title: Hybrid Stage I Procedure as Initial Palliation for Neonate With Hypoplastic Left Heart Syndrome and Right Congenital Diaphragmatic Hernia.
abstract: During the past decade, a hybrid procedure has emerged and dramatically evolved as an alternative stage I palliation to the conventional Norwood procedure in neonates with hypoplastic left heart syndrome (HLHS). The hybrid approach avoids the need for cardiopulmonary bypass (CPB) utilizing stenting of the arterial duct and bilateral pulmonary artery banding. Cerebral and coronary perfusion pressure is maintained, and the pulmonary vasculature is protected from higher systemic pressure. Elimination of risks associated with CPB gains vital time to stabilize the patient and correct coexisting noncardiac anomalies and allows growth in preparation for the later stages of the Fontan pathway. The association of HLHS with right congenital diaphragmatic hernia (CDH) is rare. We report performing a successful hybrid stage I palliation on a neonate with HLHS and severe right CDH.
authors.affiliation: 1 NYMC-WMC, Valhalla, NY, USA.
authors.forename: Draginja
authors.initials: D
authors.lastname: Cvetkovic
authors.affiliation: 2 Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Giamelli
authors.affiliation: 2 Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lyew
authors.affiliation: 2 Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Markus
authors.initials: M
authors.lastname: Erb
authors.affiliation: 2 Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Suvro
authors.initials: S
authors.lastname: Sett
authors.affiliation: 2 Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Youmna
authors.initials: Y
authors.lastname: DiStefano
mesh_terms: D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000503:physiopathology / Q000601:surgery*; D007231:Infant, Newborn; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome
keywords: CDH; HLHS; cardiovascular hybrid procedure