Stage 1 Palliation of Hypoplastic Left Heart Syndrome: What the Pediatric Anesthesiologist Needs to Know
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Purpose of Review
The purpose of this review is to discuss the features of stage 1 palliation of hypoplastic left heart syndrome (HLHS). Comparison will be made between traditional surgical approaches and hybrid approaches. Anesthetic considerations for infants with these types of palliations will be discussed.
While historically surgical palliation in the neonatal period or neonatal heart transplant has been the primary means of survival for neonates with HLHS, in the last two decades, more centers have been performing hybrid palliation of this defect. This palliation can be performed with the expectation that a comprehensive second-stage palliation will be done in the next several months, or it can be used as a bridge to transplant. Other uses are also being explored as research continues.
Advances in the care of neonates with HLHS have led to increased survival. As surgical technique and non-surgical care of these infants continue to improve, the pediatric anesthesiologist will need to be familiar with the anatomic and physiologic implications of the various types of palliation.
KeywordsHypoplastic left heart syndrome Anesthesia Norwood procedure Sano procedure Hybrid palliation Norwood procedure Sano modification
Compliance with Ethical Standards
Conflict of Interest
Dawn M. Sweeney and Jane Arcadi declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
Neither Dr. Arcadi nor Dr. Sweeney performed any animal or human subject studies in this article.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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