World journal for pediatric & congenital heart surgery
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World J Pediatr Congenit Heart Surg · Jul 2010
Hard choices for high-risk patients with critical left ventricular outflow obstruction: contemporary comparison of hybrid versus surgical strategy.
Surgical management of high-risk newborns with critical left ventricular outflow tract obstruction (LVOTO) involves difficult decision making and complex procedures associated with significant morbidity and mortality. We sought to compare the outcomes of the hybrid and surgical strategies for the management of neonates with critical LVOTO considered at high risk in a contemporary nonrandomized cohort. This is a retrospective review of all patients undergoing management of critical LVOTO between January 2001 and December 2008. ⋯ No differences in operative and 6-month mortality were detected between management strategies. Although initial surgical insult is lessened by the hybrid palliation, important interstage mortality and ongoing morbidity result in similar 6-month survival with either strategy. Patient-related factors have a larger influence on outcome than the management strategy chosen.