PMID: 1898174Sep 11, 1991Paper

Hypoplastic left heart syndrome

The Annals of Thoracic Surgery
W I Norwood

Abstract

The evolution of the present approach to the newborn with hypoplastic left heart is outlined. Preoperatively, maintenance of ductal patency with prostaglandin E1 and balancing of systemic and pulmonary blood flow are essential. Operative details of the first-stage palliation and the definitive second-stage procedure are described. The more recent adoption of an intermediate-stage hemi-Fontan procedure is also described. Since January 1989, 151 patients have been treated using this three-stage approach, with 109 early survivors. Seventy-eight have undergone the hemi-Fontan operation with nine deaths (5 of whom came to this stage early nonelectively because of shunt failure or ventricular dysfunction). Twenty-seven of the 78 patients undergoing hemi-Fontan operation have subsequently undergone definitive Fontan procedures with no deaths.

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Related Concepts

Anastomosis, Surgical
Ascending Aorta Structure
Congenital Heart Defects
Cardiac Surgery Procedures
Postoperative Procedures
Preoperative Procedure
Pulmonary Artery Structure
Superior Vena Cava Structure

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