title: [Surgical strategy and the results for hypoplastic left heart syndrome].
abstract: OBJECTIVE
  We retrospectively reviewed our surgical results in patients with hypoplastic left heart syndrome( HLHS) to investigate the influence of surgical strategy on outcome.
  
  
  METHODS
  Seventy-seven patients with classic HLHS were involved in this study. For the initial palliation, 23 patients underwent Norwood operation with modified Blalock-Taussig (BT) shunt, 23 patients underwent Norwood operation with right ventricle to pulmonary artery( RV-PA) shunt and 31 patients underwent bilateral pulmonary artery banding (BPAB). Surgical results, freedom from Fontan operation, hemodynamic data and incidence of complication after Fontan operation were compared between the 3 groups.
  
  
  RESULTS
  BPAB group had more preoperative risk factors than Norwood group. Total actuarial survival was 62.4% at 1 year and 58.2% at 3 and 5 years, and there was no difference between the groups. Freedom from Fontan completion was 59.4% at 3 years and 48.7% at 5 years without difference between the groups. The incidence of intervention for pulmonary artery stenosis was higher in Norwood with RV-PA shunt group(52.9%). Hemodynamic data obtained by cardiac catheterization were similar in the 3 groups, however, end-systolic elastance, which represents ventricular contractility, was lower in Norwood with RV-PA group.
  
  
  CONCLUSIONS
  Surgical results of Norwood with BT shunt and Norwood with RV-PA shunt were comparably satisfactory, however, there was possible concern of reduced ventricular contractility in RV-PA shunt group. BPAB was a effective and useful initial palliation in high risk cases.
authors.affiliation: Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Fukuoka, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Nakano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kado
authors.forename: Hideki
authors.initials: H
authors.lastname: Tatewaki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hinokiyama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Machida
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ebuoka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shoujima
authors.forename: Jin
authors.initials: J
authors.lastname: Ikarashi
mesh_terms: D058366:Blalock-Taussig Procedure; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D007231:Infant, Newborn; D058327:Norwood Procedures; D011651:Pulmonary Artery / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome