Background:
Till recently hypo plastic left heart syndrome ( HLHS) is considered the most congenital heart disease with very bad prognosis and outcome ,the results remain suboptimal for the traditional staged repair of these patients.
Utilizing surgical and transcatheter techniques, a hybrid strategy was developed to achieve the Fontan circulation.
Method & Result:
Total of 13 newborns underwent hybrid stage I for hypoplastic left heart syndrome ( HLHS) between May 2005 and Feb 2007,mean age is 11 days ( 6-24 D),mean weight is 3.1 kg ( 2.3-3.7 kg ), male : female ratio is 1.6:1,median hospital stay is 10 days ( 7-51 D), median ventilatory support is 4 days( 3-12 D),all except one need inotropic support for few days. Mortality is 23% .
7 patients achieved stage II , mean age is 7.9 mo ( 7-12 mo), mean weight is 6.7 kg (5.6-8.7 kg ), median ventilatory support is 11 days( 4-17 days), median hospital stay is 23 days ( 8-30 days).One patient Complicated with LPA occlusion needing LPA stent implantation . One death (14.3%). 6 patients are pending the stage III .
Conclusion:
Though small number and short experience , the result of hybrid approach in our center is good and comparable to other center and it can achieve acceptable short term outcomes in patient with HLHS .Therefore we recommend doing it and with improving learning curve we believe it will be considered as a replacement or an alternative to Norwood operation .