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Survival Analysis: Outcome of Prenatal versus Postnatal Diagnosis of Hypoplastic Left Heart Syndrome

Abdullah Alabdulgader

Introduction: Diagnosis of congenital heart diseases including Hypoplastic Left Heart Syndrome (HLHS) in prenatal becomes a routine practice. It allows better preoperative management and offer opportunity to parents and physicians to intervene earlier. We described differences in survival outcome for patients diagnosed prenatally or postnatally with HLHS in and who had surgical intervention study area. Methods: Survival analysis using Kaplan-Meier product limit method was performed to estimated probability of survival for 88 patients diagnosed with HLHS and surgical intervention. The primary outcome measures were 12 months survival after birth and after surgical intervention. Results: Overall one year survival for HLHS patients was 63%. There was difference in survival between the two study groups (65% vs. 60%) for postnatal and prenatal diagnosis of HLHS respectively. This difference was not statistically significant (P=0.4). On the other hand, there was variation in survival according to intervention (80% vs. 0%) for patient who underwent surgery and those who declined surgery correspondingly. The difference was statistically significant (P<0.0001). However, there was no statistically significant difference in survival between prenatal and postnatal diagnosis of HLHS after surgery (67% vs. 63%; P=0.7%) respectively. Conclusion: In this study surgical intervention increases survival for patients diagnosed with HLHS, but there was significant difference in survival between prenatal or postnatal diagnosis of HLHS. Further studies of large sample size are prerequisite to investigate survival outcomes in Hypoplastic Left Heart Syndrome.