title: The hybrid approach for palliation of hypoplastic left heart syndrome: Intermediate results of a single-center experience.
abstract: BACKGROUND
  Hypoplastic left heart syndrome (HLHS) is a major cause of cardiac death during the first week of life. The hybrid approach is a reliable, reproducible treatment option for patients with HLHS. Herein we report our results using this approach, focusing on its efficacy, safety and late outcome.
  
  
  METHODS
  We reviewed prospectively collected data on patients treated for HLHS using a hybrid approach between July 2007 and September 2014.
  
  
  RESULTS
  Nine patients had a stage 1 hybrid procedure, with seven undergoing a comprehensive stage 2 procedure. One patient completed the Fontan procedure. Five patients underwent balloon atrial septostomy after the hybrid procedure; in three patients, a stent was placed across the atrial septum. There were three deaths: two early after the hybrid procedure and one early after stage two palliation. Overall survival was 66%.
  
  
  CONCLUSIONS
  In our single-center series, the hybrid approach for HLHS yields intermediate results comparable to those of the Norwood strategy. The existence of dedicated teams for the diagnosis and management of these patients, preferably in high-volume centers, is of major importance in this condition.
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal. Electronic address: sergiolaranjo@gmail.com.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Laranjo
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: Glória
authors.initials: G
authors.lastname: Costa
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Freitas
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: José Diogo
authors.initials: JD
authors.lastname: Ferreira Martins
authors.affiliation: Serviço de Cirurgia Cardio-Torácica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Bakero
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: Conceição
authors.initials: C
authors.lastname: Trigo
authors.affiliation: Serviço de Anestesiologia, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Fragata
authors.affiliation: Serviço de Cirurgia Cardio-Torácica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Fragata
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital de Santa Marta - CHLC, EPE, Lisboa, Portugal.
authors.forename: Fátima
authors.initials: F
authors.lastname: F Pinto
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000401:mortality / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D010166:Palliative Care; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: Abordagem híbrida; Ductus arteriosus stent; Hybrid approach; Hypoplastic left heart syndrome; Stent canal arterial; Síndrome do coração esquerdo hipoplásico