PROGRESS IN PEDIATRIC CARDIOLOGY最新文献

{"title":"Long-chain fatty acid utilization in Eisenmenger syndrome","authors":"Omer Cavus ,&nbsp;Manisha J. Oza ,&nbsp;Austin Angelotti ,&nbsp;Jennifer DeSalvo ,&nbsp;Imhoi Koo ,&nbsp;Victor Ruiz-Velasco ,&nbsp;Elisa A. Bradley","doi":"10.1016/j.ppedcard.2026.101902","DOIUrl":"10.1016/j.ppedcard.2026.101902","url":null,"abstract":"<div><h3>Background</h3><div>Morbidity and mortality in idiopathic pulmonary arterial hypertension (iPAH) are linked to right ventricular failure (RVF), a condition characterized by a metabolic shift from fatty acid oxidation (FAO) to glycolysis. Eisenmenger Syndrome (ES), a unique form of PAH, is associated with a mortality paradox, yet the mechanism for better survival in this condition remains poorly understood.</div></div><div><h3>Objectives</h3><div>We postulated that beneficial changes in long chain fatty acid (LCFA) utilization may support right ventricular (RV) adaptations in ES, and therefore ssupport favorable RV function and improved morbidity and mortality when compared to iPAH.</div></div><div><h3>Methods</h3><div>We examined clinical and metabolomic data to identify potential mechanistic clues about RV function and morbidity/mortality in controls, iPAH, and ES subjects.</div></div><div><h3>Results</h3><div>In a small cohort with iPAH (<em>n</em> = 3) or ES (n = 3) clinical data demonstrated worse hemodynamic disease in ES (mean pulmonary artery/mPA pressure 90 ± 6 vs. 50 ± 4 mmHg, <em>p</em> &lt; 0.001), with better clinical compensation (resting heart rate 81 ± 6 vs. 105 ± 6 bpm, <em>p</em> ≤ 0.05 and lower brain natriuretic peptide levels 11 ± 6 pg/dL vs. 71 ± 18 pg/dL, <em>p</em> &lt; 0.01). Metabolomic analysis demonstrated that 97 circulating lipids were significantly different between iPAH and ES. Plasma concentration of LCFAs (Stearate, Palmitate, Oleate, Lineolate) were significantly reduced in ES compared to iPAH, and all but Lineolate were also reduced when compared to non-PAH control samples, suggesting there may be an advantageous compensatory increase in LCFA utilization (FAO) in ES. Plasma tricarboxylic acid (TCA) cycle metabolites were significantly increased in ES compared to iPAH, supporting that compensatory augmentation of FAO occurs in ES, but not likely in RV failure from iPAH.</div></div><div><h3>Conclusions</h3><div>Our preliminary data in ES differs importantly and unexpectedly from left ventricular and RV failure, in that circulating LCFA utilization appears to be increased. Further, TCA cycle activity is increased in ES, supporting that mechanisms which preserve or enhance LCFA utilization may ultimately preferentially support FAO for energy production. Further study of the impact of LCFA utilization on RV function in ES and other cohorts will be important to determine the role that metabolic substrates may play in long-term preservation of heart function in unique groups.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101902"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of pulmonary valve replacement in infancy: Time for a reassessment?","authors":"Almontasser Bella Kassier ,&nbsp;Abdelrahman Masri ,&nbsp;Hasan Iqfat ,&nbsp;Ahmed Zaghw ,&nbsp;Caroline Yunhua Shi ,&nbsp;Lazaros K. Kochilas ,&nbsp;Amna Qasim ,&nbsp;Taufiek Konrad Rajab","doi":"10.1016/j.ppedcard.2025.101901","DOIUrl":"10.1016/j.ppedcard.2025.101901","url":null,"abstract":"<div><h3>Background</h3><div>Congenital heart disease (CHD) is one of the leading causes of morbidity and mortality in children. Among these conditions, pulmonary valve (PV) defects may occur as isolated lesions or as part of more complex cardiac malformations. Pulmonary valve replacement (PVR) is a common surgical intervention; however, data on its long-term outcomes in neonates and infants remain limited, particularly given the influence of patient growth on prosthetic performance.