In congenital heart surgery, hybrid procedures describe the combined efforts of a pediatric interventional cardiologist and a pediatric cardiothoracic surgeon who work together to provide a surgical and interventional solution to a child’s heart condition. Sometimes this is necessary because of a child’s complex anatomy. Other times it may be because the patient is too sick or too small to undergo a complex, complete, open heart surgical repair. Children may recover faster if they are be able to avoid cardiopulmonary bypass and open heart surgery through various hybrid procedures.
Cardiothoracic surgeons specialize in operations that involve direct access to the child’s heart and surrounding blood vessels. Interventional cardiologists specialize is repairing heart conditions from inside the heart by threading catheters through the blood vessels. On the end of the catheters are tiny devices or tools to repair the heart.
The pediatric cardiothoracic surgeons and interventional cardiologists with Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, collaborate closely in these procedures. By working together, they can perform complex interventions to treat or stabilize patients with congenital heart disease.
Norton Children’s Heart Institute is the leading provider of pediatric heart care in Louisville and Southern Indiana. We have the pediatric cardiologists, interventional pediatric cardiologists and pediatric cardiothoracic surgeons available to decide when our subspecialists need to work together through a hybrid procedure in order to best repair your child’s heart.
Norton Children’s has a network of outreach diagnostic and treatment services conveniently located throughout Kentucky and Southern Indiana.
Example of a Hybrid Procedure
Hybrid procedure associated with hypoplastic left heart syndrome (HLHS): In this hybrid procedure, the interventional pediatric cardiologist creates a bigger hole between the two upper chambers of the heart. This can be done with a balloon atrial septostomy. A small tube (catheter) is threaded across the atrial septum, the balloon on the end of the catheter is inflated, and the inflated balloon is pulled through the septum creating a bigger opening. The interventional pediatric cardiologist has a second job in this procedure. A stent is placed in the ductus arteriosus to keep it open. This blood vessel connects the pulmonary artery to the aorta. It normally closes soon after birth, but with HLHS, the patient will benefit from it being open for a period of time until they can have open heart surgery later in their first year of life.
To complete the hybrid procedure associated with HLHS, the pediatric cardiothoracic surgeon then places bands around the two pulmonary arteries that pump blood to the lungs (left and right pulmonary arteries). This limits the blood flow to the lungs, creating a balance of blood flow to the child’s lungs and body. This hybrid procedure can help delay more complex surgery until the child is older and larger.
Other cardiac defects and conditions may require a hybrid procedure and joint efforts of our pediatric interventional cardiologists and pediatric cardiothoracic surgeons. Our pediatric cardiologists, interventional pediatric cardiologists and pediatric cardiothoracic surgeons will be able to identify what procedures warrant a hybrid procedure in order to best address your child’s heart defect or condition.