Surgical Outcome for Hypoplastic Left Heart Syndrome

The authors from the Children’s Hospital of Boston report on the early outcomes of 66 consecutive neonates who received operative care for hypoplastic left heart syndrome with a Norwood reconstruction of the neo-aorta, homograph augmentation of the aortic arch, and atrial septectomy over a 2-year period from January 2002 through December 2003. During this time, pulmonary blood flow was provided either by a modified Blalock Taussig Shunt (BT) constructed between the innominate artery and the right pulmonary artery or by a conduit placed from the infundibulum of the right ventricle to the pulmonary artery confluence (Sano). The choice of surgical procedure was determined by the preference of the surgeon rather than specific anatomic or physiologic determinants. Infants had similar demographic and preoperative clinical features. However, 8 infants (22%) in the BT shunt group had atrioventricular value regurgitation compared to no infants in the Sano group, and almost half (49%) of the BT shunt group had a “lowest” pH <7.3 compared to 24% of the infants who were treated by a Sano modification.

Thirty-seven children underwent BT shunts while 29 had the Sano modification. The duration of cardiopulmonary bypass time was significantly …