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Resource and cost considerations in treating hypoplastic left heart syndrome

Miguel Urencio1, Chris Greenleaf1, Jorge D Salazar2

  • 1Division of Cardiothoracic Surgery.

Pediatric Health, Medicine and Therapeutics
|February 2, 2018
PubMed

Insights

Hypoplastic left heart syndrome (HLHS) treatment has dramatically improved survival rates since 1983. Advances in surgery, prenatal diagnosis, and intensive care have increased stage I survival to over 90%, though it remains resource-intensive.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Neonatal Intensive Care

Background:

  • Hypoplastic left heart syndrome (HLHS) was historically a fatal diagnosis.
  • The Norwood I operation in 1983 marked the beginning of surgical intervention.
  • Significant progress has been made in managing HLHS over the past decades.

Purpose of the Study:

  • To review the surgical steps and outcomes for treating HLHS.
  • To analyze the advancements contributing to improved survival rates.
  • To compare the cost of HLHS treatment with simpler congenital heart defects.

Main Methods:

  • Review of surgical techniques for HLHS treatment.
  • Analysis of factors influencing operative survival rates.
  • Comparative cost analysis of HLHS versus other congenital heart defects.

Main Results:

  • Stage I operative survival for HLHS has increased from 53% to over 90%.
  • Improvements are attributed to surgical advances, prenatal diagnosis, enhanced bypass technology, intensive care, and monitoring.
  • Despite improved outcomes, HLHS management remains a significant challenge and resource burden.

Conclusions:

  • Multidisciplinary teamwork and technological advancements have revolutionized HLHS outcomes.
  • HLHS treatment requires substantial resources, posing a challenge for congenital heart programs.
  • Further evaluation of cost-effectiveness compared to simpler defects is warranted.

Keywords:
Norwoodcongenital heart diseasehypoplastic left heart syndrome

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