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  Vol. 162 No. 9, September 2008 TABLE OF CONTENTS
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The Paradigm Shift Toward Surgical Intervention for Neonates With Hypoplastic Left Heart Syndrome

Gil Wernovsky, MD

Arch Pediatr Adolesc Med. 2008;162(9):849-854.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Should nonintervention (or what some physicians call comfort care) be offered as an option to parents of neonates with hypoplastic left heart syndrome (HLHS)? While this may have been a reasonable choice 2 decades ago, I will argue that—for 2 primary reasons having to do with improvements in outcomes over time and by comparing HLHS with other life-threatening pediatric conditions—nonintervention should no longer be offered.

Let me state up front that I have come to these opinions through working at 2 large tertiary care, academic medical centers during the past 20 years. Both of these centers have been and still very much are strong advocates for intervention in children with high-risk, complex congenital heart disease (CHD). These centers have cared for many children whose families specifically traveled there for these high-risk interventions. My opinions undoubtedly reflect that bias and experience. My practice and research have focused . . . [Full Text of this Article]

GOOD COUNSELING BEGINS WITH GOOD DATA


COMPARISON WITH OTHER DISEASES

WHO SHOULD COUNSEL PARENTS AND HOW?

A PARADIGM SHIFT

AUTHOR INFORMATION


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RELATED ARTICLES

Healthcare Providers Must Offer Palliative Treatment to Parents of Neonates With Hypoplastic Left Heart Syndrome
Alexander A. Kon
Arch Pediatr Adolesc Med. 2008;162(9):844-848.
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Ethics in the Midst of Therapeutic Evolution
Chris Feudtner
Arch Pediatr Adolesc Med. 2008;162(9):854-857.
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