Abstract
Until the adoption of the hybrid approach, the management of neonates with hypoplastic left heart syndrome (HLHS) had always been frustrating in our hands. The classical Norwood or the Norwood-Sano operation had had prohibitive in-hospital mortality rates. Therefore, when the concept and the technique of the hybrid approach were introduced to our group in the mid-2000s by Drs. Cheatham, Galantowicz [1], and Schranz [2], the decision to embark on this strategy was made on necessity grounds. Nevertheless, our initial results with stage I were disappointing [3], which prompted the writing of two editorials [4, 5] in a scientific journal addressing the need to improve the whole infrastructure surrounding this procedure. Our learning curve was somewhat slow in the first 5 years due to a myriad of reasons including cultural resistance to changes, lack of trained human resources (both in the medical and nursing fields), use of limited X-ray equipment (C-arm), unavailability of a dedicated hybrid room, inappropriate follow-up, among others. Since our first case done in January 2005, our technique and, more importantly, the peri-operatory and interstage care evolved significantly resulting in better and reasonable in-hospital and follow-up outcomes. This chapter reports our current results with this approach emphasizing the modifications that occurred over years of practice and probably had a beneficial effect on overall results.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Galantowicz M, Cheatham JP. Lessons learned from the development of a new hybrid strategy for the management of hypoplastic left heart syndrome. Pediatr Cardiol. 2005;26(3):190–9.
Akintuerk H, Michel-Behnke I, Valeske K, Mueller M, Thul J, Bauer J, Hagel KJ, Kreuder J, Vogt P, Schranz D. Stenting of the arterial duct and banding of the pulmonary arteries: basis for combined Norwood stage I and II repair in hypoplastic left heart. Circulation. 2002;105(9):1099–103.
Pilla CB, Pedra CA, Nogueira AJ, Jatene M, Souza LC, Pedra SR, Ferreiro C, Ricachinevsky CP, Lucchese FA. Hybrid management for hypoplastic left heart syndrome : an experience from Brazil. Pediatr Cardiol. 2008;29(3):498–506.
Hijazi ZM. Hybrid therapy for hypoplastic left heart syndrome: reality check. Pediatr Cardiol. 2008;29(3):477–8.
Bacha E. Hybrid therapy for hypoplastic left heart syndrome: system-wide approach is vital. Pediatr Cardiol. 2008;29(3):479–80.
Caldarone CA, Benson LN, Holtby H, Van Arsdell GS. Main pulmonary artery to innominate artery shunt during hybrid palliation of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 2005;130(4):e1–2.
Naguib AN, Winch P, Schwartz L, Isaacs J, Rodeman R, Cheatham JP, Galantowicz M. Anesthetic management of the hybrid stage 1 procedure for hypoplastic left heart syndrome (HLHS). Paediatr Anaesth. 2010;20(1):38–46.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Pedra, C.A.C., Pedra, S.F., Jatene, M.B. (2016). The Brazilian Hybrid Approach for Hypoplastic Left Heart Syndrome. In: Butera, G., Cheatham, J., Pedra, C., Schranz, D., Tulzer, G. (eds) Fetal and Hybrid Procedures in Congenital Heart Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-40088-4_30
Download citation
DOI: https://doi.org/10.1007/978-3-319-40088-4_30
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-40086-0
Online ISBN: 978-3-319-40088-4
eBook Packages: MedicineMedicine (R0)