</div></div><div><h3>Objectives</h3><div>To evaluate the long-term outcomes and durability of pulmonary valve replacement in neonates and infants.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of 62 neonates and infants who underwent PVR across 22 centers over a 25-year period. Surgical outcomes, long-term follow-up data, and the need for reoperation were analyzed. Complete long-term outcome records were available for 22 patients.</div></div><div><h3>Results</h3><div>The study demonstrated variable long-term durability of PVR in neonates and infants, with several patients requiring reoperation during follow-up. Factors such as somatic growth and prosthetic valve limitations appeared to contribute to the need for subsequent interventions.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need to reassess current strategies for pulmonary valve replacement. Alternative approaches, including partial heart transplantation, may offer improved long-term outcomes for this patient population and warrant further investigation.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101901"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of QRS fragmentation in children with acute myocarditis: Single center experience","authors":"Khalifah A. Aldawsari ,&nbsp;Claudia Mattos ,&nbsp;Becky Li ,&nbsp;Mubeena Abdulkarim ,&nbsp;Michael Lopez","doi":"10.1016/j.ppedcard.2026.101904","DOIUrl":"10.1016/j.ppedcard.2026.101904","url":null,"abstract":"<div><h3>Background</h3><div>Acute myocarditis in children presents with a broad spectrum of clinical features, often delaying diagnosis. Fragmented QRS (fQRS) is an emerging EKG finding associated with various cardiac conditions.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the prevalence and significance of fQRS in children with acute myocarditis.</div></div><div><h3>Methods</h3><div>Patients less than 18 years of age who presented to our institution between April 2012 and January 2023 with a discharge diagnosis of acute myocarditis were included. Demographic and clinical data, as well as EKG and imaging results, were retrospectively reviewed. fQRS was defined as the presence of an additional R wave (R’) or notching in the nadir of the S wave or the presence of more than 1 R’ in at least 2 contiguous leads corresponding to the cardiac regions.</div></div><div><h3>Results</h3><div>99 patients (median age 13 years; 76% male). Chest pain was the most common presenting symptom (74.7%). At presentation, 20.2% (95% CI: 12.8–29.5) exhibited fQRS, predominantly in inferior leads. Median follow-up was 403 days, during which 3 patients (15% of those with positive fQRS) had persistent fQRS despite being clinically asymptomatic. On univariate regression, younger age was significantly associated with fQRS at presentation (<em>p</em> = 0.043). No associations were found with biomarkers, echocardiographic parameters, or outcomes.</div></div><div><h3>Conclusion</h3><div>fQRS is an additional EKG finding that may assist in diagnosing acute myocarditis, particularly in younger children. While fQRS may support the diagnosis of myocarditis, it was not associated with disease severity or prognosis. Larger studies are warranted to clarify its role.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101904"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first six international conferences on cardiomyopathy in children: Beginning with the end in mind","authors":"Steven E. Lipshultz ,&nbsp;Thomas D. Ryan ,&nbsp;Leah C. Mumm ,&nbsp;Teresa M. Lee","doi":"10.1016/j.ppedcard.2025.101900","DOIUrl":"10.1016/j.ppedcard.2025.101900","url":null,"abstract":"","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101900"},"PeriodicalIF":0.8,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yasui procedure results: A multicenter retrospective study","authors":"Ilya A. Soynov ,&nbsp;Artem