A modified hybrid stage I procedure for treatment of hypoplastic left heart syndrome: an original surgical approach

Abstract

We present an original surgical approach--posterolateral thoracotomy--for hybrid stage I procedure. This is a review of prospectively collected data on patients treated for hypoplastic left heart syndrome (HLHS) using a hybrid approach (n=33) between December 2007 and March 2010. The hybrid approach includes pulmonary artery bands, a ductal stent through posterolateral thoracotomy access. Overall survival was 88.5%. Our original surgical approach in hybrid stage I on patients treated for HLHS can yield acceptable intermediate results that are comparable with a traditional Norwood strategy. Potential advantages of the lateral thoracotomy in the hybrid approach include the avoidance of median sternotomy, minimal postoperative pericardial adhesions, better access to patent ductus arteriosus (PDA) stenting, the possibility of visual and manual control of the stent position, and short operative time.

Early Outcomes of Hypoplastic Left Heart Syndrome Infants: Meta-Analysis of Studies Comparing the Hybrid and Norwood Procedures

“…High risk 1/10 -90% 90% Haponiuk et al 42 10 -4/10 ---Guleserian et al 43 24 High risk 7/24 2/17 --Kitahori et al 44 17 High risk 0/17 0/17 --Bockeria et al 45 33 -4/33 5/29 --Sasaki et al 46 12…”

Surgical correction of hypoplastic left heart syndrome: a new approach

“…A hybrid approach simplifies the surgery by maintaining the patent ductus arteriosus (DA) with a stent implantation (10,11) or through the prolonged use of prostaglandin E1 (12), associated with the banding of the pulmonary branches. However, the results of this approach have proven unsatisfactory (13,14).…”

A new technique for the correction of hypoplastic left heart syndrome

“…Hybrid approaches involving the maintenance of the patent ductus arteriosus with the implantation of a stent (10,11) or the prolonged administration of prostaglandin E1 (12) associated with the banding of the pulmonary branches simplifies the surgical approach but have yielded unsatisfactory results (13,14). …”