title: Hybrid stage I palliation in a 1.1 kg, 28-week preterm neonate with posterior malalignment ventricular septal defect, left ventricular outflow tract obstruction, and coarctation of the aorta.
abstract: The hybrid stage I procedure has emerged as a less-invasive alternative to the standard surgical Norwood procedure in the palliation of high-risk hypoplastic left heart syndrome and variants. This approach may also benefit patients requiring complex neonatal repair who have significant anatomic and/or perioperative risk factors that either prevent or complicate durable and robust biventricular circulation from being safely achieved. An extremely low-birth weight (1.1 kg) 28-week gestation preterm neonate with postnatal diagnosis of posterior malalignment ventricular septal defect, severe left ventricular outflow tract obstruction, aortic annular hypoplasia, and aortic arch obstruction underwent initial palliation with a hybrid stage I procedure. In this case, hybrid stage I palliation allowed for both somatic and left heart growth followed by ultimate uncomplicated biventricular repair.
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Kunal B
authors.initials: KB
authors.lastname: Karani
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Farhan
authors.initials: F
authors.lastname: Zafar
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: David L S
authors.initials: DL
authors.lastname: Morales
authors.affiliation: The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA bryan.goldstein@cchmc.org.
authors.forename: Bryan H
authors.initials: BH
authors.lastname: Goldstein
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities / Q000601:surgery*; D001017:Aortic Coarctation / Q000175:diagnosis / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D006328:Cardiac Catheterization; D004452:Echocardiography; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D010166:Palliative Care; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000601:surgery*
keywords: hybrid stage I procedure; hypoplastic left heart syndrome; malalignment ventricular septal defect; neurodevelopmental outcomes; prematurity