Faria Renato Max, Pacheco Juliana Torres, Oliveira Itamar Ribeiro de, Vidal José Madson, Rodrigues Anilton Bezerra, Costa Ana Luiza Lafeta, Nina Vinicius José da Silva, Cascudo Marcelo Matos
Hospital Wilson Rosado, Mossoró, RN, Brazil.
Casa de Saúde São Lucas, Natal, RN, Brazil.
Braz J Cardiovasc Surg. 2017 May-Jun;32(3):210-214. doi: 10.21470/1678-9741-2017-0058.
: Although it only corresponds to 2.5% of congenital heart defects, hypoplastic left heart syndrome (HLHS) is responsible for more than 25% of cardiac deaths in the first week of life. Palliative surgery performed after the second week of life is considered an important risk factor in the treatment of HLHS.
: The aim of this study is to describe the initial experience of a medical center in Northeastern Brazil with a modified off-pump hybrid approach for palliation of HLHS.
: From November 2012 through November 2015, the medical records of 8 patients with HLHS undergoing hybrid procedure were retrospectively evaluated in a tertiary private hospital in Northeastern Brazil. The modified off-pump hybrid palliation consisted of stenting of the ductus arteriosus guided by fluoroscopy without contrast and banding of the main pulmonary artery branches. Demographic and clinical variables were recorded for descriptive analysis.
: Eight patients were included in this study, of whom 37.5% were female. The median age and weight at the time of the procedure was 2 days (p25% and p75% = 2 and 4.5 days, respectively) and 3150 g (p25% and p75% = 3077.5 g and 3400 g, respectively), respectively. The median length in intensive care unit stay was 6 days (p25% and p75% = 3.5% and 8 days, respectively). There were no in-hospital deaths. Four patients have undergone to the second stage of the surgical treatment of HLHS.
: In this series, the initial experience with the modified off-pump hybrid procedure showed to be safe, allowing a low early mortality rate among children presenting HLHS.
尽管左心发育不全综合征（HLHS）仅占先天性心脏病的2.5%，但它却导致了超过25%的出生后第一周内的心脏死亡。出生后第二周后进行的姑息性手术被认为是HLHS治疗中的一个重要危险因素。
本研究的目的是描述巴西东北部一家医疗中心采用改良非体外循环杂交方法治疗HLHS的初步经验。
2012年11月至2015年11月，在巴西东北部一家三级私立医院对8例接受杂交手术的HLHS患者的病历进行回顾性评估。改良非体外循环杂交姑息治疗包括在无造影剂的荧光透视引导下对动脉导管进行支架置入以及对主肺动脉分支进行束带结扎。记录人口统计学和临床变量以进行描述性分析。
本研究纳入8例患者，其中37.5%为女性。手术时的中位年龄和体重分别为2天（第25百分位数和第75百分位数分别为2天和4.5天）和3150克（第25百分位数和第75百分位数分别为3077.5克和3400克）。在重症监护病房的中位住院时间为6天（第25百分位数和第75百分位数分别为3.5天和8天）。无院内死亡。4例患者已接受HLHS手术治疗的第二阶段。
在本系列中，改良非体外循环杂交手术的初步经验显示是安全的，使HLHS患儿的早期死亡率较低。
