Outcome of Norwood operation for hypoplastic left heart syndrome

Mohanty, Smruti R.

doi:10.1007/s12055-017-0642-7

Cited by 1 publication

(1 citation statement)

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“…But when resources are devoted to the treatment of neonates with HLHS in economies where resources are scarce and the distribution glaringly uneven as is the case in India, critical debate often ensues. 19,21,22 The arguments are not difficult to grasp: Dean and coworkers showed in a 2011 study 23 of 1,941 neonates that stage 1 palliation had a median length of stay (LOS) of 25 days and charges of $214,680. If one factors the costs of Stage 2 and stage 3 palliation (Glenn and Fontan procedures, respectively)-median LOS and charges of eight days and $82,174 and 11 days and $79,549, respectively, the enormity of the resource requirements becomes obvious.…”

Section: Economic Efficiency Versus Distributive Justice In Low-resou...mentioning

confidence: 99%

Management of Hypoplastic Left Heart Syndrome in Low-Resource Settings and the Ethics of Decision-Making

Edwin

Palacios-Macedo

et al. 2022

World J Pediatr Congenit Heart Surg

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Hypoplastic left heart syndrome (HLHS) is possibly the most challenging congenital heart defect to confront in any setting. The highly specialized infrastructure and resources needed to treat HLHS is not available in many low-resource settings. However, low-resource settings must not be assumed to be synonymous with low- and middle-income countries as national income is not necessarily indicative of a country’s prioritization of healthcare resources. Besides, a low-resource setting may be institution-specific as well as country-specific. We have stratified institutional capabilities for addressing the requirements of treatment for HLHS into five levels based on the capacity for diagnosis, intervention, and post-discharge monitoring. Depending on institutional capabilities, children born with HLHS in low-resource settings experience a spectrum of outcomes ranging from death without diagnosis to the hybrid or Norwood stage 1 palliation. The decision-making is ethically challenging when resources are scarce and economic efficiency must be considered in the context of distributive justice. Even in settings that would be classified as resource-rich where survival after surgery and quality of life afterward keep improving, not every parent would choose surgical intervention for their hypothetical child with HLHS.

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Section: Economic Efficiency Versus Distributive Justice In Low-resou...mentioning

confidence: 99%