHER
Collaborators: name: National Heart, Lung, and Blood Institute (NHLBI)
name: Pediatric Heart Network
First posted: 2005-06-27
Enrollment: 555
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This trial will evaluate the efficacy and safety of the modified Blalock-Taussig shunt (MBTS) compared to the right ventricle to pulmonary artery (RV-to-PA) shunt; compare the effect of the MBTS to that of the RV-to-PA shunt on the incidence of death or cardiac transplantation at 12 months post randomization; and compare the effect of the two shunts on intensive care unit (ICU) morbidity, unintended cardiovascular interventional procedures, right ventricular function, tricuspid valve regurgitation, pulmonary artery growth, and neurodevelopmental outcome.

Detailed description: BACKGROUND:

Hypoplastic left heart syndrome (HLHS) and related single right ventricle anomalies are the highest risk congenital cardiovascular malformations. Surgical repair begins with the Norwood procedure during the newborn period, a stage II procedure at 4 to 6 months of age, and Fontan procedure at 18 to 36 months. The Norwood procedure remains one of the highest risk procedures in congenital heart surgery. A few small nonrandomized studies of a novel approach to the Norwood procedure have reported improved outcomes. This new approach uses a RV-to-PA shunt to provide pulmonary blood flow rather than the standard MBTS. This multi-center, randomized clinical trial will evaluate early and intermediate-term outcomes for patients undergoing a Norwood procedure with either the RV-to-PA shunt or the MBTS.

This study has been approved by the Institutional Review/Research Ethics Boards of all participating clinical centers:

Hospital for Sick Children, Toronto, Canada

Children's Hospital Boston, Boston, MA

Columbia College of Physicians and Surgeons, New York, NY

Children's Hospital of Philadelphia, Philadelphia, PA

Duke University Medical Center, Durham, NC

Brody School of Medicine at East Carolina University, Greenville, NC

Wake Forest Baptist Medical Center, Winston Salem, NC

Medical University of South Carolina, Charleston, SC

Children's Hospital of Wisconsin, Milwaukee, WI

University of Michigan, Ann Arbor, MI

Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Children's Hospital of Los Angeles, Los Angeles, CA

Egleston Children's Hospital, Emory University, Atlanta, GA

Congenital Heart Institute of Florida, University of South Florida, St. Petersburg, FL

Alfred I. duPont Hospital for Children, Wilmington, DE

DESIGN NARRATIVE:

This is a prospective, randomized clinical trial of the RV-to-PA shunt versus MBTS in patients undergoing a Norwood procedure.

Eligibility criteria: Inclusion Criteria:

* Diagnosis of hypoplastic left heart syndrome or related single, morphologic right ventricle anomaly
* Planned Norwood procedure
* Informed consent of parent(s) or legal guardian

Exclusion Criteria:

* Single, morphologic left ventricle anomaly
* Preoperative identification of anatomy rendering either an MBTS or an RV-to-PA shunt technically impossible
* Any major congenital abnormality (i.e., congenital diaphragmatic hernia, tracheoesophageal fistula) or acquired extra-cardiac disorder (e.g., meconium aspiration with need for high frequency ventilation, persistent renal failure requiring dialysis) that, in the opinion of the investigator, could independently affect the likelihood of the subject meeting the primary endpoint

