Molfetta AD et al. – The study described the evolution of ventricular energetics parameters in patients with hyperplastic left heart syndrome (HLHS) during different stages of palliation including the hybrid, the Norwood, the bidirectional Glenn (BDG), and the Fontan procedures. The authors concluded that ventricular energetic parameters can help in a more comprehensive evaluation of these complex patients for understanding their adaptation to different pathophysiological conditions in a better way.

Methods

• A retrospective clinical study comprising of 29 patients with HLHS undergoing cardiac catheterisation following hybrid (n = 7), Norwood (n = 6), Glenn (n = 8), or Fontan (n = 8) procedures.

Results

• Ventricular volumes were significantly higher in the Norwood circulation compared with hybrid circulation, with gradual decrease passing from the first stage to the Fontan completion.
• On the other hand, ventricular elastances were lower in the Norwood circulation compared with hybrid circulation and gradually increased passing from first stage to the Fontan completion.
• Arterial elastance and Rtot increased in the Fontan circulation, a progressive increase of ventricular work was reported and finally ventricular efficiency was shown to improve passing from first to the last stage of palliation.