Too Many Achilles' Heels.

In this issue of The Annals of Thoracic Surgery, a multicenter study initiated by the National Pediatric Cardiology Quality Improvement Collaborative analyzed a large cohort of infants with hypoplastic left heart syndrome (HLHS), which included other variants, after stage 1 palliation. 1 Handler S.S. Chan T. Ghanayem N.S. et al. Impact of reintervention during stage 1 palliation hospitalization: a national, multicenter study. Ann Thorac Surg. 2023; 115: 975-982 Abstract Full Text Full Text PDF Scopus (1) Google Scholar The analysis included 1367 patients operated on at 69 different institutions. Interstage reinterventions were required in 339 patients, which represent nearly 25% of their entire patient population. Despite this cohort representing a more up-to-date picture of Norwood outcomes, reintervention and mortality rates remain persistently high, which is overall similar to previous publications. 2 Ohye R.G. Sleeper L.A. Mahony L. et al. Comparison of shunt types in the Norwood procedure for single-ventricle lesions. N Engl J Med. 2010; 362: 1980-1992 Crossref PubMed Scopus (704) Google Scholar ,3 Michalowksi A.K. Gauvreau K. Kaza A. et al. Technical performance score: a predictor of outcomes after the Norwood procedure. Ann Thorac Surg. 2021; 112: 1290-1297 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar Impact of Reintervention During Stage 1 Palliation Hospitalization: A National, Multicenter StudyThe Annals of Thoracic SurgeryVol. 115Issue 4PreviewStage 1 palliation (S1P) for hypoplastic left heart syndrome remains associated with high morbidity and mortality. Previous studies on burden of reinterventions did not include patients who remain hospitalized before stage 2 palliation (S2P). This study described the rate of reintervention during S1P hospitalization and sought to determine the impact of reintervention on outcomes. Full-Text PDF