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The Annals of Thoracic Surgery, Vol 45, 122-128, Copyright © 1988 by The Society of Thoracic Surgeons
JD Pigott, JD Murphy, G Barber and WI Norwood
From August, 1985, through August, 1987, 104 consecutive, nonselected
neonates underwent palliation of hypoplastic left heart syndrome. The
technique included pulmonary artery homograft augmentation of the
diminutive ascending aorta and aortic arch, atrial septectomy, transection
of the main pulmonary artery with patch closure of the distal main
pulmonary artery, anastomosis of the proximal main pulmonary artery to the
augmented ascending aorta, and a 4-mm, modified, right Blalock-Taussig (N =
21) or central (N = 83) shunt. There were 30 early and 11 late deaths.
Early mortality was most commonly associated with hypoventilation.
Complications included development of aortic arch obstruction (N = 11) and
progressive hypoxemia (N = 11). Alterations in surgical techniques and
perioperative management should permit continued improvement in early and
long-term survival.
ARTICLES
Palliative reconstructive surgery for hypoplastic left heart syndrome
Children's Hospital of Philadelphia, PA 19104.
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