Hypoplastic left heart: a practical guide

The past decade has witnessed remarkable progress in the treatment of children born with a hypoplastic left heart. Compared with a mortality rate of more than 95% at 1 month of age before surgical intervention was possible, there is currently a survival rate of almost 60% at 5 years of age for all newborns with this condition who undergo the Norwood operation, and for newborns given heart transplantations. The current survival rate for all infants suffering from hypoplastic left heart syndrome and given heart transplantation is almost 80% at the age of 5 years. Uncertainty pertaining to the long-term outlook still exists, however. Many families and physicians continue to exercise the option of no treatment. These ethical issues will continue to be argued until the results of palliative reconstructive surgery or cardiac transplantation attain a level of success achieved for other neonatal cardiac operations.