Objective: Two different strategies have emerged in the initial palliation for hypoplastic left heart syndrome, the conventional Norwood operation and the so-called hybrid procedure. We have used each of these at our center. The purpose of the present study was to compare the outcomes of both procedures.
Methods: From 2007 to 2012, 40 patients presented to the Cardinal Glennon Children's Medical Center with hypoplastic left heart syndrome or 1 of its variants. Of the 40 patients, 24 underwent a hybrid procedure and 16 a Norwood procedure for initial palliation. The medical records, echocardiograms, and cardiac catheterization data were retrospectively reviewed. Standard statistical analysis was performed.
Results: The patients who underwent the hybrid procedure weighed less than those who underwent the Norwood procedure. Overall unadjusted survival was better in the Norwood group, although this did not reach statistical significance. Overall hospital resource usage was similar in both cohorts, taking into account both first and second palliation stages.
Conclusions: In our review, we found no statistically significant difference in survival or resource usage between those patients undergoing the Norwood procedure and those undergoing a hybrid procedure as initial palliation for hypoplastic left heart syndrome.
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http://dx.doi.org/10.1016/j.jtcvs.2014.02.066 | DOI Listing |
Ann Thorac Surg
January 2025
Division of Cardiothoracic Surgery, University of Utah Health, Salt Lake City, UT. Electronic address:
Background: Prior investigations of the center-specific case volume on outcomes in hypoplastic left heart syndrome have conflicting results. This study utilized the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry to investigate the center volume-outcome relationship in patients following the Norwood procedure with consideration of pre-operative high-risk features.
Methods: Between 2016 and 2023, centers were categorized by Norwood procedure volume into low (≤ 5 cases/year), medium (6 to 10 cases/year), and high-volume centers (> 10 cases/year).
Open Heart
January 2025
Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.
Introduction: Data on the characteristics and outcomes of pregnancy and among patients with Fontan physiology are limited. We aimed to evaluate the immediate and long-term outcomes among these patients who were followed at our centre.
Methods: We included adult patients who had undergone Fontan surgery for congenital heart disease and were pregnant between 1994 and 2021.
Pediatrics
January 2025
Cincinnati Children's Hospital Medical Center and Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
We present the case of a child born with hypoplastic left heart syndrome. After developing multiple complications following the first surgical stage (Norwood procedure), her parents decide not to proceed with the second stage (Glenn operation). Cardiac surgeons, pediatric intensivists, a psychologist, and a bioethicist analyze whether further surgical intervention is ethically obligatory.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Duke University Hospital, Durham, North Carolina.
Background: This study sought to determine the safety of primary and staged biventricular repair in neonates with interrupted aortic arch (IAA), ventricular septal defect (VSD), and severe left ventricular outflow tract obstruction (LVOTO).
Methods: Patients with a fundamental diagnosis of IAA and VSD between 2015 and 2020 were extracted from The Society of Thoracic Surgeons National Database by using a Participant User File. The objective was to compare outcomes for neonates undergoing primary and staged Yasui and Ross operations.
Ann Thorac Surg Short Rep
September 2024
Department of Pediatric Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
Undetected coronary anomalies at Norwood procedure are associated with poor prognosis due to inadequate myocardial protection. We report a case of anomalous origin of the right coronary artery from the main pulmonary artery trunk with hypoplastic left heart syndrome and aortic atresia. Although, during bilateral pulmonary artery banding as initial palliation, the proximity between the right coronary artery origin and the aortic root made a visual diagnosis difficult, it was diagnosed using computed tomography before the Norwood procedure.
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