FRIDAY, March 13, 2026 (HealthDay News) -- For children with single-ventricle disease, death or major morbidity occurs in 87 percent, and while overall outcomes do not differ by shunt type, there is an interaction between shunt type and severity of tricuspid regurgitation, according to a study published online March 11 in the Journal of the American College of Cardiology.
Kevin D. Hill, M.D., from Duke University in Durham, North Carolina, and colleagues examined Single Ventricle Reconstruction (SVR) trial global morbidity and longitudinal outcomes using an end point incorporating death, transplant, parent-reported adaptive function and quality of life, right ventricular function, major complications, and hospital stay. During 16 years of follow-up, participants were ranked by their worst outcome.
The researchers found that 87 percent (480/549) of SVR trial participants experienced death or major morbidity. There was an interaction seen between shunt type and pre-Norwood tricuspid regurgitation; no shunt-related difference in outcomes was seen for those with no or mild pre-Norwood tricuspid regurgitation (odds ratio, 1.3; 95 percent confidence interval, 0.9 to 1.8; P = 0.14), but outcomes were worse for right ventricle-to-pulmonary artery shunt (RVPAS) participants with moderate or severe pre-Norwood tricuspid regurgitation (odds ratio, 0.4; 95 percent confidence interval, 0.2 to 0.9; P = 0.03). These findings were confirmed in sensitivity analyses; RVPAS participants with moderate or severe pre-Norwood tricuspid regurgitation had increased mortality (hazard ratio, 5.4; 95 percent confidence interval, 2.2 to 13.1; P = 0.0002). Significant independent predictors of worse outcomes were prematurity and site.
"Now that we understand these trajectories and the risk factors for suboptimal outcomes, we can counsel families more clearly and tailor therapies to each child," Hill said in a statement.