Modification of stage II procedure after hybrid palliation (bilateral pulmonary artery banding and ductal stenting) for hypoplastic left-sided heart syndrome: Modified arch reconstruction with retained stented ductus patch

摘要

Bilateral pulmonary artery banding and ductkl stenting can be used as a "hybrid" alternative to Norwood-based management for the palliation of neonates with single ventricle physiology.1 By using the hybrid strategy, first-stage palliation defers cardiopulmonary bypass and arch reconstruction to a second-stage procedure at 4 to 6 months of age. At the second stage, distal aortic arch reconstruction is more difficult than a neonatal Norwood reconstruction because the ductal stent often extends into the descending aorta.