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Ann Thorac Surg 1991;52:701-704
© 1991 The Society of Thoracic Surgeons

Articles

Transplantation after first-stage reconstruction for hypoplastic left heart syndrome

Edward L. Bove, MD*

Section of Thoracic Surgery, Department of Surgery, The University of Michigan Medical Center, Ann Arbor, Michigan, USA

* Address reprint requests to Dr Bove, The University of Michigan Medical Center, Box 0344, Taubman Health Care Center, 1500 E Medical Center Dr, Ann Arbor, MI 48105.

The surgical treatment of infants born with hypoplastic left heart syndrome has received considerable attention in recent years. Although this lesion was previously considered uniformly fatal, dramatic successes have been achieved with the use of staged reconstructive and replacement therapies. However, both surgical options have benefits and limitations, and neither has demonstrated clear superiority over the other. As survival for first-stage reconstruction by the Norwood procedure has improved, a greater number of patients are potential candidates for the Fontan operation, but not all will be suitable at an acceptable risk. These patients may be treated by cardiac transplantation. The results of a treatment protocol for 90 patients with classic hypoplastic left heart syndrome or its variants at The University of Michigan are reported, with particular attention given to those patients surviving initial palliation but judged to be unsuitable for a subsequent Fontan procedure.




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