Efficiency at Heart: Navigating the Hybrid Single-Ventricle Pathway.

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease Management
• Healthcare Resource Utilization

Background:

• Single-ventricle cardiac defects (SVCDs) represent a significant healthcare burden.
• Traditional palliation involves the Norwood pathway, while the hybrid strategy redistributes risks.
• This study evaluates resource use in hybrid-palliated SVCD patients.

Purpose of the Study:

• To characterize healthcare resource utilization for single-ventricle cardiac defects (SVCDs) managed with the hybrid strategy.
• To compare resource intensity and patterns with the traditional Norwood pathway.

Main Methods:

• Retrospective analysis of SVCD patients undergoing hybrid palliation from 2008-2021.
• Primary endpoints included hospitalization duration, cardiology visits, echocardiograms, catheterizations, and advanced imaging.
• Follow-up extended to 6 months post-Fontan, 4 years of age, or death/transplant.

Main Results:

• The hybrid pathway involved a median of 63 total hospital days per patient.
• Resource intensity was highest during the initial interstage period, particularly for cardiology follow-up and echocardiography.
• Cardiac catheterizations and advanced imaging were more frequent in the second interstage period.

Conclusions:

• Hybrid palliation for SVCDs requires substantial healthcare resources.
• Surveillance intensity decreases as patients advance through the palliation pathway.
• Resource use patterns for hybrid palliation are comparable to those of the Norwood pathway.