AUTHOR=Gil-Jaurena Juan-Miguel , Zunzunegui José-Luis , Pérez-Caballero Ramón , Pita Ana , Pardo Carlos , Calle Corazón , Murgoitio Uxue , Ballesteros Fernando , Rodríguez Alejandro , Medrano Constancio 

TITLE=Hybrid Procedures. Opening Doors for Surgeon and Cardiologist Close Collaboration

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.687909

DOI=10.3389/fped.2021.687909

ISSN=2296-2360

ABSTRACT=Background. Surgeon and cardiologist on their own cannot cope with patients needs, occasionally. Hypoplastic left heart syndrome witnessed the collaboration between them for a palliative, hybrid procedure. As a strategy, hybrid approach has been applied in several, unforeseeable settings. Our initial experience is presented, pointing at indications, shortcomings and mid-term results.

Methods. Seventy-one patients were scheduled for a hybrid procedure along eight years. This was defined as: close collaboration between surgeon and cardiologist working together in the same room, either cath-lab (27 patients) or theatre (44 patients)

Results. Six groups were arbitrarily defined. A: vascular cut-down in the cath-lab (27 neonates); B: bilateral banding (plus ductal stent) in hypoplastic left heart syndrome or alike (15 children); C: perventricular closure of muscular ventricular septal defect (10 cases); D: Balloon/stenting of pulmonary branches along with major surgical procedure (12 kids); E: surgical implantation of Melody valve (6 patients) and others (F, 1 case). Two complications were recorded: left ventricular free wall puncture and previous conduit tearing. Both drawbacks were successfully sort out under cardiopulmonary by-pass.

Conclusion. Surgeon and cardiologist partnership can succeed where their isolated endeavors are not enough. Hybrid procedures keep on spreading, overcoming initial expectations. As a bridge to biventricular repair or transplant, bilateral banding plus ductal stent sounds interesting. Novel indications can be classified into different groups. Hybrid procedures are not complication-free.