title: Extracorporeal Membrane Oxygenation in Single Ventricle Lesions Palliated Via the Hybrid Approach.
abstract: Describing outcomes for children with hypoplastic left heart syndrome (HLHS) undergoing hybrid palliation (pulmonary artery band and stent placement in the patent ductus arteriosus) requiring extracorporeal membrane oxygenation (ECMO) support for cardiorespiratory failure.
  
  
  
  We reviewed the Extracorporeal Life Support Organization database for all patients with a diagnosis of an HLHS undergoing hybrid stage 1 palliation supported with ECMO and those patients with hybrid palliation supported with ECMO after comprehensive stage 2 palliation. Patients were identified using a combination of International Classification of Diseases, Ninth Revision and registry diagnosis and procedure codes. We report survival to hospital discharge and ECMO complications.
  
  
  
  We identified 44 patients with HLHS requiring ECMO following stage 1 hybrid approach. Median age at cannulation was 13.5 days. Only 16% survived to hospital discharge. In all, 20 (50%) patients had a cardiac arrest prior to going onto ECMO and for 3 (19%) patients, ECMO was initiated during cardiopulmonary resuscitation.
  
  
  
  Overall survival for ECMO support in patients with HLHS palliated via the hybrid approach is very poor (16%) and is worse than 31% survival reported for ECMO after conventional stage 1 palliation. The reasons for these poor outcomes require further investigation.
authors: Pediatric Intensive Care, Leiden University Medical Center, the Netherlands p.p.roeleveld@lumc.nl.
authors: Peter P
authors: PP
authors: Roeleveld
authors: Pediatric Intensive Care, Leiden University Medical Center, the Netherlands.
authors: Rob de
authors: Rd
authors: Wilde
authors: Department of Congenital cardiac surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors: Mark
authors: M
authors: Hazekamp
authors: ELSO Registry, Ann Arbor, MI, USA.
authors: Peter T
authors: PT
authors: Rycus
authors: Pediatric Cardiac Intensive Care, Boston Children's Hospital, Boston, MA, USA.
authors: Ravi R
authors: RR
authors: Thiagarajan
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: ECMO; HLHS; hybrid palliation; stage 1 Norwood