The Evolution of Therapeutic Strategies: Niche Apportionment for Hybrid Palliation

Publication date: Available online 18 June 2018 Source:The Annals of Thoracic Surgery Author(s): Christoph Haller, Christopher A. Caldarone Hybrid palliation, the concept to stabilize univentricular circulation with bilateral pulmonary artery banding and maintenance of ductal patency, has significantly widened the therapeutic spectrum for patients with single ventricle malformations or borderline hypoplasia. Although the concept has already been a part of early attempts to improve outcome in hypoplastic left heart syndrome, it has not attracted much attention initially. Technical refinement and expertise have led to results that ultimately allowed the palliative strategy to gain traction and to be selectively adopted. By now, we have gained almost two decades of experience and, as much as hybrid palliation has changed our approach to single ventricle management, new strategies and indications have been formed by this experience. We therefore review concepts and patterns of use of hybrid palliation, as well as benefits and challenges of the respective pathways to highlight the current status of the hybrid procedure.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research