Key result
Hybrid palliation yields ~66% overall survival in hypoplastic left heart syndrome.
Why the study?
Hypoplastic left heart syndrome is a major cause of cardiac death in the first week of life and the hybrid approach is a treatment option whose efficacy, safety, and late outcomes require evaluation.
Cohort (n=9)
No
In a small, single-center prospective series, the hybrid approach for hypoplastic left heart syndrome yielded a 66% overall survival, suggesting it is a viable alternative to the Norwood strategy.
Answers are grounded in this paper and cite their sources.
Supports hybrid palliation feasibility in small HLHS series; leaves open comparative efficacy versus Norwood.
Hypoplastic left heart syndrome (HLHS) is a major cause of cardiac death during the first week of life. The hybrid approach is a reliable, reproducible treatment option for patients with HLHS. Herein we report our results using this approach, focusing on its efficacy, safety and late outcome. We reviewed prospectively collected data on patients treated for HLHS using a hybrid approach between July 2007 and September 2014. Nine patients had a stage 1 hybrid procedure, with seven undergoing a comprehensive stage 2 procedure. One patient completed the Fontan procedure. Five patients underwent balloon atrial septostomy after the hybrid procedure; in three patients, a stent was placed across the atrial septum. There were three deaths: two early after the hybrid procedure and one early after stage two palliation. Overall survival was 66%. In our single-center series, the hybrid approach for HLHS yields intermediate results comparable to those of the Norwood strategy. The existence of dedicated teams for the diagnosis and management of these patients, preferably in high-volume centers, is of major importance in this condition. A síndrome do coração esquerdo hipoplásico (SCEH) é uma das principais causas de morte durante a primeira semana de vida. A abordagem híbrida é uma opção de paliação para doentes com SCEH. Reportamos os nossos resultados com esta abordagem, com foco particular na sua eficácia, segurança e resultado final. Trabalho prospetivo. Revisão dos dados clínicos de doentes com SCEH, submetidos a abordagem híbrida de paliação entre julho de 2007 e setembro de 2014. Nove doentes foram submetidos a primeiro estadio híbrido de paliação. Destes, sete completaram segundo estadio e um doente foi submetido a cirurgia de Fontan. Cinco doentes foram submetidos a atriosseptostomia com balão. Em três procedeu-se a implantação de stent no septo interauricular. Verificaram-se três óbitos: dois logo após o primeiro estadio híbrido e um após o segundo estadio. A sobrevida global foi de 66%. Na nossa experiência, a abordagem híbrida para SCEH produz resultados comparáveis aos da estratégia de Norwood. A necessidade de uma equipa dedicada para o diagnóstico e manejo destes doentes, de preferência em centros de alto volume, é de grande importância nesta condição particular.
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Laranjo et al. (2015) conducted a cohort in Hypoplastic left heart syndrome (HLHS) (n=9). Hybrid approach for palliation was evaluated on Overall survival. The hybrid approach for palliation of hypoplastic left heart syndrome resulted in an overall survival of 66% among 9 treated patients.
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