V. Gorbatykh ,&nbsp;Ekaterina N. Amansakhatova ,&nbsp;Aleksey N. Arkhipov ,&nbsp;Anton A. Avramenko ,&nbsp;Dmitriy V. Gorbunov ,&nbsp;Evgeniy V. Grekhov ,&nbsp;Konstantin B. Kazantsev ,&nbsp;Vladislav G. Kolbik ,&nbsp;Yuriy Y. Kulyabin ,&nbsp;Yury I. Linnik ,&nbsp;Serezha N. Manukian ,&nbsp;Ruben R. Movsesyan ,&nbsp;Nataliya R. Nichay ,&nbsp;Denis Y. Petrushenko ,&nbsp;Mikhail V. Plotnikov ,&nbsp;Pavel V. Teplov ,&nbsp;Igor A. Kornilov ,&nbsp;Konstantin Drozdovski","doi":"10.1016/j.ppedcard.2025.101884","DOIUrl":"10.1016/j.ppedcard.2025.101884","url":null,"abstract":"<div><h3>Background</h3><div>Aortic atresia or stenosis with ventricular septal defect (VSD) is a rare congenital heart defect. In 1987, Yasui introduced a biventricular repair for severe subaortic obstruction and subaortic VSD. Contemporary series report early mortality &lt;15 %. Comparative inferences by surgical strategy remain limited by small samples, with the largest published series including 25 patients.</div></div><div><h3>Objectives</h3><div>To evaluate the outcomes and complications following primary versus staged Yasui procedures.</div></div><div><h3>Methods</h3><div>Retrospective multicenter study included 26 patients who underwent the Yasui procedure at 10 cardiac surgery centers in Russia, Belarus, and Kazakhstan (2008–2023).</div></div><div><h3>Results</h3><div>There were no deaths in the primary Yasui group; 12-month survival in the staged Yasui group was 76.9 % (95 % CI: 54 %–88 %, <em>p</em> = 0.08). Freedom from reoperation at 92 months was 58.9 % (95 % CI: 23.5 %–82.4 %) in the primary Yasui group and 34.0 % (95 % CI: 9.1 %–61.6 %) in the staged group. Freedom from left ventricular outflow tract obstruction (LVOT) at 60 months was 76 % (95 % CI: 30.7 %–93.9 %) in the primary Yasui group and 57 % (95 % CI: 21.7 %–81.5 %) in the staged Yasui group.</div></div><div><h3>Conclusions</h3><div>In this multicenter descriptive series, biventricular repair using the Yasui procedure was feasible and associated with low early mortality in selected patients with hypoplastic left heart syndrome (HLHS) and associated VSD. Within the limits of this small retrospective cohort, surgical strategy (primary vs staged Yasui) did not appear to affect mortality, reoperation, or the incidence of LVOT obstruction.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"79 ","pages":"Article 101884"},"PeriodicalIF":0.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anthropometry and nutritional status of pediatric patients with congenital heart defects at a secondary hospital in North Aceh, Indonesia: A retrospective chart review","authors":"Julia Fitriany ,&nbsp;Nora Maulina ,&nbsp;Mauliza ,&nbsp;Sri Wahyuni ,&nbsp;Muhammad Yasin","doi":"10.1016/j.ppedcard.2025.101896","DOIUrl":"10.1016/j.ppedcard.2025.101896","url":null,"abstract":"<div><h3>Background</h3><div>Children with congenital heart defects (CHD) are at heightened risk of growth faltering due to increased metabolic demand, feeding difficulties, and infections, yet regional anthropometric data from Aceh are scarce.</div></div><div><h3>Objective</h3><div>To describe the anthropometric profiles and nutritional status of pediatric patients aged 0–18 years with CHD at RSUD Cut Meutia, North Aceh, Indonesia, from January 2021 to October 2024.</div></div><div><h3>Methods</h3><div>We conducted a retrospective chart review of children aged 0–18 years with echocardiography-confirmed CHD managed at a secondary referral hospital in North Aceh. Weight, length/height, and body mass index were converted to age-appropriate z-scores using World Health Organization growth standards and references. Nutritional categories were summarized descriptively across age groups and by CHD type.