Primary outcomes:
measure: Proportion of Patients Who Died or Received a Heart Transplant
timeFrame: Measured at 12 months
Secondary outcomes:
measure: Proportion of Deaths or Heart Transplants Over Time From Randomization to the End of the Trial
timeFrame: From Randomization to the End of the Trial, an average of 32 months
measure: Echocardiographic Measures of Heart Size and Function: Right Ventricle (RV) End-diastolic Volume Indexed to Body Surface Area (BSA)
timeFrame: Measured post-Norwood, an average of 17 days post-Norwood
measure: Echocardiographic Measures of Heart Size and Function: RV End-diastolic Volume Indexed to BSA
timeFrame: Measured pre-stage II surgery, an average of 15 days pre-stage II surgery
measure: Echocardiographic Measures of Heart Size and Function: RV End-diastolic Volume Indexed to BSA
timeFrame: Measured at 14 months of age
measure: Echocardiographic Measures of Heart Size and Function: RV End-systolic Volume Indexed to BSA
timeFrame: Measured post-Norwood, an average of 17 days post-Norwood
measure: Echocardiographic Measures of Heart Size and Function: RV End-systolic Volume Indexed to BSA
timeFrame: Measured pre-stage II surgery, an average of 15 days pre-stage II surgery
measure: Echocardiographic Measures of Heart Size and Function: RV End-systolic Volume Indexed to BSA
timeFrame: Measured at 14 months of age
measure: Echocardiographic Measures of Heart Size and Function: RV Ejection Fraction
timeFrame: Measured post-Norwood, an average of 17 days post-Norwood
measure: Echocardiographic Measures of Heart Size and Function: RV Ejection Fraction
timeFrame: Measured pre-stage II surgery, an average of 15 days pre-stage II surgery
measure: Echocardiographic Measures of Heart Size and Function: RV Ejection Fraction
timeFrame: Measured at 14 months of age
measure: Angiographic Findings: Left Pulmonary Artery Size
timeFrame: Measured pre-stage II surgery, on average 26 days prior to stage II palliation
measure: Angiographic Findings: Right Pulmonary Artery Size
timeFrame: Measured pre-stage II surgery, on average 26 days prior to stage II palliation
measure: Unintended Cardiovascular Interventional Procedures
timeFrame: From Randomization to 12 months
measure: Complications: Total Number Experienced During Norwood Hospitalization
timeFrame: Norwood Hospitalization, an average of 36 days
measure: Complications: Total Number Experienced From Norwood Discharge to Stage II Discharge
timeFrame: From Norwood Discharge to Stage II discharge, an average of 4.2 months
measure: Complications: Total Number Experienced From Stage II Discharge to 14 Months of Age
timeFrame: From Stage II Discharge to 14 Months of Age, an average of 8.9 months
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: Children's Hospital of Los Angeles
state: California
city: Wilmington
country: United States
facility: Alfred I. duPont Hospital for Children
state: Delaware
city: Saint Petersburg
country: United States
facility: Cardiac Surgical Associates
state: Florida
city: Atlanta
country: United States
facility: Children's Healthcare of Atlanta at Egleston
state: Georgia
city: Boston
country: United States
facility: Children's Hospital Boston
