title: Anaesthetic and post-operative management of a modified Norwood operation for hypoplastic left heart syndrome: a retrospective series of 11 cases.
abstract: OBJECTIVE
  This study aimed to describe the pre-operative and operative findings, as well as the post-operative haemodynamics of patients operated on for hypoplastic left heart. The findings of patients who survived or did not survive were also compared to anticipate the risk factors for mortality.
  
  
  METHODS
  We retrospectively reviewed the anaesthetic and intensive care records of 11 (seven male and four female) patients who underwent a modified Norwood operation as neonates. There were eight patients who survived, while three did not survive after the operation. Haemodynamics, oxygenation, and medications of patients were recorded for the pre-operative and post-operative conditions for 2 days, and compared between groups of patients who survived and those who did not.
  
  
  RESULTS
  The normalised modified Blalock-Taussig shunt area was 3.28, 0.57 square millimetres per kilogram (mean, standard deviation) for the group of patients who survived and 3.55, 1.4 square millimetres per kilogram for the group of patients who did not survive (p = 0.51). The group of patients who survived had a significantly larger normalised aortic annulus area (3.3, 0.89 square millimetres per kilogram versus 1.68, 0.21 square millimetres per kilogram, p = 0.01), lower median age (5.57 (3-8) days versus 46.67 (4-90) days, p = 0.02), and lower weight (2.95, 0.46 kilograms versus 3.85, 0.56 kilograms, p = 0.03) than the group of patients who did not survive. Furthermore, the group of patients who did not survive had a significantly worse pre-operative condition, lower systemic venous and arterial oxygen saturation, and need for a high dose of drugs in the pre-operative and post-operative periods (p was less than 0.05 for each variable).
  
  
  CONCLUSIONS
  The pre-operative, operative, and post-operative findings may be related to mortality early after the modified Norwood operation for hypoplastic left heart syndrome.
authors.affiliation: Department of Anesthesiology and Reanimation, Medicana Hospitals Camlica, Uskudar, Istanbul, Turkey.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Yildiz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kirbas
authors.forename: Onur
authors.initials: O
authors.lastname: Gurer
authors.forename: Mehmet S
authors.initials: MS
authors.lastname: Bilal
mesh_terms: D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D005260:Female; D006439:Hemodynamics; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000401:mortality* / Q000601:surgery; D007231:Infant, Newborn; D008297:Male; D058327:Norwood Procedures / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D018685:Anesthetics, Inhalation; D014665:Vasodilator Agents