[Recent strategies for a cyanotic heart disease]

Minimally invasive cardiac surgery has been performed for patients with patent ductus arteriosus (PDA), atrial septal defect (ASD), and ventricular septal defect (VSD). Video-assisted thoracoscopic interruption of PDA (VAT-SPDA) is effective for infants and neonates, especially for low birth weight babies. On the other hand, catheter intervention using PDA and ASD occluder devices have been widely used in our country. However, serious complications were reported in some papers. Recently, the device occlude has been applied to VSD. In percutaneous approach, there have been serious complications such as aortic regurgitation and complete atrioventricular block. The transatrial and perventricular approach are now advocated to avoid these complications. These approaches are called "hybrid approach", which is achieved with collaboration between catherter interventionists and cardiac surgeons. In the future, the hybrid approach including stent graft insertion and transaortic valve implantation would be important alternative procedure in both adult and pediatric cardiovascular surgery.