Hybrid Approach to Complete Repair of Cyanotic Congenital Heart Defects

Victor S. Mataev, Victor B. Samsonov, Manolis G. Pursanov, Mihail R. Chiaureli, Vladimir P. Podzolkov, Timur Y. Danilov

Bakulev scientific center for cardiovascular surgery, Moscow, Russia

Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–A

Abstract

Aim of thestudy.To represent our experience in complete repair of cyanosis heart defects by means of hybrid approach.

Materials and methods.6 patients with pulmonary stenosis (TOF-4 patients, Pulmonary atresia with VSD-2 patients) after previously performed palliation with high risk of conventional surgery. Previously all patients had systemic-to-pulmonary sunt, RVOT reconstruction without VSD closure was performed in in 3 patients, and balloon angioplasty of the pulmonary artery – 2 patients.

Surgery was performed in a conventional operating room (with mobile C-arm) on cardiopulmonary bypass, moderate hypothermia and kardioplegia.The hybrid phase was pulmonary artery stenting in 4 patients (right PA - 1, left PA -1, both branches – 2), patent systemic-to-pulmonary shunt closure and MAPCA embolization in 2 patients.

Results.Hybrid surgery was successful in 5 patients. In 1 case, due to left pulmonary artery stent migration distal to stenotic site, conventional plasty was performed. All patients were discharged from hospital on 17,0±7,1(9-27) day after surgery.

Conclusion.Close cooperation between surgeons and interventionists is one of the key points in successful treatment of patient with complex CHD, especially those, requiring staged repair. Hybrid approach is a safe alternative to conventional surgery in high risk cyanotic patients with pulmonary stenosis and additional sourcesof pulmonary blood flow.