Assessment of B-Natriuretic Peptide Levels After Stage 1 Palliation in Hypoplastic Left Heart Syndrome Patients

We describe the perioperative BNP trends in patients with HLHS from S1P until interstage discharge to home, death, or S2P. This prospective cohort study includes all newborns with hypoplastic left heart syndrome (HLHS) who underwent Norwood procedures (S1P) at Texas Children’s Hospital from April 2018 through April 2019. Our study included 19 newborns with HLHS. There was no interstage mortality; 47% were discharged home prior to the S2P procedure. Nine patients (50%) had higher BNP levels immediately after arrival to the cardiac intensive care unit (ICU) after S1P compared to preoperative levels. BNP levels were higher in those with a shorter duration of mechanical intubation (P = 0.02) and those with moderately depressed right ventricular systolic function in the immediate postoperative period (P = 0.02). RVPAs patients had higher BNP levels (median 3357 pg/mL) than mBTTs (median 2862 pg/mL), that was not statistically significant (P = 0.4). Despite higher BNP levels in RVPAs in the early postoperative period, these subjects had shorter mechanical ventilation, ICU, and hospital length of stay duration. BNP trends for HLHS patients vary in the postoperative period after S1P. RVPAs had higher BNP levels than mBTTs in the early postoperative period after S1P; however, this was not associated with worse outcomes.