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Early outcomes from a new regional programme for the surgical management of hypoplastic left heart syndrome
Author(s) -
Orr Yishay,
Leclair Karen,
Jacobe Stephen,
Badawi Nadia,
Nicholson Ian A.,
Chard Richard B.,
Sholler Gary F.,
Winlaw David S.
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12103
Subject(s) - hypoplastic left heart syndrome , medicine , perioperative , pediatrics , surgery , intensive care medicine , heart disease
Background Early survival and quality of outcome after surgery for hypoplastic left heart syndrome ( HLHS ) are influenced by patient‐specific factors, the quality of surgery and perioperative care. Some skills are common to the care of other complex neonatal presentations but integrating this expertise is a key challenge for new programmes. We began offering surgery for HLHS from 2006 and provided a regional service from J anuary 2009 and report early outcomes. Methods Prospectively collected data for neonates with HLHS undergoing surgical palliation from J anuary 2006 until J une 2011 were analysed. Standard definitions of high‐risk and standard‐risk presentations were utilized. Results Thirty neonates underwent surgical palliation of HLHS with a modified Norwood procedure with an overall survival to stage II palliation of 80%. A total of 46.7% of our patients were categorized as high‐risk, mostly on the basis of low birth weight. Survival to stage II palliation was 100% in standard‐risk patients and 57.1% in the high‐risk group. Conclusion Outcomes for this new programme are comparable to reported outcomes demonstrating the feasibility of integrating a new complex procedure within an existing multidisciplinary unit handling large volumes of other complex neonatal work. Excellent outcomes can be achieved in standard‐risk patients. Outcomes in the high‐risk group may be improved by alternative approaches and rigorous case selection.