Contemporary results and current strategies in the management of hypoplastic left heart syndrome.

The treatment of hypoplastic left heart syndrome (HLHS) is clearly evolving. Over the last few years, the standard surgical approach has been modified by the application of the right ventricle to pulmonary artery conduit and regional perfusion techniques. Even more radical conceptual changes are now occurring. New treatment paradigms, such as the "hybrid" procedure, are dramatically altering the approach to treatment, whereas fetal intervention aims to impact the developmental biology responsible for hypoplastic left heart syndrome. This institutional review presents contemporary surgical results from Children's Hospital Boston between 2001 and 2006. An overview for stage 1 palliation will be presented, as well as the outcomes obtained from the initial experience with these new treatment schemes.