PMID- 20576042
OWN - NLM
STAT- MEDLINE
DCOM- 20101012
LR  - 20220310
IS  - 1747-0803 (Electronic)
IS  - 1747-079X (Linking)
VI  - 5
IP  - 3
DP  - 2010 May-Jun
TI  - Hybrid procedures: adverse events and procedural characteristics--results of a 
      multi-institutional registry.
PG  - 233-42
LID - 10.1111/j.1747-0803.2010.00416.x [doi]
AB  - INTRODUCTION: Procedural cooperation between cardiac surgeon and interventional 
      cardiologist to facilitate interventions such as device delivery or angioplasty 
      (hybrid procedure) has become increasingly common in the management of patients 
      with congenital heart disease. DESIGN: Data were prospectively collected using a 
      multicenter registry (C3PO). Between February 2007 and December 2008, seven 
      institutions submitted data regarding 7019 cardiac catheterization procedures. 
      Procedural data and adverse events (AEs) of 128 hybrid procedures were evaluated. 
      RESULTS: There was significant variability in the number of hybrid procedures per 
      center, ranging from one to 89 with a median of eight. A total of 60% of 
      interventional (vs. strictly diagnostic) hybrid procedures were performed by one 
      center. The median weight was 3.7 kg (0.7-86 kg). Single-ventricle circulation 
      was present in 60% of the procedures. Hybrid procedures included: patent ductus 
      arteriosus (PDA) stent placement (n = 55), vascular rehabilitation (n = 25), 
      ventricular septal defect (VSD) device closure (n = 7), valvotomy (n = 3), and 
      diagnostic hybrid procedures (n = 38). Sixteen AEs occurred in 15/128 (12%) 
      procedures. These included minor or trivial AEs (n = 9), moderate AEs (n = 5), 
      major AEs (n = 1), and catastrophic AEs (n = 1). The type of AE documented 
      included arrhythmias (n = 6), hypoxia or hypotension (n = 3), vessel or cardiac 
      trauma (n = 2), and other events (n = 5). Of documented AEs, 9/16 (56%) were 
      classified as not preventable, 6/16 (38%) as possibly preventable, and 1/16 (6%) 
      as preventable. The incidence of AE related to PDA stent placement with surgical 
      exposure (5/50, 10%) was significantly lower when compared with PDA stent 
      placement performed percutaneously (4/5, 80%, P= .002). CONCLUSION: Hybrid 
      procedures appear to have a low incidence of associated major AEs. PDA stent 
      placement performed as a palliation of hypoplastic left heart syndrome (HLHS) or 
      complex single/two ventricle patients may have a lower incidence of AEs if 
      performed using a direct approach with surgical exposure rather than a 
      percutaneous approach. Accurate definitions of these innovative procedures are 
      required to facilitate prospective data collection.
FAU - Holzer, Ralf
AU  - Holzer R
AD  - Department of Cardiology, Nationwide Children's Hospital, Columbus, Ohio 43205, 
      USA. ralf.holzer@nationwidechildrens.org
FAU - Marshall, Audrey
AU  - Marshall A
FAU - Kreutzer, Jackie
AU  - Kreutzer J
FAU - Hirsch, Russel
AU  - Hirsch R
FAU - Chisolm, Joanne
AU  - Chisolm J
FAU - Hill, Sharon
AU  - Hill S
FAU - Galantowicz, Mark
AU  - Galantowicz M
FAU - Phillips, Alistair
AU  - Phillips A
FAU - Cheatham, John
AU  - Cheatham J
FAU - Bergerson, Lisa
AU  - Bergerson L
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Congenit Heart Dis
JT  - Congenital heart disease
JID - 101256510
SB  - IM
MH  - Cardiac Catheterization/*adverse effects/instrumentation/statistics & numerical 
      data
MH  - Cardiac Surgical Procedures/*adverse effects/instrumentation/statistics & 
      numerical data
MH  - Child
MH  - Child, Preschool
MH  - Cooperative Behavior
MH  - Heart Defects, Congenital/*diagnosis/surgery/*therapy
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Palliative Care
MH  - Patient Care Team
MH  - Patient Selection
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Registries
MH  - Risk Assessment
MH  - Risk Factors
MH  - Stents
MH  - Treatment Outcome
MH  - United States
EDAT- 2010/06/26 06:00
MHDA- 2010/10/13 06:00
CRDT- 2010/06/26 06:00
PHST- 2010/06/26 06:00 [entrez]
PHST- 2010/06/26 06:00 [pubmed]
PHST- 2010/10/13 06:00 [medline]
AID - CHD416 [pii]
AID - 10.1111/j.1747-0803.2010.00416.x [doi]
PST - ppublish
SO  - Congenit Heart Dis. 2010 May-Jun;5(3):233-42. doi: 
      10.1111/j.1747-0803.2010.00416.x.