OBJECTIVE: Our objective was to review the early results of hybrid procedures in hypoplastic left heart syndrome (HLHS) at our institution. METHOD: Eight HLHS patients were submitted to the first stage of the procedure and the indications were the surgeon's preference in 4 (50%), sepsis in 2 (25%), severe ventricular dysfunction in 1 (12.5%) and severe brain damage with pulmonary hypertension in the latter (12.5%). RESULTS: Three (37.5%) patients died after the intervention, 2 (25%) underwent the second stage and none underwent the third stage. Three (37.5%) patients are currently waiting for the second stage and 2 of these are currently hospitalized: one with pneumonia-related sepsis and the other with pneumonia post atrial septal defect stenting. Reinterventions were necessary in 50% of the cases, more than once in 2 patients (balloon atrioseptostomy in 3 and atrial septal defect stenting in 1). Mean mechanical ventilation duration in the first stage was 585 hours and mean hospitalization time in the intensive care unit was 32 days. Both patients undergoing the second stage died: sudden death in one and residual left pulmonary artery stenosis after percutaneous dilatation in the other. CONCLUSION: Hybrid procedures should be considered as complex as Norwood operation due to the learning curve, technically difficulties to perform the second stage, need of multiple interstage reinterventions and anatomic sequelae related to previous procedures.
Hypoplastic left heart syndrome; Angioplasty; Heart defects, congenital; Stents; Pulmonary artery
