학술논문
Decreasing Interstage Mortality After the Norwood Procedure: A 30‐Year Experience
Document Type
article
Author
Michelle Kaplinski; Richard F. Ittenbach; Mallory L. Hunt; Donna Stephan; Shobha S. Natarajan; Chitra Ravishankar; Therese M. Giglia; Jack Rychik; Jonathan J. Rome; Marlene Mahle; Andrea T. Kennedy; James M. Steven; Stephanie M. Fuller; Susan C. Nicolson; Thomas L. Spray; J. William Gaynor; Christopher E. Mascio
Source
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 9, Iss 19 (2020)
Subject
Language
English
ISSN
2047-9980
Abstract
Background The superior cavo‐pulmonary connection was introduced at our institution in 1988 for infants undergoing surgery for hypoplastic left heart syndrome. Patients with hypoplastic left heart syndrome remain at high risk for mortality in the time period between the Norwood procedure and the superior cavo‐pulmonary connection. The primary objectives of this study were to compare interstage mortality across 4 eras and analyze factors that may impact interstage mortality. Methods and Results Patients with hypoplastic left heart syndrome who underwent the Norwood procedure, were discharged from the hospital, and were eligible for superior cavo‐pulmonary connection between January 1, 1988, and December 31, 2017, were included. The study period was divided into 4 eras based on changes in operative or medical management. Mortality rates were estimated with 95% CIs. Adjusted and unadjusted logistic regression models were used to identify risk factors for mortality. There were 1111 patients who met the inclusion criteria. Overall, interstage mortality was 120/1111 (10.8%). Interstage mortality was significantly lower in era 4 relative to era 1 (4.6% versus 13.4%; P=0.02) during the time that age at the superior cavo‐pulmonary connection was the lowest (135 days; P