Current Status of Staged Reconstruction for Hypoplastic Left Heart Syndrome

Show simple item record Bove, Edward L. en_US 2006-09-08T20:16:33Z 2006-09-08T20:16:33Z 1998-07 en_US
dc.identifier.citation Bove, E.L.; (1998). "Current Status of Staged Reconstruction for Hypoplastic Left Heart Syndrome." Pediatric Cardiology 19(4): 308-315. <> en_US
dc.identifier.issn 0172-0643 en_US
dc.identifier.uri en_US
dc.description.abstract Once considered a uniformly fatal condition, the outlook for newborns with hypoplastic left heart syndrome has been dramatically altered with staged reconstructive procedures. Refinements in operative technique and perioperative management have been largely responsible for this improved outlook. At the University of Michigan, 253 patients underwent the Norwood operation for classic hypoplastic left heart syndrome between January 1990 and November 1997. Hospital survival was 76%. Among patients considered at standard risk, survival was significantly higher (86%) than that for those patients with important risk factors (42%, p = 0.0001). Adverse survival was most strongly associated with significant associated noncardiac congenital conditions ( p = 0.008) and severe preoperative obstruction to pulmonary venous return ( p = 0.03). Survival following second-stage reconstruction with a hemi-Fontan or bidirectional Glenn procedure was 97%. The Fontan procedure has been completed in 94 of these patients with a hospital survival rate of 88%. Survival after the Fontan procedure improved significantly when the second stage of the reconstruction was completed with a hemi-Fontan procedure compared to a bidirectional Glenn (98% vs 81%, p = 0.05). Among the patients considered at standard risk, actuarial survival was 70% at 5 years. The largest decrease in survival occurred in the first month of life and late deaths affected primarily those patients in the high-risk group. Neurodevelopmental outcome studies demonstrated normal verbal and performance scores in the majority of patients. Staged reconstruction has significantly improved the intermediate-term outlook for patients with hypoplastic left heart syndrome. Factors addressing improvements in early first-stage survival would be expected to add significantly to an overall improved late outcome. en_US
dc.format.extent 186513 bytes
dc.format.extent 3115 bytes
dc.format.mimetype application/pdf
dc.format.mimetype text/plain
dc.language.iso en_US
dc.publisher Springer-Verlag; Springer-Verlag New York Inc. en_US
dc.subject.other Key Words: Hypoplastic Left Heart Syndrome en_US
dc.subject.other Legacy en_US
dc.title Current Status of Staged Reconstruction for Hypoplastic Left Heart Syndrome en_US
dc.type Article en_US
dc.subject.hlbsecondlevel Public Health en_US
dc.subject.hlbsecondlevel Pediatrics en_US
dc.subject.hlbtoplevel Health Sciences en_US
dc.description.peerreviewed Peer Reviewed en_US
dc.contributor.affiliationum Pediatric Cardiovascular Surgery, The University of Michigan Health System, Ann Arbor, MI 48109, USA, US en_US
dc.contributor.affiliationumcampus Ann Arbor en_US
dc.identifier.pmid 9636254 en_US
dc.description.bitstreamurl en_US
dc.identifier.doi en_US
dc.identifier.source Pediatric Cardiology en_US
dc.owningcollname Interdisciplinary and Peer-Reviewed
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