state: Massachusetts
city: Ann Arbor
country: United States
facility: University of Michigan Health System/Mott Hospital
state: Michigan
city: New York
country: United States
facility: Columbia College of Physicians and Surgeons
state: New York
city: Durham
country: United States
facility: Duke University Medical Center
state: North Carolina
city: Cincinnati
country: United States
facility: Cincinnati Children's Hospital Medical Center
state: Ohio
city: Philadelphia
country: United States
facility: Children's Hospital of Philadelphia
state: Pennsylvania
city: Charleston
country: United States
facility: Medical University of South Carolina
state: South Carolina
city: Milwaukee
country: United States
facility: Children's Hospital of Wisconsin
state: Wisconsin
city: Toronto
country: Canada
facility: Hospital for Sick Children
state: Ontario
Study officials:
affiliation: New England Research Institutes, Watertown, MA
name: Julie E Miller, MPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: Ohye RG, Gaynor JW, Ghanayem NS, Goldberg CS, Laussen PC, Frommelt PC, Newburger JW, Pearson GD, Tabbutt S, Wernovsky G, Wruck LM, Atz AM, Colan SD, Jaggers J, McCrindle BW, Prakash A, Puchalski MD, Sleeper LA, Stylianou MP, Mahony L; Pediatric Heart Network Investigators. Design and rationale of a randomized trial comparing the Blalock-Taussig and right ventricle-pulmonary artery shunts in the Norwood procedure. J Thorac Cardiovasc Surg. 2008 Oct;136(4):968-75. doi: 10.1016/j.jtcvs.2008.01.013. Epub 2008 May 19.
citation: Johnson JN, Ansong AK, Li JS, Xu M, Gorentz J, Hehir DA, del Castillo SL, Lai WW, Uzark K, Pasquali SK. Celiac artery flow pattern in infants with single right ventricle following the Norwood procedure with a modified Blalock-Taussig or right ventricle to pulmonary artery shunt. Pediatr Cardiol. 2011 Apr;32(4):479-86. doi: 10.1007/s00246-011-9906-y. Epub 2011 Feb 18.
citation: Virzi L, Pemberton V, Ohye RG, Tabbutt S, Lu M, Atz TC, Barnard T, Dunbar-Masterson C, Ghanayem NS, Jacobs JP, Lambert LM, Lewis A, Pike N, Pizarro C, Radojewski E, Teitel D, Xu M, Pearson GD. Reporting adverse events in a surgical trial for complex congenital heart disease: the Pediatric Heart Network experience. J Thorac Cardiovasc Surg. 2011 Sep;142(3):531-7. doi: 10.1016/j.jtcvs.2010.11.052. Epub 2011 Mar 12.
citation: Atz AM, Travison TG, Williams IA, Pearson GD, Laussen PC, Mahle WT, Cook AL, Kirsh JA, Sklansky M, Khaikin S, Goldberg C, Frommelt M, Krawczeski C, Puchalski MD, Jacobs JP, Baffa JM, Rychik J, Ohye RG; Pediatric Heart Network Investigators. Prenatal diagnosis and risk factors for preoperative death in neonates with single right ventricle and systemic outflow obstruction: screening data from the Pediatric Heart Network Single Ventricle Reconstruction Trial( *). J Thorac Cardiovasc Surg. 2010 Dec;140(6):1245-50. doi: 10.1016/j.jtcvs.2010.05.022. Epub 2010 Jun 18.
citation: Ohye RG, Sleeper LA, Mahony L, Newburger JW, Pearson GD, Lu M, Goldberg CS, Tabbutt S, Frommelt PC, Ghanayem NS, Laussen PC, Rhodes JF, Lewis AB, Mital S, Ravishankar C, Williams IA, Dunbar-Masterson C, Atz AM, Colan S, Minich LL, Pizarro C, Kanter KR, Jaggers J, Jacobs JP, Krawczeski CD, Pike N, McCrindle BW, Virzi L, Gaynor JW; Pediatric Heart Network Investigators. Comparison of shunt types in the Norwood procedure for single-ventricle lesions. N Engl J Med. 2010 May 27;362(21):1980-92. doi: 10.1056/NEJMoa0912461.
