Survival analysis and risk factors for mortality in transplantation and staged surgery for hypoplastic left heart syndrome
Pamela C. Jenkins, MD, PhD*,
Michael F. Flanagan, MD, FACC*,
Kathy J. Jenkins, MD, MPH ,
James D. Sargent, MD*,
Charles E. Canter, MD, FACC ,
Richard E. Chinnock, MD ,
Robert N. Vincent, MD, FACC||,
Anna N. A. Tosteson, ScD¶ and
Gerald T. O’Connor, PhD, DSc, FACC¶
* Department of Pediatrics, Dartmouth Medical School, Hanover, New Hampshire, USA
Department of Cardiology, Children’s Hospital, Boston, Massachusetts, USA
Department of Cardiology, St. Louis Children’s Hospital, St. Louis, Missouri, USA
Department of Cardiology, Loma Linda University Children’s Hospital, Loma Linda, California, USA
|| Department of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
¶ Departments of Medicine and Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire, USA
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Figure 1 Distribution of 242 patients with HLHS who met entry criteria.
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Figure 2 Survival curves for transplantation and staged surgery. Unadjusted survival curves.
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Figure 3 The timing of mortality in each strategy. The difference in mortality is significant for preoperative, one-year and five-year mortality: *p < 0.001, p < 0.01.
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Figure 4 Comparison of one-year mortality rates by valvar atresia. Transplantation had a lower mortality for atresia of one or both left-sided valves than staged surgery does; differences are significant at the p < 0.05 level.
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Figure 5 Relative contribution of each risk factor to the explained one-year mortality risk. This pie graph shows that the increased mortality encountered with aortic and mitral atresia in staged surgery accounts for >50% of the explained mortality risk in patients with HLHS.
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