Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: The European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Paediatric and Congenital Cardiology (AEPC) Hypoplastic Left Heart Syndrome Guidelines Task Force

Alphonso, Nelson; Angelini, Annalisa; Barron, David J.; Bellsham‐Revell, Hannah; Blom, Nico A.; Brown, Kate; Davis, Deborah A.; Duncan, Daniel R.; Fedrigo, Marny; Galletti, Lorenzo; Hehir, David A.; Herberg, Ulrike; Jacobs, Jeffrey P.; Januszewska, Katarzyna; Karl, Tom R.; Force, Chaiman HLHS Guidelines Task; Malec, Edward; Maruszewski, Bohdan; Montgomerie, James; Pizzaro, Christian; Schranz, Dietmar; Shillingford, Amanda J.; Simpson, John

doi:10.1093/ejcts/ezaa188

Cited by 54 publications

(31 citation statements)

References 669 publications

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“…If technical and material details are taken into account, percutaneous duct stenting can be performed with almost no mortality [ 11 , 12 ]. The detailed technique of duct stenting, and manipulation of atrial septum and aortic coarctation were recently described as part of the AEPC/EATS HLHS guidelines [ 36 ]. The interstage remains a vulnerable period, that requires closed monitoring of the infants.…”

Section: Current Hybrid Procedures and Follow-up Resultsmentioning

confidence: 99%

Hypoplastic Left Heart: Stage-I Will be Performed Interventionally, Soon

2021

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The hypoplasia of left-sided heart structures shows great variability and complexity. What the many variants have in common is that their heart structures are neither fully developed before nor after birth. Fetuses and newborns require an individual therapy depending on anatomy and function of the heart. Fetal interventions focus on improving left heart structures by catheter-based interventions and maternal hyperoxygenation which promotes growth as the left ventricular preload and blood flow within the cavity increase. Stage-I management of newborns with single ventricle physiology is usually based on the Norwood/Sano surgery or the Hybrid approach. Two more steps are required to ultimately achieve a Fontan circulation. Some centers also use the Hybrid approach for subsequent Norwood operation beyond the neonatal period. After the Hybrid approach, a comprehensive stage-II or corrective surgery is performed, the latter if a bi-ventricular circulation is possible. With progressively improved catheter-based interventions, particularly ductal stenting and manipulations of the atrial septum, the next advance is to develop a bespoke flow restrictor that can be easily inserted into the branches of the pulmonary artery. The main goal is to avoid complex heart operations under general anesthesia, followed by substantial intensive care in the neonatal period, especially for patients with complex heart defects. Based on the current state of the art of surgical treatment of hypoplastic left heart syndrome and variants with the Norwood surgery or the Hybrid approach, our main focus is on an alternative percutaneous transcatheter technique in the sense of a completely non-surgical stage-I approach.

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Section: Current Hybrid Procedures and Follow-up Resultsmentioning

confidence: 99%

Hypoplastic Left Heart: Stage-I Will be Performed Interventionally, Soon

2021

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“…The presence of aortic atresia with a diminutive aorta is considered by some groups to be a contraindication to HP, and a very tight isthmus may also become compromised (thus compromising coronary flow) with a ductal stent (13,14). If there are any concerns over the great vessel anatomy, then a CT or MRI scan may provide further anatomical information to guide decision making (15).…”

Section: Imaging Prior To Staged Palliationmentioning

confidence: 99%

Noninvasive Imaging in Interventional Cardiology: Hypoplastic Left Heart Syndrome

Bellsham‐Revell

2021

Front. Cardiovasc. Med.

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Hypoplastic left heart syndrome (HLHS) is a spectrum of left heart underdevelopment leaving the left side unable to support the systemic circulation. If active management is pursued, then the condition is managed with staged palliation to the Fontan circulation, leaving a systemic right ventricle. Through all surgical stages, and even after completion of Fontan, there are multiple areas that may require intervention, most frequently the branch pulmonary arteries which are essential to a successful Fontan circulation. Echocardiography is the mainstay of assessment, but there is an increasing use of magnetic resonance imaging (MRI) and computed tomography (CT) particularly in relation to extracardiac structures which can be more challenging with echocardiography. Both MRI and CT require set-up, experience and training, and usually sedation or anesthetic in smaller children, but can provide excellent imaging to guide interventions. Cardiac MRI is also able to quantify right ventricular (RV) function which can be challenging on echocardiography. This article describes the modalities available and their use in assessing patients with HLHS prior to catheter interventions.