citation: Ohye RG, Devaney EJ, Hirsch JC, Bove EL. The modified Blalock-Taussig shunt versus the right ventricle-to-pulmonary artery conduit for the Norwood procedure. Pediatr Cardiol. 2007 Mar-Apr;28(2):122-5. doi: 10.1007/s00246-006-1449-2. Epub 2007 Feb 16.
citation: Dolgner SJ, Tjoeng YL, Chan T. Analysis of the Single Ventricle Reconstruction Trial Using Restricted Mean Survival Time and Shunt Type Received. J Am Heart Assoc. 2022 Sep 20;11(18):e025978. doi: 10.1161/JAHA.122.025978. Epub 2022 Sep 8. No abstract available.
citation: Miller TA, Ghanayem NS, Newburger JW, McCrindle BW, Hu C, DeWitt AG, Cnota JF, Tractenberg FL, Pemberton VL, Wolf MJ, Votava-Smith JK, Fifer CG, Lambert LM, Shah A, Graham EM, Pizarro C, Jacobs JP, Miller SG, Minich LL; Pediatric Heart Network Investigators. Gestational Age, Birth Weight, and Outcomes Six Years After the Norwood Procedure. Pediatrics. 2019 May;143(5):e20182577. doi: 10.1542/peds.2018-2577. Epub 2019 Apr 12.
citation: Frommelt PC, Hu C, Trachtenberg F, Baffa JM, Boruta RJ, Chowdhury S, Cnota JF, Dragulescu A, Levine JC, Lu J, Mercer-Rosa L, Miller TA, Shah A, Slesnick TC, Stapleton G, Stelter J, Wong P, Newburger JW. Impact of Initial Shunt Type on Echocardiographic Indices in Children After Single Right Ventricle Palliations. Circ Cardiovasc Imaging. 2019 Feb;12(2):e007865. doi: 10.1161/CIRCIMAGING.118.007865.
citation: Mahle WT, Hu C, Trachtenberg F, Menteer J, Kindel SJ, Dipchand AI, Richmond ME, Daly KP, Henderson HT, Lin KY, McCulloch M, Lal AK, Schumacher KR, Jacobs JP, Atz AM, Villa CR, Burns KM, Newburger JW; Pediatric Heart Network Investigators. Heart failure after the Norwood procedure: An analysis of the Single Ventricle Reconstruction Trial. J Heart Lung Transplant. 2018 Jul;37(7):879-885. doi: 10.1016/j.healun.2018.02.009. Epub 2018 Feb 16.
citation: Newburger JW, Sleeper LA, Gaynor JW, Hollenbeck-Pringle D, Frommelt PC, Li JS, Mahle WT, Williams IA, Atz AM, Burns KM, Chen S, Cnota J, Dunbar-Masterson C, Ghanayem NS, Goldberg CS, Jacobs JP, Lewis AB, Mital S, Pizarro C, Eckhauser A, Stark P, Ohye RG; Pediatric Heart Network Investigators. Transplant-Free Survival and Interventions at 6 Years in the SVR Trial. Circulation. 2018 May 22;137(21):2246-2253. doi: 10.1161/CIRCULATIONAHA.117.029375. Epub 2018 Feb 1.
citation: Bucholz EM, Sleeper LA, Newburger JW. Neighborhood Socioeconomic Status and Outcomes Following the Norwood Procedure: An Analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Data Set. J Am Heart Assoc. 2018 Feb 2;7(3):e007065. doi: 10.1161/JAHA.117.007065.
citation: Ramroop R, Manase G, Lu D, Manase D, Chen S, Kim R, Lee T, Mahle WT, McHugh K, Mitchell M, Tristani-Firouzi M, Wechsler SB, Wilder NS, Zak V, Lafreniere-Roula M, Newburger JW, Gaynor JW, Russell MW, Mital S. Adrenergic receptor genotypes influence postoperative outcomes in infants in the Single-Ventricle Reconstruction Trial. J Thorac Cardiovasc Surg. 2017 Nov;154(5):1703-1710.e3. doi: 10.1016/j.jtcvs.2017.06.041. Epub 2017 Jun 24.
