Pre & Post Stage 1 Management with Aparna Hoskote, consultant in cardiac ICU at Great Ormond St Hospital London.

The time around the stage 1 procedure is the time of the highest mortality for single ventricle patients, up to 15%. What we do in the #pedsICU really matters for these patients but there is very little high quality evidence to inform our practice. Consequently, practice varies greatly around the world with things to learn from many great centers.

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Selected references

  1. Shekerdemian, L. Perioperative manipulation of the circulation in children with congenital heart disease. Heart 95, 1286 (2009).
  2. Barron, D. J. et al. Hypoplastic left heart syndrome. The Lancet 374, 551–564 (2009).
  3. Tabbutt, S. et al. Risk factors for hospital morbidity and mortality after the Norwood procedure: A report from the Pediatric Heart Network Single Ventricle Reconstruction trial. J Thorac Cardiovasc Surg 144, 882–895 (2012).
  4. Ghanayem, N. S. et al. Interstage mortality after the Norwood procedure: Results of the multicenter Single Ventricle Reconstruction trial. J Thorac Cardiovasc Surg 144, 896–906 (2012).
  5. Tabbutt, Ramamoorthy, S. & Chandra. Impact of inspired gas mixtures on preoperative infants with hypoplastic left heart syndrome during controlled ventilation. Circulation 104, I159-64 (2001).
  6. Alphonso, N. et al. Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: The European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Paediatric and Congenital Cardiology (AEPC) Hypoplastic Left Heart Syndrome Guidelines Task Force. European Journal of Cardio-Thoracic Surgery 58, 416–499 (2020).
  7. Ramamoorthy, C. et al. Effects of Inspired Hypoxic and Hypercapnic Gas Mixtures on Cerebral Oxygen Saturation in Neonates with Univentricular Heart Defects. Anesthesiology 96, 283–288 (2002).
  8. Ohye, R. G. et al. Comparison of shunt types in the Norwood procedure for single-ventricle lesions. New England Journal of Medicine 362, 1980–1992 (2010).

Season 2, Episode 7
Published: March 13, 2021
Run time: 1:18

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S2, Episode 5
The sick interstage single ventricle patient

The sick interstage single ventricle patient with Peta Alexander from Boston Children’s, Mike Clifford from Royal Children’s Melbourne & Greg Kelly from Sydney Children’s Hospital…

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