Abstract
BackgroundThe traditional approach for adult congenital heart disease combined with valvular disease is surgical treatment under cardiopulmonary bypass (CPB). This approach has a high incidence of postoperative complications, especially in patients with pulmonary hypertension and old age. We present two patients in whom the hybrid procedure was used to treat congenital malformations, followed by valve formation and replacement surgery.Case presentationA 63-year-old man had a muscular ventricular septal defect complicated by mitral regurgitation and a 57-year-old man had patent ductus arteriosus complicated by aortic stenosis. In both of the patients, the congenital malformation was successfully treated by the hybrid procedure, followed by valve repair or replacement. Both patients had no complications. A post-procedure echocardiogram showed no residual shunt across the duct.ConclusionsOur findings suggest that the hybrid procedure is a useful alternative for treating adult congenital heart disease with valvular heart disease. This procedure reduces the surgical incision and difficulty of surgery, shortens the CPB time, avoids residual leakage after surgery, and reduces recovery and hospitalization times.
Highlights
The traditional approach for adult congenital heart disease combined with valvular disease is surgical treatment under cardiopulmonary bypass (CPB)
Our findings suggest that the hybrid procedure is a useful alternative for treating adult congenital heart disease with valvular heart disease
Longer CPB time, aortic cross clamp time and presence of pulmonary hypertension are associated with higher incidence of postoperative complications [4]
Summary
In the treatment of adult congenital heart disease with valvular heart disease, single-incision one-stop shop combined with the hybrid procedure with open surgery to treat such diseases appears to be a useful alternative. The advantages of this surgery compared with standard treatment are as follows. (1) The surgical incision is reduced, the operation is simpler, and the difficulty of surgery is greatly reduced. (2) The CPB time and aortic cross clamp time are shortened, and the myocardial protection effect is good. (3) Tissue damage is minimal to avoid residual leakage after surgery. Relatively high treatment costs may hinder implementation of this method
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