citation: Meza JM, Hickey EJ, Blackstone EH, Jaquiss RDB, Anderson BR, Williams WG, Cai S, Van Arsdell GS, Karamlou T, McCrindle BW. The Optimal Timing of Stage 2 Palliation for Hypoplastic Left Heart Syndrome: An Analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Data Set. Circulation. 2017 Oct 31;136(18):1737-1748. doi: 10.1161/CIRCULATIONAHA.117.028481. Epub 2017 Jul 7.
citation: Chowdhury SM, Graham EM, Atz AM, Bradley SM, Kavarana MN, Butts RJ. Validation of a Simple Score to Determine Risk of Hospital Mortality After the Norwood Procedure. Semin Thorac Cardiovasc Surg. 2016 Summer;28(2):425-433. doi: 10.1053/j.semtcvs.2016.04.004. Epub 2016 Apr 19.
citation: Burch PT, Ravishankar C, Newburger JW, Lambert LM, Pemberton VL, Granger S, Floh AA, Anderson JB, Hill GD, Hill KD, Oster ME, Lewis AB, Schumacher KR, Zyblewski SC, Davies RR, Jacobs JP, Lai WW, Minich LL; Pediatric Heart Network Investigators. Assessment of Growth 6 Years after the Norwood Procedure. J Pediatr. 2017 Jan;180:270-274.e6. doi: 10.1016/j.jpeds.2016.09.048. Epub 2016 Nov 14.
citation: Plummer ST, Hornik CP, Baker H, Fleming GA, Foerster S, Ferguson ME, Glatz AC, Hirsch R, Jacobs JP, Lee KJ, Lewis AB, Li JS, Martin M, Porras D, Radtke WA, Rhodes JF, Vincent JA, Zampi JD, Hill KD. Maladaptive aortic properties after the Norwood procedure: An angiographic analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial. J Thorac Cardiovasc Surg. 2016 Aug;152(2):471-479.e3. doi: 10.1016/j.jtcvs.2016.03.091. Epub 2016 Apr 14.
citation: Yilmaz B, Narayan HK, Wilpers A, Wiess C, Fifer WP, Williams IA. Electrocardiographic intervals in foetuses with CHD. Cardiol Young. 2016 Jan;26(1):84-9. doi: 10.1017/S1047951114002686. Epub 2015 Jan 20.
citation: Frommelt PC, Gerstenberger E, Cnota JF, Cohen MS, Gorentz J, Hill KD, John JB, Levine JC, Lu J, Mahle WT, McCandless RT, Mertens L, Pearson GD, Spencer C, Thacker D, Williams IA, Wong PC, Newburger JW; Pediatric Heart Network Investigators. Impact of initial shunt type on cardiac size and function in children with single right ventricle anomalies before the Fontan procedure: the single ventricle reconstruction extension trial. J Am Coll Cardiol. 2014 Nov 11;64(19):2026-35. doi: 10.1016/j.jacc.2014.08.033. Epub 2014 Nov 3.
citation: Burch PT, Gerstenberger E, Ravishankar C, Hehir DA, Davies RR, Colan SD, Sleeper LA, Newburger JW, Clabby ML, Williams IA, Li JS, Uzark K, Cooper DS, Lambert LM, Pemberton VL, Pike NA, Anderson JB, Dunbar-Masterson C, Khaikin S, Zyblewski SC, Minich LL; Pediatric Heart Network Investigators. Longitudinal assessment of growth in hypoplastic left heart syndrome: results from the single ventricle reconstruction trial. J Am Heart Assoc. 2014 Jun 23;3(3):e000079. doi: 10.1161/JAHA.114.000079.
citation: Goldberg CS, Lu M, Sleeper LA, Mahle WT, Gaynor JW, Williams IA, Mussatto KA, Ohye RG, Graham EM, Frank DU, Jacobs JP, Krawczeski C, Lambert L, Lewis A, Pemberton VL, Sananes R, Sood E, Wechsler SB, Bellinger DC, Newburger JW; Pediatric Heart Network Investigators. Factors associated with neurodevelopment for children with single ventricle lesions. J Pediatr. 2014 Sep;165(3):490-496.e8. doi: 10.1016/j.jpeds.2014.05.019. Epub 2014 Jun 19.
