title: Hybrid approaches to complex congenital cardiac surgery.
abstract: OBJECTIVE
  A hybrid operation is a joint procedure involving the interventional cardiologist and the cardiac surgeon concomitantly to optimise surgical management. The aim of our study was to demonstrate the conceptual development and the feasibility of a hybrid approach to complex congenital cardiac surgery.
  
  
  METHODS
  Descriptive study of two different indications for concomitant intervention by the cardiologist and the cardiac surgeon. Seven patients with complex congenital heart defects requiring high risk operative interventions were included in the study. The indications were: (1) intraoperative stenting of a pulmonary artery stenosis with concomitant additional surgical procedures (n=4). (2) Balloon occlusion of Blalock-Taussig shunts or major aorto-pulmonary collateral artery to control pulmonary blood flow during surgical repair (n=3).
  
  
  RESULTS
  All patients had successful hybrid procedures. There were no important complications related to the temporal proximity of the interventional procedure and cardiac surgery, the latter being significantly facilitated by the former.
  
  
  CONCLUSIONS
  Intraoperative stenting of pulmonary artery stenosis with additional surgical repair and balloon occlusion on cardiopulmonary bypass can be performed safely and may be complementary in patients with complex lesions by providing a better result in combination than either alone can offer.
authors.affiliation: Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, WC1N 3JH London, UK.
authors.forename: V E
authors.initials: VE
authors.lastname: Hjortdal
authors.forename: A N
authors.initials: AN
authors.lastname: Redington
authors.forename: M R
authors.initials: MR
authors.lastname: de Leval
authors.forename: V T
authors.initials: VT
authors.lastname: Tsang
mesh_terms: D000293:Adolescent; D000328:Adult; D021721:Balloon Occlusion / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass; D002404:Catheterization / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D011666:Pulmonary Valve Stenosis / Q000628:therapy; D012086:Reoperation / Q000379:methods; D015607:Stents