Alexander A Brescia1, Saadeh Jureidini2, Saar Danon2, Eric Armbrecht3, Andrew C Fiore1, Charles B Huddleston4. 1. Division of Cardiothoracic Surgery, St Louis University School of Medicine and Cardinal Glennon Medical Center, St Louis, Mo. 2. Division of Pediatric Cardiology, St Louis University School of Medicine and Cardinal Glennon Medical Center, St Louis, Mo. 3. Division of Pediatrics, St Louis University School of Medicine and Cardinal Glennon Medical Center, St Louis, Mo. 4. Division of Cardiothoracic Surgery, St Louis University School of Medicine and Cardinal Glennon Medical Center, St Louis, Mo. Electronic address: chuddle7@slu.edu.
Abstract
OBJECTIVE: Two different strategies have emerged in the initial palliation for hypoplastic left heart syndrome, the conventional Norwood operation and the so-called hybrid procedure. We have used each of these at our center. The purpose of the present study was to compare the outcomes of both procedures. METHODS: From 2007 to 2012, 40 patients presented to the Cardinal Glennon Children's Medical Center with hypoplastic left heart syndrome or 1 of its variants. Of the 40 patients, 24 underwent a hybrid procedure and 16 a Norwood procedure for initial palliation. The medical records, echocardiograms, and cardiac catheterization data were retrospectively reviewed. Standard statistical analysis was performed. RESULTS: The patients who underwent the hybrid procedure weighed less than those who underwent the Norwood procedure. Overall unadjusted survival was better in the Norwood group, although this did not reach statistical significance. Overall hospital resource usage was similar in both cohorts, taking into account both first and second palliation stages. CONCLUSIONS: In our review, we found no statistically significant difference in survival or resource usage between those patients undergoing the Norwood procedure and those undergoing a hybrid procedure as initial palliation for hypoplastic left heart syndrome.
OBJECTIVE: Two different strategies have emerged in the initial palliation for hypoplastic left heart syndrome, the conventional Norwood operation and the so-called hybrid procedure. We have used each of these at our center. The purpose of the present study was to compare the outcomes of both procedures. METHODS: From 2007 to 2012, 40 patients presented to the Cardinal Glennon Children's Medical Center with hypoplastic left heart syndrome or 1 of its variants. Of the 40 patients, 24 underwent a hybrid procedure and 16 a Norwood procedure for initial palliation. The medical records, echocardiograms, and cardiac catheterization data were retrospectively reviewed. Standard statistical analysis was performed. RESULTS: The patients who underwent the hybrid procedure weighed less than those who underwent the Norwood procedure. Overall unadjusted survival was better in the Norwood group, although this did not reach statistical significance. Overall hospital resource usage was similar in both cohorts, taking into account both first and second palliation stages. CONCLUSIONS: In our review, we found no statistically significant difference in survival or resource usage between those patients undergoing the Norwood procedure and those undergoing a hybrid procedure as initial palliation for hypoplastic left heart syndrome.
Authors: William N Evans; Alvaro Galindo; Abraham Rothman; Michael L Ciccolo; Sergio A Carrillo; Ruben J Acherman; Gary A Mayman; Kathleen A Cass; Katrinka T Kip; Carlos F Luna; Joseph M Ludwick; Robert C Rollins; William J Castillo; John A Alexander; Humberto Restrepo Journal: Pediatr Cardiol Date: 2016-03-01 Impact factor: 1.655