BACKGROUND: Hybrid procedure offers @entity1 with severe @entity299 an alternative initial procedure to conventional surgical reconstruction. We report the midterm outcomes of a cohort of neonates who had a hybrid procedure for variants of @entity1699 because they were at high risk for the Norwood procedure. METHODS: Between December 2005 and January 2013, 41 neonates underwent bilateral pulmonary artery banding followed by ductal stenting by means of a sternotomy at a median age of 6 days (range, 2 to 18 days) and weight of 2.6 kg (range, 1.5 to 3.7 kg). Thirty-five @entity1 had @entity1699 , and 6 @entity1 had critical @entity472 with hypoplastic left ventricle. Primary indications for the hybrid procedure were low birth weight in 17 @entity1 , hypoplastic left ventricle with the possibility of later biventricular repair in 6 @entity1 , intact or near-intact atrial septum in 5 @entity1 , and poor @entity1 condition in 13 @entity1 . Echocardiographic, angiographic, operative, and clinical data were reviewed. Outcomes were summarized with descriptive statistics and risk factors for mortality identified. RESULTS: All but 6 @entity1 had an antenatal diagnosis, and 24 @entity1 were from other congenital cardiac centers. Nine @entity1 had perioperative balloon aortic valvuloplasty, 1 @entity1 had fetal balloon aortic valvuloplasty, and 17 @entity1 had intervention to their atrial septum (41.4%). There were 9 inpatient deaths (21.9%) and 4 interstage deaths (9.8%) after the hybrid procedure. Twenty-eight @entity1 subsequently underwent either the Norwood procedure (11 @entity1 ), combined stage I and II (14 @entity1 ), or biventricular repair (3 @entity1 ). No @entity1 had heart transplantation. Among the @entity1 who had combined stage I and II as a second procedure after the hybrid procedure, there were 2 early deaths, 1 late death before the Fontan, and 1 late death after the Fontan completion after combined stage I and II. All @entity1 who had subsequent Norwood procedure were midterm survivors. Three of the 4 @entity1 who had biventricular repair were midterm survivors. Overall survival was 56.1% at a median follow-up of 32.0 months. By univariate analysis, @entity1 factors, intact or near-intact atrial  septum, and aortic @entity1146 were associated with nonsurvival. CONCLUSIONS: Hybrid procedure as an alternative to the Norwood procedure offers good midterm survival in @entity1 deemed at high risk for neonatal reconstruction.

Hybrid Procedure for Neonates With XXXX at High-Risk for Norwood: Midterm Outcomes.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1699 :: ('MESH:D018636', 'Disease') :: ['hypoplastic left heart syndrome'] @entity299 :: ('MESH:D006331', 'Disease') :: ['congenital heart disease'] @entity1146 :: ('MESH:D018633', 'Disease') :: ['atresia'] @entity472 :: ('MESH:D001024', 'Disease') :: ['aortic stenosis']
@entity1699 :: (MESH:D018636,Disease) :: ['Hypoplastic Left Heart Syndrome']