citation: Newburger JW, Sleeper LA, Frommelt PC, Pearson GD, Mahle WT, Chen S, Dunbar-Masterson C, Mital S, Williams IA, Ghanayem NS, Goldberg CS, Jacobs JP, Krawczeski CD, Lewis AB, Pasquali SK, Pizarro C, Gruber PJ, Atz AM, Khaikin S, Gaynor JW, Ohye RG; Pediatric Heart Network Investigators. Transplantation-free survival and interventions at 3 years in the single ventricle reconstruction trial. Circulation. 2014 May 20;129(20):2013-20. doi: 10.1161/CIRCULATIONAHA.113.006191. Epub 2014 Apr 4.
citation: Lambert LM, Pike NA, Medoff-Cooper B, Zak V, Pemberton VL, Young-Borkowski L, Clabby ML, Nelson KN, Ohye RG, Trainor B, Uzark K, Rudd N, Bannister L, Korsin R, Cooper DS, Pizarro C, Zyblewski SC, Bartle BH, Williams RV; Pediatric Heart Network Investigators. Variation in feeding practices following the Norwood procedure. J Pediatr. 2014 Feb;164(2):237-42.e1. doi: 10.1016/j.jpeds.2013.09.042. Epub 2013 Nov 6.
citation: Marx GR, Shirali G, Levine JC, Guey LT, Cnota JF, Baffa JM, Border WL, Colan S, Ensing G, Friedberg MK, Goldberg DJ, Idriss SF, John JB, Lai WW, Lu M, Menon SC, Ohye RG, Saudek D, Wong PC, Pearson GD; Pediatric Heart Network Investigators. Multicenter study comparing shunt type in the norwood procedure for single-ventricle lesions: three-dimensional echocardiographic analysis. Circ Cardiovasc Imaging. 2013 Nov;6(6):934-42. doi: 10.1161/CIRCIMAGING.113.000304. Epub 2013 Oct 4.
citation: Schwartz SM, Lu M, Ohye RG, Hill KD, Atz AM, Naim MY, Williams IA, Goldberg CS, Lewis A, Pigula F, Manning P, Pizarro C, Chai P, McCandless R, Dunbar-Masterson C, Kaltman JR, Kanter K, Sleeper LA, Schonbeck JV, Ghanayem N; Pediatric Heart Network Investigators. Risk factors for prolonged length of stay after the stage 2 procedure in the single-ventricle reconstruction trial. J Thorac Cardiovasc Surg. 2014 Jun;147(6):1791-8, 1798.e1-4. doi: 10.1016/j.jtcvs.2013.07.063. Epub 2013 Sep 24.
citation: Hill KD, Rhodes JF, Aiyagari R, Baker GH, Bergersen L, Chai PJ, Fleming GA, Fudge JC, Gillespie MJ, Gray RG, Hirsch R, Lee KJ, Li JS, Ohye RG, Oster ME, Pasquali SK, Pelech AN, Radtke WA, Takao CM, Vincent JA, Hornik CP. Intervention for recoarctation in the single ventricle reconstruction trial: incidence, risk, and outcomes. Circulation. 2013 Aug 27;128(9):954-61. doi: 10.1161/CIRCULATIONAHA.112.000488. Epub 2013 Jul 17.
citation: Williams IA, Fifer C, Jaeggi E, Levine JC, Michelfelder EC, Szwast AL. The association of fetal cerebrovascular resistance with early neurodevelopment in single ventricle congenital heart disease. Am Heart J. 2013 Apr;165(4):544-550.e1. doi: 10.1016/j.ahj.2012.11.013. Epub 2013 Feb 13.
citation: Bacha E, del Nido P. Introduction to the Single Ventricle Reconstruction trial. J Thorac Cardiovasc Surg. 2012 Oct;144(4):880-1. doi: 10.1016/j.jtcvs.2012.08.031. No abstract available.
citation: Ohye RG, Schonbeck JV, Eghtesady P, Laussen PC, Pizarro C, Shrader P, Frank DU, Graham EM, Hill KD, Jacobs JP, Kanter KR, Kirsh JA, Lambert LM, Lewis AB, Ravishankar C, Tweddell JS, Williams IA, Pearson GD; Pediatric Heart Network Investigators. Cause, timing, and location of death in the Single Ventricle Reconstruction trial. J Thorac Cardiovasc Surg. 2012 Oct;144(4):907-14. doi: 10.1016/j.jtcvs.2012.04.028. Epub 2012 Aug 15.
