Hypoplastic left heart syndrome and valvular pulmonary stenosis. A rare association that limits the management options.

A term baby had cyanosis 2 hours after delivery; echocardiography showed hypoplastic left heart syndrome HLHS and valvular pulmonary stenosis PS. The opinions of the cardiac centers in Saudi Arabia were taken; however, the baby was not accepted probably because the associated PS made him a poor candidate for a Norwood procedure and because cardiac transplant is not available for infants in Saudi Arabia. He died after 15 days. This mother should have fetal echocardiography in future pregnancies, and if HLHS is suspected she might be advised to seek medical advice antenatally at highly specialized cardiac centers abroad, as delivery there may increase the chance of surgical intervention.