MMCTS
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MMCTS (July 24, 2009). doi:10.1510/mmcts.2006.002378
Copyright © 2009 European Association for Cardio-thoracic Surgery

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Alexander M. Fabricius
Timothy J. Jones
John G. Wright
David J. Barron
William J. Brawn
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Procedure


Surgical management of hypoplastic left heart syndrome at the Birmingham Children's Hospital

Alexander M. Fabricius*, Timothy J. Jones, John Stickley, Oliver Stümper, Ashish Chikermane, Tarak Desai, Paul Miller, Rami Dhillon, Joseph V. de Giovanni, John G. Wright, David J. Barron and William J. Brawn

Birmingham Children's Hospital, Cardiac Surgery, Birmingham, B4 6NH, UK

* Corresponding author: Tel.: +44-121-333 9435. almafa{at}web.de

Currently, a three-stage surgical palliation remains the treatment of choice at Birmingham Children's Hospital. After initial introduction of the classical Norwood with pulmonary blood flow provided by a modified Blalock–Taussig shunt, a right ventricular to right pulmonary artery conduit at stage 1 Norwood palliation is now used in most cases, a bi-directional ‘Glenn’ shunt at second stage and an extra-cardiac Fontan completion at third stage. Mortality and morbidity has improved after modification of the technique. Thirty-day mortality was 32.4% (79/244) for the ‘classical’ Norwood procedure, 25.0% (7/28) for the left-sided RV-PA conduit and 12.7% (22/173) for the right-sided RV-PA conduit. Interstage mortality was 8.6% (21/244) for the ‘classical’ Norwood procedure, 14.3% (4/28) for the left and 10.1% (15/148) for right-sided RV-PA conduit. After stage II, 30-day mortality was 3.0% (10/335) for all groups. Stage III 30-day mortality was 0.9% (1/115) for all groups.

Key Words: CP shunt • Fontan procedure • Hypoplastic left heart syndrome (HLHS) • Left ventricular hypoplasia • Norwood procedure

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Copyright © 2009 by The European Association for Cardio-thoracic Surgery.