Feeding, growth, nutrition, and optimal interstage surveillance for infants with hypoplastic left heart syndrome

2011 ◽  
Vol 21 (S2) ◽  
pp. 59-64 ◽  
Author(s):  
David A. Hehir ◽  
David S. Cooper ◽  
Elizabeth M. Walters ◽  
Nancy S. Ghanayem
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Home Monitoring ◽  
Failure To Thrive ◽  
Normal Growth ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Interstage Mortality ◽  
Annual International Symposium ◽  
Stage 1 ◽  
Left Heart Syndrome

AbstractImprovement in operative survival of patients with hypoplastic left heart syndrome has led to increasing emphasis on prevention of interstage mortality. Many centres have improved interstage results through programmes of home monitoring following discharge after the Norwood (Stage 1) operation. Experience with heightened interstage surveillance has identified failure to thrive during infancy as a modifiable risk factor for this population, one that has been linked to concerning outcomes at subsequent palliative surgeries. Ensuring normal growth as an infant has thus become a priority of management of patients with functionally univentricular hearts. Herein, we review the existing evidence for best practices in interstage surveillance and optimal nutrition in infants with functionally univentricular hearts. In addition, we highlight data presented at HeartWeek 2011, from Cardiology 2011, the 15th Annual Update on Pediatric and Congenital Cardiovascular Disease, and the 11th Annual International Symposium on Congenital Heart Disease.

Percutaneous Stage 1 Palliation for Hypoplastic Left Heart Syndrome

2021 ◽  
Author(s):  
Ashley M. Kiene ◽  
Benjamin Rush Waller ◽  
Christopher Knott Craig ◽  
Shyam Sathanandam
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Stage 1 ◽  
Left Heart Syndrome

Impact of Confounding on Cost, Survival, and Length-of-Stay Outcomes for Neonates with Hypoplastic Left Heart Syndrome Undergoing Stage 1 Palliation Surgery

2020 ◽  
Vol 41 (5) ◽  
pp. 996-1011
Author(s):  
Cynthia L. Gong ◽  
Ashley Y. Song ◽  
Robin Horak ◽  
Philippe S. Friedlich ◽  
Ashwini Lakshmanan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hypoplastic Left Heart Syndrome ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Stage 1 ◽  
Left Heart Syndrome

Anesthetic management of the hybrid stage 1 procedure for hypoplastic left heart syndrome (HLHS)

2010 ◽  
Vol 20 (1) ◽  
pp. 38-46 ◽  
Author(s):  
AYMEN N. NAGUIB ◽  
PETER WINCH ◽  
LAWRENCE SCHWARTZ ◽  
JANET ISAACS ◽  
ROBERTA RODEMAN ◽  
...  
Keyword(s):  
Hypoplastic Left Heart Syndrome ◽  
Anesthetic Management ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Stage 1 ◽  
Left Heart Syndrome

scholarly journals Identified mortality risk factors associated with presentation, initial hospitalisation, and interstage period for the Norwood operation in a multi-centre registry: a report from the National Pediatric Cardiology-Quality Improvement Collaborative

2013 ◽  
Vol 24 (2) ◽  
pp. 253-262 ◽  
Author(s):  
Russell R. Cross ◽  
Ashraf S. Harahsheh ◽  
Robert McCarter ◽  
Gerard R. Martin ◽  
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Pediatric Cardiology ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Quality Improvement Collaborative ◽  
Interstage Mortality ◽  
Independent Risk Factors ◽  
Stage 1 ◽  
Left Heart Syndrome

AbstractIntroductionDespite improvements in care following Stage 1 palliation, interstage mortality remains substantial. The National Pediatric Cardiology-Quality Improvement Collaborative captures clinical process and outcome data on infants discharged into the interstage period after Stage 1. We sought to identify risk factors for interstage mortality using these data.Materials and methodsPatients who reached Stage 2 palliation or died in the interstage were included. The analysis was considered exploratory and hypothesis generating. Kaplan–Meier survival analysis was used to screen for univariate predictors, and Cox multiple regression modelling was used to identify potential independent risk factors.ResultsData on 247 patients who met the criteria between June, 2008 and June, 2011 were collected from 33 surgical centres. There were 23 interstage mortalities (9%). The identified independent risk factors of interstage mortality with associated relative risk were: hypoplastic left heart syndrome with aortic stenosis and mitral atresia (relative risk = 13), anti-seizure medications at discharge (relative risk = 12.5), earlier gestational age (relative risk = 11.1), nasogastric or nasojejunal feeding (relative risk = 5.5), unscheduled readmissions (relative risk = 5.3), hypoplastic left heart syndrome with aortic atresia and mitral stenosis (relative risk = 5.2), fewer clinic visits with primary cardiologist identified (relative risk = 3.1), and fewer post-operative vasoactive medications (relative risk = 2.2).ConclusionInterstage mortality remains substantial, and there are multiple potential risk factors. Future efforts should focus on further exploration of each risk factor, with potential integration of the factors into surveillance schemes and clinical practice strategies.

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