New Therapeutic Avenues with Hybrid Pediatric Cardiac Surgery

• DOI: 10.1532/hsf.804
• Publication Date: 2015-03-29T07:03:38Z
• Authors: Emile A. Bacha; Ziyad M. Hijazi; Qi-Ling Cao; Joanne P. Starr; David Waight; Peter Koenig; Brojandra Agarwala
• Keywords: Ventricular outflow tract; Balloon dilation; Concomitant

Abstract Background: Minimally invasive strategies can be expanded by combining standard surgical and interventional techniques. Methods: A longitudinal prospective study was conducted of all pediatric patients who have undergone hybrid cardiac surgery at the University Chicago Children's Hospital. Hybrid defined as combined catheter-based interventions in either one setting or planned sequential settings within a 24-hour period. Results: Between June 2000 2003, 24 were treated with approaches. Sixteen muscular ventricular septal defects (VSDs)with mean age 4 months (range, 2 weeks to years) underwent Amplatzer device closure catheterization laboratory followed completion (group 1A [n = 9]: right (RV)outflow tract enlargement, 6 patients; other VSDs, 5 tricuspid valvuloplasty, 3 bidirectional Glenn shunt, 1 patient; Maze procedure, retrieval embolized device, patient) or, more recently, 1-stage intraoperative off-pump 1B;n =7)with subsequent repair concomitant heart lesions (double-outlet RV, arch hypoplasia/coarctation aorta, pulmonary artery (PA) debanding, patient). Cardioplegic arrest avoided shortened VSD patients. Eight branch PA stenoses 2)underwent stenting stent balloon dilation along RV outflow procedure (5 patients)or Fontan (3 mitral Damus-Kaye-Stansel patient each). All survived hospitalization. Complications from approach group included regurgitation patients, disk malposition patient, embolization into aorta residual patient. No complications occurred 1B rupture overinflation dysfunction each 2. During follow-up period 18 2-36 months), died suddenly several after discharge. are doing well. Conclusions: performed tandem surgeons cardiologists is safe effective means reducing eliminating cardiopulmonary bypass. Patients VSDs small, poor vascular access, currently perventricular approach.