Risk-stratified approach to hybrid transcatheter-surgical palliation of hypoplastic left heart syndrome

D. S. Lim, B. B. Peeler, G. P. Matherne, I. L. Kron, H. P. Gutgesell

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

We prospectively employed a risk-stratified approach to first-stage palliation of hypoplastic left heart syndrome. High-risk features included severe tricuspid insufficiency, severe right ventricular dysfunction, a severely restrictive or intact atrial septum, an ascending aortic diameter ≤ 2 mm, late presentation, weight < 2 kg, or significant extracardiac issues, Infants without high-risk features underwent a Norwood procedure (with Sano modification), whereas infants with high-risk features underwent a hybrid procedure consisting of bilateral pulmonary artery banding, ductal stenting, and atrial septostomy or a Norwood/Sano. Operative survival for 10 infants without high-risk features undergoing a Norwood/Sano procedure was 90%. Operative survival for 5 infants with high-risk features undergoing hybrid palliation was 100%, compared to 29% in 7 infants with high-risk features undergoing the Norwood/Sano procedure. Although only short-term data are available, this hybrid palliative procedure may have a role for infants with hypoplastic left heart syndrome and high-risk features.

Original languageEnglish (US)
Pages (from-to)91-95
Number of pages5
JournalPediatric Cardiology
Volume27
Issue number1
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

Keywords

  • Hybrid palliation
  • Hypoplastic left heart syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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