Management of hypoplastic left heart syndrome with intact atrial septum: a two-centre experience

Cardiology in the Young
Shyam K SathanandamBettina F Cuneo

Abstract

Introduction Hypoplastic left heart syndrome with an intact atrial septum is a poor predictor of outcomes. Prenatal assessment of pulmonary venous Doppler and emergent postnatal cardiac intervention may be associated with better outcomes. Materials and methods A retrospective review of all hypoplastic left heart syndrome patients in two centres over a 5-year period was performed. Group 1 included patients with adequate inter-atrial communication. Group 2 included patients with prenatal diagnosis with an intact atrial septum who had immediate transcatheter intervention. Group 3 included patients with intact atrial septum who were not prenatally diagnosed and underwent either delayed intervention or no intervention before stage 1 palliation. Primary outcome was survival up to stage 2 palliation. The incidence of hypoplastic left heart syndrome with a restrictive atrial communication was 11.2% (n=19 of 170). Overall survival to stage 2 or heart transplantation was 85% and 67% for Groups 1 and 2, respectively (n=129/151, n=8/12; p=0.03), and 0% (n=0/7) for Group 3. Survival benefits were observed between Groups 2 and 3 (p<0.001). Foetal pulmonary vein Doppler reverse/forward velocity time integral ratio of ⩾18% (sensitivity, 0.99, ...Continue Reading

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Citations

Aug 3, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Srinath T GowdaHarinder R Singh
Jul 11, 2020·Seminars in Cardiothoracic and Vascular Anesthesia·Ray S ChoiMorgan L Brown
Feb 19, 2021·Frontiers in Cardiovascular Medicine·Hannah Bellsham-Revell
Jan 15, 2021·The Annals of Thoracic Surgery·Waldemar F CarloJeffrey A Alten
Nov 30, 2021·Journal of Cardiac Surgery·Antonio F CornoJorge D Salazar

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