Congenital heart disease

Outcomes in infants with restrictive atrial septum and pre-stage 1 palliation septal intervention

Am Heart JPublished Multicenter retrospective cohort study

Main finding · Operative survival, post-S1P length of stay (LOS), and one-year mortalityResult — go to the resultAdjusted odds ratio 2.2 CI 1.44,3.38

Authors' conclusion

RAS identifies a high-risk phenotype with early instability and excess early and one-year mortality. These findings highlight the need for improved risk stratification and more effective, standardized atrial decompression strategies for infants with clinically significant atrial restriction.

Study context

Population
Infants undergoing stage 1 palliation (S1P) from 2016 to 2024 and included in the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC)infants who underwent S1P at 70 centers
Participants
3,644 infants
Exposure
RAS with pre-S1P intervention vs no RAS
  • RAS with pre-S1P interventionn = 164
  • RAS without pre-S1P interventionn = 369
  • no RASn = 3,111reference
Outcome
Operative survival, post-S1P length of stay (LOS), and one-year mortality
Methodological detailsadjusted for demographic and clinical factors through multivariable regression
  • Adjusted for demographic and clinical factors through multivariable regression

Main finding

As reported in the abstract

Operative survival, post-S1P length of stay (LOS), and one-year mortality

Adjusted odds ratio

2.2

CI 1.44,3.38

P < 0.001

RAS with pre-S1P intervention vs no RAS
aOR 2.2 (CI 1.44,3.38); P < 0.001

Observational data: associations, not effects.

Secondary outcomes

OutcomeRAS with pre-S1P interventionRAS without pre-S1P interventionNo RAS
Pre-operative instability
Inotrope use43%Not reported in the abstract15%RAS without pre-S1P intervention: not reported in the abstract
Mechanical ventilation57%Not reported in the abstract19%RAS without pre-S1P intervention: not reported in the abstract
Persistent shock18%Not reported in the abstract7%RAS without pre-S1P intervention: not reported in the abstract
Hybrid S1P23%Not reported in the abstract10%RAS without pre-S1P intervention: not reported in the abstract
  • Pre-operative instability: all p<0.001
  • Hybrid S1P: p<0.001

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Outcomes in infants with restrictive atrial septum and pre-stage 1 palliation septal intervention. Am Heart J. Published 1 October 2026. doi:10.1016/j.ahj.2026.107620

Summarised from the published abstract; every number is checked against it

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