Intraoperative Hybrid Stenting of Recurrent Coarctation and Arch Hypoplasia with Large Stents in Patients with Univentricular Hearts

Abstract

Objective: Obstruction of the reconstructed aortic arch, tubular hypoplasia and recurrent coarctation (RC) is an important risk factor after the Norwood procedure or similar surgery. Balloon angioplasty (BA) may be effective but pressure gradient relief is often incomplete, with a high incidence of restenosis usually within the first year. Percutaneous interventions may have an increased risk due to limited vascular access or a very tortuous catheter course. Combining operative and interventional approaches (hybrid procedures) with direct puncture of the heart or the great vessels may facilitate implantation of even large devices. For the past two years we have adopted the concept of intraoperative hybrid stenting of RC and arch hypoplasia with large stents in patients with univentricular hearts as standard care procedure.