Hybrid Procedures. Opening Doors for Surgeon and Cardiologist Close Collaboration

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Pediatric Cardiology

Background:

• Collaboration between cardiac surgeons and cardiologists enables interventions beyond individual capabilities.
• The hybrid approach, initially for hypoplastic heart syndrome, has broadened to diverse cardiac interventions.
• This multidisciplinary strategy leverages combined expertise for complex pediatric cardiac cases.

Purpose of the Study:

• To evaluate the efficacy and scope of hybrid cardiac procedures.
• To analyze outcomes of collaborative surgical and cardiological interventions.
• To explore novel indications and classifications for hybrid cardiac interventions.

Main Methods:

• Seventy-one patients underwent hybrid procedures over eight years.
• Procedures were conducted in either a cardiac catheterization laboratory or an operating theater.
• Interventions included vascular cut-downs, banding, septal defect closure, pulmonary branch stenting, and valve implantation.

Main Results:

• Six distinct groups of hybrid procedures were identified based on indication and technique.
• Two complications occurred (left ventricular free wall puncture, conduit tearing), both managed successfully.
• The study highlights the successful application of hybrid approaches across various pediatric cardiac conditions.

Conclusions:

• Multidisciplinary collaboration between cardiac surgeons and cardiologists enhances treatment possibilities.
• Hybrid procedures demonstrate expanding utility and positive outcomes, exceeding initial projections.
• Specific hybrid strategies, like banding plus ductal stenting, show promise as bridges to biventricular repair or transplant.