[One-stop hybrid cardiac surgery for neonates and young children with congenital heart disease].
OBJECTIVE
To summarize our 5 years experiences of one-stop hybrid procedure (OHP) for the management of congenital heart disease (CHD) in neonates and young children (< 2 years old).


METHODS
Clinical data derived from consecutive 152 young children and neonates with CHD underwent OHP between March 2004 to March 2009 were analyzed. Patients were divided into 3 groups: Balloon plasty group (n = 72), device closure group (n = 43) and collateral arteries occlusion group (n = 37). All procedures were image-guided and performed in a specially designed hybrid operation room. Incidence of major adverse cardiovascular events was obtained.


RESULTS
Patients received successful per-ventricular valvuloplasty or per-aortic balloon angioplasty in balloon plasty group. Two patients in this group with severe right ventricle outflow obstruction received regular open-heart outflow tract reconstruction immediately (n = 1) or selective conventional open-heart operation after discharge (n = 1). One neonate with pulmonary atresia with intact ventricular septum died from liver failure 6 month after OHP. In device closure group, device closure was failed in 3 cases (2 with atrial and 1 with ventricular septum defects), 1 young child with ventricular septum defects died from pneumonia after successful device closure. No device malposition was observed in device closure group during the follow-up. All patients received major collateral arteries occlusion and open-heart correction were discharged without complication.


CONCLUSIONS
OHP could avoid or shorten the application of cardiopulmonary bypass and reduce the surgical trauma in selected young children with CHD. Although OHP was feasible and safe, the image outfits, image-guided technology and OHP-related device should be further developed and improved for better procedure outcome.
Li
Shou-Jun
SJ
Center for Pediatric Cardiac Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Hu
Sheng-Shou
SS
Zhang
Hao
H
Shen
Xiang-Dong
XD
Yan
Jun
J
Wang
Xu
X
Xu
Zhong-Ying
ZY
Deng
Xi-Cheng
XC
Li
Yong-Qing
YQ
D002315:Cardiopulmonary Bypass; D013504:Cardiovascular Surgical Procedures / Q000379:methods* / Q000401:mortality; D002404:Catheterization; D006330:Heart Defects, Congenital / Q000601:surgery*; D006749:Hospital Design and Construction; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009873:Operating Rooms; D011183:Postoperative Complications; D025321:Surgery, Computer-Assisted