OBJECTIVE: Hybrid palliation is an alternative to Norwood stage 1 for the initial management of @entity1699 . Contemporary multicenter hybrid use and institutional/ @entity1 factors associated with hybrid use relative to the Norwood have not been evaluated. We describe hybrid use in relation to institutional volume, @entity1 factors, and short-term outcomes. METHODS: @entity1 aged 60 days or less listed in The Society of @entity299 Database (2010-2012) undergoing initial palliation of @entity1699 were included. Annual institutional hybrid use rates were calculated: [hybrid procedures/(Norwood + hybrid + transplant procedures)]. In-hospital outcomes for primary hybrid and primary Norwood were compared and stratified by high (defined as >= 50%) versus low (defined as  <=10%) institutional hybrid use. RESULTS: Of 1728 @entity1 (100 centers), most (n  =  1496, 87%) underwent an index Norwood; 232 @entity1 (13%) underwent an index hybrid procedure. Preoperative @entity1 risk factors were more prevalent in @entity1 undergoing the hybrid procedure. Only 13 of 100 institutions were high hybrid users, and these tended to have lower @entity1699 index case volume. Unadjusted in-hospital mortality was higher for the hybrid compared with the Norwood procedure (30% vs 16%; P  <  .001). In-hospital mortality for the hybrid procedure was not associated with hybrid use (26% among institutions with low use vs 28% among institutions with high use). However, centers with high hybrid use had higher mortality after the Norwood (43%) compared with centers with low hybrid use (16%). CONCLUSIONS: Few centers currently select the hybrid procedure for most @entity1 with @entity1699 . Although unadjusted in-hospital hybrid mortality is higher than Norwood mortality, potential risk factors are more prevalent among hybrid cases. Institutions with higher hybrid use have lower @entity1699 case volume and higher Norwood mortality.

Stage 1 hybrid palliation for XXXX --assessment of contemporary patterns of use: an analysis of The Society of @entity299 Database.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'infants', 'Infants'] @entity1699 :: ('MESH:D018636', 'Disease') :: ['hypoplastic left heart syndrome', 'annual hypoplastic left heart syndrome'] @entity299 :: ('MESH:D006331', 'Disease') :: ['Thoracic Surgeons Congenital Heart Surgery']
@entity1699 :: (MESH:D018636,Disease) :: ['hypoplastic left heart syndrome']
