Individualized approach in the management of patients with hypoplastic left heart syndrome (HLHS).
Individualized approach in the management of patients with hypoplastic left heart syndrome (HLHS).
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DOI：
10.1053/j.pcsu.2013.01.001
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
E. Bacha
中科院分区：
文献类型：
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作者：
E. Bacha
在过去的十年中，“经典的”第一阶段姑息治疗（诺伍德/BT分流术）的新变化出现了，并通过了医学界的审查。“一刀切”的做法可能不再足够。在这篇综述中，从患者的初始解剖和生理学的角度对各种姑息性选择（诺伍德/BT分流术、诺伍德/RV-PA导管、混合I期（有或无导管支架植入术）、心脏移植）的最佳适应症进行了综述，以指导临床管理。还尽可能客观地审查了对决策有用的现有知识。
Over the past decade new variations on the "classic" first stage palliation (the Norwood/BT shunt) for patients with Hypoplastic Left Heart Syndrome have emerged and been vetted by the medical community. A "one size fits all" approach may not be adequate anymore. In this review, the optimal indications for the various palliative options (Norwood/BT shunt, Norwood/RV-PA conduit, Hybrid Stage I with or without ductal stenting, heart transplantation) are reviewed from a standpoint of the initial anatomy and physiology of the patient, letting it guide clinical management. Current knowledge useful for decision-making is also reviewed as objectively as possible.