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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Corno, Antonio Francesco 2015. “Functionally” Univentricular Hearts: Impact of Pre-Natal Diagnosis. Frontiers in Pediatrics, Vol. 3,

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    Mavroudis, Constantine Mavroudis, Constantine D. Jacobs, Jeffrey P. Siegel, Allison Pasquali, Sara K. Hill, Kevin D. and Jacobs, Marshall L. 2014. Procedure-Based Complications to Guide Informed Consent: Analysis of Society of Thoracic Surgeons-Congenital Heart Surgery Database. The Annals of Thoracic Surgery, Vol. 97, Issue. 5, p. 1838.

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    Isaacs, David and Kilham, Henry A 2013. Ethical issues in hypoplastic left heart syndrome. Journal of Paediatrics and Child Health, Vol. 49, Issue. 10, p. 873.

    Mavroudis, Constantine Mavroudis, Constantine D. Green, Jeanette Sade, Robert M. Jacobs, Jeffrey P. and Kodish, Eric 2012. Ethical considerations for post-cardiotomy extracorporeal membrane oxygenation. Cardiology in the Young, Vol. 22, Issue. 06, p. 780.


Informed consent, bioethical equipoise, and hypoplastic left heart syndrome

  • Constantine Mavroudis (a1) (a2), Constantine D. Mavroudis (a3), Ruth M. Farrell (a2), Marshall L. Jacobs (a1), Jeffrey P. Jacobs (a4) and Eric D. Kodish (a2)
  • DOI:
  • Published online: 13 December 2011

In utero diagnosis of complex progressive cardiac disease such as hypoplastic left heart syndrome presents a novel opportunity for antepartum, intrapartum, and neonatal management. The clinical possibilities and potential for differing outcomes challenge the mother–foetus dyad with regard to informed consent. Previous studies reveal that rates of termination of pregnancy for foetuses with hypoplastic left heart syndrome vary widely in the United States and Europe, leading us to surmise that informed consent may be practised differently. The purpose of this paper is to review the ethical considerations and physician responsibilities of informed consent as they relate to prenatal and postnatal patients with hypoplastic left heart syndrome. Special consideration is paid to the informed consent process as practised by the obstetrician, perinatologist, paediatric cardiologist, and paediatric cardiac surgeon as it relates to termination of pregnancy, comfort care, and surgical palliation. We will argue that informed consent as it relates to hypoplastic left heart syndrome is far from standardised and that there exists a state of bioethical equipoise concerning the extent and limits of its application in the current clinical setting.

Corresponding author
Correspondence to: Dr C. Mavroudis, MD, Department of Pediatric and Adult Congenital Heart Surgery, Cleveland Clinic Children's Hospital, 9500 Euclid Avenue/M41-02, Cleveland, Ohio 44195, United States of America. Tel: +1 216 636 5288; Fax: +1 216 636 5859; E-mail:
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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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