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.

The Society of Thoracic Surgeons has rated Norton Children’s Heart Institute’s pediatric heart care among the best in the region. 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.

Why Choose Norton Children’s Heart Institute

No other congenital heart surgery program in Kentucky, Ohio or Southern Indiana is rated higher by the Society of Thoracic Surgeons than the Norton Children’s Heart Institute Pediatric Cardiothoracic Surgery Program.

• Norton Children’s Hospital is a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
• Our board-certified and fellowship-trained pediatric cardiovascular surgeons are leaders in the field as clinicians and researchers.
• More than 5,000 children a year visit Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, for advanced heart care.
• Norton Children’s Heart Institute successfully performs more than 17,500 procedures a year.
• The Society of Thoracic Surgeons rated Norton Children’s Heart Institute among the best in the region after studying years of our patients’ outcomes and our ability to treat a range of pediatric heart conditions, including the most severe.
• Norton Children’s Heart Institute has satellite outpatient offices in Ashland, Bowling Green, Campbellsville, Elizabethtown, Frankfort, London, Madisonville, Murray, Owensboro, Paducah and Shepherdsville in Kentucky; as well as Corydon, Jasper, Madison and Scottsburg in Indiana; 28 tele-echocardiography locations in Kentucky and Southern Indiana; and six fetal echocardiography locations across Kentucky.
• The American Board of Thoracic Surgery has awarded the cardiothoracic surgeons at Norton Children’s Hospital with subspecialty certification in congenital heart surgery.
• The Jennifer Lawrence Cardiac Intensive Care Unit (CICU) is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.
• Our multidisciplinary approach to pediatric heart surgery brings together our specialists in cardiothoracic surgery, cardiology, anesthesiology, cardiac critical care and other areas to create a complete care plan tailored for your child.