LAUSR

We investigated patient and procedural factors associated with failure of staged palliation after the Norwood procedure in patients with right ventricular dysfunction (RVDfx). Patients from the Pediatric Heart Network Single Ventricle Reconstruction (SVR) Trial dataset were selected if RVDfx was present, defined as an ejection fraction of less than 44% and a fractional area of change of less than 35% on the post-Norwood echocardiogram. Transplantfree survival after the Norwood procedure was analyzed using multiphase parametric hazard analysis and factors associated with death or transplant were identified. In the SVR cohort, 123 (34%) infants had RVDfx. The six-month transplant-free survival was 87% (70%CI 82-91%). The independent factors associated with increased risk of death or transplant were BT shunt, increased RV size, infectious disease complications and low surgeon volume. Patient factors can help identify which patient with RVDfx is at higher risk of death and help decision making around early transplant listing.