We have located links that may give you full text access.
COMPARATIVE STUDY
JOURNAL ARTICLE
Current status of staged reconstruction for hypoplastic left heart syndrome.
Pediatric Cardiology 1998 July
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.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app