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Ann Thorac Surg 2004;77:483
© 2004 The Society of Thoracic Surgeons

Invited commentary

Department of Cardiac Surgery, Pediatric Cardiology/Cardiac Surgery, Children's Hospital of Oakland, 747 52nd St, Oakland, CA 94609-1809, USA

e-mail: jlamberti@mail.cho.org

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This paper describes the current approach to the surgical treatment of hypoplastic left heart syndrome (HLHS) at Loma Linda University Children's Hospital (LLUCH), the institution that pioneered the use of cardiac transplantation as the primary therapy for HLHS.

Several years ago, Checchia and associates recognized that the ongoing shortage of donor hearts and the recent reports of improved results for the staged surgical management of HLHS mandated consideration of a new strategy for management of HLHS syndrome at LLUCH. In August 1999, the authors implemented a new algorithm for decision-making in the treatment of HLHS. Operative risk was predicted based on a weighted score derived from six variables. The Norwood approach was then recommended for "low-risk" patients and cardiac transplantation was recommended for "high risk" patients. All Norwood patients . . . [Full Text of this Article]