Ten-Year Institutional Experience With Palliative Surgery for Hypoplastic Left Heart Syndrome

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Abstract
Background We reviewed 212 consecutive patients who underwent stage I palliative surgery for hypoplastic left heart syndrome (HLHS) at our institution between January 1983 and June 1993. Methods and Results Six surgeons participated in the care of these patients. Follow-up is 97% complete. Preoperative anatomic and physiological factors and procedural features of the stage I operation were analyzed for impact on stage I mortality, survival to stage II palliation, and actuarial survival. Hospital mortality was not significantly lower during the second half of the study period (P=.242). Operative mortality was 46.2%. Multivariate analysis revealed improved stage I operative survival in patients with mitral stenosis (MS) and aortic stenosis (AS; P=.006). Additional risk factors for stage I mortality were a lower immediately pre–stage I pH (P=.034) and weight <3 kg (P=.015). Overall first-year actuarial survival for MS/AS was 59%, and it was 33% for all others (P=.001). Among stage I survivors, patients with ...