title: Resuscitation and perioperative management of the high-risk single ventricle patient: first-stage palliation.
abstract: Infants born with hypoplastic left heart syndrome or other lesions resulting in a single right ventricle face the highest risk of mortality among all forms of congenital heart disease. Before the modern era of surgical palliation, these conditions were universally lethal; recent refinements in surgical technique and perioperative management have translated into dramatic improvements in survival. Nonetheless, these infants remain at a high risk of morbidity and mortality, and an appreciation of single ventricle physiology is fundamental to the care of these high-risk patients. Herein, resuscitation and perioperative management of infants with hypoplastic left heart syndrome are reviewed. Basic neonatal and pediatric life support recommendations are summarized, and perioperative first-stage clinical management strategies are reviewed.
authors.affiliation: Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. adamlowry@gmail.com
authors.forename: Adam W
authors.initials: AW
authors.lastname: Lowry
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000401:mortality; D015897:Comorbidity; D006352:Heart Ventricles / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D007223:Infant; D007231:Infant, Newborn; D058327:Norwood Procedures / Q000009:adverse effects / Q000401:mortality; D010166:Palliative Care; D019990:Perioperative Care; D012307:Risk Factors; D016896:Treatment Outcome; D016276:Ventricular Function