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The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome

The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome COMMENTARY The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome HOULD NONINTERVEN- progress that has been made in HLHS with ongoing surgical modification; tion (or what some phy- inthepast2decadeshasbeenparticu- and,importantly,childrenwithHLHS sicianscall comfort care) larlyrewardingandformsthebasisof are at no greater risk of mortality or beofferedasanoptionto my opinions. short-term morbidity following the S parentsofneonateswith Fontanprocedurethanotherchildren hypoplastic left heart syndrome with complex CHD with a function- GOOD COUNSELING 17,18 (HLHS)? While this may have been a ally univentricular heart. Alterna- BEGINS WITH GOOD DATA reasonablechoice2decadesago,Iwill tivestostagedreconstructioninclude 19-21 arguethat—for2primaryreasonshav- primarycardiactransplantation or What is our current best understand- ing to do with improvements in out- ahybridstrategycombininginterven- ing of HLHS and the associated comes over time and by comparing tionalcatheterizationtechniqueswith short- and long-term outcomes? Hy- HLHS with other life-threatening pe- surgery,ultimatelyfollowedbyaneven poplastic left heart syndrome is an diatric conditions—nonintervention newer modification of the Fontan uncommon condition, affecting ap- should no longer be offered. 22-25 principle. proximately1 in 5000 newborns an- Whichever intervention is per- nually in the United States, which See also page 844 formed, there is an on-going hazard translates into nearly 1000 neo- of premature mortality, repeated hos- nates per year born with HLHS and pitalizations, and reduced ability to http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Pediatrics American Medical Association

The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome

JAMA Pediatrics , Volume 162 (9) – Sep 1, 2008

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References (49)

Publisher
American Medical Association
Copyright
Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6203
eISSN
2168-6211
DOI
10.1001/archpedi.162.9.849
pmid
18762602
Publisher site
See Article on Publisher Site

Abstract

COMMENTARY The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome HOULD NONINTERVEN- progress that has been made in HLHS with ongoing surgical modification; tion (or what some phy- inthepast2decadeshasbeenparticu- and,importantly,childrenwithHLHS sicianscall comfort care) larlyrewardingandformsthebasisof are at no greater risk of mortality or beofferedasanoptionto my opinions. short-term morbidity following the S parentsofneonateswith Fontanprocedurethanotherchildren hypoplastic left heart syndrome with complex CHD with a function- GOOD COUNSELING 17,18 (HLHS)? While this may have been a ally univentricular heart. Alterna- BEGINS WITH GOOD DATA reasonablechoice2decadesago,Iwill tivestostagedreconstructioninclude 19-21 arguethat—for2primaryreasonshav- primarycardiactransplantation or What is our current best understand- ing to do with improvements in out- ahybridstrategycombininginterven- ing of HLHS and the associated comes over time and by comparing tionalcatheterizationtechniqueswith short- and long-term outcomes? Hy- HLHS with other life-threatening pe- surgery,ultimatelyfollowedbyaneven poplastic left heart syndrome is an diatric conditions—nonintervention newer modification of the Fontan uncommon condition, affecting ap- should no longer be offered. 22-25 principle. proximately1 in 5000 newborns an- Whichever intervention is per- nually in the United States, which See also page 844 formed, there is an on-going hazard translates into nearly 1000 neo- of premature mortality, repeated hos- nates per year born with HLHS and pitalizations, and reduced ability to

Journal

JAMA PediatricsAmerican Medical Association

Published: Sep 1, 2008

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