{"doi":"10.1016/j.xjon.2025.02.003","title":"The influence of initial Norwood palliation on cardiac transplantation in the failing Fontan: A dual-institution study","abstract":"Objective To explore the differences in perioperative cardiac transplant courses and outcomes between patients with failed Fontan physiology who initially underwent a Norwood procedure and those who did not. Methods A retrospective review of 78 cardiac transplant patients with failed Fontan physiology from 1994 to 2021 was conducted; 42 had a previous Norwood procedure (FFN) and 36 did not (FF). Results Although patients in the FFN group appeared to have a more complex perioperative course, they experienced better discharge and 1-year survival compared with patients in the FF group: discharge survival of 81% of patients in the FFN group compared with 75% of patients in the FF group ( P = .5256); 1-year survival of 80.5% of patients in the FFN group compared with 73.5% of patients in the FF group ( P = .4737). Notable trends in the perioperative courses of the FFN cohort compared with the FF cohort included: more frequent neoaortic reconstruction at the time of transplant (7 patients in the FFN group [16.7%] vs 1 patient in the FF group [2.8%], P = .0627), greater rate of sternal re-entry events (5 patients in the FFN group [11.9%] vs 2 patients in the FF group [5.7%], P = .4454), longer median duration of surgery (FFN 611.5 minutes vs FF 556 minutes, P = .3928), longer median cardiopulmonary bypass times (FFN 222.5 minutes vs FF 202 minutes, P = .1584), more use of open sternal management (14 patients in the FFN group [33.3%] vs 7 patients in the FF group [20%], P = .1908), and longer median length of hospital stay (FFN 41 days vs FF 30 days, P = .4035). Conclusions Despite patients in the FFN group exhibiting a more complex operative and perioperative course, discharge and 1-year survival were better than those of patients in the FF group.","journal":"JTCVS Open","year":2025,"id":551673,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9536,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":952962,"name":"Danielle Aronowitz","orcid":"0000-0003-0043-8558","position":1,"is_corresponding":false},{"id":1447743,"name":"N. Singh","orcid":"0000-0002-4125-9794","position":2,"is_corresponding":false},{"id":265308,"name":"Ruta Brazauskas","orcid":null,"position":3,"is_corresponding":false},{"id":783690,"name":"Danielle S. Burstein","orcid":"0000-0002-9870-7607","position":4,"is_corresponding":false},{"id":1448026,"name":"Rachel M. White","orcid":null,"position":5,"is_corresponding":false},{"id":402261,"name":"Stephanie Fuller","orcid":"0000-0001-5836-7866","position":6,"is_corresponding":false},{"id":289368,"name":"J. William Gaynor","orcid":"0000-0001-7955-5604","position":7,"is_corresponding":false},{"id":935975,"name":"Ronald K. Woods","orcid":"0000-0002-2829-1167","position":8,"is_corresponding":false},{"id":1447742,"name":"Ryan G. McQueen","orcid":"0000-0003-1450-3285","position":0,"is_corresponding":true}],"reference_count":15,"raw_metadata":null,"created_at":"2026-07-19T02:54:29.318076Z","pmid":"40631020","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}