Survival Rates Improve for Infant Heart Surgery

A study has found that survival rates have been steadily improving for infants who undergo surgery for hypoplastic left heart syndrome (HLHS), a life-threatening congenital condition. The study reported on 840 infants operated on for HLHS at the Children's Hospital of Philadelphia (PA, USA) and was published in a November supplement of Circulation.

HLHS is the second-most common congenital heart defect presenting in the first week of life, and without surgery is invariably fatal. Currently, surgery is performed in three stages: the first on newborns, the second at about six months of age, and a third--the Fontan procedure--between one and two years of age. Researchers found that rates for hospital survival after the first stage improved from 56% in 1984-1989 to 71% in 1995-1998. Even better, survival rates for January 1999 through April 2000 showed an 86% survival rate.

The improved survival rates are the result of refinements in surgical techniques and in the pre-and post-surgical management of children with HLHS. Two other contributing factors were the introduction of the intermediate surgical procedure in 1989 and the increased experience of surgeons.

"Until now, relatively litle has been known about longer-term survival of patients with HlHS, but our study shows very few late deaths among patients discharged after the third stage,” said William Mahle, M.D., attending cardiologist at the Cardiac Center of The Children's Hospital.



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Children's Hospital of Philadelphia