Hybrid approaches to complex congenital cardiac surgery

Objectives: A hybrid operation is a joint procedure involving the interventional cardiologist and the cardiac surgeon concomitantly to optimise surgical management. The aim of our study was to demonstrate the conceptual development and the feasibility of a hybrid approach to complex congenital cardi...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2002-12, Vol.22 (6), p.885-890
Main Authors: Hjortdal, V.E., Redington, A.N., de Leval, M.R., Tsang, V.T.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Balloon Occlusion - methods
Biological and medical sciences
Cardiac Surgical Procedures - methods
Cardiology. Vascular system
Cardiopulmonary Bypass
Catheterisation
Catheterization - methods
Child
Child, Preschool
Combined Modality Therapy
Complex congenital heart defects
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Feasibility Studies
Female
Heart
Heart Defects, Congenital - surgery
Heart Defects, Congenital - therapy
Humans
Hybrid
Intraoperative Care - methods
Male
Medical sciences
Pulmonary Valve Stenosis - therapy
Reoperation - methods
Stents
Surgery
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Summary:Objectives: A hybrid operation is a joint procedure involving the interventional cardiologist and the cardiac surgeon concomitantly to optimise surgical management. The aim of our study was to demonstrate the conceptual development and the feasibility of a hybrid approach to complex congenital cardiac surgery. Methods: Descriptive study of two different indications for concomitant intervention by the cardiologist and the cardiac surgeon. Seven patients with complex congenital heart defects requiring high risk operative interventions were included in the study. The indications were: (1) intraoperative stenting of a pulmonary artery stenosis with concomitant additional surgical procedures (n=4). (2) Balloon occlusion of Blalock-Taussig shunts or major aorto-pulmonary collateral artery to control pulmonary blood flow during surgical repair (n=3). Results: All patients had successful hybrid procedures. There were no important complications related to the temporal proximity of the interventional procedure and cardiac surgery, the latter being significantly facilitated by the former. Conclusions: Intraoperative stenting of pulmonary artery stenosis with additional surgical repair and balloon occlusion on cardiopulmonary bypass can be performed safely and may be complementary in patients with complex lesions by providing a better result in combination than either alone can offer.
ISSN:1010-7940
1873-734X
DOI:10.1016/S1010-7940(02)00586-9