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Hybrid approach for complex CHD
서울아산병원 소아심장외과¹ , 서울아산병원 소아심장과²
서동만¹, 이승철¹ , 신홍주¹ , 윤태진¹ , 박정준¹, 박인숙² , 고재곤² , 김영휘² , 유정진²
Background: In complex congenital heart disease, some conditions like unfavorable anatomy, patient’s very low body weight, undue timing of presentation and co-morbidity make surgical total correction difficult. In those cases, hybrid procedure could make the patients stand while those conditions resolved. Subjects: From May 2009 to April 2010, eight patients with unfavorable conditions for surgical correction had received hybrid procedure. Three patients had Tetlalogy of Fallot (TOF), two had pulmonary atresia with intact ventricular septum (PA with IVS), one had pulmonary atresia with ventricular septal defect (PA with VSD) and two had variant hypoplastic left heart syndrome (HLHS). The median age at hybrid intervention was 27 days (range, 8 to 79 days) and the median body weight was 2.5 kg (range, 1.6 to 4 kg). The stents were inserted with interventional method in two cases and with operative method under cardiopulmonary bypass (CPB) in six cases. Results: There was no hybrid-related mortality. Four patients successfully reached the total correction state of congenital heart defect and the other four patients are waiting for the total correction operation. The median interval between hybrid procedure and total correction operation was 192 days (range, 53 to 224 days) and the median body weight at total correction was 5.8 kg (range, 4.9 to 6.7 kg). Conclusion: Hybrid approach to the congenital heart defect patients with unfavorable conditions for surgical correction was one of good options. It could make us wait the more favorable time to correct complex congenital heart defects.


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