{
  "abstract": "Objective\n\nThe management of patients with hypoplastic left heart syndrome with tricuspid regurgitation remains controversial. We evaluate risk factors for mortality/transplant/Fontan takedown in patients with hypoplastic left heart syndrome with tricuspid regurgitation and the effect of tricuspid valve surgery on clinical trajectories.Methods\n\nA retrospective chart review was performed for all hypoplastic left heart syndrome primary surgical Norwood recipients at our center who had moderate or greater tricuspid regurgitation (2006-2023). Freedom from a primary outcome of combined mortality/transplant/Fontan takedown was compared between those who underwent tricuspid valve surgery (N = 30, 67%) and those who did not (N = 15, 33%; Cox regression, log-rank). Among those who developed tricuspid regurgitation anytime post-Norwood (N = 37), tricuspid valve repair efficacy was assessed (Wilcoxon signed-rank, McNemar's test). Cumulative incidence of recurrent tricuspid regurgitation and right ventricle dysfunction was estimated (Aalen-Johansen estimator, death/transplant as competing risks).Results\n\nPatients with pre-Norwood tricuspid regurgitation experienced a mortality-dominated trajectory (5-year freedom from mortality 37.5%), whereas patients with post-Norwood/pre-Glenn tricuspid regurgitation experienced a transplant-dominated trajectory (5-year freedom from mortality 88.5%, composite outcome 55.9%). On univariable Cox regression, pre-Norwood right ventricle dysfunction (hazard ratio, 9.75, P < .001) was associated with the primary outcome; pre-Norwood tricuspid regurgitation tended toward association (hazard ratio, 2.40, P = .10). On multivariable analysis, pre-Norwood right ventricle dysfunction (hazard ratio, 12.79 [3.16-51.80], P < .001) and pre-Norwood tricuspid regurgitation (hazard ratio, 3.10 [1.03-9.31], P = .04) were both independently associated with the primary outcome. Among those with post-Norwood tricuspid regurgitation who underwent tricuspid valve surgery, tricuspid regurgitation severity decreased, with 43% achieving preserved freedom from moderate or greater tricuspid regurgitation.Conclusions\n\nPre-Norwood right ventricle dysfunction and pre-Norwood tricuspid regurgitation were found to be associated with the primary outcome. In those with post-Norwood tricuspid regurgitation, tricuspid valve repair reduced tricuspid regurgitation but was not associated with improved survival.",
  "abstract_shown": true,
  "affiliations": [
    "Section of Congenital and Pediatric Cardiac Surgery, Division of Cardiac, Thoracic, and Vascular Surgery, NY-Presbyterian Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY.",
    "Division of Pediatric Cardiology, Department of Pediatrics, NY-Presbyterian Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY.",
    "Division of Neonatology, Department of Pediatrics, NY-Presbyterian Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Elizabeth M Cordoves"
    },
    {
      "affs": [
        0
      ],
      "name": "Gerardo Ramos-Lemos"
    },
    {
      "affs": [
        0
      ],
      "name": "Vincent R LaSala"
    },
    {
      "affs": [
        0
      ],
      "name": "Halil Beqaj"
    },
    {
      "affs": [
        0
      ],
      "name": "Paul Trackey"
    },
    {
      "affs": [
        0
      ],
      "name": "Andrew B Goldstone"
    },
    {
      "affs": [
        1
      ],
      "name": "Stephanie Levasseur"
    },
    {
      "affs": [
        1
      ],
      "name": "Amee Shah"
    },
    {
      "affs": [
        2
      ],
      "name": "Ganga Krishnamurthy"
    },
    {
      "affs": [
        0
      ],
      "name": "Emile A Bacha"
    },
    {
      "affs": [
        0
      ],
      "name": "David M Kalfa"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6td38ny0escty.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.102070",
  "fulltext_url": "https://europepmc.org/articles/PMC13711412",
  "id": "6td38ny0escty",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948216",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Congenital: Hypoplastic Left Heart Syndrome"
    ],
    [
      "openalex",
      "2713|Congenital Heart Disease Studies"
    ]
  ],
  "openalex": "W7203948808",
  "pdf_url": "https://europepmc.org/articles/PMC13711412?pdf=render",
  "pmcid": "PMC13711412",
  "pmid": "42948216",
  "published": "2026-08-21",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6td38ny0escty.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:35Z",
      "native_id": "MED:42948216",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948216"
    },
    {
      "first_seen": "2026-10-31T12:22:11Z",
      "native_id": "PMC13711412",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.102070"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Congenital Heart Disease Studies",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Risk factors and outcomes of tricuspid valve surgery in hypoplastic left heart syndrome patients with tricuspid regurgitation.",
  "title_text": "Risk factors and outcomes of tricuspid valve surgery in hypoplastic left heart syndrome patients with tricuspid regurgitation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:11Z",
  "url": "https://research.draconitic.com/paper/6td38ny0escty",
  "venue": "JTCVS open",
  "versions": []
}