Bailout after failed biventricular management of critical aortic stenosis: another application of the hybrid approach

Ann Thorac Surg. 2009 May;87(5):e40-2. doi: 10.1016/j.athoracsur.2009.02.007.

Abstract

The decision between a single-ventricle and biventricular strategy can be particularly difficult in patients with critical left ventricular outflow obstruction who have marginal left ventricular size or function. Overzealous pursuit of a biventricular strategy in borderline cases can lead to death or require conversion to a single-ventricle physiology at increased risk. We describe novel use of the hybrid approach as a bailout option for a patient with critical aortic stenosis who, despite balloon valvuloplasty, exhibited persistent severe left ventricular dysfunction. This approach provides a simple and effective pathway to treat patients with a failed biventricular circulation, at a considerably lower risk, while keeping all therapeutic options open.

Publication types

  • Case Reports

MeSH terms

  • Aortic Valve / pathology
  • Aortic Valve Stenosis / diagnostic imaging
  • Cardiomegaly / diagnostic imaging
  • Echocardiography
  • Electrocardiography
  • Humans
  • Infant, Newborn
  • Length of Stay
  • Pulmonary Artery / surgery
  • Radiography
  • Respiratory Distress Syndrome, Newborn / complications*
  • Stents
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / surgery*
  • Ventricular Outflow Obstruction / complications
  • Ventricular Outflow Obstruction / surgery*