Palliative Switch: A Surgical Decision After Hybrid Procedure. (January 2014)

• Record Type: Journal Article
• Authors: Perez-Negueruela, Carolina; Mayol, Javier; Cesar, Sergi; Muchart, Jordi; Segura, Susana; Caffarena-Calvar, Jose Maria
• Is Part Of: World journal for pediatric & congenital heart surgery. Volume 5:Number 1(2014:Jan.)
• Page Start: 85
• Page End: 87
• Publication Date: 2014-01
• Subjects: palliative switch -- hybrid procedure -- single ventricle -- systemic outflow tract obstruction; Pediatric cardiology -- Periodicals; Congenital heart disease in children -- Periodicals; Heart -- Abnormalities -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Heart Defects, Congenital -- surgery -- Periodicals; Cardiac Surgical Procedures -- Periodicals; Child -- Periodicals; Adult -- Periodicals; 618.9212
• DOI: 10.1177/2150135113512135
• Languages: English
• ISSNs: 2150-1351

Abstract

The first-stage palliation of newborns with single-ventricle anatomy and transposed great arteries can be very challenging when associated with systemic ventricular outflow obstruction and aortic arch obstruction. Often, the initial intervention is a stage I Norwood procedure. We present the case of a newborn with double inlet left ventricle, discordant ventriculoarterial connection with restrictive ventricular foramen, and severe aortic arch obstruction. A hybrid procedure was performed initially as a means of addressing hemodynamic instability. Three months later, a palliative arterial switch procedure was performed as an alternative to the combined Norwood-Glenn procedure. Palliative arterial switch combined with arch reconstruction can be an effective surgical option in these complex, challenging patients.