Morbidities in patients with hypoplastic left heart syndrome.
We sought to document morbidities and growth for patients with hypoplastic left heart syndrome (HLHS) to inform the initial surgical decision and understand healthcare needs. Data were obtained on 137 patients with HLHS, born between 1989 and 1994, who survived staged surgery ( n = 62) or transplantation ( n = 75) and had follow-up information available from four pediatric cardiac surgical centers. In patients with HLHS older than 1 year of age at follow-up, 93% experienced at least one major postsurgical morbidity. Morbidities depended on the surgery received. Hypertension, renal compromise, and abnormal infections were more common in transplanted patients than staged surgery patients. Staged surgery patients used more anticongestive medications and experienced more morbidities requiring interventional catheterization than did transplanted patients. Rejection was common for transplanted patients. On average these children spent 23 days per year in the hospital. Patients with HLHS were small for their age; 43% of staged surgery patients weighed below the third percentile at last information, compared to 19% of transplanted patients ( p = 0.003). The median height percentile was the 10th in both groups. Normal activity level was reported in more transplanted patients (90%) than staged surgery patients (49%; p < 0.001). Trade-offs between mortality and morbidity outcomes can help inform the initial surgical decision.
Jenkins
P C
PC
Department of Pediatrics, Dartmouth Medical School, Hanover, NH 03755, USA. pcj@hitchcock.org
Flanagan
M F
MF
Jenkins
K J
KJ
Sargent
J D
JD
Canter
C E
CE
Chinnock
R E
RE
Vincent
R N
RN
O'Connor
G T
GT
D000203:Activities of Daily Living; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D007223:Infant; D008297:Male; D009017:Morbidity; D013903:Thoracic Surgery / Q000379:methods; D014481:United States / Q000453:epidemiology