Prenatally diagnosed hypoplastic left heart syndrome - Outcomes after postnatal surgery

Mary Munn, C. G. Brumfield, Y. Lau, E. V. Calvin

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: To identify prenatally diagnosed cases of hypoplastic left heart syndrome (HLHS) and then to determine postnatal outcomes after surgical interventions. Methods: An ultrasound and pediatric cardiology database was used to identify all fetuses diagnosed prenatally from 1991-1996 with HLHS. Fetal karyotypes were performed on cultured amniocytes. After diagnosis, parents were given several management options: pregnancy termination before 22 weeks, postnatal hospice care, or surgery using the Norwood procedure or cardiac transplantation. Ultrasound and echocardiography findings were later compared to karyotype results and postnatal outcome data. Results: Fifteen fetuses with HLHS were identified. Two (16%) chromosome abnormalities and three (20%) structural defects were detected. Three mothers (20%) opted for pregnancy termination, two (13%) chose postnatal hospice care, and one aneuploid fetus had an intrauterine death. Nine parents (60%) chose surgery for their infants; however, one infant was not an appropriate surgical candidate due to a coexisting diaphragmatic hernia. Eight infants underwent surgery and two survived (25%). Of the four infants scheduled to undergo the Norwood procedure, one died preoperatively, two died intraoperatively, and one infant survived and is doing well at age 8 months. Of the four infants scheduled for cardiac transplantation, two died awaiting transplant and one died postoperatively. One infant survived cardiac transplantation but has microcephaly and developmental delay at age two. Conclusions: In prenatally diagnosed HLHS at our institution, the survival rate following surgery for infants felt to be the best candidates was only 25%.

Original languageEnglish (US)
Pages (from-to)147-150
Number of pages4
JournalJournal of Maternal-Fetal Medicine
Volume8
Issue number4
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Hypoplastic Left Heart Syndrome
Heart Transplantation
Norwood Procedures
Postnatal Care
Hospice Care
Fetus
Karyotype
Parents
Pregnancy
Microcephaly
Diaphragmatic Hernia
Aneuploidy
Cardiology
Chromosome Aberrations
Echocardiography
Survival Rate
Mothers
Databases
Pediatrics
Transplants

Keywords

  • Fetal hypoplastic left heart
  • Postnatal outcome

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Prenatally diagnosed hypoplastic left heart syndrome - Outcomes after postnatal surgery. / Munn, Mary; Brumfield, C. G.; Lau, Y.; Calvin, E. V.

In: Journal of Maternal-Fetal Medicine, Vol. 8, No. 4, 1999, p. 147-150.

Research output: Contribution to journalArticle

Munn, Mary ; Brumfield, C. G. ; Lau, Y. ; Calvin, E. V. / Prenatally diagnosed hypoplastic left heart syndrome - Outcomes after postnatal surgery. In: Journal of Maternal-Fetal Medicine. 1999 ; Vol. 8, No. 4. pp. 147-150.
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