The comparison of Hybrid technique to the traditional complete surgical way for CoA/VSD under the age of three months

Objective The Hybrid technique is a new way to repair the CoA/VSD,which is the combination of balloon dilation on CoA and surgically repairing VSD.The purpose of this study is to assess the advantage of the Hybrid technique when compared to the traditional surgical way in the treatment of CoA/VSD in patients under the age of three months.Methods 75 patients with CoA/VSD underwent one stage complete repair from Jan 2004 to Aug 2011.The age ranged from 9 days to 91days with a mean of 47.1 ± 23.5 days.Body weights ranged from 1.9 kg to 6.5 kg(mean 3.9 ± 1.1kg).Cardiopulmonary bypass duration was 31min～ 161min,with a mean of 74.7 ± 33.4 min.Aortic clamp duration was 10 min～61 min,with a mean of 34.0 ± 12.1 min.All cases were divided into three groups (A,B and C) according to different operative ways.Group A was operated inthe traditonal way through the mid-sternal approach,Group B was repaired by the combination of the mid-sternal incision and thoracic lateral incision,Group C was by the Hybrid technique through mid-sternal approach.Results Group C (Hybrid) had no death,no hoarseness due to recurrent laryngeal nerve palsy.Compared to the other two groups,Group C patients had less timeon the aortic clamp,cardiopulmonary bypass,mechanical support and ICU stay (P＜0.05).During follow-up for one month to two and a half years,only one case was re-operated due to aortic arch restenosis.No pseudoaneurysmwas found.Conclusions The Hybrid technique had better results in the treatment of CoA/VSD in patients under the age of three months..The incidence of aortic restenosiswas acceptable during the early and mid-term followup. Key words: Aortic coarctation; Ventricular septal defects; Balloon dilatation