citation: Ghanayem NS, Allen KR, Tabbutt S, Atz AM, Clabby ML, Cooper DS, Eghtesady P, Frommelt PC, Gruber PJ, Hill KD, Kaltman JR, Laussen PC, Lewis AB, Lurito KJ, Minich LL, Ohye RG, Schonbeck JV, Schwartz SM, Singh RK, Goldberg CS; Pediatric Heart Network Investigators. Interstage mortality after the Norwood procedure: Results of the multicenter Single Ventricle Reconstruction trial. J Thorac Cardiovasc Surg. 2012 Oct;144(4):896-906. doi: 10.1016/j.jtcvs.2012.05.020. Epub 2012 Jul 11.
citation: Tabbutt S, Ghanayem N, Ravishankar C, Sleeper LA, Cooper DS, Frank DU, Lu M, Pizarro C, Frommelt P, Goldberg CS, Graham EM, Krawczeski CD, Lai WW, Lewis A, Kirsh JA, Mahony L, Ohye RG, Simsic J, Lodge AJ, Spurrier E, Stylianou M, Laussen P; Pediatric Heart Network Investigators. Risk factors for hospital morbidity and mortality after the Norwood procedure: A report from the Pediatric Heart Network Single Ventricle Reconstruction trial. J Thorac Cardiovasc Surg. 2012 Oct;144(4):882-95. doi: 10.1016/j.jtcvs.2012.05.019. Epub 2012 Jun 15.
citation: Pasquali SK, Ohye RG, Lu M, Kaltman J, Caldarone CA, Pizarro C, Dunbar-Masterson C, Gaynor JW, Jacobs JP, Kaza AK, Newburger J, Rhodes JF, Scheurer M, Silver E, Sleeper LA, Tabbutt S, Tweddell J, Uzark K, Wells W, Mahle WT, Pearson GD; Pediatric Heart Network Investigators. Variation in perioperative care across centers for infants undergoing the Norwood procedure. J Thorac Cardiovasc Surg. 2012 Oct;144(4):915-21. doi: 10.1016/j.jtcvs.2012.05.021. Epub 2012 Jun 12.
citation: Frommelt PC, Guey LT, Minich LL, Bhat M, Bradley TJ, Colan SD, Ensing G, Gorentz J, Heydarian H, John JB, Lai WW, Levine JC, Mahle WT, Miller SG, Ohye RG, Pearson GD, Shirali GS, Wong PC, Cohen MS; Pediatric Heart Network Investigators. Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy?: the Single Vventricle Reconstruction trial. Circulation. 2012 May 29;125(21):2630-8. doi: 10.1161/CIRCULATIONAHA.111.072694. Epub 2012 Apr 21.
citation: Newburger JW, Sleeper LA, Bellinger DC, Goldberg CS, Tabbutt S, Lu M, Mussatto KA, Williams IA, Gustafson KE, Mital S, Pike N, Sood E, Mahle WT, Cooper DS, Dunbar-Masterson C, Krawczeski CD, Lewis A, Menon SC, Pemberton VL, Ravishankar C, Atz TW, Ohye RG, Gaynor JW; Pediatric Heart Network Investigators. Early developmental outcome in children with hypoplastic left heart syndrome and related anomalies: the single ventricle reconstruction trial. Circulation. 2012 May 1;125(17):2081-91. doi: 10.1161/CIRCULATIONAHA.111.064113. Epub 2012 Mar 28.
citation: Tweddell JS, Sleeper LA, Ohye RG, Williams IA, Mahony L, Pizarro C, Pemberton VL, Frommelt PC, Bradley SM, Cnota JF, Hirsch J, Kirshbom PM, Li JS, Pike N, Puchalski M, Ravishankar C, Jacobs JP, Laussen PC, McCrindle BW; Pediatric Heart Network Investigators. Intermediate-term mortality and cardiac transplantation in infants with single-ventricle lesions: risk factors and their interaction with shunt type. J Thorac Cardiovasc Surg. 2012 Jul;144(1):152-9. doi: 10.1016/j.jtcvs.2012.01.016. Epub 2012 Feb 15.