The effect of morphologic subtype on outcomes following the Sano-Norwood procedure

OBJECTIVES: Controversy exists concerning outcomes of patients with different morphologic subtypes of hypoplastic left heart syndrome undergoing the Norwood procedure, in particular, aortic atresia-mitral stenosis (AA-MS) patients receiving a systemic–pulmonary modified Blalock-Taussig (mBT) shunt. We sought to determine the influence of known risk factors and morphology on early survival in our cohort of Sano–Norwood patients with right ventricle–pulmonary artery (RV–PA) conduits as the source of pulmonary blood flow. METHODS: We studied early survival in patients with Sano-modified Norwood procedures from 2002 to 2010 and included both typical and atypical (including unbalanced atrioventricular canal defect) morphologic variants. We included a comparison group composed of classical Norwood patients with mBT shunts. RESULTS: Of 264 Sano–Norwood patients, 49 had AA-MS and 30 had atypical morphologies. Weight ≤2.5 kg was associated with a poorer 1-year survival (P = 0.0007), though ascending aorta (AscAo) size