抄録
Seven infants with hypoplastic left heart syndorome underwent palliative surgery of the original Norwood stage 1 operation in 4 babies, Doty's method in one, and the modified Norwood stage 1 in two. Only a 14-day-old baby survived the modified Norwood operation. All patients required prostaglandin El infusion, all but one also required catecholamine support, and five needed ventilatory support, preoperatively. Causes of death were myocardial damage in five, residual coarctation of the aorta or acquired stenosis of the new aorta (stenosis of the new outflow tract to the systemic circulation) in four, bleeding in two, high pulmonary blood flow in one and sepsis in one. Operation was neccesary within 5 days of life in 3 babies with closing foramen ovale who did not survive. Analysis of the experiences suggest that adequ-ate relief of the coarctation of the aorta, reconstruction of non-stennotic outflow tract to the systemic circulation, adequate size of the shunt, and good myocardial protection might be mandatory to obtain good outcome.
