Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and…

Meta-analysisJournal of cardiothoracic surgery· May 2026

Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis.

Abdullah Almehandi, Adel Altarkait, Yahya Ali … Saif Awlad Thani

Congenital Cardiac SurgeryMeta-analysisPrognosisQ3IF 1.6

Postoperative extracorporeal membrane oxygenation after the Norwood procedure is associated with far higher in-hospital mortality

Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis.

Abdullah Almehandi … Saif Awlad Thani

Journal of cardiothoracic surgery · May 2026 · Q3 in Respiratory Medicine

Background

Survival following the Norwood procedure has improved substantially, but outcomes for the high-risk subgroup requiring postoperative extracorporeal membrane oxygenation (extracorporeal membrane oxygenation) remain unclear.

Methods

MAIN BODY: We systematically searched PubMed, EMBASE, Cochrane Central and Web of Science (final search: 25 February 2025).

n = 2,612 patients

Results

Extracorporeal membrane oxygenation patients died in hospital far more often than those without it

RR 5.53 (95% CI 4.41 to 6.93)

CI excludes the null - significant

More results

Primary outcomes were short-term mortality, secondary outcomes included stages-2-and-3 palliation completion, operative times, recovery parameters, and complications.

Cardiopulmonary bypass duration was significantly longer in the extracorporeal membrane oxygenation group (MD = 28.07 min, CI = 18.19-37.95, p = 0.0004).

More results

Postoperative ICU recovery was significantly prolonged for extracorporeal membrane oxygenation patients (MD = 10.56 days, CI = 1.28-19.83, p = 0.03), though hospital recovery was similar.

Risk of bias (ROBINS-I) was formally assessed.

“

Conclusion · 1 of 2

Our analysis supports that extracorporeal membrane oxygenation use post-Norwood procedure identifies a high-risk subgroup with significantly higher early-mortality and resource utilisation.

Conclusion · 2 of 2

However, this association must be interpreted cautiously due to heterogenous extracorporeal membrane oxygenation indications. Future efforts should focus on identifying modifiable risk factors to improve outcomes.

Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis.

Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis.

Related papers