Stage II Reconstruction After Hybrid Palliation for High-Risk Patients With a Single Ventricle

Intraoperative pulmonary flow study for decision making in the comprehensive stage II hybrid procedure

“…An incorrect decision to perform BSCC can result in elevated superior vena caval pressure, cyanosis, and the need for BSCC takedown. 2,6 On the other hand, an incorrect decision to use a systemic-pulmonary shunt results in ongoing parallel circulation with volume loading of the ventricle, pressure-dependent pulmonary flow, and potential hemodynamic instability that can follow a stage I Norwood procedure. In one recent report, the only 2 hospital deaths after the stage II hybrid procedure involved BSCC takedown.…”

Heart Transplantation for Congenital Heart Disease in the First Year of Life

“…This approach has received considerable attention in Columbus, Ohio [23] and among a few other centers with hybrid laboratories which are designed to permit simultaneous high-resolution imaging, cardiac catheterization, and cardiac surgery [24, 25]. While the approach has produced reasonable outcomes, it has been slow to “catch-on,” perhaps because it requires careful patient selection and considerable operator experience to compete with outcomes following the now “standard” stage-one Norwood procedure.…”

Comparison of in-hospital and longer-term outcomes of hybrid and Norwood stage 1 palliation of hypoplastic left heart syndrome

“…16 Over the last few years, numerous single-center studies have shown success of the hybrid approach for HLHS in short-term hospital-based outcomes. 17 In Giessen, Germany, 18 58 newborns underwent ductal stenting and bilateral pulmonary artery banding between 1998 and 2006. The 30-day mortality rate for combined ductal stent placement and bilateral pulmonary artery banding was 3.4%.…”