Experience With the Norwood Operation for Hypoplastic Left Heart Syndrome

García-Hernández, J.A.; González-Rodríguez, Juan David; Martínez-López, A.I.; Canalejo-González, David; Romero-Parreño, Antonio; Soto, José Santos de; Loscertales-Abril, M.; Cayuela, Aurelio; Fournier-Carazo, Mauro Gil

doi:10.1016/s1885-5857(08)60009-2

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…High mortality and morbidity rates similar to our series have also been reported in the literature. [ 7 ] The single digit mortality rates reported from experienced centers were achieved by learning from their mistakes by surgical modifications, new strategies and improved multidisciplinary perioperative care. [ 8 ] As we understand from our early experience and the reports from other institutes, the mortality and morbidity rates of clinics can be quite high, when they are in the learning curve for Norwood surgery[ 9 , 10 ] and it can be speculated that Norwood surgery is still in the development phase in our country.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience

Özdemir¹,

Korun²,

Dedemoğlu³

et al. 2022

Turk Gogus Kalp Dama

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Background: In this study, we aimed to analyze the predictors and risk factors of mortality in patients who underwent Norwood I procedure with the diagnosis of hypoplastic left heart syndrome. Methods: Between January 2009 and December 2020, a total of 139 patients (95 males, 44 females) who underwent Norwood I procedure with the diagnosis of hypoplastic left heart syndrome in our center were retrospectively analyzed. Results: The median birth weight was 3,200 (range, 3,000 to 3,350) g and the median age at the time of operation was seven (range, 5 to 10) days. Pulmonary flow was achieved with a Sano shunt in the majority (72%) of patients. Survival rate was 41% after the first stage. Reoperation for bleeding (p=0.017), reoperation for residual lesion (p=0.011), and postoperative peak lactate level (p=0.029), were associated with in-hospital mortality. Nineteen (33%) of 57 patients died before the second stage. Thirty-three (58%) patients underwent second stage, and survival after the second stage was 94%. Thirteen patients underwent third stage, and survival after the third stage was 85%. Estimated probability of survival at six months, and one, two, three, and four years were 33%, 33%, 25%, 25%, and 22% respectively. Conclusion: Hospital and inter-stage mortality rates are still high and this seems to be the most challenging period in term of survival efforts of the patients with hypoplastic left heart syndrome. Early recognition and reintervention of anatomical residual defects, close follow-up in the inter-stage period, and the accumulation of multidisciplinary experience may help to improve the results to acceptable limits.

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