</div></div><div><h3>Results</h3><div>A total of 102 children were analyzed; 62.7 % were aged 0–5 years, and sex distribution was balanced (51 males, 51 females). Acyanotic CHD predominated (87.3 %), driven by patent ductus arteriosus (39.2 %) and ventricular septal defect (21.6 %); cyanotic CHD accounted for 12.7 %. Among children &lt;5 years, 46.9 % were severely underweight, 50.0 % severely stunted, and 28.1 % severely wasted. Despite this, 54.7 % of &lt;5-year-olds were in the normal BMI-for-age range. Among 5–18-year-olds, 31.6 % were severely thin and 44.7 % had normal BMI-for-age. The divergence between BMI-for-age and weight- and length/height-based indices suggests that reliance on BMI alone may under-detect chronic deficits.</div></div><div><h3>Conclusion</h3><div>In this single-center cohort, acyanotic lesions predominated and substantial malnutrition was evident—particularly in children &lt;5 years. These findings support timely hemodynamic assessment and correction of significant left-to-right shunts, structured energy- and protein-dense nutrition support from diagnosis, and integrated growth monitoring using multiple WHO indices. Given missing clinical modifiers and unequal group sizes, results are descriptive and hypothesis-generating; multicenter prospective studies are needed.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101896"},"PeriodicalIF":0.8,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ductal stenting in a neonate with double aortic arch, pulmonary atresia, and ventricular septal defect without airway compression","authors":"Naif Alkhushi","doi":"10.1016/j.ppedcard.2025.101894","DOIUrl":"10.1016/j.ppedcard.2025.101894","url":null,"abstract":"<div><h3>Background</h3><div>Double aortic arch (DAA) associated with pulmonary atresia and ventricular septal defect (PA/VSD) is an extremely rare cardiac anomaly. This combination poses unique diagnostic and interventional challenges.</div></div><div><h3>Case presentation</h3><div>A full-term male neonate developed cyanosis shortly after birth. Echocardiography and computed tomography (CT) revealed a balanced DAA with PA/VSD, confluent pulmonary arteries without major aortopulmonary collateral arteries (MAPCAs), and no evidence of airway or esophageal compression. Fluorescence in situ hybridization (FISH) confirmed a 22q11.2 microdeletion. Given the absence of tracheoesophageal compression, initial palliation with ductal stenting was performed, and definitive surgical repair was deferred until 4–6 months of age to avoid thoracotomy during the vulnerable neonatal period.</div></div><div><h3>Conclusion</h3><div>In neonates with DAA associated with PA/VSD, the presence of confluent pulmonary arteries and absence of tracheoesophageal compression make ductal stenting a feasible and less invasive alternative to surgical palliation during the neonatal period.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101894"},"PeriodicalIF":0.8,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic neonatal Takotsubo syndrome induced by high-dose inotropic agents: A case report","authors":"Ching-Ming Lin ,&nbsp;Kuo-Jen Lu ,&nbsp;Wen-Hsien Lu","doi":"10.1016/j.ppedcard.2025.101895","DOIUrl":"10.1016/j.ppedcard.2025.101895","url":null,"abstract":"<div><div>Takotsubo syndrome is a transient cardiac condition characterized by reversible left ventricular dysfunction, commonly seen in adults under extreme stress. Its occurrence in neonates is exceedingly rare. We report a premature female neonate who developed classic echocardiographic features of Takotsubo syndrome following high-dose inotropic support. Withdrawal of catecholamines led to rapid hemodynamic stabilization and full recovery of ventricular function. This case highlights the need for awareness of this condition in neonatal intensive care settings.