Bailout after failed biventricular management of critical aortic stenosis: another application of the hybrid approach.
The decision between a single-ventricle and biventricular strategy can be particularly difficult in patients with critical left ventricular outflow obstruction who have marginal left ventricular size or function. Overzealous pursuit of a biventricular strategy in borderline cases can lead to death or require conversion to a single-ventricle physiology at increased risk. We describe novel use of the hybrid approach as a bailout option for a patient with critical aortic stenosis who, despite balloon valvuloplasty, exhibited persistent severe left ventricular dysfunction. This approach provides a simple and effective pathway to treat patients with a failed biventricular circulation, at a considerably lower risk, while keeping all therapeutic options open.
Pizarro
Christian
C
Nemours Cardiac Center at the Alfred I. duPont Hospital for Children, Wilmington, Delaware 19899, USA. cpizarro@nemours.org
Bhat
Majeed A
MA
Derby
Christopher D
CD
Radtke
Wolfgang A
WA
D001021:Aortic Valve / Q000473:pathology; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging; D006332:Cardiomegaly / Q000000981:diagnostic imaging; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D011651:Pulmonary Artery / Q000601:surgery; D011859:Radiography; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications*; D015607:Stents; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000601:surgery*; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000601:surgery*