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Risk Factors and Outcomes for Infants Requiring Unplanned Reintervention After Stage 2 Palliation for
Sangitha Krishnan1, Yuen Lie Tjoeng2, Matthew Files1
1Pediatric Cardiology, Seattle Children's Hospital, Department of Pediatrics, University of Washington, Seattle, Washington.
The Annals of Thoracic Surgery
|March 14, 2026
Summary
Unplanned reinterventions after Stage 2 palliation for single ventricle heart disease increase morbidity and decrease survival. Identifying risk factors like tube feedings and additional procedures can help improve outcomes.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Single ventricle heart disease (SVHD) requires staged palliation.
- Unplanned reinterventions after Stage 1 palliation are linked to poor outcomes.
- The impact of unplanned reinterventions after Stage 2 palliation is not well understood.
Purpose of the Study:
- To identify risk factors for unplanned reinterventions after Stage 2 palliation in SVHD patients.
- To assess the impact of these reinterventions on patient outcomes.
Main Methods:
- Utilized the National Pediatric Cardiology Quality Improvement Collaborative database.
- Employed multivariate regression models to analyze risk factors and outcomes.
- Included 2095 patients who underwent Stage 2 palliation.
Main Results:
- 19.1% of patients required unplanned reintervention after Stage 2 palliation.
- Risk factors included Hybrid Stage 1 palliation, prior reintervention, tube feedings, and additional cardiac procedures during Stage 2.
- Reinterventions were associated with longer length of stay, future interventions, and decreased transplant-free survival.
Conclusions:
- Unplanned reinterventions post-Stage 2 palliation significantly increase morbidity.
- Longer hospital stays, need for future interventions, and reduced transplant-free survival are key outcomes.
- Identified risk factors offer potential targets for improving patient outcomes.
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