Hybrid Procedures for Complex Congenital Cardiac Lesions

Authors

  • Constantinos A. Contrafouris
  • Fotios A. Mitropoulos
  • Andrew C. Chatzis
  • Nikolaos M. Giannopoulos
  • Michael Milonakis
  • Spyridon Rammos
  • Mike Azariades

DOI:

https://doi.org/10.1532/HSF98.20091044

Abstract

Background: We present an alternative treatment employing a hybrid approach used in 3 patients with congenital heart disease. The goal was to provide optimal therapy by minimizing the potentially harmful effects of methods that accompany conventional surgical procedures.

Methods: Two patients aged 4 and 6 months underwent beating-heart closure of a muscular ventricular septal defect (VSD) with an occluding device. In addition, an 8-year-old patient with supraaortic, main, and branch pulmonary artery (PA) stenosis underwent conventional surgical patch augmentation of the ascending aorta and the main PA and intraoperative stenting of the branch PA stenoses.

Results: No patient deaths occurred. One patient developed a postoperative pneumothorax. Median intensive care unit and hospital stays for the VSD patients were 1 and 5 days and for the other patients 2 and 20 days, respectively. At median follow-up of 25 months, all patients were well and had required no further interventions.

Conclusions: Patients with muscular VSD can currently be treated with the hybrid approach. Intraoperative PA stenting in addition to conventional surgical repair can be performed safely and may be complementary in patients with complex lesions.

References

Amin Z, Gu X, Berry JM, Gidding T, Rocchini AL 1999. Perventricular closure of ventricular septal defects without cardiopulmonary bypass. Ann Thorac Surg 68:149-54.nBacha EA, Cao QI, Starr JP, et al. 2003. Perventricular device closure of muscular ventricular septal defects on the beating heart: technique and results. J Thorac Cardiovasc Surg 126:1718-23.nBacha EA, Hijazi ZM, Cao Ql, Starr JP, Waight D, Koenig P, Agarwala B 2004. New therapeutic avenues with hybrid pediatric cardiac surgery. Heart Surg Forum 7:33-40.nFishherger SB, Bridges ND, Keane JF, et al. 1993. Congenital heart disease: intraoperative device closure of ventricular septal defects. Circulation 88:205-9.nHjortdal VE, Redington AN, de Leval MR, Tsang VT 2002. Hybrid approaches to complex cardiac surgery. Eur J Cardiothorac Surg 22:885-90.nMitropoulos FA, Laks H, Kapadia N, et al. 2007. Intraoperative pulmonary artery stenting: an altemative technique for the management of pulmonary artery stenosis. Ann Thorac Surg 84:1338-41.nUngerleider RM, Johnston TA, O Laughlin MP, Jaggers JJ, Gaskin PR 2001. Intraoperative stents to rehabilitate severely stenotic pulmonary vessels. Ann Thorac Surg 71:476-81.n

Published

2009-06-22

How to Cite

Contrafouris, C. A., Mitropoulos, F. A., Chatzis, A. C., Giannopoulos, N. M., Milonakis, M., Rammos, S., & Azariades, M. (2009). Hybrid Procedures for Complex Congenital Cardiac Lesions. The Heart Surgery Forum, 12(3), E155-E157. https://doi.org/10.1532/HSF98.20091044

Issue

Section

Article