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Feeding, growth, nutrition, and optimal interstage surveillance for infants with hypoplastic left heart syndrome

David A Hehir1, David S Cooper, Elizabeth M Walters

  • 1Division of Pediatric Cardiology, Children's Hospital of Wisconsin and Medical College of Wisconsin, 9000 West Wisconsin Ave., Milwaukee, WI 53201, USA. dhehir@mcw.edu

Cardiology in the Young
|December 14, 2011
PubMed

Insights

Preventing interstage mortality in hypoplastic left heart syndrome (HLHS) is crucial. Optimal infant nutrition and home monitoring programs are key to ensuring normal growth and improving outcomes after the Norwood operation.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Neonatal Care

Background:

  • Improved survival after the Norwood (Stage 1) operation for hypoplastic left heart syndrome (HLHS) necessitates focus on interstage mortality.
  • Home monitoring programs have enhanced interstage outcomes for HLHS patients.
  • Failure to thrive in infancy is a modifiable risk factor impacting outcomes in subsequent palliative surgeries for functionally univentricular hearts.

Purpose of the Study:

  • To review evidence on best practices for interstage surveillance in infants with functionally univentricular hearts.
  • To outline optimal nutritional strategies for infants with functionally univentricular hearts during the interstage period.
  • To highlight relevant data presented at major pediatric cardiovascular disease conferences in 2011.

Main Methods:

  • Literature review of existing evidence on interstage surveillance and nutrition.
  • Synthesis of data presented at HeartWeek 2011, Cardiology 2011, and the 11th Annual International Symposium on Congenital Heart Disease.
  • Focus on modifiable risk factors and management priorities for infants with functionally univentricular hearts.

Main Results:

  • Heightened interstage surveillance has identified failure to thrive as a significant risk factor.
  • Ensuring normal infant growth is a priority for managing patients with functionally univentricular hearts.
  • Home monitoring programs are effective in improving interstage results.

Conclusions:

  • Optimizing infant nutrition and implementing robust interstage surveillance are critical for preventing mortality and improving outcomes in HLHS patients.
  • Focusing on growth during infancy is essential for successful palliative surgical pathways.
  • Evidence-based strategies for nutrition and monitoring are vital for this vulnerable population.

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