Jan 6 (HeartCenterOnline) - A ventricular assist device may improve the outcome for infants who have had the Norwood procedure, an operation to correct a severe heart defect called hypoplastic left heart syndrome (HLHS).

Although the Norwood procedure has given hope to many infants born with HLHS, the survival rate is not consistent among centers where the procedure is performed. Furthermore, survivors of the procedure have shown a higher incidence of mental difficulties, including mental retardation, cerebral palsy and learning disabilities.

HLHS is the name for a heart defect in which the left side of the heart is severely malformed and unable to pump oxygen-rich blood to the rest of the body. The Norwood procedure re-routes the blood flow around some of the defective areas of the heart by creating new pathways for blood circulation to and from the lungs.

Infants placed on a ventricular assist device following the procedure fared better following surgery, according to a report published in the January issue of the The Annals of Thoracic Surgery. The report noted that the use of the device can lead to excellent hospital survival and possibly improve circulation of blood to the brain, which may reduce the incidence of brain injury.

A ventricular assist device, or VAD, helps the heart circulate oxygen-rich blood throughout the body. A VAD assists the heart; it does not replace it. VADs are often used to help people survive as they wait for a heart transplant or those with heart failure.

The report's authors note that the routine use of VAD following a Norwood procedure is "not a panacea." Of the 18 infants in which the VAD was used, two died from complications and others tended to have somewhat longer stays in the intensive care unit.

However, the use of a VAD following Norwood appeared to improve survival rates and reduce the incidence of brain injury. Followup studies are being conducted to confirm that a VAD can protect the brain during recovery.

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