ABSTRACT
Introduction A collaborative interaction between pediatric cardiothoracic surgeons and interventional cardiologists, coupled with new technology, has enabled the development of new hybrid treatment strategies for patients with congenital heart disease. The goal of hybrid therapies is to reduce the accumulated insults of necessary interventions over the lifetime of a child with complex congenital heart disease, thereby improving their quantity and quality of life. The short and long term outcomes for children with hypoplastic left heart syndrome (HLHS) using traditional staged open heart procedures remain suboptimal. Further improvement using these traditional strategies may not be possible given the nature of the disease, the physiology established, and the accumulated insults. A recent report from the Congenital Heart Surgeon’s Society, from 1994 to 2000 involving 29 institutions, demonstrated only a 54% survival after 5 years using conventional palliative techniques for HLHS.1 In addition, only 28% of patients underwent Fontan completion with another 20% as potential candidates. This report again identifies the period around the Stage 1 Norwood operation as the greatest risk for mortality and morbidity.
