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A Comprehensive Approach To The Management Of Patients With HLHS: An Analysis Of 76 Patients (2015-2021)
Mark S. Bleiweis, MD, Giles J. Peek, MD, Joseph Philip, MD, James C. Fudge, Kevin J. Sullivan, Jennifer Co-Vu, MD, Dipankar Gupta, Frederick Jay Fricker, MD, Himesh V. Vyas, MD, Jose F. Hernandez-Rivera, MD, Mohammed Ebraheem, MD, Omar M. Sharaf, BS, Connie S. Nixon, RN, Jeffrey P. Jacobs, MD.
University of Florida, Gainesville, FL, USA.

Background: We report a comprehensive approach to all 76 neonates with HLHS undergoing initial neonatal surgery at our institution (2015-2021).
Methods: Standard risk patients underwent Norwood Stage 1 (n=56). High risk patients underwent Hybrid Stage 1 (n=9, with risk factors other than major cardiac risk factors), Hybrid Stage 1 + Ventricular Assist Device (Hybrid+VAD, n=8, with major cardiac risk factors), or primary transplantation (n=3, with major cardiac risk factors).
Results:

Norwood Stage 1: survival=96.4% (54/56): 45 underwent successful Glenn, 2 underwent successful biventricular repair, one underwent successful heart transplant, 5 are awaiting Glenn, and one is awaiting biventricular repair.
Hybrid Stage 1 without VAD: survival=88.9% (8/9): 3 underwent successful heart transplant, 2 are awaiting heart transplant, 2 underwent comprehensive Stage 2 with 1 death, one is awaiting comprehensive Stage 2, and one underwent successful biventricular repair.
Transplantation (prostaglandin bridge): one year survival=66.7% (2/3): 2 underwent successful heart transplant and one died while awaiting transplantation.
HYBRD+VAD: one year survival=62.5% (5/8): five underwent successful transplantation (mean time on VAD=142 days, range=64-196 days) and three died while awaiting transplantation (mean time on VAD=97.3 days, range=56-138 days).
Conclusion: In 76 patients, our comprehensive approach to the management of patients with HLHS is associated with an Operative Mortality after Norwood Stage 1 Operation of 3.57% (2/56) and a one-year survival in all 76 patients of 90.8% (69/76).


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