Congenital heart diseaseSecondary analysis
Single-Ventricle Disease
- Secondary analysis of the Single Ventricle Reconstruction (SVR) randomised trial
- multi-institutional
- hierarchically ranked composite endpoint
- risk-adjusted ordinal logistic regression
Authors' conclusion
Few patients with single ventricles survive free of major morbidity. Although overall outcomes did not differ by shunt type, the observed interaction between shunt type and severity of tricuspid regurgitation highlights an important area for future investigation.
Study context
- Population
- SVR trial participants with single-ventricle disease
- Participants
- 549 participants
- Comparison
- Right ventricle-to-pulmonary artery shunt (RVPAS) vs modified Blalock-Taussig-Thomas shunt
- Primary endpoint
- Hierarchically ranked composite endpoint (death, transplant, parent-reported adaptive function and QoL, RV function, major complications, hospital stay), ranked by worst outcome
- Follow-up
- 16 years
Primary result
As reported in the abstract
Hierarchical composite by shunt type, by pre-Norwood tricuspid regurgitation
RVPAS vs Modified Blalock-Taussig-Thomas shuntOdds ratio (95% CI)P value
no or mild pre-Norwood TR: no difference
1.3(0.9–1.8)
P = 0.14moderate or severe pre-Norwood TR: worse outcomes with RVPAS
0.4(0.2–0.9)
P = 0.03- Death or major morbidity, all participants
- 87% (480/549)
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Mortality, moderate or severe pre-Norwood TR (Cox sensitivity analysis) · increased mortality with RVPAS | 5.4 (2.2–13.1) | P = 0.0002 | |
| 0.050.21520Hazard ratio (log scale) |
Predictors of worse outcomes
- Prematurity and site were significant independent predictors of worse outcomes
Original publication
Single-Ventricle Disease. J Am Coll Cardiol. Published 11 March 2026. doi:10.1016/j.jacc.2026.01.049
Summarised from the published abstract; every number is checked against it