Abstract 17678: Earlier Stage I Operation in Neonates With Hypoplastic Left Heart Syndrome is Not Associated With Worse Short-term Outcomes

Introduction: We have previously reported that earlier stage I palliation (S1P) is protective against White Matter Injury (WMI) for term infants with hypoplastic left heart syndrome (HLHS). The present study compares clinical outcomes from the acute hospitalization between neonates who had early (≤ 4 days) versus late surgery (> 4 days). Hypothesis: Earlier S1P intervention is associated with greater post-operative complications rates. Methods: A retrospective chart review was performed on all neonates with HLHS or variants who underwent S1P at a single institution between 10/2008 - 03/2013. Excluded were a preterm (<37 weeks gestation), left-ventricle physiology, prior operations and international referral. Anthropometric data, pre- post- and intra-operative factors, post-operative complications, and both intensive care unit (ICU) and hospital length of stay were evaluated for differences between early vs. late surgery. Analysis was performed excluding patients who had either early, or late surgery for non-elective diagnoses. Results: A total of 145 infants, 114 (73 with early surgery, 41 late) met inclusion criteria. The mean day of surgery was 4.2 days (early 2.7±0.1 days, late 6.9±3.7 days). There were no significant differences between the groups’ post-operative complications or operative factors (see Table 1). In addition exclusion of patients with non-elective change to their surgical date did not change results significantly. Neonates who had earlier surgery had significantly longer post-operative ICU stay (median 9 days vs. median 13 days, p = 0.02). Conclusion: Early surgery for neonates with HLHS was not associated with either protection against or greater risk for post-operative complications. Neonates who have earlier surgery have a longer initial post-operative ICU stay, but total ICU and hospital stay was not different than that for infants with surgery after day four.