Linking shape and clinical outcomes: Statistical shape model of Bidirectional Glenn connection in congenital single ventricle patients

Q: What are the key findings of this study?

Statistical shape modeling revealed that specific 3D morphological features of the superior cavopulmonary connection significantly correlated with SCPC pressure (r = -0.50) and length of ICU stay.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Congenital single ventricle physiology post Bidirectional Glenn procedure (n=29). Intervention: 3D morphological variations of the superior cavopulmonary connection (SCPC). Primary outcome: Correlation between SCPC 3D shape vector and SCPC pressure (r = -0.50, 95% CI -0.731 to -0.146, p=0.006).

Q: What does this research mean for the field?

Three-dimensional shape features of the superior cavopulmonary connection post-Bidirectional Glenn surgery are significantly associated with SCPC pressure and ICU duration, with narrower non-stenotic left pulmonary artery geometry predicting worse clinical outcomes. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Maria Arrese-Zubizarreta; Naiara Rodríguez-Flórez; Raphaël Sivera; Liam Swanson; Claudio Capelli; Syed Faaz Ashraf; Jan L. Bruse; Tain-Yen Hsia; Silvia Schievano

doi:10.1371/journal.pdig.0001611

August 18, 2026PLOS Digital HealthOpen Access

Linking shape and clinical outcomes: Statistical shape model of Bidirectional Glenn connection in congenital single ventricle patients

View Full Paper

Ask AI

Bookmark

Share

Key result

Specific SCPC 3D shape features are linked to hemodynamics and post-op ICU length of stay.

r = -0.50
95% CI -0.731 to -0.146
P=0.006
n=29

Figures

Why the study?

Despite advances in the Bidirectional Glenn procedure, morbidity and mortality remain significant, and the broader impact of 3D anatomical variations of the superior cavopulmonary connection on clinical outcomes remains poorly understood.

Key Points

To characterize 3D morphological variability of the superior cavopulmonary connection following the Bidirectional Glenn procedure and determine whether statistical shape features associate with postoperative clinical outcomes.
Analyzed cardiovascular magnetic resonance imaging from N=29 congenital single ventricle patients following Bidirectional Glenn surgery without overt connection or arterial stenosis.
Constructed a 3D anatomical template using the Deformetrica framework to extract patient-specific shape deformation vectors.
Assessed correlations between shape deformations, conventional morphometric dimensions, and clinical metrics (connection pressure, oxygen saturation, ICU stay, hospital stay) via partial least squares regression.
Shape deformation vectors significantly correlated with superior cavopulmonary connection pressure (r = -0.50, p = 0.006; 95% BCa CI [-0.73, -0.15]), with lower pressures linked to a wider, straighter left pulmonary artery.
Length of ICU stay positively correlated with shape deformation patterns indicating left pulmonary artery narrowing (rho = 0.56, p < 0.05; 95% BCa CI [+0.23, +0.78]).
No statistically significant associations were observed for oxygen saturation (r = -0.382, p = 0.052) or total hospital stay (rho = 0.063, p = 0.76), and conventional morphometric parameters failed to correlate directly with pressure.

Study Design

Type

Observational (n=29)

Multicenter

No

Structured PICO

P

Population

29 pediatric patients with congenital single ventricle physiology post-Bidirectional Glenn procedure, without clinically significant stenosis, evaluated via CMR imaging at an average of 2.9 years post-surgery.

E

Exposure

Statistical Shape Modeling (SSM) to characterize 3D morphological variability of the superior cavopulmonary connection (SCPC)

O

Outcome

Correlation of patient-specific 3D shape deformations with clinical metrics including SCPC pressure, oxygen saturation (SaO2), intensive care unit (ICU) stay, and total hospital staysurrogate

Main Result

Effect estimate: r = -0.50 (95% CI -0.731 to -0.146)

p-value: p=0.006

Limitations

Small sample size (N = 29) from a single center, limiting statistical power and generalizability.
Retrospective design without longitudinal 3D data to account for preoperative anatomical and hemodynamic factors.
Potential inter-operator and inter-batch variability in retrospective catheterization and monitoring data.
Assumption of linear relationships between shape vectors and clinical variables via PLS regression.
relatively small sample size (N = 29)
high dimensionality of the initial shape data

Implication

Statistical shape modeling of the superior cavopulmonary connection post-Bidirectional Glenn reveals 3D morphological features that significantly correlate with SCPC pressure and ICU stay, offering potential novel biomarkers for risk stratification.

Abstract

In patients with congenital single ventricle physiology, the Bidirectional Glenn procedure is a critical intermediate step toward Fontan circulation. Despite technical advances, morbidity and mortality remain significant. While left pulmonary artery (LPA) stenosis is a recognized complication, the broader impact of 3D anatomical variations on outcomes remains poorly understood. We aimed to characterize morphological variability of the superior cavopulmonary connection (SCPC) following the Bidirectional Glenn and assess its relationship with clinical outcomes. Statistical Shape Modeling (SSM) was applied to cardiovascular magnetic resonance images from 29 single ventricle patients following Bidirectional Glenn, whose SCPC showed no clinically important SCPC or pulmonary arterial stenosis. A population-based 3D anatomical template was generated using the Deformetrica framework. Patient-specific shape deformations were quantified and correlated with clinical metrics—including SCPC pressure, oxygen saturation, intensive care unit (ICU) stay, and total hospital stay—via Partial Least Squares (PLS) regression. Associations were compared to correlations with conventional morphological parameters. SSM revealed 3D shape features significantly associated with SCPC pressure and ICU stay (p < 0.01). Lower SCPC pressure correlated with straighter, wider LPA geometry. In contrast, narrower—but without overt stenosis—LPA morphologies were associated with worse outcomes. Conventional geometric metrics did not show such correlations. No association was observed between SCPC shape and total hospital stay. This study provides a novel 3D shape-based characterization of SCPC anatomy in single ventricle patients post Bidirectional Glenn surgery and its link to outcomes. SSM-derived morphological biomarkers offer potential for improved risk stratification and surgical planning in congenital heart disease.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Arrese-Zubizarreta et al. (2026) conducted an observational in Congenital single ventricle physiology post Bidirectional Glenn procedure (n=29). 3D morphological variations of the superior cavopulmonary connection (SCPC) was evaluated on Correlation between SCPC 3D shape vector and SCPC pressure (r = -0.50, 95% CI -0.731 to -0.146, p=0.006). Statistical shape modeling revealed that specific 3D morphological features of the superior cavopulmonary connection significantly correlated with SCPC pressure (r = -0.50) and length of ICU stay.

synapsesocial.com/papers/6a86b5eb8a91293e6a1cd846 https://doi.org/10.1371/journal.pdig.0001611

View Full Paper

Ask AI

Bookmark

Share

Linking shape and clinical outcomes: Statistical shape model of Bidirectional Glenn connection in congenital single ventricle patients

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Linking shape and clinical outcomes: Statistical shape model of Bidirectional Glenn connection in congenital single ventricle patients

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading