Hybrid palliation in hypoplastic left heart syndrome.

Abstract:

PURPOSE OF REVIEW:Despite progressive improvement in surgical results, hypoplastic left heart syndrome remains one of the congenital heart abnormalities with the greatest morbidity and mortality. Hybrid approaches to management, combining surgical and interventional catheterization procedures, have been introduced to minimize exposure to cardiopulmonary bypass, and improve outcomes for these high-risk infants. RECENT FINDINGS:First-stage palliation of hypoplastic left heart syndrome has been performed as a hybrid procedure combining surgical pulmonary artery banding with catheterization stenting of the ductus arteriosus and balloon atrial septostomy, especially in high-risk patients. Additionally, several centers have performed second-stage palliation - bidirectional Glenn or hemi-Fontan procedures - in a manner that allows the subsequent 'Fontan' procedure to be completed in the catheterization laboratory with a covered stent. SUMMARY:These innovative procedures offer the potential of an alternative management strategy for hypoplastic left heart syndrome. They have been applied to a very limited number of patients and long-term results are not available. Their role in management of hypoplastic left heart syndrome remains to be defined, especially as results of conventional surgical management continue to improve.

journal_name

Curr Opin Cardiol

authors

Gutgesell HP,Lim DS

doi

10.1097/HCO.0b013e328014d945

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

55-9

issue

2

eissn

0268-4705

issn

1531-7080

pii

00001573-200703000-00002

journal_volume

22

pub_type

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