ArticleFrontiers in cardiovascular medicine2026
Gestational age as predictor of postoperative prognosis in neonates with pulmonary atresia with intact ventricular septum undergoing biventricular repair.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pulmonary atresia with intact ventricular septum (PA/IVS) is a rare critical congenital heart defect. Although biventricular repair is reserved for those with adequate right ventricular development, significant outcome variability persists even among anatomically similar patients, implicating non-structural determinants of surgical recovery. Gestational age has been recognized as a prognostic factor in various congenital heart diseases, yet its specific impact on short-term outcomes after biventricular repair for PA/IVS remains inadequately characterized. Methods: This retrospective cohort study enrolled 97 consecutive pediatric patients with PA/IVS who underwent biventricular repair at a single tertiary referral center from 1999 to 2024. Participants were categorized as preterm or term according to standard gestational age criteria. Results: The cohort comprised 21 preterm infants and 76 term infants. Multivariable analysis showed each additional gestational week reduced adverse outcome risk by 45% (OR 0.55, 95% CI 0.41-0.75). Term infants demonstrated significantly lower risk vs. preterm infants (OR 0.14, 95% CI 0.04-0.46). Restricted cubic spline regression revealed a nonlinear threshold effect ( Conclusions: This study establishes a gestational age threshold effect for short-term outcomes in PA/IVS patients undergoing biventricular repair. Extending gestation beyond 37.6 weeks significantly improves short-term outcomes in PA/IVS patients undergoing biventricular repair, providing crucial evidence-based guidance for perinatal management.
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