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“…Tretter: Recently, the Association for European Paediatric and Congenital Cardiology and The European Association for Cardio-Thoracic Surgery published the following two manuscripts: 14,15 • "Clinical guidelines for the management of patients with transposition of the great arteries with intact ventricular septum" 14 • "Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: The European Association for Cardio-Thoracic Surgery and the Association for European Paediatric and Congenital Cardiology Hypoplastic Left Heart Syndrome Guidelines Task Force". 15 Can you comment on the value of such joint multidisciplinary publication of Guidelines? Dr. Hanséus: I think that sometimes we are afraid of guidelines, thinking they will challenge the concept of us doing the best for the individual patient.…”

Section: Dr Hanséusmentioning

confidence: 99%

Global leadership in paediatric and congenital cardiac care: “Humility in Leadership – an interview with Katarina Hanséus, MD, PhD, President of the Association for European Paediatric and Congenital Cardiology (AEPC)”

Tretter

Jacobs

2021

Cardiol Young

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Dr. Katarina Hanséus is the focus of our fourth in a series of interviews in Cardiology in the Young entitled, “Global Leadership in Paediatric and Congenital Cardiac Care”. Dr. Hanséus was born in Malmö, Sweden. She attended undergraduate school in her home town in Malmö, Sweden, graduating in 1974. Dr. Hanséus then went on to complete medical school at University of Lund in Lund, Sweden, graduating in 1980, where additionally she completed a Doctoral Dissertation in the evaluation of cardiac function and chamber size in children using Doppler and cross-sectional echocardiography. Under the Swedish Board of National Welfare, Dr. Hanséus completed her authorisation as a paediatrician in 1986, followed by her authorisation as a paediatric cardiologist in 1988, at University of Lund. She was appointed head of Paediatric Cardiology in 2000 at the Children’s Heart Center, Skane University Hospital, Lund, Sweden. The programme at Lund serves as one of the two national referral centres for comprehensive paediatric and congenital cardiac care, including paediatric cardiac surgery, in Sweden. From 2006 to 2013, she served as the clinical and administrative head of the Department of Neonatology, Paediatric Surgery, Paediatric Intensive Care, Paediatric Cardiology, and Paediatric Cardiac Surgery, returning as the head of Paediatric Cardiology in 2013, for which she currently holds the position.Dr. Hanséus is a recognised leader in the field of Paediatric Cardiology and has been involved in leadership within the Swedish Pediatric Society, the Swedish Association for Pediatric Cardiology, and the Association for European Paediatric and Congenital Cardiology throughout her career. Within the Association for European Paediatric and Congenital Cardiology, she served as the Secretary General from 2011 to 2016, the President Elect in 2018, and is the current President serving from 2019 until 2022. This article presents our interview with Dr. Hanséus, an interview that covers her experience as a leader in the field of Paediatric Cardiology, including the history and goals of the Association for European Paediatric and Congenital Cardiology, and her role and vision as their current President.

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Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: The European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Paediatric and Congenital Cardiology (AEPC) Hypoplastic Left Heart Syndrome Guidelines Task Force

Cited by 54 publications

References 669 publications

Hypoplastic Left Heart: Stage-I Will be Performed Interventionally, Soon

Hypoplastic Left Heart: Stage-I Will be Performed Interventionally, Soon

Noninvasive Imaging in Interventional Cardiology: Hypoplastic Left Heart Syndrome

Global leadership in paediatric and congenital cardiac care: “Humility in Leadership – an interview with Katarina Hanséus, MD, PhD, President of the Association for European Paediatric and Congenital Cardiology (AEPC)”

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