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101895"},"PeriodicalIF":0.8,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of SMAD6 gene variant and descriptive brief insights into genetics of aortic valve disease","authors":"Snehal Mallakmir ,&nbsp;Bhushan Chavan ,&nbsp;Shilpa Kamble","doi":"10.1016/j.ppedcard.2025.101889","DOIUrl":"10.1016/j.ppedcard.2025.101889","url":null,"abstract":"<div><h3>Aim</h3><div>Indian reports on the genetic etiology of aortopathy are scarce, and insights into this subject are needed.</div></div><div><h3>Method</h3><div>We report a case of a 12-year-old boy with a bicuspid valve and a dilated ascending aorta with a heterozygous pathogenic variation in the <em>SMAD6</em> gene. We conducted a PUBMED and OMIM literature search on genetic evaluation in aortopathy and/or aortic valve disease.</div></div><div><h3>Results</h3><div>Heterozygous indel in the <em>SMAD6</em> gene, resulting in a frameshift-insertion and premature truncation of the protein, was detected in our patient, which has not been reported before. <em>SMAD6</em> has emerged as an important contributor to aortic disease recently, along with other genes, and a brief review is presented here.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101889"},"PeriodicalIF":0.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral and end-organ protection outcomes following the Norwood procedure: A retrospective cohort study","authors":"O.S. Anikina ,&nbsp;I.A. Soynov ,&nbsp;Yu.Yu. Kulyabin ,&nbsp;E.N. Amansakhatova ,&nbsp;I.A. Velyukhanov ,&nbsp;A.N. Arkhipov ,&nbsp;S.M. Ivanzov ,&nbsp;S.N. Manukian ,&nbsp;I.A. Kornilov","doi":"10.1016/j.ppedcard.2025.101893","DOIUrl":"10.1016/j.ppedcard.2025.101893","url":null,"abstract":"<div><h3>Background</h3><div>Hypoplastic left heart syndrome (HLHS) remains one of the most challenging congenital heart defects, and the Norwood procedure is the cornerstone of first-stage palliation. Two perfusion strategies - deep hypothermic circulatory arrest (DHCA) and selective antegrade cerebral perfusion (SACP) - are widely used during aortic arch reconstruction. However, comparative evidence regarding cerebral and end-organ protection in neonates is inconsistent.</div></div><div><h3>Objectives</h3><div>To evaluate end-organ protection outcomes associated with SACP versus DHCA during the Norwood procedure.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single-center cohort study of 93 neonates with HLHS undergoing the Norwood procedure between 2014 and 2025. Patients were divided into two groups: DHCA (<em>n</em> = 45) and SACP (<em>n</em> = 48). Primary endpoint was acute kidney injury (AKI) according to pediatric KDIGO criteria. Secondary endpoints included hospital mortality, neurological injuries.</div></div><div><h3>Results</h3><div>Overall hospital mortality was 15 % (DHCA 17.7 % vs. SACP 12.5 %, <em>p</em> = 0.566). Ischemic brain lesions were significantly more frequent in the DHCA group (17.8 %) compared to the SACP group (2.1 %, <em>p</em> = 0.013). DHCA duration &gt;45 min identified as a key risk factor of ischemic injury (HR 1.08, 95 % CI 1.02–1.14, <em>p</em> = 0.003). Hemorrhagic brain lesions occurred in 4.4 % (DHCA) vs. 10.4 % (SACP, <em>p</em> = 0.436), low body weight &lt; 2.6 kg was an independent predictor. AKI incidence was higher in the DHCA group (55.5 %) than in the SACP group (33.3 %, <em>p</em> = 0.038). SACP was associated with a lower AKI risk (HR 0.32, 95 % CI 0.12–0.84, <em>p</em> = 0.047), while a vasoactive-inotropic score &gt; 10 within 48 h predicted AKI (HR 1.03, 95 % CI 1.01–1.07, <em>p</em> = 0.019).</div></div><div><h3>Conclusions</h3><div>In neonates undergoing the Norwood procedure, SACP was associated with lower rates of AKI and ischemic cerebral injury compared to DHCA. Perfusion strategy choice should be considered alongside patient risk factors to optimize outcomes.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"80 ","pages":"Article 101893"},"PeriodicalIF":0.8,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}