The hypoplastic left heart complex: fetal predictors of growth and surgical repair

2020 ◽  
Author(s):  
K. Haberer ◽  
D. Fruitman ◽  
A. Power ◽  
L. K. Hornberger ◽  
L. Eckersley
Keyword(s):  
Surgical Repair ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Hypoplastic Left Heart Complex

scholarly journals Hypoplastic left heart complex.

1967 ◽  
Vol 4 (2) ◽  
pp. 83-87 ◽  
Author(s):  
E D Alberman ◽  
J M Fedrick ◽  
W H Schutt
Keyword(s):  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Hypoplastic Left Heart Complex

scholarly journals Growth of hypoplastic mitral valves in hypoplastic left heart complex and similar constellations after anatomical left superior vena cava correction

2020 ◽  
Vol 59 (1) ◽  
pp. 236-243
Author(s):  
Robert A Cesnjevar ◽  
Frank Harig ◽  
Moritz Dietz ◽  
Muhannad Alkassar ◽  
Wolfgang Waellisch ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Coronary Sinus ◽  
Superior Vena ◽  
Vena Cava ◽  
Innominate Vein ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Mitral Inflow ◽  
Z Scores ◽  
Hypoplastic Left Heart Complex

Abstract OBJECTIVES Left superior vena cava (LSVC)-related obstruction of mitral inflow is a rare finding in patients with complex cardiac anomalies like hypoplastic left heart complex. We report our experience by establishing a left superior to right superior caval vein continuity (innominate vein creation by direct LSVC–right superior vena cava end-to-side-anastomosis), and coronary sinus unroofing if indicated for LSVC-related mitral inflow obstruction. METHODS Nineteen patients (median age: 1.0 ± 0.3 years; range: 7 days–4.8 years) underwent anatomical correction of LSVC without the use of foreign material in conjunction with repair or palliation of congenital anomalies in a single centre between April 2015 and November 2019. Indications for the procedure were LSVC-related obstruction of left ventricular inflow due to a dilated coronary sinus. Additional procedures included mitral (n = 7) or atrioventricular (n = 3) valve surgery, right ventricular to pulmonary artery conduit (n = 3), first stage palliation (n = 3) or biventricular repair (n = 5) of hypoplastic left heart complex. Three patients needed secondary mitral valve replacement (n = 3). RESULTS All LSVC or coronary sinus-related obstructions were effectively relieved. No patient died early, 2 patients died late after the procedure. One patient needed stenting of the superior vena cava below the unobstructed cephalad vein anastomosis at the former right superior vena cava-cannulation-site. Follow-up was complete and demonstrated an 89.5% survival after 2.5 ± 0.4 years. Innominate vein patency was 100% documented by echocardiography (n = 19), cardiac catheterization (n = 6) or both. Mean mitral valve z-scores before the operation were −1.7 ± 0.2 (range −3.8 to 0.3) and increased to 0.7 ± 0.2 (range −0.7 to 1.9) after LSVC repair. CONCLUSIONS Anatomical correction by surgical creation of an innominate vein is an effective method to relieve LSVC-related obstructions and promotes mitral valvar growth. Mitral ring sizes were at least normalized after surgery at the time of discharge. Further prospective follow-up studies to evaluate the growth potential of left-sided heart structures by reporting cardiac z-scores are needed to evaluate the true impact of coronary sinus unroofing.

Comparability of Z-Score Equations of Cardiac Structures in Hypoplastic Left Heart Complex

2013 ◽  
Vol 26 (11) ◽  
pp. 1314-1321 ◽  
Author(s):  
Martijn H.T. den Dekker ◽  
Martijn G. Slieker ◽  
A. Christian Blank ◽  
Felix Haas ◽  
Matthias W. Freund
Keyword(s):  
Z Score ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Hypoplastic Left Heart Complex

Case report: duct dependency in hypoplastic left heart complex can be reversible without surgery

2020 ◽  
pp. 1-4
Author(s):  
Abdullah N. Alhuzaimi
Keyword(s):  
Case Report ◽  
Left Ventricle ◽  
Aortic Arch ◽  
Loading Condition ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Resource Limitations ◽  
Hypoplastic Left Heart Complex

Abstract We describe an infant with duct-dependent hypoplastic left heart complex with moderate hypoplasia of the left ventricle and aortic arch who was not operated due to resource limitations. The left-sided structures grew remarkably due to favourable loading condition changes of the left ventricle, allowing weaning from prostaglandin at the age of 3 months and discharging the patient without intervention.

Biventricular repair in patients with hypoplastic left heart complex

2007 ◽  
Vol 55 (S 1) ◽  
Author(s):  
S Daebritz ◽  
J Sachweh ◽  
A Tiete ◽  
R Sodian ◽  
D Rassoulian ◽  
...  
Keyword(s):  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Biventricular Repair ◽  
Hypoplastic Left Heart Complex

scholarly journals Follow-up after biventricular repair of the hypoplastic left heart complex

2019 ◽  
Author(s):  
Rinske J IJsselhof ◽  
Saniyé D R Duchateau ◽  
Rianne M Schouten ◽  
Matthias W Freund ◽  
Jörg Heuser ◽  
...  
Keyword(s):  
Growth Rate ◽  
Left Ventricular ◽  
Interquartile Range ◽  
First Year ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Biventricular Repair ◽  
Z Scores ◽  
Hypoplastic Left Heart Complex

Abstract OBJECTIVES In hypoplastic left heart complex patients, biventricular repair is preferred over staged-single ventricle palliation; however, there are too few studies to support either strategy. Therefore, we retrospectively characterized our patient cohort with hypoplastic left heart complex after biventricular repair to measure left-sided heart structures and assess our treatment strategy. METHODS Patients with hypoplastic left heart complex who had biventricular repair between 2004 and 2018 were retrospectively reviewed. Operative results were evaluated and echocardiographic mitral valve (MV) and aortic valve (AoV) dimensions, left ventricular length and left ventricular internal diastolic diameter (LVIDd) were measured preoperatively and during follow-up after 0.5, 1, 3, 5 and 10 years. RESULTS In 32 patients, the median age at surgery was 10 (interquartile range 5.0) days. The median follow-up was 6.19 (interquartile range 6.04) years. During the 10-year follow-up, the mean Z-scores increased from −2.82 to −1.49 and from −2.29 to 0.62 for MV and AoV, respectively. Analysis of variance results with post hoc paired t-tests showed that growth of left-sided heart structures was accelerated in the first year after repair, but was not equal, with the MV lagging behind the AoV (P = 0.033), resulting in significantly smaller MV Z-scores compared with AoV Z-scores at 10-year follow-up (P < 0.001). There were 2 (6%) early deaths. The major adverse events occurred in 4 (13%) patients. The surgical or catheter-based reintervention was required in 14 (44%) patients. CONCLUSIONS The growth rate of heart structures was most prominent during the first year after biventricular repair with lower growth rate of the MV compared with the AoV.

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