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Int J Angiol 2018; 27(01): 050-053
DOI: 10.1055/s-0037-1602374
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hybrid Strategy for High-Risk Neonates with Interrupted Aortic Arch: A Can Well Worth Kicking?

Eva Kapravelou
1   Department of Paediatric Cardiology, Evelina Children's Hospital, London, United Kingdom
,
David Anderson
1   Department of Paediatric Cardiology, Evelina Children's Hospital, London, United Kingdom
,
Gareth J. Morgan
1   Department of Paediatric Cardiology, Evelina Children's Hospital, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
19 April 2017 (online)

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Abstract

The use of hybrid techniques to avoid neonatal cardiopulmonary bypass in high-risk individuals is well reported in the setting of hypoplastic left heart syndrome. We describe the use of that technique as a bridging procedure in high-risk neonates with an interrupted aortic arch. We report three cases where hybrid branch pulmonary artery banding and ductal stent implantation has been successfully used to defer complete repair, allowing recovery, maturity, and weight gain. This strategy may be considered for patients deemed at high risk for primary neonatal repair.

Keywords

interrupted aortic arch - hybrid procedure - low birth weight
 

  • References

  • 1 Jonas RA. Management of interrupted aortic arch. Semin Thorac Cardiovasc Surg 2015; 27 (02) 177-188
    CrossrefPubMedGoogle Scholar
  • 2 Flint JD, Gentles TL, MacCormick J, Spinetto H, Finucane AK. Outcomes using predominantly single-stage approach to interrupted aortic arch and associated defects. Ann Thorac Surg 2010; 89 (02) 564-569
    CrossrefPubMedGoogle Scholar
  • 3 Hussein A, Iyengar AJ, Jones B. , et al. Twenty-three years of single-stage end-to-side anastomosis repair of interrupted aortic arches. J Thorac Cardiovasc Surg 2010; 139 (04) 942-947 , 949, discussion 948
    CrossrefPubMedGoogle Scholar
  • 4 Head CE, Jowett VC, Sharland GK, Simpson JM. Timing of presentation and postnatal outcome of infants suspected of having coarctation of the aorta during fetal life. Heart 2005; 91 (08) 1070-1074
    CrossrefPubMedGoogle Scholar
  • 5 Joynt CA, Robertson CM, Cheung PY. , et al; Western Canadian Complex Pediatric Therapies Follow-up Group. Two-year neurodevelopmental outcomes of infants undergoing neonatal cardiac surgery for interrupted aortic arch: a descriptive analysis. J Thorac Cardiovasc Surg 2009; 138 (04) 924-932
    CrossrefPubMedGoogle Scholar
  • 6 Todman SH, Eltayeb O, Ruzmetov M. , et al. Outcomes of interrupted aortic arch repair using the carotid artery turndown procedure. J Thorac Cardiovasc Surg 2013; 145 (01) 176-182
    CrossrefPubMedGoogle Scholar
  • 7 Akintürk H, Michel-Behnke I, Valeske K. , et al. Hybrid transcatheter-surgical palliation: basis for univentricular or biventricular repair: the Giessen experience. Pediatr Cardiol 2007; 28 (02) 79-87
    CrossrefPubMedGoogle Scholar
  • 8 Karamlou T, Overman D, Hill KD. , et al. Stage 1 hybrid palliation for hypoplastic left heart syndrome--assessment of contemporary patterns of use: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database. J Thorac Cardiovasc Surg 2015; 149 (01) 195-201 , 202.e1
    CrossrefPubMedGoogle Scholar
  • 9 Schranz D, Bauer A, Reich B. , et al. Fifteen-year single center experience with the “Giessen Hybrid” approach for hypoplastic left heart and variants: current strategies and outcomes. Pediatr Cardiol 2015; 36 (02) 365-373
    CrossrefPubMedGoogle Scholar
  • 10 Lloyd DF, Cutler L, Tibby SM. , et al. Analysis of preoperative condition and interstage mortality in Norwood and hybrid procedures for hypoplastic left heart syndrome using the Aristotle scoring system. Heart 2014; 100 (10) 775-780
    CrossrefPubMedGoogle Scholar
  • 11 Murphy MO, Bellsham-Revell H, Morgan GJ. , et al. Hybrid procedure for neonates with hypoplastic left heart syndrome at high-risk for Norwood: midterm outcomes. Ann Thorac Surg 2015; 100 (06) 2286-2290 , discussion 2291–2292
    CrossrefPubMedGoogle Scholar
  • 12 Taqatqa A, Diab KA, Stuart C. , et al. Extended application of the hybrid procedure in neonates with left-sided obstructive lesions in an evolving cardiac program. Pediatr Cardiol 2016; 37 (03) 465-471
    CrossrefPubMedGoogle Scholar
  • 13 Karimi M, Farouk A, Golden A, Gilkeson R. Hybrid palliation of interrupted aortic arch in a high-risk neonate. Ann Pediatr Cardiol 2010; 3 (01) 74-76
    CrossrefPubMedGoogle Scholar
  • 14 Goreczny S, Qureshi S, Rosenthal E. , et al. Self-expanding stent implantation in arterial duct during hybrid palliation of hypoplastic left heart syndrome: midterm experience with a specially designed stent. EuroIntervention 2015; 10 (11) 1318-1325
    CrossrefPubMedGoogle Scholar
  • 15 Qureshi SA, Maruszewski B, McKay R, Arnold R, West CA, Hamilton DI. Determinants of survival following repair of interrupted aortic arch in infancy. Int J Cardiol 1990; 26 (03) 303-312
    CrossrefPubMedGoogle Scholar
  • 16 Goff DA, Luan X, Gerdes M. , et al. Younger gestational age is associated with worse neurodevelopmental outcomes after cardiac surgery in infancy. J Thorac Cardiovasc Surg 2012; 143 (03) 535-542
    CrossrefPubMedGoogle Scholar
  • 17 Gach P, Dabadie A, Sorensen C. , et al. Multimodality imaging of aortic coarctation: From the fetus to the adolescent. Diagn Interv Imaging 2016; 97 (05) 581-590
    CrossrefPubMedGoogle Scholar