Hybrid Palliation for Ductal-Dependent Systemic Circulation

Pediatr Cardiol. 2016 Jun;37(5):868-77. doi: 10.1007/s00246-016-1361-3. Epub 2016 Mar 1.

Abstract

We reviewed our hybrid palliation experience for 91 neonates, with ductal-dependent systemic circulation, born between August 2007 and October 2015. For analysis, we stratified the 91 patients by a risk factor (RF) score and divided them into three groups: (1) high-risk two-functional ventricles (2V) median RF score of 3 (N = 20); (2) low-risk one-functional ventricle (1V) RF score 0-1 (N = 32); and (3) high-risk 1V RF score ≥2 (N = 39). Midterm survival (median 4 years) by group was: (1) 95 %, (2) 91 %, and (3) 15 %, (p = 0.001). In conclusion, hybrid palliation was associated with excellent midterm results for high-risk 2V and low-risk 1V patients with ductal-dependent systemic circulation. In contrast, high-risk 1V patients had significantly worse outcomes.

Keywords: Ductal-dependent systemic circulation; Hybrid procedure; Hypoplastic aortic arch; Hypoplastic left heart syndrome.

MeSH terms

  • Blood Circulation
  • Heart Ventricles
  • Humans
  • Hypoplastic Left Heart Syndrome
  • Palliative Care*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome