Summary:
Hypoplastic left heart syndrome (HLHS)represents a lethal congenital heart disease,which used to be considered
inoperable.The improvement of results of cardiac surgery in neonates improved also the prognosis of patients with
this heart lesion.HLHS,however,continues to be an unresolved problem from ethical,psychological,social and
economical points of view.Opinions regarding the care for these patients depend on economical,political,cultural
and religious factors.Based on recent experience it is evident,that HLHS is an operable disease in a child,who
without surgery would otherwise die.Approximately 40%of patients with HLHS can live 15 years after surgery.
The long-term prognosis remains,however,unclear.Because of the need of demanding care for a patient with HLHS,
it is necessary to see also the quality of life and hear the opinion of parents.Psychomotor development and the quality
of life may be altered by complications.An individualized approach in fetuses and neonates with HLHS on the basis
of prenatal diagnosis,analysis of risk factors,provision of detailed informations to parents and indications for surgery
in neonates having chance for an acceptable result is considered to be the most acceptable solution.In the future it
will be necessary to concentrate the research on prenatal diagnostics,treatment and postoperative follow-up including
psychomotor development and quality of life.In the preparation of legislative,which would reflect more sensitively
the contemporary possibilities of medicine and at the same time regard the problems of health care organization,as
well as social and economic aspects,narrow interdisciplinary cooperation will be required.
Key words:
circulation,heart,congenital heart disease,hypoplastic left heart syndrome,surgical treatment,ethics,
psychology,legislative.
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