Journal article

Publication year: 2015

Pages: 365-373

Journal: Pediatric Cardiology

Volume number: 36

Issue number: 2

ISSN: 0172-0643

eISSN: 1432-1971

Open access status: Hybrid

DOI Link: https://doi.org/10.1007/s00246-014-1015-2

Publisher: Springer

Abstract: 
Presented is a retrospective outcome study of a 15-year single institutional experience with a contemporary cohort of patients with hypoplastic left heart syndrome and complex that underwent a "Giessen Hybrid" stage I as initial palliation. Hybrid approach consisting of surgical bilateral pulmonary artery banding and percutaneous duct stenting with or without atrial septum manipulation was developed from a rescue approach to a first-line procedure. Comprehensive Aristotle score defined pre-operative condition. Fifteen-year follow-up mortality is reported as occurring within the staged univentricular palliation or before and after biventricular repair. Hybrid stage I was performed in 154 patients; 107 should be treated by single ventricle palliation, 33 by biventricular repair (BVR), 7 received heart transplantation, and 7 were treated by comfort care, respectively. Overall 34 children died. The Aristotle score (mean value 18.2 +/- A 3) classified for univentricular circulations in newborns did not have statistical impact on the outcome. Two patients died during stage I (1.2 %), and the interstage I mortality was 6.7 %, and stage II mortality 9 %, respectively. Stage III was up to now performed in 57 patients without mortality. At 1 year, the overall unadjusted survival of HLHS and variants was 84 % and following BVR 89 %, respectively. The Fifteen-year survival rate for HLHS and variants was 77 %, with no significant impact of birth weight of less than 2.5 kg. In conclusion, Hybrid stage I fulfilled the criteria of life-saving approach. In our institution, Hybrid procedure replaced Norwood-staged palliation with a considerable mid- and long-term survival rate. Considering interstage mortality close surveillance is mandatory.

Harvard Citation style: Schranz, D., Bauer, A., Reich, B., Steinbrenner, B., Recla, S., Schmidt, D., et al. (2015) Fifteen-year Single Center Experience with the "Giessen Hybrid" Approach for Hypoplastic Left Heart and Variants: Current Strategies and Outcomes, Pediatric Cardiology, 36(2), pp. 365-373. https://doi.org/10.1007/s00246-014-1015-2

APA Citation style: Schranz, D., Bauer, A., Reich, B., Steinbrenner, B., Recla, S., Schmidt, D., Apitz, C., Thul, J., Valeske, K., Bauer, J., Mueller, M., Jux, C., Michel-Behnke, I., & Akintuerk, H. (2015). Fifteen-year Single Center Experience with the "Giessen Hybrid" Approach for Hypoplastic Left Heart and Variants: Current Strategies and Outcomes. Pediatric Cardiology. 36(2), 365-373. https://doi.org/10.1007/s00246-014-1015-2