Improving the outcome of high-risk neonates with hypoplastic left heart syndrome: hybrid procedure or conventional surgical palliation?
Despite significant progress, surgical outcome for high-risk patients with hypoplastic left heart syndrome (HLHS) remain suboptimal. The hybrid palliation lessens the initial operative insult and is expected to improve overall survival; however the outcome of this management sequence is unknown. Retrospective review of all high-risk neonates (prematurity, low birth weight, associated genetic or co-morbid conditions) undergoing initial palliation for HLHS either by hybrid or Stage I Norwood procedure at a single institution between January 2001 and December 2006. The two strategies were compared using survival after stage II as the end-point for outcome. The cohort included 33 patients (14 hybrid and 19 Norwood) with a mean age of 3.8+/-2.4 days, weight of 2.6+/-0.6 kg and Aristotle comprehensive score of 18.7+/-2.5. Aortic atresia was present in 5/14 hybrid and 12/19 Norwood patients. The mean gestational age was 36.8+/-2.2 weeks, six patients were under 36 weeks in each group. Patients undergoing hybrid palliation had a lower preoperative pH [7.14+/-0.2 vs 7.25+/-0.05, p=0.04], higher incidence of organ dysfunction [9/14 (64%) vs 5/19 (26%), p=0.03] and less associated cardiac anomalies [3/13 (21%) vs 13/19 (68%), p=0.009]. Ho...Continue Reading
Comparison of gastrointestinal morbidity after Norwood and hybrid palliation for complex heart defects
Hypoplastic left heart syndrome and aortic atresia-mitral stenosis variant: role of myocardial protection strategy and impact of ventriculo-coronary connections after stage I palliation
The effect of intraoperative hypotension on the outcomes of initial hybrid palliation for single ventricle congenital heart disease: an historical cohort study
Is "treat your child normally" helpful advice for parents of survivors of treatment of hypoplastic left heart syndrome?
Hybrid approach for hypoplastic left heart syndrome and its variants: the fate of the pulmonary arteries
Is routine rapid-staged bilateral pulmonary artery banding before stage 1 Norwood a viable strategy?
Hybrid versus Norwood procedure for hypoplastic left heart syndrome: contemporary series from a single center
Bilateral pulmonary arterial banding results in an increased need for subsequent pulmonary artery interventions
Impaired cerebral perfusion after bilateral pulmonary arterial banding in patients with hypoplastic left heart syndrome
Hybrid stage I palliation for hypoplastic left heart syndrome has no advantage on ventricular energetics: a theoretical analysis
Mitral stenosis and aortic atresia in hypoplastic left heart syndrome: survival analysis after stage I palliation
Precise evaluation of bilateral pulmonary artery banding for initial palliation in high-risk hypoplastic left heart syndrome
Use of a pressure guidewire to assess pulmonary artery band adequacy in the hybrid stage I procedure for high-risk neonates with hypoplastic left heart syndrome and variants
Interstage weight gain for patients with hypoplastic left heart syndrome undergoing the hybrid procedure
Evaluation of bilateral pulmonary artery banding for initial palliation in single-ventricle neonates and infants: risk factors for mortality before the bidirectional Glenn procedure
Improving early outcomes following hybrid procedure for patients with single ventricle and systemic outflow obstruction: defining risk factors†
The hybrid approach for palliation of hypoplastic left heart syndrome: Intermediate results of a single-center experience
Bilateral pulmonary artery banding for resuscitation in high-risk, single-ventricle neonates and infants: a single-center experience
Stage 1 hybrid palliation for hypoplastic left heart syndrome--assessment of contemporary patterns of use: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database
Hybrid palliation for critical systemic outflow obstruction: neither rapid stage 1 Norwood nor comprehensive stage 2 mitigate consequences of early risk factors
Extracorporeal Membrane Oxygenation Outcomes After the Comprehensive Stage II Procedure in Patients With Single Ventricles
Ventricular function and vascular dimensions after Norwood and hybrid palliation of hypoplastic left heart syndrome
Preoperative pulmonary hemodynamics and assessment of operability: is there a pulmonary vascular resistance that precludes cardiac operation?
Comment on hybrid stage I management in: Anesthesia for high-risk procedures in the catheterization laboratory, an educational review by Daaboul DG, DiNardo J, and Nasr V
Anesthesia for bilateral pulmonary banding as part of hybrid stage I approach palliating neonates with hypoplastic left heart syndrome.
Guidelines for the management of neonates and infants with hypoplastic left heart syndrome: The European Association for Cardio-Thoracic Surgery (EACTS) and the Association for European Paediatric and Congenital Cardiology (AEPC) Hypoplastic Left Heart Syndrome Guidelines Task Force.
Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.